Time Restricted Feeding for the Pseudo-Athlete

 

If you’re reading this, you have probably also been perusing other blogs that make fantastical claims about the benefits of the ketogenic diet and intermittent fasting.  Like anything else in the United States, the more extreme the better, so now we have people pushing 100% carnivorous diets – not even veggies or fruit – making the hardcore keto community look like a bunch of granola-crunching, bleeding-heart vegans.  Gotta love America!

The problem with zealotry of any stripe is that, when extremists appropriate a reasonable idea, the moderates of the world become less receptive to the merits of that idea.  Let’s use politics as an illustration: for decades, US policy on North Korea has not moved the needle in a positive direction.  President Trump recently decided to take a completely different approach to the situation, engaging Kim Jong Un in one-on-one talks.  Trump thinks that he can persuade North Korea’s leader to denuclearize by assuring Kim Jong Un we have no interest in nuking his country and enticing him with integration into the world economy, lifting his entire country out of poverty.

Is this gambit going to work?  It’s like predicting movement in the stock market – nobody knows.  I’m not interested in debating the merits of Trump’s plan.  I’m merely pointing out that, when Trump indicated his intention to hold a summit, moderate voices were highly critical.  “That’s not the way we do things,” was the primary message I heard.  To me, it felt like a knee-jerk rejection of Trump’s plan because it was Trump’s plan.  Listen, decades of insisting on concessions from North Korea before sitting down to the negotiating table in a meaningful way has produced bupkis.  So why not try a different approach that employs the not-so-radical strategy of…talking?

Bringing the conversation back to a realm in which I actually have some expertise and not just barely informed opinions, I want to talk about intermittent fasting (IF).  This practice has gained popularity, especially among low-carb, high-fat (LCHF) enthusiasts.  This makes perfect sense, as fasting is another way to encourage the body to enter ketosis, and we know that ketosis has the potential to do some great stuff.  However, because the ketogenic diet (KD) is rather extreme, IF gets tarnished by association.  [HD: As a quick aside, KD enthusiasts, please don’t leave long comments about how the KD is easy to follow.  Maybe it is for you, but the majority of people out there will try it and fail.]

As I discussed with Dr. Bret Scher on The Low Carb Cardiologist Podcast, I first approached the concept of IF with my usual degree of skepticism, asking “Why is this a stupid thing to do?”  I then dug into the research, which means I read numerous scientific papers – not blogs – from (mostly) peer-reviewed medical journals.  Although human data is not exactly robust at this point, there is enough total data to suggest that IF is not stupid.  In fact, it may have some important health benefits.  This is not a medical-o-pedia site, so I will not recreate all the physiology in this post.  If you’d like more detail, I highly recommend this review article from the journal Obesity: Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting.

When it comes to IF, on one end of the spectrum, the potential benefits by which many people seem to be intrigued are weight loss and improved insulin resistance/diabetes control.  On the other end of the IF fascination-spectrum, there are hardcore bodybuilders who strategically plan their meal timing and composition in the quest to gain ever-increasing amounts of muscle without a concomitant gain of fat*.  The question I have is: can IF benefit the large group of people in between the ends of the spectrum?  In other words, if you’re not overweight, in fairly decent shape, and not interested in lifting very heavy things, what can IF do for you?

Unfortunately, it’s difficult to answer this question in a data-free zone.  All we have are anecdotes from the blogosphere.  Although it burns my muffin when people cite anecdotes as if they’re data handed down on stone tablets, I think it can be interesting to read about the experiences of someone like us – particularly if we trust that person to give a balanced assessment.  In that spirit, I’d like to share my experience with IF, specifically Time Restricted Feeding (TRF).

