Tag Archives: weight loss

What You Need to Know About Intermittent Fasting

Toronto Naturopathic Doctor

I recently contributed an article for our friends at Joyous Health on intermittent fasting, what it’s all about, and how Jonah and I do it.

Sometimes when we contribute articles, then are edited and we will post them here so you can read them the way we wrote them. In this case the article was posted almost exactly as we sent it, but for the nerds out there, the references were not cited in the text, so if we’ve posted the original so you know exactly where you can follow our reference trail (because we’re nerds too).

Enjoy!

Du La, ND, Traditional Chinese Medicine Practitioner, Acupuncturist, Birth Doula

Posted: 2017 November 8

What You Need to Know About Intermittent Fasting

“Fasting! That sounds great!” [sarcastic, but still supportive, if that’s possible] was my response, when my husband told me he was planning to begin this, at the time, somewhat novel dietary approach.

At that time, only a few years ago, the only persons we knew who fasted regularly were friends who observed for Lent or Ramadan, but it is now on the verge of becoming (if not already) a health fad.

Since that first, (supportive) conversation, I have also begun practicing intermittent fasting, and believe I am a convert!

What is Intermittent Fasting?

Intermittent fasting (“IF” from here on in) is precisely what the name implies, “fasting, but not continuously”. There are different approaches to IF. Essentially, anything goes, as long as fasting periods are at least approximately 16 hours duration.

Popular protocols are the “Warrior Diet” in which all daily eating is done in a four-hour window, leaving 20 hours for fasting1; “alternate day fasting” (sometimes referred to as “5:2” fasting), in which eating is confined to 12 hours daily (e.g., between 8:00 AM and PM) for five days weekly, and an all-day fast is performed two, non-consecutive days (e.g., Tuesday and Thursday) weekly1; and what we practice, eating all our meals within an eight-hour window daily (in our case, between 11:00 AM and 7:00 PM).

Why? Just, Why?

My husband began experimenting with fasting, partially because he is a naturopathic doctor and professionally he wanted to experience fasting; but mainly it made sense for him because after our children were born, he was becoming a “skinny fat guy”, outwardly appearing thin, but thicker and softer in the middle, and with increasing (though not yet worrisome) blood lipids (e.g., cholesterol) levels.

Fasting increases fat burning2, and decreased body fat levels are associated with improved blood lipid levels, blood sugar control, heart health and a slimmer appearance (which, presumably, is why so much Online fasting information is found on sites more directed at vanity than health).

Research demonstrates that fasting is associated with:

  • Weight loss1
  • Decreased body-fat percentage1
  • Decreased waist circumference1
  • Improved appetite control1
  • Decreased “bad” cholesterol and blood triglycerides1
  • Decreased systemic inflammation1 (measured using blood markers for inflammation, e.g., c-reactive protein)
  • Improved blood-sugar control1
  • Deceased blood pressure1
  • Decreased cancer risk1
  • Increased rates of cellular repair1
  • Improved memory and learning3
  • Increased lifespan4

Some truly remarkable health benefits occur with periods of fasting longer than those discussed here, and outside the scope of this post. Fasting for periods of at least two-days triggers cellular regeneration5, and fasting periods of three-days promote regeneration of myelin, the tissue that suffers autoimmune damage in multiple sclerosis6.

How Does Intermittent Fasting Work?

Many of the benefits of IF are associated with fat loss. Fasting essentially gives your body an opportunity to burn fat for fuel.

Your body is constantly burning calories in the form of sugars (glucose) to stay alive. In order to provide tissues with the sugar needed, your liver and muscles store glucose as “glycogen”, enough for about 12 to 14 hours7 (unless intensely exercising). After this source of fuel is depleted, assuming no carbohydrates are consumed to replenish stores, the body begins to metabolize (“burn”) fat for fuel8.

Is Intermittent Fasting Challenging?

Less than you may think. In fact, our own experience has been that it actually streamlines our day.

Research demonstrates that although fasting and caloric restriction (“dieting”) are equally beneficial for weight loss9, improving insulin sensitivity and other health biomarkers3; fasting is simpler to organize, and easier because it reduces appetite, while caloric restrictions does not (in fact, people who reduce calories by constant restriction/dieting, experience constant hunger10).

