New research suggests intermittent fasting increases the risk of dying from heart disease. But the evidence is mixed
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Kaitlin Day, RMIT University and Sharayah Carter, RMIT University
Intermittent fasting has gained popularity in recent years as a dietary approach with potential health benefits. So you might have been surprised to see headlines last week suggesting the practice could increase a person’s risk of death from heart disease.
The news stories were based on recent research which found a link between time-restricted eating, a form of intermittent fasting, and an increased risk of death from cardiovascular disease, or heart disease.
So what can we make of these findings? And how do they measure up with what else we know about intermittent fasting and heart disease?
The study in question
The research was presented as a scientific poster at an American Heart Association conference last week. The full study hasn’t yet been published in a peer-reviewed journal.
The researchers used data from the National Health and Nutrition Examination Survey (NHANES), a long-running survey that collects information from a large number of people in the United States.
This type of research, known as observational research, involves analysing large groups of people to identify relationships between lifestyle factors and disease. The study covered a 15-year period.
It showed people who ate their meals within an eight-hour window faced a 91% increased risk of dying from heart disease compared to those spreading their meals over 12 to 16 hours. When we look more closely at the data, it suggests 7.5% of those who ate within eight hours died from heart disease during the study, compared to 3.6% of those who ate across 12 to 16 hours.
We don’t know if the authors controlled for other factors that can influence health, such as body weight, medication use or diet quality. It’s likely some of these questions will be answered once the full details of the study are published.
It’s also worth noting that participants may have eaten during a shorter window for a range of reasons – not necessarily because they were intentionally following a time-restricted diet. For example, they may have had a poor appetite due to illness, which could have also influenced the results.
Other research
Although this research may have a number of limitations, its findings aren’t entirely unique. They align with several other published studies using the NHANES data set.
For example, one study showed eating over a longer period of time reduced the risk of death from heart disease by 64% in people with heart failure.
Another study in people with diabetes showed those who ate more frequently had a lower risk of death from heart disease.
A recent study found an overnight fast shorter than ten hours and longer than 14 hours increased the risk dying from of heart disease. This suggests too short a fast could also be a problem.
But I thought intermittent fasting was healthy?
There are conflicting results about intermittent fasting in the scientific literature, partly due to the different types of intermittent fasting.
There’s time restricted eating, which limits eating to a period of time each day, and which the current study looks at. There are also different patterns of fast and feed days, such as the well-known 5:2 diet, where on fast days people generally consume about 25% of their energy needs, while on feed days there is no restriction on food intake.
Despite these different fasting patterns, systematic reviews of randomised controlled trials (RCTs) consistently demonstrate benefits for intermittent fasting in terms of weight loss and heart disease risk factors (for example, blood pressure and cholesterol levels).
RCTs indicate intermittent fasting yields comparable improvements in these areas to other dietary interventions, such as daily moderate energy restriction.
So why do we see such different results?
RCTs directly compare two conditions, such as intermittent fasting versus daily energy restriction, and control for a range of factors that could affect outcomes. So they offer insights into causal relationships we can’t get through observational studies alone.
However, they often focus on specific groups and short-term outcomes. On average, these studies follow participants for around 12 months, leaving long-term effects unknown.
While observational research provides valuable insights into population-level trends over longer periods, it relies on self-reporting and cannot demonstrate cause and effect.
Relying on people to accurately report their own eating habits is tricky, as they may have difficulty remembering what and when they ate. This is a long-standing issue in observational studies and makes relying only on these types of studies to help us understand the relationship between diet and disease challenging.
It’s likely the relationship between eating timing and health is more complex than simply eating more or less regularly. Our bodies are controlled by a group of internal clocks (our circadian rhythm), and when our behaviour doesn’t align with these clocks, such as when we eat at unusual times, our bodies can have trouble managing this.
So, is intermittent fasting safe?
There’s no simple answer to this question. RCTs have shown it appears a safe option for weight loss in the short term.
However, people in the NHANES dataset who eat within a limited period of the day appear to be at higher risk of dying from heart disease. Of course, many other factors could be causing them to eat in this way, and influence the results.
When faced with conflicting data, it’s generally agreed among scientists that RCTs provide a higher level of evidence. There are too many unknowns to accept the conclusions of an epidemiological study like this one without asking questions. Unsurprisingly, it has been subject to criticism.
