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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Laziness Does Not Exist – by Dr. Devon Price
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Some cultures prize productivity as an ideal above most other things, and it’s certainly so in the US. Not only is this not great for mental health in general, but also—as Dr. Price explains—it’s based on a lie.
Generally speaking, when a person appears lazy there is something stopping them/you from doing better, and it’s not some mystical unseen force of laziness, not a set character trait, not a moral failing. Rather, the root cause may be physical, psychological, socioeconomic, or something else entirely.
Those causes can in some cases be overcome (for example, a little CBT can often set aside perfectionist anxiety that results in procrastination), and in some cases they can’t, at least on an individual level (disabilities often stubbornly remain disabling, and societal problems require societal solutions).
This matters for our mental health in areas well beyond the labor marketplace, of course, and these ideas extend to personal projects and even personal relationships. Whatever it is, if it’s leaving you exhausted, then probably something needs to be changed (even if the something is just “expectations”).
The book does offer practical solutions to all manner of such situations, improving what can be improved, making easier what can be made easier, and accepting what just needs to be accepted.
The style of this book is casual yet insightful and deep, easy-reading yet with all the acumen of an accomplished social psychologist.
Bottom line: if life leaves you exhausted, this book can be the antidote and cure
Click here to check out Laziness Does Not Exist, and break free!
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An Underrated Tool Against Alzheimer’s
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Dementia in general, and Alzheimer’s in particular, affects a lot of people, and probably even more than the stats show, because some (estimated to be: about half) will go undiagnosed and thus unreported:
Alzheimer’s: The Bad News And The Good
At 10almonds, we often talk about brain health, whether from a nutrition standpoint or other lifestyle factors. For nutrition, by the way, check out:
Today we’ll be looking at some new science for an underrated tool:
Bilingualism as protective factor
It’s well-known that bilingualism offers brain benefits, but most people would be hard-pressed to name what, specifically, those brain benefits are.
As doctors Kristina Coulter and Natalie Phillips found in a recent study, one of the measurable benefits may be a defense against generalized (i.e. not necessarily language-related) memory loss Alzheimer’s disease.
Specifically,
❝We used surface-based morphometry methods to measure cortical thickness and volume of language-related and AD-related brain regions. We did not observe evidence of brain reserve in language-related regions.
However, reduced hippocampal volume was observed for monolingual, but not bilingual, older adults with AD. Thus, bilingualism is hypothesized to contribute to reserve in the form of brain maintenance in the context of AD.❞
Read in full: Bilinguals show evidence of brain maintenance in Alzheimer’s disease
This is important, because while language is processed in various parts of the brain beyond the scope of this article, the hippocampi* are where memory is stored.
*usually mentioned in the singular as “hippocampus”, but you have one on each side, unless some terrible accident or incident befell you.
What this means in practical terms: these results suggest that being bilingual means we will retain more of our capacity for memory, even if we get Alzheimer’s disease, than people who are monolingual.
Furthermore, while we’re talking practicality:
❝…our subsample may be characterized as mostly late bilinguals (i.e., learning an L2 after age 5), having moderate self-reported L2 ability, and relatively few participants reporting daily L2 use (33 out of 119)❞
(L2 = second language)
This is important, because it means you don’t have to have grown up speaking multiple languages, you don’t even have to speak it well, and you don’t have to be using your second language(s) on a daily basis, to enjoy benefits. Merely having them in your head appears to be sufficient to trigger the brain to go “oh, we need to boost and maintain the hippocampal volume”.
We would hypothesize that using second language(s) regularly and/or speaking second language(s) well offers additional protection, and the data would support this if it weren’t for the fact that the sample sizes for daily and high-level speakers are a bit small to draw conclusions.
But the important part is: simply knowing another language, including if you literally just learned it later in life, is already protective of hippocampal volume in the context of Alzheimer’s disease.
Here’s a pop-science article about the study, that goes into it in more detail than we have room to here:
Bilingualism linked to greater brain resilience in older adults
Want to learn a new language?
