This article was first published in The Montreal Gazette.
It’s hard to know how to eat well these days. Last month, claims that intermittent fasting doubled the risk of cardiovascular death dominated the news cycle. In my previous column, I explained why this probably wasn’t true and why most people don’t need to worry. But I doubt the many claims made about intermittent fasting, especially when it comes to weight loss.
Intermittent fasting, or time-restricted eating as it’s sometimes called, is popular and all the rage among the movers and shakers of pop culture. The rich and famous swear by it and there are more than a few examples of people who have used it to lose a considerable amount of weight. It may also be helpful in controlling blood sugar and improving insulin resistance, which can help reduce the need for diabetes medications.
The benefits are clear. But what’s less clear is whether there’s anything inherently special about intermittent fasting or whether it’s just another diet among many. Intermittent fasting is clearly more convenient for many people. Its basic premise is to limit food consumption to a 12- or 10- or 8-hour window (different people adopt different protocols). Unlike many other diets, it does not require calorie counting, avoiding specific foods, or any changes in meal preparation. Just look at the clock.
But while intermittent fasting is more convenient, it’s not necessarily better. In one study, compared to a normal diet, intermittent fasting did not lead to greater weight loss after one year. It also did not improve any other metabolic outcomes such as blood pressure, cholesterol or insulin resistance. Data on its effectiveness are inconsistent.
But the burning question in the field is whether intermittent fasting has any inherent benefits beyond simple calorie restriction. Some believe that intermittent fasting is simply a way to eat less, while others believe that when you eat is also important.
A recent study in the Annals of Internal Medicine attempted to answer this question by conducting a special randomized controlled trial. Forty-one patients were randomly assigned to a restricted diet or calorie restriction, but during the three-month study period the participants obtained food from a special metabolic study kitchen. So instead of being told to do this or that, they were provided with all the foods they were supposed to eat, minimizing the possibility of deviating from the study protocol.
The advantage of this approach is that both groups got the same number of calories per day, with the only difference being when they consumed them. before 1:00 p.m. The calorie restriction group could eat heavily throughout the day.
Both groups lost more than two kilograms (five pounds), but the weight loss was almost identical in both. Measures of blood glucose and insulin resistance were also not different between the groups. The conclusions drawn from this study were that when calories are held constant, intermittent fasting does not lead to more weight loss than simply eating less throughout the day. In other words, intermittent fasting works by reducing your calorie intake. No more and no less.
Intermittent fasting is popular (for now) because of its relative simplicity and simplicity of messaging. This results in (modest) weight loss, but you could probably do just as well just by eating less consistently throughout the day.
For some people, time-limited eating will be easy and intuitive, while for others it will be difficult and unsustainable. Ultimately, the best diet is the one you can stick to and the one that makes you eat less overall.
There are many outlandish claims about the health benefits of intermittent fasting. But in the end, it just seems like another way to eat less, which we should all be doing anyway.
#diet
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