Surely if I ask you right now what is the most correct way to eat to stay young and healthy you will tell me that it is to have 6 meals a day, a high carbohydrate breakfast, avoid junk food, drink plenty of water and eat protein at every meal, however…
What if I told you that fasting has more benefits than the lifestyle I just mentioned?
You’ll probably tell me that I’ll lose muscle mass, faint from low blood glucose levels or even increase my body fat % by putting my body into an ’emergency’ state where everything I eat will be stored as fat.
However, as you’ll see below, nothing of what I’ve just said happens during the fast and you’ll probably even be surprised to see that the exact opposite happens…
- 1. What is Intermittent Fasting?
- 2. Health benefits of Intermittent Fasting
- 3. Age-Delaying Fasting?
- 4. Is it bad to go so many hours without eating?
- 5. How does Intermittent Fasting work?
- 6. Should we eat breakfast?
- 7. Is muscle mass lost during Intermittent Fasting?
- 8. ADF Protocol or Alternate Fasting Days
- 9. Intermittent Fasting and Fat Loss
- 10. How Intermittent Fasting affects obese and thin people
- 11. How does Intermittent Fasting affect sportsmen and women?
- 12. Intermittent Fasting for Athletes
- 13. Recommended supplements for Intermittent Fasting
- 14. Bibliography Sources
- 15. Related Entries
What is Intermittent Fasting?
Intermittent Fasting is nothing more than restricting the number of calories we eat over a period of time. There are two types of Intermittent Fasting:
- A fast where we take in the extra calories for 5 days and 2 days, we restrict them to around 600-800kcal.
- A daily fast where we take in all the calories in a window of 6-8h and the rest of the day we only take in liquids.
I personally recommend the fasting in point 2, as the circadian rhythms are more constant, it is easier to follow and we can adjust it for those who practice the sport.
Health benefits of Intermittent Fasting
Intermittent Fasting can be an excellent tool to delay the symptoms of the passage of time
But to understand how fasting slows down the ageing process, we need to touch on some physiology (don’t worry, you’ll see that anyone can understand this). When we eat meals every few hours, the IGF-1 (Insulin Growth Factor) levels rise, which leads to cell multiplication and therefore to cell ageing.
Furthermore, as they are constantly multiplying, the probability of mutations is higher (remember that some of today’s diseases such as colon cancer can be produced through this mechanism).
One of the main benefits of Intermittent Fasting is to delay the signs of ageing, i.e. fasting can be linked to the “anti-ageing” effect
Intermittent fasting decreases the expression of IGF-1 and brings the body into “repair” mode, thus extending the life span of the cells. This is of great importance as it has been seen that this process can prevent even breast cancer.
Another factor that is affected and that enhances the delay of aging is the telomeres. The telomeres are the ends of the chromosomes, which act as the “biological clocks” of the cells, where a number of multiplications are reached and the cells die. However, intermittent fasting not only prevents internal ageing, but also external ageing. As we can see in the study the cells die.
However, intermittent fasting not only prevents internal ageing, but also external ageing. As we can see in the study “Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study” monkeys which performed intermittent fasting looked much younger than those that performed “normal” fasting even at the same age (24 years).
Subject who was on a normal diet versus subject who was fasting intermittently
Is it bad to go so many hours without eating?
This is one of the biggest fears that people have and has made us eat meals every 3 hours. The reality is totally different, we don’t need to eat food every 3-4 hours to maintain an adequate supply to the cells and to be able to perform both physically and mentally.
In fact, we can go as long as 84 hours without eating and our glucose levels are kept constant by the action of epinephrine (also known as adrenaline).
Obviously at no point in the diet will we be doing 84h fasting, but we can get an idea of how our body tolerates being without food for more than 5 hours without repercussions.
In fact, fasting reserves are as follows:
- Glucose or H. from C.: 300 gr. (4 cal/gr.)= 1.200 Kcal. Lasts more than 24 hours.
- Fat: 10 to 11 kg. (9 cal/gr.)= 100.000 Kcal. They last more than 40 days and in dead subjects there are still reserves. It is the most important.
- Proteins: 10’5 kg. (4 cal/gr.)= 45.000 Kcal. Only if consumed.
