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Intermittent Fasting: What is it, and how does it work?
By Johns Hopkins Health
Image by Gracia Lam
Intermittent fasting is an eating plan that switches between fasting and eating on a regular schedule. Research shows that intermittent fasting is a way to manage your weight and prevent — or even reverse — some forms of disease. But how do you do it? And is it safe?
What is intermittent fasting?
Many diets focus on what to eat, but intermittent fasting is all about when you eat.
With intermittent fasting, you only eat during a specific time. Fasting for a certain number of hours each day or eating just one meal a couple days a week, can help your body burn fat. And scientific evidence points to some health benefits, as well.
Johns Hopkins neuroscientist Mark Mattson, Ph.D., has studied intermittent fasting for 25 years. He says that our bodies have evolved to be able to go without food for many hours, or even several days or longer. In prehistoric times, before humans learned to farm, they were hunters and gatherers who evolved to survive — and thrive — for long periods without eating. They had to: It took a lot of time and energy to hunt game and gather nuts and berries.
Even 50 years ago, it was easier to maintain a healthy weight. Johns Hopkins dietitian Christie Williams, M.S., R.D.N., explains: “There were no computers, and TV shows turned off at 11 p.m.; people stopped eating because they went to bed. Portions were much smaller. More people worked and played outside and, in general, got more exercise.”
Nowadays, TV, the internet and other entertainment are available 24/7. We stay awake for longer hours to catch our favorite shows, play games and chat online. We’re sitting and snacking all day — and most of the night.”
Extra calories and less activity can mean a higher risk of obesity, type 2 diabetes, heart disease and other illnesses. Scientific studies are showing that intermittent fasting may help reverse these trends.
How does intermittent fasting work?
There are several different ways to do intermittent fasting, but they are all based on choosing regular time periods to eat and fast. For instance, you might try eating only during an eight-hour period each day and fast for the remainder. Or you might choose to eat only one meal a day two days a week. There are many different intermittent fasting schedules.
Mattson says that after hours without food, the body exhausts its sugar stores and starts burning fat. He refers to this as metabolic switching.
“Intermittent fasting contrasts with the normal eating pattern for most Americans, who eat throughout their waking hours,” Mattson says. “If someone is eating three meals a day, plus snacks, and they’re not exercising, then every time they eat, they’re running on those calories and not burning their fat stores.”
Intermittent fasting works by prolonging the period when your body has burned through the calories consumed during your last meal and begins burning fat.
Intermittent Fasting Plans
It’s important to check with your doctor before starting intermittent fasting. Once you get his or her go-ahead, the actual practice is simple. You can pick a daily approach, which restricts daily eating to one six- to eight-hour period each day. For instance, you may choose to try 16/8 fasting: eating for eight hours and fasting for 16. Williams is a fan of the daily regimen: She says most people find it easy to stick with this pattern over the long term.
Another, known as the 5:2 approach, involves eating regularly five days a week. For the other two days, you limit yourself to one 500–600 calorie meal. An example would be if you chose to eat normally on every day of the week except Mondays and Thursdays, which would be your one-meal days.
Longer periods without food, such as 24, 36, 48 and 72-hour fasting periods, are not necessarily better for you and may be dangerous. Going too long without eating might actually encourage your body to start storing more fat in response to starvation.
Mattson’s research shows that it can take two to four weeks before the body becomes accustomed to intermittent fasting. You might feel hungry or cranky while you’re getting used to the new routine. But, he observes, research subjects who make it through the adjustment period tend to stick with the plan, because they notice they feel better.
What can I eat while intermittent fasting?
During the times when you’re not eating, water and zero-calorie beverages such as black coffee and tea are permitted.
And during your eating periods, “eating normally” does not mean going crazy. You’re not likely to lose weight or get healthier if you pack your feeding times with high-calorie junk food, super-sized fried items and treats.
But what Williams likes about intermittent fasting is that it allows for a range of different foods to be eaten — and enjoyed. “We want people to be mindful and take pleasure in eating good, nutritious food,” she says. She adds that eating with others and sharing the mealtime experience adds satisfaction and supports good health.
Williams, like most nutrition experts, regards the Mediterranean diet as a good blueprint of what to eat, whether you’re trying intermittent fasting or not. You can hardly go wrong when you pick complex, unrefined carbohydrates such as whole grains, leafy greens, healthy fats and lean protein.
Intermittent Fasting Benefits
Research shows that the intermittent fasting periods do more than burn fat. Mattson explains, “When changes occur with this metabolic switch, it affects the body and brain.”
One of Mattson’s studies published in the New England Journal of Medicine revealed data about a range of health benefits associated with the practice. These include a longer life, a leaner body and a sharper mind.
“Many things happen during intermittent fasting that can protect organs against chronic diseases like type 2 diabetes, heart disease, age-related neurodegenerative disorders, even inflammatory bowel disease and many cancers,” he says.
Here are some intermittent fasting benefits research has revealed so far:
Thinking and memory. Studies discovered that intermittent fasting boosts working memory in animals and verbal memory in adult humans.
Heart health. Intermittent fasting improved blood pressure and resting heart rates as well as other heart-related measurements.