That said, to gain a better understanding of the long-term safety of intermittent fasting, we need to be able follow up individuals in these RCTs over five or ten years.
In the meantime, if you’re interested in trying intermittent fasting, you should speak to a health professional first.
Kaitlin Day, Lecturer in Human Nutrition, RMIT University and Sharayah Carter, Lecturer Nutrition and Dietetics, RMIT University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Come As You Are – by Dr. Emily Nagoski
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We’ve all heard the jokes, things like: Q: “Why is the clitoris like Antarctica?” A: “Most men know it’s there; most don’t give a damn”
But… How much do people, in general, really know about the anatomy and physiology of sexual function? Usually very little, but often without knowing how little we know.
This book looks to change that. Geared to a female audience, but almost everyone will gain useful knowledge from this.
The writing style is very easy-to-read, and there are “tl;dr” summaries for those who prefer to skim for relevant information in this rather sizeable (400 pages) tome.
Yes, that’s “what most people don’t know”. Four. Hundred. Pages.
We recommend reading it. You can thank us later!
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This Book May Save Your Life – by Dr. Karan Rajan
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The title is a bold sell, but the book does include a lot of information about what can go wrong in your body, and how those things can be avoided.
What it’s not: a reiteration of Dr. Michael Greger’s “How Not To Die“. It’s not dense medical information, and it doesn’t cite papers at a rate of ten per page.
What it is: an easy-reading tour guide of the human body and its many quirks and foibles, and how we can leverage those to our benefit. On which note…
Hopefully, your insides will never see the light of day, but this author is a general surgeon and as such, is an experienced and well-qualified tour guide. Here, we learn about everything from the long and interesting journey through our gut, to the unique anatomical features and liabilities of the brain. From the bizarre oddities of the genitals, to things most people don’t know about the process of death.
The style of the book is very casual, with lots of short sections (almost mini chapters-within-chapters, really) making for very light reading—and certainly enjoyable reading too, unless you are inclined to squeamishness.
Bottom line: in honesty, the book is more informative than it is instructional, though it does contain the promised health tips too. With that in mind, it’s a very enjoyable and educational read, and we do recommend it.
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Apples vs Carrots – Which is Healthier?
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Our Verdict
When comparing apples to carrots, we picked the carrots.
Why?
Both are sweet crunchy snacks, both rightly considered very healthy options, but one comes out clearly on top…
Both contain lots of antioxidants, albeit mostly different ones. They’re both good for this.
Looking at their macros, however, apples have more carbs while carrots have more fiber. The carb:fiber ratio in apples is already sufficient to make them very healthy, but carrots do win.
In the category of vitamins, carrots have many times more of vitamins A, B1, B2, B3, B5, B6, B9, C, E, K, and choline. Apples are not higher in any vitamins.
In terms of minerals, carrots have a lot more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. Apples are not higher in any minerals.
If “an apple a day keeps the doctor away”, what might a carrot a day do?
Want to learn more?
You might like to read:
Sugar: From Apples to Bees, and High-Fructose C’s
Take care!
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Resistance Beyond Weights
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Resistance, Your Way
We’ve talked before about the importance of resistance training:
Resistance Is Useful! (Especially As We Get Older)
And we’ve even talked about how to make resistance training more effective:
(High Intensity Interval Training, but make it High Intensity Resistance Training)
Which resistance training exercises are best?
There are two reasonable correct answers here:
- The resistance training exercises that you will actually do (because it’s no good knowing the best exercise ever if you’re not going to do it because it is in some way offputting to you)
- The resistance training exercises that will prevent you from getting a broken bone in the event of some accident or incident
This latter is interesting, because when people think resistance training, the usually immediate go-to exercises are often things like the bench press, or the chest machine in the gym.
But ask yourself: how often do we hear about some friend or relative who in their old age has broken their humerus?
It can happen, for sure, but it’s not as often as breaking a hip, a tarsal (ankle bones), or a carpal (wrist bones).
So, how can we train to make those bones strong?
Strong bones grow under strong muscles
When archaeologists dig up a skeleton from a thousand years ago, one of the occupations that’s easy to recognize is an archer. Why?