HD, the Pseudo-Athlete

Regular readers know me as an Endocrinologist who hates diabetes, loves transgender care, and rails against a medical system that is burning doctors out at an alarming rate.  Along the way, you’ve probably picked up a few personal tidbits about me, but I haven’t discussed my own diet and exercise regimen much.  Frankly, telling people “the way I do it” seems self-indulgent and has the potential to come off as pedantic.  But, in order to know if my experience with TRF is at all extrapolatable to you, I think it’s important you know some basics about me and what I hoped to gain from TRF.  If you don’t like it, let me know in the Comments!

In my younger years, I played competitive sports in some fashion right up until my early 20’s, and then it all went downhill from there.  What happened?  Life happened, like it does to pretty much everybody else who gradually slides from fitness into a less desirable state of being.  Medical school, residency, fellowship, and then my real doctor job occupied most of my waking moments, so I learned to cram my workouts in when time permitted.  Being relatively vain, I focused on strength training, to the exclusion of cardio, flexibility, and mobility training.  I dutifully lifted weights on a consistent basis, punctuated by hikes, bike rides, and other more cardiovascular activities.  But my gym lifting routines were stale, the outdoor activities weren’t occurring as frequently as they should, and I wasn’t thinking much about my diet.  I had some decent muscle definition, but I also had some subtle love handles forming.  Peddling my bike up a steep hill, with my toddler on the back, caused my heart to nearly explode out of my chest – I was clearly not the same man as I was a couple decades ago!

It took a health scare to jolt me awake, lighting a blazing inferno under my butt to make some changes.  I began focusing more on my diet, reducing starchy carbohydrates and simply making better choices.  I started learning more about exercise, experimenting with a few personal training sessions, videos and numerous workout styles.  A close friend who had already ridden in this rodeo introduced me to P90X, Insanity, and other high-intensity, interval-training (HIIT) workouts.  I became addicted to the adrenaline rush provided by these workouts, to the point where my mood would deflate if I went too many days between sessions.

I continue to take two steps forward, one step back, as I am slowly learning how to listen to my middle-aged body.  Apparently, it is very easy for me to overtrain, so I have to be judicious in my workout selection.  I now exercise 4-7 days per week, though not every workout involves massive calorie burn or high-repetition strength training.  I try to alternate HIIT workouts with more moderate running, hiking, and biking.  I must do a dedicated yoga or flexibility/mobility routine once weekly or every other week; if I don’t, I tend to have more aches and pains.

At this point, I would consider myself a pseudo-athlete.  I think I’m fitter than the average weekend warrior who bikes 50 miles and then hobbles around in pain until the following Friday.  But I am not going to win any CrossFit competitions.  And I’m definitely not breaking records of any kind.  Although I have a respectable six-pack, I don’t quite meet strength coach-extraordinaire Charles Poliquin‘s credo, “You need to have penis skin over your abs.”  [HD: I’m paraphrasing this from an interview Charles did on Tim Ferriss’ podcast, in which Charles stated that one should have “penis skin” over one’s abs in order to “deserve” to eat any carbs.]

At this stage of my life, my primary fitness goal is to not get hurt.  I am often nursing some tendinitis here and some knee/shoulder pain there, but I am typically able to work around my IOD (Injury Of the Day).  I can keep up with my kid and enjoy the great outdoors, so I’m just trying to do my best to maintain the status quo, as the status quo is pretty darn good [HD: Just because I’m happy with my current level of fitness doesn’t mean that I’m not on a quest to become stronger, faster, and more durable.  I’m just not willing to risk injury in the pursuit of it all.]  With that in mind, on to my experience with TRF.

What did I want from TRF?

Given that we’ve established I’m already in decent shape and simply trying to maintain it, what did I hope to gain from TRF?  Well, I’ve mentioned on Dr. Scher’s podcast that my fasting blood sugar tends to run in the 100-110s with a Hemoglobin A1c around 5.6.  I’ve been laboring under the assumption that I have prediabetes (more about this later), so I was very interested to see if my blood sugar and A1c would improve with TRF.  However, because I am already lean, I planned to eat enough calories to keep my weight constant, thereby isolating the effect of time restriction from the effect of weight loss.  As you all know, weight loss tends to improve blood sugar and A1c levels, so I did not want that confounder.

