Sunday, April 12, 2020

Retrospective #421: Heart Benefits of Intermittent Fasting

A thank-you email from a neighbor and friend included a link to a 2018 Cleveland Clinic’s Heart and Vascular News article, “How Fasting Affects Your Heart.” The subtitle is, “A Cardiologist’s Perspective on Pros and Cons of Fasting.” The Cleveland Clinic is “mainstream medicine,” thus way behind the curve on nutrition, especially saturated fat, but the article makes some excellent points about the benefits of Intermittent Fasting.
Quoting from the article: “Cardiologist Haitham Ahmed, MD, sees many advantages in fasting from food for short periods, and given the promising findings in this ‘emerging area’ of research, he expects that more people will want to try it. Though it depends on what you’re hoping to accomplish (it’s not safe for everyone), it’s beneficial to limit your food intake, in general.  He says, ‘By every measure, eating less is better.’”
The first sub-heading in the article, “CAN EATING LESS STRENGTHEN YOUR HEART?” begins, “Research shows that fasting can lower blood pressure, reduce cholesterol, control diabetes and reduce weight. Dr. Ahmed says, ‘Four of the major risk factors for heart disease are high blood pressure and cholesterol, diabetes and weight, so there’s a secondary impact. If we reduce those, we can reduce the risk of heart disease.’”
Well, I’d call that an endorsement of fasting. The Four Horsemen of the Apocalypse managed by fasting. Alas, “One word of caution, though,” Dr. Ahmed says. “Fasting can lead to an electrolyte imbalance. This can make the heart unstable and prone to arrhythmias. So, whenever we prescribe a protein-sparing modified fast, we do blood tests…and prescribe potassium supplementation to prevent electrolyte imbalance from occurring.’”
The fasting community generally agrees. Electrolyte balance is a good cautionary note. I take supplemental potassium (99mg). I also take magnesium (500mg) daily. And I add salt to almost everything I eat, and my Electrolyte Panel, a blood test ordered by my doctor once a year, is always great, with everything in mid-range.
The “protein-sparing modified fast” Dr. Ahmed described is a Very Low Carb (VLC), moderate protein diet with just enough dietary fat to allow the body to burn body fat to provide whatever energy is needed for homeostasis (energy balance). The body has a reduced need for glucose from dietary carbohydrates on VLC because it makes the glucose it needs from the glycerol molecule from fat breakdown and via gluconeogenesis from proteins not needed and stored as amino acids in the liver, thus “sparing” the breakdown of muscle protein for glucose. The liver also makes ketones, which the brain loves, from the breakdown of dietary and body fat.
The Cleveland Clinic’s Dr. Ahmed continues, “Is fasting a good way to lose weight? Although it offers health benefits – including reduced heart disease and weight loss – it’s not really the best way to lose weight. While fasting helps you drop pounds quickly, it doesn’t help you stay in shape.” What?!!! Okay, then add exercise! Remember, though: exercise definitely has cardiovascular and many other health benefits, but weight loss is not among them.
The Cleveland Clinic then says, “The only time we really recommend fasting for weight [loss] is if someone needs rapid weight loss, for instance, for surgery.” So, are they saying it’s okay for fat people to otherwise be fat, until it makes surgery riskier and therefore inadvisable for the patient (and the surgeon)? Geez….
The rest of the Cleveland Clinic article is garbage, with advice to eat a “healthy diet” of “low-fat yogurt” and high-carb foods like “dates,” “dried fruit,” “chick peas” and “peanut butter” before and after attempting a fasting diet.
My summation: Cleveland Clinic concludes that fasting is a “healthy diet” for the overweight and obese for the four benefits they acknowledge – that it “can lower blood pressure, reduce cholesterol, control diabetes and reduce weight,” and thus, “reduce the risk of heart disease.”
Given that, I would double down; I would say that fasting is THE optimal lifestyle for the ENTIRE population. Watch this video of the Diet Doctor’s Andreas Eenfeldt interviewing Dominic D'Agostino. In it, D’Agostino, a leading researcher in ketogenic metabolism, says he follows a “ketogenic intermittent fasting diet” about 95% of the time. 

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