First off, to be clear, IF is not a short-cut. It is not simply “not eating” (that’s called starving yourself, and is not a health practice). Although fairly simple, I consider IF somewhat “advanced eating” and I suggest if you are a new to this topic, speak to a health professional before starting.

Fasting is mildly stressful for your body, imposing a mild stress on cells. This is one of the proposed mechanisms for the physiological benefits it yields3. It follows that you should be eating nourishing food to allow your body the nutrients it requires to endure the stress you are imposing on it. We follow a sort-of paleo/keto hybrid guideline, but a simple, well-balanced diet is adequate, and in fact, likely superior to the diet most subjects in human fasting research eat.

The IF approach we use is to fast almost every day (we aren’t too strict on week-ends), overnight (eight hours we would not be eating anyway). We stop eating after dinner (around 7:00 PM) and have our first meal of the day at around 11:00 AM.

For us, this simple routine checks a number of boxes:

  1. It allows our bodies approximately two to four hours of fat-burning daily
  1. Compared to other IF approaches, it is easier to create a routine (same eating pattern, every day)
  1. It is easy to integrate into a routine. Dieting usually requires the learning of new recipes for each meal, adding responsibilities to peoples already busy schedules
  1. It allows us to avoid a meal that is typically “starchy” in nature (which is inconsistent with our overall paleo/keto eating approach)
  1. It eliminates the option of late night snacking, which is for most will not be a nutritious food (“Let’s crack open a bag of baby carrots and watch Netflix”, said no one ever), and contributes to weight gain, high cholesterol and blood-sugar, and liver damage11
  1. Practically, it likely (we haven’t measured), allows us to reduce our daily caloric intake

IF is not focused on reducing daily calorie intake, but rather restricting it to a particular, in this case eight-hour, time window. That said, research suggests caloric restriction of approximately 30% both delays onset of chronic diseases of aging and prolongs lifespan.4, 12

  1. Neither of us is particularly hungry in the morning, which makes it easy

We enjoy espresso about an hour after the kids are off to school, about 90-minutes after waking, which we find takes the edge off if we do happen to notice hunger. (FYI: Research generally does not support an appetite-suppressing action for caffeine13, but it works for us)

Great, Let’s Go!

Easy Tiger!

Like all things, IF is fairly straightforward, but it isn’t for everyone.

Do not fast, intermittently or otherwise, if you:

  • Eat a poor diet (IF is not a “weight loss hack”)
  • Have a personal medical history of having an eating disorder
  • Sleep poorly
  • Are “depleted” or “worn down”
  • Are a woman having hormonal imbalance
  • Exercise intensely
  • Are not well-versed in nutrition and cooking (without professional guidance)

References

  1. Bubbs M. Intermittent fasting: therapeutic diet or fad diet. Lecture presented at unrecalled; 2015; location unrecalled.

I did this as a CME and have only a copy of the PowerPoint presentation and my own notes. I can’t find the full reference material, but the information presented here is actually referenced in the PowerPoint, so it’s legit.