As for other effects of TRF, I wanted to see if my body composition would noticeably change.  Additionally, I became fascinated by the concept of fasting having anti-cancer and anti-dementia potential, but obviously there is no way to assess that during a 6-month trial.  Nonetheless, I figured that if I liked TRF for tangible reasons, I might continue it for the vague promise of eventually not getting cancer or Alzhemier’s disease.  For the record, I am fully aware if I never get cancer or Alzheimer’s, it might simply be good luck and good genetics, having nothing to do with TRF.

So, before starting TRF, I asked my poor primary care doctor to order a battery of fasting labs for me.  Hey, at least I didn’t ask for a reverse T3.  Here are the highlights:

Glucose 109 mg/dL
Hemoglobin A1c 5.6%
Insulin 2.2 uIU/mL
hsCRP <0.20 mg/L
Triglycerides 41
LDL 127
HDL 78
Total Cholesterol 213

As you can see, my fasting blood sugar puts me into the prediabetic category, with an A1c that is pushing the limits of what is considered totally normal.  But my insulin level is at the lower limit of detection of the assay (2.0 uIU/mL), and my triglycerides and HDL look like those of a lean, insulin-sensitive individual.

The Protocol

I did not make this overly complicated.  I simply picked four days out of the week when it’s convenient for me to skip breakfast.  Why only four days?  Number one: I enjoy the ritual of breakfast and didn’t want to completely give it up.  Number two: I am often the house chef for family breakfasts, and it’s hard to smell delicious food and not actually put it in my mouth.  Given that I was interested in finding the MED (minimum effective dose) for TRF, I figured I could start with 4/7 and titrate up from there if desired.  I’ve been consistent with this schedule since January 2018, with the exception of when I’m on vacation, so it’s been about five months.  My fast lasts from post-dinner one day to lunch the next, about 16 hours.  I still drink one cup of black coffee in the morning in order to feel like a functional human being [HD: I used to put only a splash of cream into my coffee, so eliminating that was easy].

My Experience with TRF

The first four mornings of fasting, I had quite the gnawing sensation in my stomach.  It mostly resolved with breaking the fast, though it was tough to figure out how much food to eat.  My brain seemed confused by the schedule, and I didn’t feel like I could trust my appetite regulation center.  A few times early on, I felt satisfied by a reasonable amount of food, but the gnawing didn’t resolve until I ate more.  As of day five, though, the gnawing disappeared and fasting has mostly been easy.  Occasionally, I feel intense hunger before the 16-hour mark, so I have broken the fast an hour early a few times.

One benefit of TRF that surprised me is the absence of a drive to eat around 9:30-10am.  On days when I eat breakfast, I am always hungry by mid-morning, so I tend to snack on nuts, veggies/hummus, or fruit/almond butter.  On TRF days, I typically do not have intense hunger.  Of note, my breakfasts are usually fairly high in protein, but they do contain some carbs, so I wonder if I could achieve the same effect by completely eliminating carbs from breakfast [HD: LCHF enthusiasts swear that carb ingestion begets carb cravings, and I think they may be right].

Anyway, it took me several weeks to figure out how to eat enough during the day to maintain my weight.  I tried breaking the fast with a typical breakfast, followed 2 hours later by a typical lunch, but that just felt like one meal running into another.  Then I tried eating a small snack, followed by lunch a little later, but I found I wasn’t hungry enough to eat a proper lunch.  Ultimately, I settled on breaking the fast with a slightly larger lunch than usual.  I also got more religious about drinking a post-exercise protein shake after every workout.  After losing a few pounds early on, I quickly regained them and have maintained my weight exactly at baseline.  I will admit it’s possible that my body is smarter than I, meaning it may have lowered my resting metabolic rate to account for a mild caloric deficit.  Since I’m not tracking calories, I just don’t know.

