Sunday, April 29, 2018

Type 2 Nutrition #430: “I don’t always skip meals…”

I had to chuckle the other day when I saw a page posted by Mark Gibbons, a member (as I am) of the Jason Fung Fan Club Fasting Support page on the net. The full quote was, “I DON’T ALWAYS SKIP MEALS…BUT WHEN I DO IT’S FOR DAYS AND DAYS AND DAYS.” Brilliant, as the Brits say. It’s an allusion, of course, to “The Most Interesting Man in the World” meme made famous by the TV commercial for Dos Equis beer some years ago.
This beer commercial has been parodied hundreds of times. What I liked about this one in particular is that is captures the essence of Extended Fasting, a practice that is gaining a small but very devoted following. The reason for the devotion is that, to virtually everyone’s surprise, it works for losing weight, and it’s sooo easy.
Extended Fasting means for two or three consecutive days taking little or no nourishment by mouth. I prefer the term Extended Fasting to Intermittent Fasting which first gained currency and apparently includes other types of fasting: 16:8, One Meal a Day (OMAD), 5:2, and various other forms such as Alternate Day fasting. In my opinion all of them are understandable attempts to deal with the fears and uncertainties of abstaining from eating for an extended time. From time to time I’ve tried them all for weight loss, with mixed results.
I can attest, however, to the efficacy of Extended Fasting. I transitioned to it last spring when I was living alone for two months. I wanted to gin myself up to start it and avoid the flack I knew I would get from my wife if she were here. It was suggested to me the previous fall by Megan Ramos, Director of the Intensive Dietary Management program in Jason Fung’s office in Toronto. I told her I would start with Alternate Day fasting.
I had already been eating Very Low Carb (since 2002), so I was keto- or at least fat-adapted. That meant that, without taking nourishment by mouth, I would immediately transition into burning body fat without hunger. Alternate day fasting worked so well I quickly transitioned to consecutive day, first two and then three-day. I know I could easily have gone four days, or five or more. Our social calendar simply doesn’t permit it, for now.
The metabolic mechanisms at play here are simple. The hormone insulin is the central (but not the only) player. It has at least two roles. The first is to transport glucose from digested carbs and other sources (such as gluconeogenesis) to the cells where it is supposed to open up receptors there to allow the energy in. Insulin Resistance in type 2s and pre-diabetics slows down and blocks that uptake.
The 2nd mechanism is that when glucose levels drop, after the glucose has been taken up and/or when few carbs have been taken by mouth, blood insulin levels drop. This sends a signal to the liver to switch fuels from glucose to fat. That’s what body fat is for, a backup energy source. But fat stores are only accessible when your blood insulin level drops. And that’s more difficult for people who have Insulin Resistance (type 2s and pre-diabetics) because with IR, as your glucose continues to circulate, blood glucose and insulin levels stay high!
That’s why Extended Fasting works for weight loss. When you eat nothing to speak of, and especially don’t eat carbs, particularly if you are already fat-adapted, you body transitions to burning body fat for energy, and you’re not hungry. You can literally go for days on end with no hunger, high levels of energy, and a feeling of being “pumped.”
I started at 375 pounds in 2002. Over the years I lost 170 pounds following a Very Low Carb (VLC) diet. Like most, however, I regained some (45 pounds). When I started Extended Fasting my goal was to lose 63 pounds, to reach 187 pounds, thus becoming “Half the Man I Once Was.” With Extended Fasting, it took 8 months, but I did it. But I’ve now regained some again, so my new goal is less ambitious. It is to get to 195 and stay below 200.
As the commercial ended with, “Stay thirsty, my friends,” so I end this post with, “Stay thin, my friends, with… Extended Fasting.” To maintain 195, I plan to eat VLC/OMAD and one or two day fasts, when and as needed.

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