Here are some options where you can get going right away:
If you are thinking “sounds good, but learning a language is too much work”, then that is why we included that third option there. It’s specifically for one language, and that language is Esperanto, arguably the world’s easiest language and specifically designed to be super quick and easy to get good at. Also, it’s free!
Do, kial ne lerni novan lingvon rapide kaj facile? 😉
Want to know more?
For ways to reduce your overall Alzheimer’s risk according to science, check out:
Take care!
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Are Supplements Worth Taking?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝There seems to be a lot of suggestions to take supplements for every thing, from your head to your toes. I know it’s up to the individual but what are the facts or stats to support taking them versus not?❞
Short answer:
- supplementary vitamins and minerals are probably neither needed nor beneficial for most (more on this later) people, with the exception of vitamin D which most people over a certain age need unless they are white and getting a lot of sun.
- other kinds of supplement can be very beneficial or useless, depending on what they are, of course, and also your own personal physiology.
With regard to vitamins and minerals, in most cases they should be covered by a healthy balanced diet, and the bioavailability is usually better from food anyway (bearing in mind, we say vitamin such-and-such, or name an elemental mineral, but there are usually multiple, often many, forms of each—and supplements will usually use whatever is cheapest to produce and most chemically stable).
However! It is also quite common for food to be grown in whatever way is cheapest and produces the greatest visible yield, rather than for micronutrient coverage.
This goes for most if not all plants, and it goes extra for animals (because of the greater costs and inefficiencies involved in rearing animals).
We wrote about this a while back in a mythbusting edition of 10almonds, covering:
- Food is less nutritious now than it used to be: True or False?
- Supplements aren’t absorbed properly and thus are a waste of money: True or False?
- We can get everything we need from our diet: True or False?
You can read the answers and explanations, and see the science that we presented, here:
Do We Need Supplements, And Do They Work?
You may be wondering: what was that about “most (more on this later) people”?
Sometimes someone will have a nutrient deficiency that can’t be easily remedied with diet. Often this occurs when their body:
- has trouble absorbing that nutrient, or
- does something inconvenient with it that makes a lot of it unusable when it gets it.
…which is why calcium, iron, vitamin B12, and vitamin D are quite common supplements to get prescribed by doctors after a certain age.
Still, it’s best to try getting things from one’s diet first all of all, of course.
Things we can’t (reasonably) get from food
This is another category entirely. There are many supplements that are convenient forms of things readily found in a lot of food, such as vitamins and minerals, or phytochemicals like quercetin, fisetin, and lycopene (to name just a few of very many).
Then there are things not readily found in food, or at least, not in food that’s readily available in supermarkets.
For example, if you go to your local supermarket and ask where the mimosa is, they’ll try to sell you a cocktail mix instead of the roots, bark, or leaves of a tropical tree. It is also unlikely they’ll stock lion’s mane mushroom, or reishi.
If perchance you do get the chance to acquire fresh lion’s mane mushroom, by the way, give it a try! It’s delicious shallow-fried in a little olive oil with black pepper and garlic.
In short, this last category, the things most of us can’t reasonably get from food without going far out of our way, are the kind of thing whereby supplements actually can be helpful.
And yet, still, not every supplement has evidence to support the claims made by its sellers, so it’s good to do your research beforehand. We do that on Mondays, with our “Research Review Monday” editions, of which you can find in our searchable research review archive ← we also review some drugs that can’t be classified as supplements, but mostly, it’s supplements.
Take care!
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Heart Attack: His & Hers (Be Prepared!)