Remember earlier when I mentioned I’m vain?  Well, one thing I’ve noticed with TRF is that I seem to have better muscle preservation/more definition, even weeks when I find myself doing more cardio and less resistance training.  There are some interesting potential mechanisms involving growth hormone and other factors which I may dig into further in a future post.  As for the timing of exercise, I typically work out in the afternoons on work days, and in the mornings on non-work days.  I tried doing a couple of workouts in the fasted state; let’s just say they didn’t go well.  One was HIIT (I totally bonked), while the other was lifting (didn’t feel as strong as usual).  I have not yet tried a moderate-intensity run in the fasted state; perhaps that will work out better.

Overall, I’d say my subjective experience with TRF has been neutral to slightly positive.  I have the same amount of energy, and I have the same problems with sleep (sometimes good, sometimes not, still haven’t figured it out).  I like not feeling hungry mid-morning on fasting days, as it frees me up to focus on other things.  So far, I haven’t found a workout I can do in a fasted state, but I also haven’t tried very hard.  I like the aesthetic benefits with respect to muscle preservation, though I’m still not sure I haven’t imagined the whole thing in an elaborate placebo-hallucination.  The question is, have there been any objective benefits?

January 2018 May 2018
Glucose 109 mg/dL 112 mg/dL
Hemoglobin A1c 5.6% 5.6%
Insulin 2.2 uIU/mL 2.1 uIU/mL
hsCRP <0.20 mg/L not performed
Triglycerides 41 49
LDL 127 106
HDL  78   82
Total Cholesterol 213 198

Conclusion

Objectively, I’m going to say there has been no statistically significant difference in my metabolic parameters.  Is it because I’m already as good as I can get?  Is it because I need to up-titrate the dose of TRF to 7/7?  Should I start fasting during vacations?  Of course not – that’s just crazy talk.

For now, I will likely continue to experiment with TRF, as I think there may be some long-term, less tangible benefits to be had.  As for the hyperglycemia issue, don’t think I’ve forgotten about that.  I hope to have some exciting stuff to share with you about that in the future, as I have been reaching out to some pretty smart researchers in the diabetes world about the increasingly appreciated phenomenon of hyperglycemia in insulin-sensitive (pseudo-)athletes.  Until then, I should probably rein in the chocolate-chip cookie eating.

 

*If you want to dive deep down the rabbit hole of intermittent fasting for bodybuilders, read everything on Martin Berkhan’s site Lean Gains.  I am a huge fan of his no-nonsense writing style.  If you think I’m blunt, Martin is me on steroids (figurative steroids, not literal steroids).  And, as they say in Boston, he’s “wicked smahhht.”

 

It’s your turn now.  Have you experimented with Intermittent Fasting in any form?  What positives/negatives have you noticed?  Did you get pre- and post-experiment blood work?  What were your results?  Have you figured out how to exercise in a fasted state?  What works for you?  Comment below!

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Image Credit: Photo by Marcelo Leal on Unsplash

19 Replies to “Time Restricted Feeding for the Pseudo-Athlete”

  1. Entertaining and informative! I love the Tim Ferris-like self experimentation. Though please stop before injecting anything into yourself.

    You don’t think a 21 point drop in LDL is significant? I’d say that’s pretty good, 16% reduction.

    I have reassured some patients who don’t eat breakfast that instead of feeling guilty, they should just say they are intermittent fasting! I love breakfast, the waffles and pancakes with lots of syrup, and blueberry muffins and bacon and sausage. So thus I just wind up skipping breakfast. I have never noticed a difference in lunch time hunger whether eating breakfast or not.

    If intermittent fasting works, then intermittent exercising should work as well. I am merely lengthening the high intensity intervals. Weekend warrior sounds so disparaging.

    Thanks HD!