As for the issue of fatigue, not only is it not impaired but it even gets better. This fact was reflected in the study “Intermittent fasting dissociates beneficial effects of dietary restriction on glucose metabolism and neuronal resistance to injury from calorie intake” where plasmic glucose was reduced, insulin resistance decreased (remember that good insulin sensitivity prevents diabetes and produces cleaner muscle gain with less fat) and even improved stress resistance by preventing neuronal injury.
Plasma glucose (a), insulin (b) and BHB (c) levels As we can see, glucose and insulin levels are lower and BHB levels are higher. This shows that our body improves the use of carbohydrates and that it encourages the use of fat as an energy source.
How does Intermittent Fasting work?
During fasting a number of hormonal triggers take place in our body
Intermittent fasting improves the uptake of fat by the tissues, so the body uses the fat as primary fuel as well as generating glucose from glycerol and amino acids (gluconeogenesis). It is believed that the amount of glucose generated through this process in 24 hours of fasting consists of about 35-40g (enough to maintain the supply to those cells such as red blood cells which cannot use another source as fuel).
During the fasting period, a number of mechanisms are triggered which release growth hormone from the hypothalamus. This growth hormone (GH) prevents glucose from being consumed by the cells, so the use of fats is even higher. It is also lipolytic (breakdown of fat reserves) and protects the breakdown in proteins, so it is a hormone that maintains muscle mass.
Another hormone which is raised during fasting is TSH (Thyroid Stimulating Hormone) by increasing our metabolism and decreasing the use of insulin. This is of great importance as people with hypothyroidism can take advantage of this effect to combat their illness.
Should we eat breakfast?
The first thing to understand is that when we wake up our cortisol (also called stress hormone) levels are elevated, as are other hormones such as epinephrine (adrenaline) and growth hormone (HGH). Although there are many theories about this phenomenon, the one that seems to be most widespread and accepted is that these hormones are elevated due to our ancestors, as they prepared the body to forage for food (hunters).
These high cortisol levels on waking are known as CAR (Cortisol Awakening Response) whose maximum peak is 30 minutes after waking up. The fact that our cortisol levels are high does not necessarily mean that we are losing muscle mass, it’s just that we are catabolising, or to explain this in other words, that we are degrading macromolecules to obtain energy, so this can be glucose through glycogen or fatty acids from our fat reserves.
Degradation of muscle tissue to obtain energy through protein hardly occurs, as protein provides almost no energy (gluconeogenesis) and furthermore our growth hormone levels prevent this degradation.
Graph showing the time when our cortisol levels are at their highest is at 10:00 a.m. 08:00-09:00 A.M
Cortisol levels as we wake up, maximum at 30 minutes
Another thing we should keep in mind is that our lifestyle can further increase these cortisol levels. As we can see in the study “Differences in cortisol awakening response on work days and weekends in women and men from the Whitehall II cohort“, the subjects had higher cortisol levels on work days, as opposed to weekends, when levels were lower.
Within the socio-economic position, those who were poorer had higher cortisol levels, so as is reflected, our daily stress translates into higher cortisol levels.
Another important factor to consider for breakfast is insulin, which is associated with CAR levels, being of great importance in people with type 2 diabetes .
A “big breakfast”, and soon we are sleepy…
Our insulin levels are higher in the morning for two reasons:
- High cortisol levels leading to insulin resistance
- Increased secretion of increments
We will focus on point two which is of great importance. The incretins, for those who do not know, are a series of hormones secreted in the intestine in response to a meal.
There are two main types of incretins, GIP and GLP-1. As we can see in the study ‘Differential islet and incretin hormone responses in morning versus afternoon after standardized meal in healthy men’, incretin levels are higher in the early morning than in the afternoon, resulting in higher insulin levels and lower blood glucose levels.
Comparison between morning and afternoon, as we can see glucose and insulin levels are much higher in the morning, unlike glucagon which is lower in the afternoon
As many of you will know, when high levels of insulin are produced in a short period of time and subsequent depletion of blood glucose levels, there is a greater feeling of hunger. Does this mean that eating breakfast is a bad thing? NEVER! The only thing I want to demonstrate is that not having breakfast is not a bad thing as many people say, and that our current breakfasts can be an important factor in issues such as being overweight or having diabetes.
