Dr. Tello's advice to patients who want to try some form of structured fasting is to start with a healthy Mediterranean, plant-based diet. Get rid of any over-reliance on red meat or processed carbohydrates first.

Next, cut out snacking as much as possible.

“Give your body time to stop digesting your previous meal before embarking on your next meal. Otherwise, your body never taps into the energy stored in your fat cells,” she said. “I tell people, 'Just eat three meals a day.' People look at me like I'm nuts.”

The final step is to extend the number of hours during which you fast by ditching any late-night snacks and postponing breakfast. That lengthens by several hours the fasting that occurs naturally during sleep.

“I just sort of stumbled into this pattern myself, and it works. And now I know why,” she said. Have coffee or tea in the morning, get busy with work, then eat the day's first meal several hours later than a traditional breakfast. After dinner, the kitchen is closed; no late-night snacks.

“That's really doable for many people,” she said. “For physicians who are busy, this works great.”
This is, essentially, what I, too, do. I don't think that, decades ago, there was any other way than trial and error to arrive at something like this. Just what seems to work.

It's been long known that half starving small animals can increase their lives by relatively large fractions, but, in humans what happens is the brain requires the protein from the muscles. First go the muscles, then the brain, itself. World war 2 results of prisoners in Germany.

The last time I asked my doctor about it, about four years ago, the day he had a young substitute doctor, the substitute told me that, really, nobody, still, knows what to eat, when. The obvious restrictions depend on a person's health in general and specific. In fact, some persons do good on diets that lead to higher blood-sugar levels, and, so on. As for eating over the course of an hour, what comes to my mind, from the last time I read about it, there is a second shot of insulin, after about forty minutes, which can be quite harmful (to the body) on its own. So, eat, well within the forty minutes, or continue eating, well past the hour.

As with anything, intermittent fasting can have a downside. If you are interested in intermittent fasting or currently practicing it, be aware that there can be some drawbacks. Here are a few you should be cognizant of:

Orthorexia. Intermittent fasting could lead to disordered eating behaviors, such as orthorexia, which is defined as an obsession with proper or “healthy” eating. Symptoms include the need to talk about your diet constantly, and a preoccupation with what you will eat next. If you notice that your diet has become inflexible—so much so that you avoid or cancel social events because they are not consistent with your eating habits—take heed and consider switching to another dieting method.

Disrupted sleep. Although not eating before bedtime improves your ability to get to sleep, researchers have also shown that intermittent fasting may disrupt your sleep cycle by decreasing the amount of REM sleep you get. REM sleep is important for memory, mood, and learning capacity.

Decreased alertness. While intermittent fasting has been shown to increase alertness, when done over the long term, it can decrease it. This is simply due to the fact that your body is not getting enough fuel and, therefore, incapable of producing enough energy. Fasting can lead to fatigue, difficulty concentrating, and even dizziness.

Increased guilt. Breaking your fast or missing your fasting window by eating either too early or too late could cause anxiety and/or shame. Be alert for these feelings, as they may be signs of something larger, such as disordered eating.

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Increased cortisol levels. Since fasting is a stress on the body—similar to exercise—it can increase your cortisol levels, especially when you deprive yourself of food for longer periods. Cortisol is the body’s stress hormone, and increased levels are associated with increased stress as well as fat storage.

Higher LDL levels. In metabolically healthy obese adults who did alternate-day fasting in one randomized clinical trial, researchers found significantly increased LDL levels by month 12 compared with those who engaged in regular daily calorie restrictions.

Pancreatic damage. In a study presented at the 2018 annual meeting of the European Society of Endocrinology, Brazilian researchers found that, after a 90-day regimen of alternate-day fasting, lab rats lost weight, but lost muscle and gained stomach fat as well. Further, pancreatic changes suggested an increase in the risk of diabetes.

Although researchers seem to be making strides, the long-term effects of intermittent fasting are still largely unknown. Keep this in mind if you are thinking of incorporating intermittent fasting into your lifestyle, and when your patients ask for your counsel. And, if you’re going to practice or recommend intermittent fasting, note that there is a safe and healthy way to do so.
Although not formally recognized in the Diagnostic and Statistical Manual, awareness about orthorexia is on the rise. The term ‘orthorexia’ was coined in 1998 and means an obsession with proper or ‘healthful’ eating. Although being aware of and concerned with the nutritional quality of the food you eat isn’t a problem in and of itself, people with orthorexia become so fixated on so-called ‘healthy eating’ that they actually damage their own well-being.

WARNING SIGNS & SYMPTOMS OF ORTHOREXIA:

Compulsive checking of ingredient lists and nutritional labels

An increase in concern about the health of ingredients

Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)

An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’

Unusual interest in the health of what others are eating

Spending hours per day thinking about what food might be served at upcoming events

Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available

Obsessive following of food and ‘healthy lifestyle’ blogs on Twitter and Instagram

Body image concerns may or may not be present