    1. Ha! No, definitely will not be injecting myself with anything.

      As for the LDL reduction, I have the benefit of knowing that my prior lipid levels fluctuate in the same zone, so I don’t think this drop means anything.

  2. Thanks for sharing your experience with TRF, quite interesting indeed.

    Concerning your mildly elevated fasting glucose and Hb1Ac, have you considered having either a GCK mutation (MODY2) or any other mutations known to increase fasting plasma glucose?

    Have you checked your postprandial glucose values at 30min and 60min? Are they higher then you would expect if you were truly insulin sensitive?

    In the article “Blood Glucose Levels of Subelite Athletes During 6 Days of Free Living”, it is not clear to me if those few athletes both high fasting glucose and high post prandial glucose value (although not reaching criteria of IGT at 2h post prandial) are truly insulin sensitive. (see articles below).

    Thanks!

    https://www.ncbi.nlm.nih.gov/pubmed/26106223
    https://www.ncbi.nlm.nih.gov/pubmed/28298470
    https://www.ncbi.nlm.nih.gov/pubmed/27699707
    https://www.ncbi.nlm.nih.gov/pubmed/29853473
    https://www.ncbi.nlm.nih.gov/pubmed/28983719

    1. Concerning your mildly elevated fasting glucose and Hb1Ac, have you considered having either a GCK mutation (MODY2) or any other mutations known to increase fasting plasma glucose?

      Well, I didn’t plan to get too deep into the glycemia issue in this post, as I wanted to explore it further in a later post. But since I know you love this stuff, Jasmin, I’ll make an exception. 😉 Yes, I have considered that I could have a GCK mutation. However, I have seen some higher than normal postprandial numbers when I’ve checked, so I don’t think I have an issue just with FBG. As I understand it, I think this would make a GCK mutation less likely. I believe my postprandial excursions themselves have, on occasion, been more significant than what one would expect with a GCK mutation (>50 mg/dl). Also, my A1c is 5.6, and people with GCK mutations tend to be 5.8 – 7.6, per one of the papers you cited.

      Have you checked your postprandial glucose values at 30min and 60min? Are they higher then you would expect if you were truly insulin sensitive?

      I have, as above, and yes, they’ve been higher than what I think they should be for a truly insulin sensitive person. It would be interesting to see what my insulin levels look like at those time points, but I haven’t done that yet.

      In the article “Blood Glucose Levels of Subelite Athletes During 6 Days of Free Living”, it is not clear to me if those few athletes both high fasting glucose and high post prandial glucose value (although not reaching criteria of IGT at 2h post prandial) are truly insulin sensitive.

      Their fasting insulin levels were not as low as mine, that’s for sure. I admit that we don’t really know how insulin sensitive these athletes truly are, as the authors collected only fasting levels. Even though most of them were in single digits or close, it is possible that their provoked insulin levels could be much higher. So one of the possibilities with dysglycemia in athletes is that they are truly more insulin resistant or deficient (or both) than we might think, just by looking at them. But I don’t think that’s going to prove to be true; I think there is something else going on that is more nuanced.

      1. Yeah, I love this stuff 😉

        It is true GCK mutations seems to have even higher Hb1Ac. Interestingly , there seems to be a significant variation in the phenotype :
        “GCK-MODY is mostly described as an asymptomatic condition, with mild fasting hyperglycemia (5.5-8 mmol/L), minor postprandial glucose extrusion, and a family history of diabetes. Usually, only a proper diet is sufficient to maintain an appropriate glucose level and prevent diabetic complications. However, new studies have revealed that GCK-MODY patients are not such a homogeneous group and that their phenotypes may vary considerably depending on the type of mutation. Results of these studies indicate that about half of GCK-MODY patients fulfill the criteria of DM, while the rest present with Impaired Fasting Glucose or Glucose Intolerance.”
        https://www.ncbi.nlm.nih.gov/pubmed/28663157