  1. Kim A-H, Kim YH, Son JE, Lee JH, Kim S, Choe MS et al. Intermittent fasting promotes adipose thermogenesis and metabolic homeostasis via VEGF-mediated alternative activation of macrophage. Cell Research. 2017 Oct 17; [cited 2017 Oct 20]. Available at: https://www.nature.com/cr/journal/vaop/ncurrent/full/cr2017126a.html.
  1. Collier R. Intermittent fasting: the science of going without. Canadian Medical Association Journal. 2013 Jun 11; 185(9): E363–E364. doi:  1503/cmaj.109-4451.
  1. Cherkas A, Golota S. An intermittent exhaustion of the pool of glycogen in the human organism as a simple universal health promoting mechanism. Medical Hypothesis. 2014 Mar;82(3):387-89.
  1. Wu S. Fasting triggers stem cell regeneration of damaged, old immune system. USC News. [Internet]. 2014 Jun 5; [cited 2017 Oct 20]. Available at: https://news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system/.
  1. Gersema E. Diet that mimics fasting may also reduce multiple sclerosis symptoms. USC News. [Internet] 2016 May 26; [cited 2017 Oct 20]. Available at: http://news.usc.edu/101187/diet-that-mimics-fasting-may-also-reduce-multiple-sclerosis-symptoms/.
  1. net. Glycogen [Internet]. [Cited 2017 Oct 20]. Available at: http://www.exrx.net/Nutrition/Glycogen.html.
  1. Izumida Y, Yahagi N, Takeuchi Y, et al. Glycogen shortage during fasting triggers liver–brain–adipose neurocircuitry to facilitate fat utilization. Nature Communications. 2013;4:2316. doi:10.1038/ncomms3316.
  1. Seimon RV, Roekenes JA, Zibellini J, Zhu B, Gibson AA, Hills AP, Wood RE, King NA, Byrne NM, Sainsbury A. Do intermittent diets provide physiological benefits over continuous diets for weight loss? A systematic review of clinical trials. Molecular and Cellular Endocrinology.2015 Dec 15;418 Pt 2:153-72. doi: 10.1016/j.mce.2015.09.014. Epub 2015 Sep 16.
  1. Speakman JR, Hambly C. Starving for life: what animal studies can and cannot tell us about the use of caloric restriction to prolong human lifespan. Journal of Nutrition. 2007 Apr; [cited 2017 Oct 20]. Available at: http://jn.nutrition.org/content/137/4/1078.full.
  1. Hatori M, Volmers C, Zarrinpar A, DiTacchio L, Bushon EA, Gill S et al. Time-restricted feeding without reducing caloric intake prevents metabolic diseases in mice fed a high-fat diet. Cell Metabolism. 15(6):848-60.
  1. Roth GS, Ingram DK, Lane MA. Caloric restriction in primates and relevance to humans. Annals of the New York Academy of Science.2001 Apr;928:305-15.
  1. Schubert MM, Irwin C, Seay RF, Clarke HE, Allegro D, Desbrow B. Caffeine, coffee, and appetite control: a review. International Journal of Food Sciences and Nutrition.2017 Dec;68(8):901-912. doi: 10.1080/09637486.2017.1320537. Epub 2017 Apr 27.

 

 

 

 

 

Metabolic Detoxification

Toronto naturopathic doctor

Clean From the Inside Out

Metabolic detoxification is the mechanism by which the vast majority of chemicals are removed from your body. Chemicals you are exposed to in the course of your daily life, and which can remain in your body’s fat stores long-term, include:

  • Hormone disrupting pesticides in foods
  • Cancer causing food additives
  • Food additives that have been linked to hyperactivity in children
  • Hormone disrupting toxic metals in fish
  • Chemicals in household cleaners that are carcinogenic, and have been linked to birth defects
  • Chemicals in air pollution that have been linked to heart disease
  • Hormone disrupting chemicals that are ubiquitous in the environment (e.g., in fire retardants, non-stick cookwear)
  • Liver-toxic chemicals in medications (e.g., antibiotics, acetaminophen [Tylenol®])

How does metabolic detoxification work?

Many organs participate in metabolic detoxification, but the organs most involved in this process are the liver and lymphoid tissue in the gastrointestinal tract.

“Toxins” you are exposed to are carried in your blood. Metabolic detoxification is a multi-stage process:

  • “Phase 1” of metabolic detoxification involves “extraction” of these chemicals from your blood.
  • “Phase 2” involves binding of these chemicals, usually to proteins, that act as “carriers”, to be, ultimately removed from your body.
  • Once “packaged” for removal, toxins are excreted in the urine, or into the gut via bile for excretion by bowel movements.

Is a metabolic detoxification protocol appropriate for me?

Anyone can benefit from periodic metabolic detoxification: we are all exposed to potentially harmful chemicals daily; we are not all genetically “efficient detoxifiers” (some of us are as much as 1000 times less efficient at detoxification than others); and research demonstrates that detoxifying efficiency can be improved using a metabolic detoxification program.

Completing a metabolic detoxification program may be ideal for you if you:

  • Have been diagnosed with a health condition that may be related to exposure to toxic substances (e.g., fibromyalgia, infertility, obesity, hyperactivity) 
  • Frequently experience non-specific symptoms such as fatigue, poor concentration, headaches , abdominal bloating, constipation or muscle aches
  • Work (e.g., farmer, painter) or live (e.g., old home, urban environment) in an environment where you are exposed to high levels of potentially toxic substances
  • Are a “smoker
  • Are planning to become pregnant
  • Have a score of greater than 15 on completion of a “Metabolic Screening Questionnaire” (a measurement tool for symptoms such as fatigue, poor concentration, headaches, abdominal bloating, constipation, muscle aches, etc. that may be related to inefficient metabolic detoxification)

Is there scientific support for use of metabolic detoxification programs?