Physical performance. Young men who fasted for 16 hours showed fat loss while maintaining muscle mass. Mice who were fed on alternate days showed better endurance in running.
Diabetes and obesity. In animal studies, intermittent fasting prevented obesity. And in six brief studies, obese adult humans lost weight through intermittent fasting.
Tissue health. In animals, intermittent fasting reduced tissue damage in surgery and improved results.
Is intermittent fasting safe?
Some people try intermittent fasting for weight management, and others use the method to address chronic conditions such as irritable bowel syndrome, high cholesterol or arthritis. But intermittent fasting isn’t for everyone.
Williams stresses that before you try intermittent fasting (or any diet), you should check in with your primary care practitioner first. Some people should steer clear of trying intermittent fasting:
Children and teens under age 18.
Women who are pregnant or breastfeeding.
People with diabetes or blood sugar problems.
Those with a history of eating disorders.
But, Williams says, people not in these categories who can do intermittent fasting safely can continue the regimen indefinitely. “It can be a lifestyle change,” she says, “and one with benefits.”
Keep in mind that intermittent fasting may have different effects on different people. Talk to your doctor if you start experiencing unusual anxiety, headaches, nausea or other symptoms after you start intermittent fasting.
A Visual Guide to the SARS-CoV-2 Coronavirus
Illustrations by Veronica Falconieri Hays (Scientific American)
What scientists know about the inner workings of the pathogen that has infected the world
For all the mysteries that remain about the novel coronavirus and the COVID-19 disease it causes, scientists have generated an incredible amount of fine-grained knowledge in a surprisingly short time.
Thousands of different coronaviruses may inhabit the planet. Four of them are responsible for many of our common colds. Two others have already triggered alarming outbreaks of disease: in 2002 a coronavirus caused severe acute respiratory syndrome (SARS), which killed more than 770 people worldwide, and in 2012 a different strain started Middle East respiratory syndrome (MERS), taking more than 800 lives. SARS burned out within a year; MERS still lingers.
The newest coronavirus, SARS-CoV-2, has created a far deadlier pandemic in part because once it infects a person it can lie undetected for a long time. An individual who had the SARS coronavirus did not transmit it until 24 to 36 hours after displaying symptoms such as fever and dry cough; people feeling ill could be isolated before they made others sick. But people with COVID-19 can transmit the virus before they show clear symptoms. Not feeling ill, infected men and women work, commute, shop, eat out and attend parties, all the while exhaling coronavirus into the airspace of people around them. The virus can remain undetected inside the human body for so long partly because its genome produces proteins that delay our immune system from sounding an alarm. Meanwhile lung cells die as the virus secretly reproduces. When the immune system does hear the call, it can go into overdrive, suffocating the very cells it is trying to save.
In the graphics that follow, Scientific American presents detailed explanations, current as of mid-June, into how SARS-CoV-2 sneaks inside human cells, makes copies of itself and bursts out to infiltrate many more cells, widening infection. It shows how the immune system would normally attempt to neutralize virus particles and how CoV-2 can block that effort. It explain some of the virus’s surprising abilities, such as its capacity to proofread new virus copies as they are being made to prevent mutations that could destroy them. And it shows how drugs and vaccines might still be able to overcome the intruders.
Virus invasion and immune response
A SARS-CoV-2 particle enters a person’s nose or mouth and floats in the airway until it brushes against a lung cell that has an ACE2 receptor on the surface. The virus binds to that cell, slips inside and uses the cell’s machinery to help make copies of itself. They break out, leaving the cell for dead, and penetrate other cells. Infected cells send out alarms to the immune system to try to neutralize or destroy the pathogens, but the viruses can prevent or intercept the signals, buying time to replicate widely before a person shows symptoms.
Drug and vaccine intervention
Commercial and university labs are investigating well over 100 drugs to fight COVID-19, the disease the SARS-CoV-2 virus causes. Most drugs would not destroy the virus directly but would interfere with it enough to allow the body’s immune system to clear the infection. Antiviral drugs generally stop a virus from attaching to a lung cell, prevent a virus from reproducing if it does invade a cell, or dampen an overreaction by the immune system, which can cause severe symptoms in infected people. Vaccines prepare the immune system to quickly and effectively fight a future infection.
The remarkable and mysterious Coronavirus genome
The SARS-CoV-2 genome is a strand of RNA that is about 29,900 bases long—near the limit for RNA viruses. Influenza has about 13,500 bases, and the rhinoviruses that cause common colds have about 8,000. (A base is a pair of compounds that are the building blocks of RNA and DNA.) Because the genome is so large, many mutations could occur during replication that would cripple the virus, but SARS-CoV-2 can proofread and correct copies. This quality control is common in human cells and in DNA viruses but highly unusual in RNA viruses. The long genome also has accessory genes, not fully understood, some of which may help it fend off our immune system.
This article was originally published with the title “Inside the Coronavirus” in Scientific American 323, 1, 32-37 (July 2020). doi:10.1038/scientificamerican0720-32
Source: By Mark Fischetti, Veronica Falconieri Hays, Britt Glaunsinger, Jen Christiansen | Scientific American July 2020 Issue
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