        Also, while many reviews mention that “a key feature is that the glucose is regulated at its higher set point” and that “this is shown by the limited excursions in blood glucose, with 70% having a 2-h glucose increment 3 mmol/L during an oral glucose tolerance test”, they fail to mention the much higher post-prandial glycose excursion at 30min post meal (or post OGTT). According to this paper, patients with MODY2 do have 30min post prandial glucose elevations up to 10mmol/L…
        https://www.ncbi.nlm.nih.gov/pubmed/8132752

        Yet, MODY2 is not the only situation where thin people have decreased glucose tolerance . Some people without MODY2 or pre-diabetes/DM2 also seem to have decreased glucose tolerance with higher post prandial glycemia. One famous example is Robb Wolf, who claims to have a poor tolerance to most refined carbohydrates and grains despite being thin and fit. He also has a strong family history of diabetes. In his most recent book, “Wired to eat” , he encourages people to test their personal glucose tolerance with post prandial glucose testing. Another famous examples would be Dr Peter Attia who used to have metabolic syndrome despite being very active and reversed his metabolic syndrome with a low carb diet. Another interesting case is Dr Tim Noakes, which despite being very active and barely overweight, developed type2 diabetes after following a high carb diet for 30 years. He also had a very strong family history of diabetes.

        I have a friend who , just like you, as similar mild glucose intolerance despite being very thin and active. His fasting glucose was around 5.9 and Hb1Ac 5.5 After eating a single babana, his blood sugar can increase up to 9.5-10.0 mmol/L in 20minutes. Analysing his data from 23andme , he discovered he has a G6PC2 mutation (rs560887):
        “In these meta-analyses, we analyzed three SNPs (rs560887, rs16856187 and rs573225) in the G6PC2 gene for an effect on FG and two SNPs (rs560887 and rs16856187) for an association with T2D. We found that all three SNPs were associated with elevated FG level in participants with normal glucose regulation, and rs560887 in the Caucasians subgroup and rs16856187 under allele and dominant model were all associated with T2D.”
        https://www.ncbi.nlm.nih.gov/pubmed/28298470

        I believe there many variations in glucose tolerance in the general population, even in people without a formal diagnosis of pre-diabetes or diabetes. This was confirmed in this study which showed huge inter-individual glucose tolerance to different foods, which correlated with fasting glucose, Hb1Ac but also microbiota configuration.
        https://www.ncbi.nlm.nih.gov/pubmed/26590418

  3. Dear Dr. HD; fast-inating article! I wonder if you’d tell us what your BMI comes in at.

    I’ve been at the pre-diabetes level of blood sugar for at least 15 years so I watch all of my numbers pretty carefully. (I’m 62, my fasting glucose is ~115, and a1c was measured last week at 5.9. My BMI is 24.8. My other numbers are all very good.) I had excellent results following the Atkin’s Diet and to this day I watch my carbs unless I’m indulging in a Mexican dinner with friends. Love those chips…

    I don’t fast but I tend to eat smaller meals anyway. Each morning I have two scrambled eggs and a cup of coffee. Through the day I typically eat an orange, a small avocado, and one of those prepackaged small bags of trail mix from Trader Joe’s. Dinner is heavy on protein and veggies or salad. And… two glasses of red wine.

    A question, please: I’ve been on HRT for about nine months, having titrated up on estradiol to get to have an estrogen level of about 200, for 4-5 months. I track my weight very carefully, weighing myself each morning before breakfast on a digital scale. I enter it all into a spreadsheet, and have graphed it for the last five years! (Call me obsessive but it sure helps me keep track of how I’m doing.) I do lots of cardio exercise. My BMI has been creeping up from about 24.1 nine months ago to 24.8/24.9 recently. Is that typical with HRT? I’ve been considering watching my diet even more carefully but I’m not sure if that’s a good idea at this point.