Research has demonstrated that a metabolic detoxification program of as few as seven days can increase removal of chemicals by the liver by 23%, and reduce “Metabolic Screening Questionnaire” scores by 47%.

In a different study, a 10-week metabolic detoxification program decreased “Metabolic Screening Questionnaire” scores by 52%.

Are metabolic detoxification programs safe?

Metabolic detoxification programs are safe, with very few exceptions.

You should not participate in a metabolic detoxification program if you are:

You should not participate in a metabolic detoxification program without the guidance of a healthcare professional if you:

  • Are using a prescription medication that has potentially dangerous side effects
  • Are using a prescription medication to manage a potentially fatal health condition
  • Have diabetes mellitus
  • Have a liver condition
  • Have a kidney condition
  • Have a history of an eating disorder

I have none-of-the-above, should I consult with a naturopathic doctor guidance for my metabolic detoxification program?

Although you can safely complete a metabolic detoxification program on your own, you will optimize the results of your program with guidance from a naturopathic doctor.

A successful metabolic detoxification program requires management of many biochemical and physiological factors, including:

  • Minimization of potentially toxic substances in the diet
  • Mobilization of fat-soluble toxins from body tissues
  • Consumption of nutrients that support your body’s “phase 1” and, more importantly, “phase 2” metabolic detoxification pathways
  • Consumption of foods that minimize potential for side effects of a metabolic detoxification program
  • Consumption of foods that optimize kidney excretion of water-soluble toxins
  • Increasing of bile production and secretion to maximize excretion of fat-soluble toxins
  • Maintenance of daily bowel habits to ensure excretion of fat-soluble toxins
  • Protection, if appropriate, of liver cells

Many commercially available detoxification products address only one or a few of these parameters.

Naturopathic doctors are the most qualified healthcare professionals in the biochemistry of metabolic detoxification; and nutritional counseling and use of nutritional supplements and botanical (herbal) medicines to optimize your body’s metabolic detoxification potential.

Are metabolic detoxification appointments covered by O.H.I.P.?

O.H.I.P. does not pay for naturopathic medicine services, but as a government-regulated healthcare profession, services offered by naturopathic doctors, including metabolic detoxification appointments provided at Toronto Centre for Naturopathic Medicine are covered by most extended healthcare plans.

Learn about our Non-Celebrity Detox program.

References

Food dyes: a rainbow of risks [Internet]. Center for Science in the Public Interest. 2010 [cited 2015 Apr 10]. Available from: http://cspinet.org/new/pdf/food-dyes-rainbow-of-risks.pdf.

Minich DM, Bland JS. Personalized lifestyle medicine: relevance for nutrition and lifestyle recommendations. ScientificWorldJournal. 2013; 2013:129841. doi:  10.1155/2013/129841.

Dirty dozen endocrine disruptors: 12 hormone-altering chemicals and how to avoid them [Internet]. Environmental Working Group. 2013 Oct 13 [cited 2015 Apr 10]. Available from: http://www.ewg.org/research/dirty-dozen-list-endocrine-disruptors.

Cleaning Supplies and Your Health [Internet]. Environmental Working Group. [cited 2015 Apr 10]. Available from: http://www.ewg.org/guides/cleaners/content/cleaners_and_health.

Ramachandran R, Kakar S. Histological patterns in drug-induced liver disease. J Clin Pathol. 2009;62;481-492.

Macintosh A, Ball K. The effects of a short program of detoxification in disease-free individuals. Alternative Therapies. 2000 Jul;6(4):70-6.

Bland JS, Barrager E, Reedy RG, Bland K. A medical food-supplemented detoxification program in the management of chronic health problems. Altern Ther Health Med. 1995 Nov 1;1(5):62-71.