However, are there any experimental studies that compare eating most calories in the morning or in the evening? The answer is yes, this study is called Weight Loss is Greater with Consumption of Large Morning Meals and Fat-Free Mass Is Preserved with Large Evening Meals in Women on a Controlled Weight Reduction Regimen.
In this study the subjects were separated into two groups:
- A group A, where the energy consumption was distributed: 35% at breakfast, 35% at lunch, 15% at dinner and 15% at the afternoon snack,
- And another group with PM pattern with 15% at breakfast, 15% at lunch, 35% at dinner and 35% at a snack in the evening.
Both diets shared similar macronutrients:
- 60% carbohydrates
- 18% protein
- 22% fat.
To obtain the weight it was carried out at 07:00 A.M after emptying the bladders and before breakfast, where after a few weeks the following result was obtained:
As we observed, weight loss was greater in those who consumed most calories in the morning as opposed to those who did so in the evening (-3.90kg vs. -3.27kg in the evening). However, when we look at the table, we realize that the loss of muscle was 1.28kg in those who ate a big breakfast unlike the 250g that lost those who made a good dinner.
This translates into a loss of fat percentage of 1.83%, unlike the 2.52% of fat lost by those who consumed most of their calories in the evening.
Is muscle mass lost during Intermittent Fasting?
One of the major objectives for both athletes and overweight people is to maintain muscle mass during a phase of fat loss. Many use protocols such as eating every 2 hours, increasing protein intake above 3g/kg body weight or even seeking supplements to help reduce cortisol, but to what extent is muscle mass lost when calories are reduced?
We must differentiate between the effects that occur in the short term and those that occur in the long term. This is because certain protocols do not have a negative influence when we talk about hours or days, but muscle loss can occur if it is sustained over a long period. An example of this is fasting.
ADF Protocol or Alternate Fasting Days
One protocol where we observe this is the ADF (Alternative Day Fasting). In it, the calorie intake is 25% of what is usually consumed, so if you consume 2400kcal daily, that day of ADF would be 600Kcal. Anyone would say that this protocol would result in significant muscle loss, as calorie intake is very low and therefore protein intake will be lower than required. However, the reality is totally different.
ADF accompanied by a high-fat diet helps to lose fat without losing muscle mass
An example of this is this study where 32 obese people were subjected to an ADF protocol for 8 weeks, in which they were given a high-fat (45% of total calories) or low-fat (25% of total calories) diet, called ADF-HF (high fat) and ADF-LF (low fat) respectively. The group that followed the ADF protocol on a high-fat diet lost 1.2kg of body fat more than those on a low-fat diet (5.4 vs 4.2Kg)
Weight loss according to diet. ADF-HF (high fat) gives better results
An important detail that occurs and that many people would have been hoping for, is that neither diet showed loss of muscle mass. This makes us rethink what it is that really makes us lose our muscle and to what extent calories have a say in the matter.
This was not the only case where this protocol was studied. In this case 64 obese people were taken and divided into 4 groups depending on the protocol:
- Group A: ADF Protocol + exercise
- Group B: Only exercise
- Group C: ADF Protocol
- Group D: Control (Without diet or exercise)
The ADF protocol they followed was based on a protocol where 450Kcal (25% of their usual calorie needs) was consumed followed by days where the person had no calorie limit (ad lib days). Interestingly, one criticism of intermittent fasting is that adherence to this type of diet is low, which is not consistent with the study where adherence was above 80 per cent.
The following result was obtained:
As we can see, after 12 weeks, the group that combined an alternating fasting and exercise lost 5kg of fat, while the group without diet and training gained almost the same percentage of fat. One of the characteristics of intermittent fasting (and carbohydrate restriction) is a better sensitivity to insulin, which translates into a rapid loss of fat at the abdominal level. This is in line with the findings of this study, resulting in a sharp drop in waist circumference.
As in the previous study, loss of muscle mass was minimal, with only ADF + exercise preventing loss of muscle mass.
Intermittent Fasting and Fat Loss
Many sportspeople, when starting a fat loss diet, come from a “bulk” phase, which is usually high in carbohydrates (intakes of about 4-5g of carbohydrates/kg body weight/day). This causes glycogen stores to be almost full and therefore the muscle to look more ‘puffy’ or ‘bulky’. As we cut calories, these glycogen reserves decrease and therefore the muscle loses volume, the main reason why many people find themselves less muscular, even with a low percentage of fat (in the case of people who are in Peak Week).
