Angelos Vlahoyiannis

Angelos is a Sports Dietitian. He graduated with honors in both his undergraduate and postgraduate studies. His research is focused on nutrition, exercise and sleep.

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April 11, 2021

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Intermittent Fasting

I n this article we will discuss about the 16:8 intermittent fasting protocol, which in the scientific literature, is often referred to as Time-Restricted Feeding, or TRF.
Time-Restricted Feeding is consisted of two distinct phases: i) an 8h period that food consumption is allowed, and ii) a 16h period that only water (and anything that has no calories) is permitted.
The term "fasting" is defined by the voluntary abstinence from the consumption of energy, hence foods and beverages that contain calories. This abstention can differ in various time-periods. On the other hand, the term "intermittent", means that something happens occasionally.

I made this introduction because in the scientific literature, there is a variety of intermittent fasting protocols, such as the Alternate Day Fasting (a caloric restriction leading to 400-500kcal for 2 to 4 days a week, which occurs day after day). So, for a daily intermittent fasting protocol I would say that the term “Time-Restricted Feeding” is preferable.

Does Intermittent Fasting sound familiar?

Yes! Ramadan is a form of intermittent fasting and actually, there are many scientific studies on this type of TRF. Up until a few years ago, the vast majority of studies investigating the effect of intermittent fasting in health and disease, were actually examining the effect of Ramadan on various systems of human physiology.

 

So, yes it's obvious that even if it looks like a new dietary trend, we are not referring to a fad-diet, but to a dietary pattern that has its roots deep in human history (Our ancestors did NOT have the convenience of eating every three hours.
"New or old trend, what benefits does it provide to our body?"

 

The adoption of a TRF protocol may:

  • Reduce abdominal fat and blood pressure (1, 2).
  • Increase insulin sensitivity (3).
  • Reduce inflammation markers in clinical populations, and in particular in patients with asthma (4).
  • Benefit patients with rheumatoid arthritis and hypertension (2,5).

 

However, taking a closer look at the methodology of the majority of these studies, it is reasonable to be skeptical as they did not control for variables, such as daily caloric intake.

 

Fortunately, the answer to this, comes from a study on the effect of Intermittent Fasting on adults who followed a resistance-training plan. In this study, body-fat percentage (not strength or muscle mass) was reduced in the group of participants that followed Time Restricted Feeding (6). In addition, the Time Restricted Feeding group showed improved glycemic control and lipid profile compared to control group.

 

“So, what really matters is how much food I consume, what food I consume or when I consume it?”

Definitely the amount of food consumption plays a key role in weight management. As we have already mentioned in the article on detoxification, the dose is what turns a substance into poison. Also, keep in mind that a food restriction protocol may be hypocaloric, or maybe not (7)!

 

So keep this in mind because…

 

Time Restricted Feeding (TRF) will not make you lose weight without being in a caloric deficit, that is consuming fewer calories than you burn. So, if TRF works for you psychologically and helps you consume fewer calories, that's great!

 

So, just to put things in perspective, if you do not reduce the calories you consume, one way or another, you will not lose weight.

 

"Is intermittent fasting safe?"

There is evidence that (not for everyone, but certainly for some), long periods of time without food may lead to some degree of nausea or dizziness (8). Furthermore, it is important to note that there is neither a negative association between body image and TRF, nor a reduced dietary control or other symptoms of eating disorders (9). However TRF may not be indicated for some diseases or conditions, such as during pregnancy, or for individuals who already suffer from eating disorders.

 

"-Ok, so how do I get started?"

-It's as simple as said, do not eat for 16 hours:

  1. You can drink water, tea, coffee or generally anything that has no calories.
  2. In the remaining 8h period, eat normally.
  3. Try to follow a balanced diet, eat unprocessed foods, rich in protein, lots of vegetables and fruits and it would be good not to exclude any food group from your diet.
Take home points:
  • Time Restricted Feeding is not a new dietary trend, but an old dietary pattern.
  • There are many studies that support the beneficial effects of TRF on health and many more to come, in order to be better informed about the pros and cons.
  • If you really want to follow a TRF protocol, try to eat unprocessed foods rich in protein and do not exclude any food group from your diet.

References

    1. Harvie, M. N., Pegington, M., Mattson, M. P., Frystyk, J., Dillon, B., Evans, G., ... & Howell, A. (2011). The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: a randomized trial in young overweight women. International journal of obesity35(5), 714-727.
    2. Goldhamer, A., Lisle, D., Parpia, B., Anderson, S. V., & Campbell, T. C. (2001). Medically supervised water-only fasting in the treatment of hypertension. Journal of manipulative and physiological therapeutics24(5), 335-339.
    3. Trabelsi, K., El Abed, K., Trepanowski, J. F., Stannard, S. R., Ghlissi, Z., Ghozzi, H., ... & Hakim, A. (2011). Effects of Ramadan fasting on biochemical and anthropometric parameters in physically active men. Asian journal of sports medicine2(3), 134.
    4. Johnson, J. B., Summer, W., Cutler, R. G., Martin, B., Hyun, D. H., Dixit, V. D., ... & Mattson, M. P. (2007). Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma. Free Radical Biology and Medicine42(5), 665-674.
    5. Müller, H., de Toledo, F. W., & Resch, K. L. (2001). Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scandinavian journal of rheumatology30(1), 1-10.
    6. Moro, T., Tinsley, G., Bianco, A., Marcolin, G., Pacelli, Q. F., Battaglia, G., ... & Paoli, A. (2016). Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. Journal of translational medicine14(1), 1-10.
    7. Stratton, M. T., Tinsley, G. M., Alesi, M. G., Hester, G. M., Olmos, A. A., Serafini, P. R., ... & VanDusseldorp, T. A. (2020). Four weeks of time-restricted feeding combined with resistance training does not differentially influence measures of body composition, muscle performance, resting energy expenditure, and blood biomarkers. Nutrients12(4), 1126.
    8. Kesztyüs, D., Cermak, P., Gulich, M., & Kesztyüs, T. (2019). Adherence to time-restricted feeding and impact on abdominal obesity in primary care patients: Results of a pilot study in a pre–post design. Nutrients11(12), 2854.
    9. Gabel, K., Hoddy, K. K., & Varady, K. A. (2019). Safety of 8-h time restricted feeding in adults with obesity. Applied Physiology, Nutrition, and Metabolism44(1), 107-109.
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Angelos Vlahoyiannis

Angelos is a Sports Dietitian - Nutritionist. He graduated on his undergraduate and postgraduate studies with honors, and he is currently Doctoral Candidate at the University of Nicosia. Awarded by the Greek Society for Biochemistry and Physiology of Exercise in the 2018 National Conference, Angelos continues to research Nutrition deeply.

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