Lamb JJ, Konda VR, Quig DW, Desai A, Minich DM, Bouillon L, Chang JL, Hsi A, Lerman RH, Kornberg J, Bland JS, Tripp ML. A program consisting of a phytonutrient-rich medical food and an elimination diet ameliorated fibromyalgia symptoms and promoted toxic-element detoxification in a pilot trial. Altern Ther Health Med. 2011 Mar-Apr;17(2):36-44.

Grün F, Blumberg B. Endocrine disrupters as obesogens. Mol Cell Endocrinol. 2009 May 25;304(1-2):19-29.

Minich DM, Bland JS. Acid-alkaline balance: role in chronic disease and detoxification. Altern Ther Health Med. 2007 Jul-Aug;13(4):62-5.[/vc_column_text][/vc_column][/vc_row]

Medical Weight Loss + FirstLine® Therapy

Toronto naturopathic doctor

Be healthy, feel great

The negative health effects associated with, not only obesity, but with being overweight or having excess body-fat are now accepted by healthcare professionals of all disciplines.

A very limited list of health conditions associated with obesity includes:

  • Heart disease (including a four-times increased risk of death from heart disease)
  • Type-2 diabetes mellitus
  • At least 13 types of cancer (including increased risk of developing breast, prostate and colon cancers; and a two-times increased risk of death from cancer in general)
  • Infertility (obese women are 43% less likely to become pregnant compared to “overweight” and other “non-obese” women)
  • Erectile dysfunction
  • Liver and gallbladder disease
  • Osteoarthritis 
  • Menstrual irregularities
  • Sleep apnea
  • Early loss of quality of life (between 3-6 years for men and women respectively)
  • Early death (by as many as 5-20 years; and a 6-12-times increase compared to the general population)

Are you “overweight”?

Overweight and obese are defined in terms of your body mass index (BMI) score. “Overweight” is defined as having a body mass index (BMI) value of 25.0-29.9. “Obese” is defined as having a body mass index (BMI) value of 30.0 or higher.

You can calculate your body mass index (BMI) score here.

Are you “overfat”?

Potentially more important to health than your body mass index (BMI) score, is your body composition. A short, muscular person may have a high body mass index (BMI) score, but in fact be very healthy.

It is excess “adiposity” (body fat) that adversely affects your health, not simply greater than average weight.

Body composition can be determined by bioelectrical impedance analysis (BIA). This is calculated using a quick, painless, simple in-office procedure.

How can we help?

Naturopathic doctors have more training in nutrition and the biochemistry of decreasing body-fat content than “conventional” medical doctors; and more training in understanding the health conditions associated with obesity, and the psychological and social obstacles to successful lifestyle change than dietitians and nutritionists.

As such, naturopathic doctors are in the unique position to be able to create customized weight management programs that include consideration of your co-existing health conditions, unique nutritional requirements, budget, lifestyle and time constraints; and which can eventually become the basis for a healthy lifestyle.

Medical Weight Loss at Toronto Centre for Naturopathic Medicine

Every patient at Toronto Centre for Naturopathic Medicine receives a personalized treatment plan, but a typical approach to creating a weight management program may include:

  • Measuring baseline values for weight, body mass index (BMI) and body composition (e.g., body-fat percentage)
  • Establishing healthy, attainable goals for weight, body mass index (BMI) score and body-fat percentage
  • Identifying and addressing motivational and psycho-social obstacles to success
  • Creation of a “holistic” nutritional plan, incorporating avoidance of poorly tolerated foods, ideal foods for management of co-existing health conditions (e.g., foods that lower potential for inflammation for those with arthritis)
  • Optimizing nutrition by including phytochemcials (plant chemicals) in your diet to increase immune system function and anti-oxidant levels, and decrease inflammation
  • Prescription of nutritional supplements or metabolic detoxification protocols to support dietary changes
  • Consistent professional support, clinically proven to increase success rate in weight management programs

What is FirstLine® Therapy, and is it right for me?

FirstLine Therapy® is a meal plan and medical food-based weight management program designed to normalize the health effects of cardio-metabolic syndrome (i.e., increased blood-cholesterol, triglyceride and blood sugar levels) by weight loss.

Although developed for the treatment of cardio-metabolic syndrome, FirstLine Therapy® can applied to any setting in which weight loss and improvements in body composition are desired.