However, it’s true that when we’re on a low-calorie diet we can lose muscle mass, especially when we restrict calories or protein intake for several days (as I mentioned at the beginning, long-term effects). A clear example of this is the study by Pasiakos, which I have spoken about several times in this blog, where reducing protein intake to 0.8g/kg body weight causes us to lose more muscle than body fat.
RDA: 0.8g/kg body weight
2xRDA: 1.6g/kg body weight
3xRDA: 2.4g/kg body weight
So what is the most negative factor in the long term?
When we stop training our muscle atrophies to a great extent, because the oxidant species (ROS) increase and the capacity to capture nutrients such as glucose (insulin resistance) or amino acids decreases, producing a cascade that will lead to muscle loss.
Graph adapted by Sergio Espinar from Michael B. Reid4
It cannot be assumed, then, that training is the best way to prevent muscle loss (Just been discovered in America). When we do physical exercise myocytes are released, substances that help protect the muscle mass and inhibit the growth of our adipocytes (cells where we store fat), that’s why people who train do NOT express genes related to atrophy/muscle loss such as MURF-1 or or atrophin, two ubiquitins that lead to sarcopenia.
How Intermittent Fasting affects obese and thin people
Little is said about the effects of skipping nutrients on the body for a set time, be it hours or days. What are the differences between people with different percentages of fat when they fast for a long time?
To this end, we will focus on the paper by Mosegaard Bak and colleagues, in which they studied fasting in obese and thin people. In this study, 18 people (9 obese and 9 thin) aged 20-35, non-smokers, without medication and with low physical activity, were subjected to 2 protocols:
- Protocol A: in which they would go 12 hours without food, which is quite similar to the intermittent fasting practiced by many.
- Protocol B: in which they would be 72h (3 days) without food.
Between the two protocols there would be a 21-day separation (washout) to avoid interference in the results obtained.
Results of the study
Higher levels of insulin and C-peptide
As expected, obese subjects had higher levels of insulin and C-peptide before the intervention, demonstrating a pattern of low-grade inflammation and resistance to this hormone. Both parameters decreased with fasting.
Highest levels of glucagon in 72h
On the other hand, higher levels of glucagon were observed during the 72h fast. For those of you who do not know, glucagon is a hormone whose main role is to “break down” liver glycogen to release it into the bloodstream and thus keep blood sugar in a controlled range.
More FFA in 12 hours
With regard to the 12-hour fast, higher levels of free fatty acids (FFA) were observed in both groups, which is not surprising since when no carbohydrates are introduced for several hours, the body resorts to lipid metabolism to save glucose, in other words, the body saves glycogen for situations of unavoidable need.
Something I found really interesting about the study, is that cortisol levels increased after 72h of fasting in thin subjects but decreased in obese people. We could speculate about the reasons for this disparate result, but in my opinion it may be because: having a lower percentage of fat in thin people means more stress on the body, something that is seen in competitors with a % of fat below 10%, where we see a worse nitrogen balance.
If we continue to observe the studies, we see that the increase of lipolysis (process by which the triglycerides stored in our body fat, known as adipose tissue, are broken) was higher in obese people, because they had a greater amount of body fat and above all, they had a lower expression of regulators in this tissue.
Does fasting affect obese and thin people in the same way?
With regard to the protein balance and the effect of fasting on the muscle tissue, we noticed a decrease in protein degradation and synthesis. In addition, worse results were obtained for markers such as mTOR and other partners, so prolonged fasting would produce a worse cellular environment for targets such as hypertrophy (increased muscle mass).
However, it should be remembered that the subjects were sedentary people, so in sports we would find different results, in which I think they would be worse.
In both obese and thin people, there was a drop in mTOR at 72h of fasting
Conclusions on the study
Paying attention to nutritional content
Intermittent fasting can be an interesting tool for some people who find it more convenient to reduce their meal frequency, either for convenience or for satiety, by preferring to eat fewer but more substantial meals. However, this can be a double-edged sword, as in many cases increasing the volume of food achieves satiety before the end of the meal, thus jeopardising the intake of macronutrients, especially protein, which is associated with improved body composition.