  4. Great work HD. Honest and thorough as usual. I would suggest adding body fat measurement to your metrics. I bet the asthetic and muscle definition benefits are from fat mass loss, even though you didn’t have much to lose to start with. As for exercise, I would suggest that gets easier by becoming an efficient fat burning machine, and thus the added benefit of LCHF and TRF, and also easier in the morning during a fast. Last, it’s an important observation you made about not feeling hungry for a snack at10am. There is definitely something to the concept of carbs making us crave more carbs. Can’t wait to read more about your BG investigations!

    1. Can I eat baguettes while doing LCHF, Dr. Scher? If not, count me out! I’ll get my fuel for HIIT from good old fashioned starches.

  5. I was hoping to lose a few pounds, so decided to try time restricted feeding. I found it very, very hard. I tend to exercise in the morning and feel way better eating before cardio (usually a 1.5 hour bike ride in the morning), followed by walking the dog for an hour. At night, dinner tends to be the meal that I put the most effort into when feeding my family and I wanted to be a part of that. I tried functioning on coffee alone in the morning for as long as I could and it was very difficult. I managed for awhile, lost weight and was initially happy with the results. But then gradually my diet went out the window. I found it so hard to delay eating that I started rewarding myself with sweets way too often. It seemed to take so much willpower to put off eating that I started just eating poorly, where normally I eat a generally healthy diet (minimally processed, whole foods). Anyway, I started to put the weight I had initially lost back on and more. I quit the experiment and went back to focusing on eating healthy and cutting out the sweets. This approach works way better for me. My weakness is desserts (particularly chocolate). I’m good at avoiding too much of these if I’m not stressed and time restricted feeding was a stress that led me right back to them.

    1. Thanks for sharing your experience, Kelly. You make an important point about identifying triggers for making poor choices. Clearly TRF was not a good fit for you. Glad to hear you’ve figured out a good alternative.

  6. I do TRF midweek. It simply works best with my workout and work shift schedule. I do a lot of running in the mid morning and work the evening shift. I don’t like to eat before I run so I end up eating a lunch at 1 or 2pm and dinner at 6pm. On the weekends I do a long run and eat breakfast before those but will skip breakfast if the run is only 2 hours. The higher my fitness is the easier it is to do without bonking as you become better at burning fat when you are more fit (as long as you do plenty of running in the aerobic zone). I definitely notice it helps to loose weight when dieting as I am not as hungry when I skip breakfast. If I eat breakfast, I am hungry sooner and all day long.

    1. That’s great that TRF fits so well into your schedule and you find it easy to run while fasted. I do wonder if I could do a short run while fasted, as opposed to HIIT. I have taken a brisk hour-long walk while fasted and that went fine. I suspect that my metabolic demands for HIIT can’t be met in a fasted state unless I become more adapted to using fat as an energy source. Which isn’t going to happen on my current diet, as it includes too many carbs.

  7. Martin Berkham may be a fine source of advice, but I took one look at him and thought “literal steroids.”

  8. I tried eating just once a day for a few months. I felt great. My glucose levels were down. My A1c down to 5.7 (from 6.3) and I lost 40+ pounds. My energy levels were up. But……my triglycerides increased to off the charts. My PCP told me that triglycerides could increase with glucose fluctuation but it was freaky high enough to make me go back to my “regular” routine, but I have no regained the wt I lost last year. Eating once a day solved many logistical eating issues, made shopping for food much more simple, and my kitchen stayed much cleaner. Not sure what that contributes to this conversation, but thought I’d comment.

    1. Did you change your macronutrient composition during your experiment with fasting? Specifically, did you eat a lot more starch or a lot more fat?

      1. Not really. I didn’t “count calories” or carbs, but only ate once a day. I’m going to revisit the elevated triglycerides issue with my PCP next visit. I’d rather be slimmer and feel better and have higher triglycerides. I can’t take the statins because I feel awful on them. My understanding is that as long as you have available food/nutrients in your belly/blood stream, you’re not going to burn any stored fat. I believe there may be something to that.

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