A 12-week clinical trial of persons diagnosed as having cardio-metabolic syndrome and hypercholesterolemia demonstrated that participation in a FirstLine Therapy® program resulted in:

  • Reduced weight by 13 pounds
  • Reduced systolic blood pressure by measures 4.9%
  • Reduced diastolic blood pressure by measures 5.7%
  • Reduced triglyceride levels by 35.2%
  • Reduced cholesterol levels by 14.5%
  • Reduced low-density lipoprotein (“bad” cholesterol) levels by 17.3%
  • Increased high-density lipoprotein (“good” cholesterol) by 7.0%
  • Reduced fasting blood-glucose levels by 2.2%
  • Reduced fasting insulin levels by 26.8%

After 12-weeks, 43% of study participants health was improved to the point they no longer met the criteria of having cardio-metabolic syndrome.

The benefits of a FirstLine Therapy® program to reduce cholesterol and blood-glucose levels is comparable to those gained using conventional treatments, but without unpleasant side effects.

“Statin” medications used to manage high cholesterol have been found to reduce “bad cholesterol” by greater than 17.3%, but are less effective in reducing weight, blood pressure, triglyceride levels, and do not increase “good” cholesterol levels as effectively. “Statins” have over 73 known side effects, including diarrhea, constipation, vomiting, heartburn, indigestion, abdominal pain, abdominal gas, nasal congestion, headache, back pain, face pain, painful urination, insomnia and decreased libido.

Metformin hydrochloride, commonly used to manage diabetes symptoms, depending on the dosage and frequency of use, will reduce fasting blood-glucose levels by 2.8 to 10.1%, and fasting insulin levels by 29%, but has over 69 side effects, include diarrhea in over 53% of users, and interacts with over 680 other pharmaceuticals.

FirstLine Therapy® has no side effects. However, the side benefits of reduction of cholesterol and blood sugar by weight loss and improved body composition include:

  • Decreased risk of developing all the health conditions associated with increased weight
  • Decreased inflammation and “aches and pains”
  • Lower foods costs
  • Increased energy
  • Improved sleep-quality
  • Improved self-confidence

Are medial weight loss and FirstLine Therapy® appointments covered by O.H.I.P.?

O.H.I.P. does not pay for naturopathic medicine services, but as a government-regulated healthcare profession, services offered by naturopathic doctors, including medical weight loss and FirstLine Therapy® appointments provided at Toronto Centre for Naturopathic Medicine are covered by most extended healthcare plans.

References

Obesity [Internet]. Mayo Foundation for Medical Education and Research; [cited 2015 Apr 1]. Available from: http://www.mayoclinic.org/diseases-conditions/obesity/basics/complications/con-20014834.

Obesity [Internet]. Medscape; [cited 2016 Aug 24]. Available from: http://emedicine.medscape.com/article/123702-overview#a6.

Obesity and cancer risk [Internet]. National Cancer Institute; [cited 2015 Apr 1]. Available from: http://www.cancer.gov/cancertopics/causes-prevention/risk/weight-activity/obesity-fact-sheet.

Obesity linked to infertility in women [Internet]. WebMD; [cited 2016 Aug 24]. Available from: http://www.webmd.com/infertility-and-reproduction/news/20071211/obesity-linked-to-infertility-in-women.

Brønnum-Hansen H, Juel K, Davidsen M, Sørensen J. Impact of selected risk factors on quality-adjusted life expectancy in Denmark. Scand J Public Health. 2007 Oct; 35(5):510-515.

Moderate obesity takes years off life expectancy [Internet]. ScienceDaily; 2009 [cited 2015 Apr 1]. Available from: http://www.sciencedaily.com/releases/2009/03/090319224823.htm.

Blackburn GL. Comparison of medically supervised and unsupervised approaches to weight loss and control. Ann Intern Med. 1993 Oct 1; 119(7 Pt 2):714-8.

Lipitor side effects [Internet]. Drugs.com; [cited 2015 Apr 2]. Available from: http://www.drugs.com/sfx/lipitor-side-effects.html.

Metformin side effects [Internet]. Drugs.com; [cited 2015 Apr 2]. Available from: http://www.drugs.com/sfx/metformin-side-effects.html.[/vc_column_text][/vc_column][/vc_row]