An archer has an unusual frequent exercise: pushing with their left arm while pulling with their right arm. This will strengthen different muscles on each side, and thus, increase bone density in different places on each arm. The left first metacarpal and right first and second metacarpals and phalanges are also a giveaway.
This is because: one cannot grow strong muscles on weak bones (or else the muscles would just break the bones), so training muscles will force the body to strengthen the relevant bones.
So: if you want strong bones, train the muscles attached to those bones
This answers the question of “how am I supposed to exercise my hips” etc.
Weights, bodyweight, resistance bands
If you go to the gym, there’s a machine for everything, and a member of gym staff will be able to advise which of their machines will strengthen which muscles.
If you train with free weights at home:
- Wrist curls (forearm supported and stationary, lifting a dumbbell in your hand, palm-upwards) will strengthen the wrist
- The farmer’s walk (carrying a heavy weight in each hand) will also strengthen your wrist
- A modified version of this involves holding the weight with just your fingertips, and then raising and lowering it by curling and uncurling your fingers)
- Lateral leg raises (you will need ankle-weights for this) will strengthen your ankles and your hips, as will hip abductions (as in today’s featured video), especially with a weight attached.
- Ankle raises (going up on your tip-toes and down again, repeat) while holding weights in your hands will strengthen your ankles
If you don’t like weights:
- Press-ups will strengthen your wrists
- Fingertip press-ups are even better: to do these, do your press-ups as normal, except that the only parts of your hands in contact with the ground are your fingertips
- This same exercise can be done the other way around, by doing pull-ups
- And that same “even better” works by doing pull-ups, but holding the bar only with one’s fingertips, and curling one’s fingers to raise oneself up
- Lateral leg raises and hip abductions can be done with a resistance band instead of with weights. The great thing about these is that whereas weights are a fixed weight, resistance bands will always provide the right amount of resistance (because if it’s too easy, you just raise your leg further until it becomes difficult again, since the resistance offered is proportional to how much tension the band is under).
Remember, resistance training is still resistance training even if “all” you’re resisting is gravity!
If it fells like work, then it’s working
As for the rest of preparing to get older?
Check out:
Training Mobility Ready For Later Life
Take care!
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How to Boost Your Metabolism When Over 50
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Dr. Dawn Andalon, a physiotherapist, explains the role of certain kinds of exercise in metabolism; here’s what to keep in mind:
Work with your body
Many people make the mistake of thinking that it is a somehow a battle of wills, and they must simply will their body to pick up the pace. That’s not how it works though, and while that can occasionally get short-term results, at best it’ll quickly result in exhaustion. So, instead:
- Strength training: engage in weight training 2–3 times per week; build muscle and combat bone loss too. Proper guidance from trainers familiar with older adults is recommended. Pilates (Dr. Andalon is a Pilates instructor) can also complement strength training by enhancing core stability and preventing injuries. The “building muscle” thing is important for metabolism, because muscle increases the body’s metabolic base rate.
- Protein intake: Dr. Andalon advises to consume 25–30 grams of lean protein per meal to support muscle growth and repair (again, important for the same reason as mentioned above re exercise). Dr. Andalon’s recommendation is more protein per meal than is usually advised, as it is generally held that the body cannot use more than about 20g at once.
- Sleep quality: prioritize good quality sleep, by practising good sleep hygiene, and also addressing any potential hormonal imbalances affecting sleep. If you do not get good quality sleep, your metabolism will get sluggish in an effort to encourage you to sleep more.
- Exercise to manage stress: regular walking (such as the popular 10,000 steps daily) helps manage stress and improve metabolism. Zone two cardio (low-intensity movement) also supports joint health, blood flow, and recovery—but the main issue about stress here is that if your body experiences unmanaged stress, it will try to save you from whatever is stressing you by reducing your metabolic base rate so that you can out-survive the bad thing. Which is helpful if the stressful thing is that the fruit trees got stripped by giraffes and hunting did not yield a kill, but not so helpful if the stressful thing is the holiday season.
- Hydration: your body cannot function properly without adequate hydration; water is needed (directly or indirectly) for all bodily processes, and your metabolism will also “dry up” without it.
- Antidiabetic & anti-inflammatory diet: minimize sugar intake and reduce processed foods, especially those with inflammatory refined oils (esp. canola & sunflower) and the like. This has very directly to do with your body’s energy metabolism, and as they say in computing, “garbage in; garbage out”.