Need for nutritional education
On the other hand, in some groups such as obese people, it can be useful to reduce some parameters, however, although it can give good results in the short term, it does not ensure that they are maintained over time since the person only learns to reduce the caloric content and does not receive nutritional education that allows him/her to lead a healthy lifestyle.
How does Intermittent Fasting affect sportsmen and women?
Fasting in sportsmen and women is one of the most frequently discussed issues in the world of fitness and sport in general, as many sportsmen and women seek to train with low glycogen stores to improve metabolic flexibility or performance:
Fasting and Metabolic Flexibility
For those who do not know what metabolic flexibility is, it could be summarised as the body’s ability to use both fatty acids and glucose efficiently, allowing for greater performance by improving efficiency. What we observe in people who fast (the real one, not the one not eating food for 8h), is that the circadian rhythm varies, so cortisol levels are lower in the morning and higher when it’s time for bed.
Intermittent Fasting for Athletes
In terms of performance, it has been observed that in sportsmen and women, such as rugby players taking part in Ramadan, there was a drop in performance. However, it must be understood that Ramadan also prevents the consumption of liquids, and this could be due to dehydration.
Another point to take into account in studies measuring the performance of sportsmen and women during Ramadan is sleep, as they need more time to catch up and the duration is usually shorter. This lack of sleep leads to decreased glycogen synthesis, lower testosterone levels and higher cortisol levels, which translates into poorer recovery from training.
If we eliminate all these negative factors such as bad sleep or dehydration, due to not consuming water during the day, and bring the framework of fasting training to a more “natural” point, we can obtain more evidence:
The first of these is a better sensitivity to glucose when training on an empty stomach.
By looking at this graph, we can see that at the end of the training (post-test) the sensitivity to glucose was higher in the fasting group (F). This is largely due to the fact that the GLUT4 receptors (glucose transporters at the muscle level) were higher in the fasting group (black bar). An important detail is that the healthy volunteers underwent a high-fat diet.
In summary, we observe that people who fast increase their glucose uptake mechanisms.
With regard to body composition in athletes, some studies lasting 3 weeks observed how a group of cycling subjects who trained on an empty stomach reduced their percentage of fat without negatively influencing muscle mass or performance. However, I am almost certain that a drop in performance would be seen in this group of cyclists if they increased their intensity to 80-90% of their VO2max(maximum volume of oxygen) as they would not have enough glycogen to meet that requirement.
For this reason, in people who are going to train at a moderate-high intensity, I recommend high-carbohydrate dinners so that fasting training starts with higher-than-normal glycogen reserves
With regard to protein synthesis, there are numerous rumours that fasting training leads to poorer protein synthesis resulting in poorer use of post-training protein. When comparing fasting versus post-training people, we observe higher levels of P70s6k, which is a protein that activates protein synthesis, or in other words, fasting training leads to higher protein synthesis, which in my opinion is mainly due to increased protein degradation during training (remember that the body tends towards homeostasis or changes to keep our body stable).
Training during fasts
Fasting in sportsmen and women is not a problem in low-moderate, short-term training, as the contribution of ATP from mitochondrial energy production pathways is significant at these intensities. However, it should be stressed that there is currently no clear evidence that fasting during training or omitting carbohydrate intake for hours before the test improves performance.
As a personal opinion, I believe that in some cases training during fasts, can be counterproductive, as in tests in high humidity and high temperature environments, producing a rise in body temperature, increased sweating and therefore a higher “requirement” for glycogen as an energy source thanks largely to the catecholamine peak that occurs.
Therefore, as with most nutrition/training issues, we must look at the context and understand that what works for an ordinary person doing 45 minutes of treadmill or 1h of weights can NOT be extrapolated to the elite athlete who wants to improve their performance.
Recommended supplements for Intermittent Fasting
In principle, recommendations on nutritional supplements are not too far removed from those that can be applied to anyone who is on a non-fasting diet. In this case, people who do fast could benefit from consuming BCAAs before starting training.
On the other hand, choosing to introduce a whey protein will help us to fulfill the nutritional requirements with respect to quantity of daily protein.
And of course, in order to improve our performance, we can always use creatine.
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