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
Burn! How To Boost Your Metabolism
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Hack Your Hunger
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When it comes to dealing with hunger, a common-sense way of dealing with it is “eat something”. However, many people find that they then eat the wrong things, in the wrong quantities, and end up in a cycle of overeating and being hungry.
If this gets to the extreme, it can turn into a full-blown eating disorder:
Eating Disorders: More Varied (And Prevalent) Than People Think
…and even in more moderate presentations, the cycle of hunger and overeating is not great for the health. So, how to avoid that?
Listen to your body (but: actually listen)
Your body says: we’re running a little low on glycogen reserves so our energy’s going to start suffering in a few hours if we don’t eat some fruit, kill something and eat its fatty organs, or perhaps find some oily nuts.
You hear: eat something bright and sugary, shout at the dog, eat some fried food, got it!
Your body says: our water balance is a little off, we could do with some sodium, potassium, and perhaps some phosphorus to correct it.
You hear: eat something salty, got it, potato chips coming right up!
…and so on. Now, we know 10almonds readers are quite a health-conscious readership, so perhaps your responses are not quite like that. But the take-away point is still important: we need to listen to the whole message, and give the body what it actually needs, not what will just shut the message off the most quickly.
Here’s how: Intuitive Eating Might Not Be What You Think
Bonus: Interoception: Improving Our Awareness Of Body Cues
About those cravings…
As illustrated a little above, a lot of cravings might not be what they first appear, and in evolutionary terms, our body is centuries behind industrialization, in terms of adaptations, which means that even if we try to take the above into account, our responses can sometimes be inappropriate in the age of supermarkets.
See also: The Science of Hunger, And How To Sate Cravings
Natural appetite suppressants
Eating more is not always the answer, not even if it’s more healthy food. And hunger pangs can be especially inconvenient if, for example, we are fasting at present, which is by the way a very healthful thing for most people:
Learn more: Intermittent Fasting: What’s the truth?
One way to suppress hunger is simply to trigger the stomach into sending “full” signals, which involves filling it. Since you do not want to overeat, the trick here is imply to use high-volume food.
Consider for example: 30 grapes and 30 raisins have approximately the same calorie count (what with raisins being dried grapes, and the calories didn’t evaporate), but the bowl of fresh fruit is going to physically fill your stomach a lot more quickly than the tiny amount of dried fruit.
More on this: Some Surprising Truths About Hunger And Satiety
Protein is of course also an appetite suppressant, but it takes about 20 minutes for the signal to kick in. So a “hack” here is to snack on something proteinous at least 15 minutes before your main meal (for example, a portion of nuts while cooking, unless you’re allergic, or some dried fish unless you’re vegetarian/vegan; you get it, pick something high in protein and good for snacking, and have a small portion before your main meal).
Nor is protein the only option!
See also: 3 Natural Appetite Suppressants Better Than Ozempic
Scale it down
Related to the above, there is a feedback loop that occurs here. The more you eat, the more your stomach slowly grows to accommodate it; the less you eat, the more your stomach slowly shrinks because the body tries hard to be an efficient organism, and will not maintain something that isn’t being used.
So, there’s a bit of a catch-22; sate your hunger by filling your stomach with high volume foods, but filling it will cause it to grow?
The trick is: do the “eat until 80% full” thing. That’s full enough that you have had a nice meal and are not suffering, without stretching the stomach.
Enjoy your food
Seriously! Actually enjoy it. Which means paying full attention to it. Eating can and should be a wonderful experience, so it’s best savored rather than inhaling a bowl of something in 30 seconds.
Have you seen those dog bowls that have obstructions to slow down how quickly a dog eats? We can leverage that kind of trick too! While you might not want to eat from a dog bowl, how about having a little bowl of pistachio nuts rather than ready-to-eat peanuts? Or any shelled nuts that we must shell as we go. If you’re allergic to nuts, there are plenty of other foods with a high work-to-food ratio. Take some time and enjoy that pomegranate, for instance!
Not that we necessarily have to make things difficult for ourselves either; we can just take appropriate care to ensure a good dining experience. Life is for living, so why not enjoy it?
See also: Mindful Eating: How To Get More Out Of What’s On Your Plate
Enjoy!
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