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The ECG Wearable That Could Cut Down Preventable Heart Attack Deaths
Nearly half of people who have heart attacks don’t realize what’s happening until it’s too late. This device could greatly reduce those preventable deaths:
New wearable ECG device could help prevent heart attacks
At a glance:
- Dry electrodes (no gel) are comfortable, durable, and unlikely to cause skin irritation
- The electrodes, which are less than one tenth the width of a human hair, are highly sensitive to the cardiac signals of the user
- The device can capture ECG signals even when it is fitted hidden out of the way behind a person’s neck
- The electrodes are also hydrophobic, meaning they don’t get wet— even if worn in the shower, swimming pool, etc
- It communicates with a smartphone app by Bluetooth (yes, it has a tiny Bluetooth chip in it)
Read more about the study, the device, the various versions tested, and which version won out as optimal:
Dry electrode geometry optimization for wearable ECG devices
(you can also see pictures of it, if you’re curious!)
In the meantime…
That device isn’t available to the public yet (the study was published literally yesterday), so if you’d like to be ahead of the game with regard to recognizing heart attack signs, read on:
Heart Attack: His & Hers (Be Prepared!)
Heart attack symptoms vary by sex. This is governed by hormones, so if you are for example a postmenopausal woman and not on HRT, your symptoms might be nearer that of men.
The following symptom list is intended as a rough “most likely” guide. You may not get all of the symptoms you “should”. You could get symptoms from the “wrong” category. So don’t sweat the minutiae, but do be aware of…
Symptoms for everyone:
- Jaw, neck, and/or back pain
- Nausea and/or vomiting
- Shortness of breath
Additional symptoms (mostly) just for men:
- Pressure and/or pain in the upper chest
- Discomfort and/or tingling in the arms
- Sudden cold sweat
Additional symptoms (mostly) just for women:
- Pressure and/or pain in the lower chest and/or abdomen
- Feeling of fullness and/or indigestion
- Fatigue, dizziness, possibly fainting
In the event of experiencing symptoms…
Call 911 or your local equivalent.This is not the time to wait to see if it goes away by itself. If unsure, call. Better safe than sorry/dead.
If you are not alone, or if it is someone with you who is having the suspected heart attack, it may be quicker to go to the Emergency Room by car, than wait for an ambulance.
Even if you choose to do that, you should still call 911 anyway, as the responder will be able to instruct you in real-time, not something we can do in a newsletter.
Note that if available, this means three people in the car is ideal:
Driver, patient, and third person on the phone giving information and following instructions.
Emergency situations rarely go entirely by-the-book, but with a little foreknowledge and at least one person with a calm head, preventable deaths can be avoided.
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Unlock Your Air-Fryer’s Potential!
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Unlock Your Air-Fryer’s Potential!
You know what they say:
“you get out of it what you put in”
…and in the case of an air-fryer, that’s very true!
More seriously:
A lot of people buy an air fryer for its health benefits and convenience, make fries a couple of times, and then mostly let it gather dust. But for those who want to unlock its potential, there’s plenty more it can do!
Let’s go over the basics first…
Isn’t it just a tiny convection oven?
Mechanically, yes. But the reason that it can be used to “air-fry” food rather than merely bake or roast the food is because of its tiny size allowing for much more rapid cooking at high temperatures.
On which note… If you’re shopping for an air-fryer:
- First of all, congratulations! You’re going to love it.
- Secondly: bigger is not better. If you go over more than about 4 liters capacity, then you don’t have an air-fryer; you have a convection oven. Which is great and all, but probably not what you wanted.
Are there health benefits beyond using less oil?
It also creates much less acrylamide than deep-frying starchy foods does. The jury is out on the health risks of acrylamide, but we can say with confidence: it’s not exactly a health food.
I tried it, but the food doesn’t cook or just burns!
The usual reason for this is either over-packing the fryer compartment (air needs to be able to circulate!), or not coating the contents in oil. The oil only needs to be a super-thin layer, but it does need to be there, or else again, you’re just baking things.
Two ways to get a super thin layer of oil on your food:
- (works for anything you can air-fry) spray the food with oil. You can buy spray-on oils at the grocery store (Fry-light and similar brands are great), or put oil in little spray bottle (of the kind that you might buy for haircare) yourself.
- (works with anything that can be shaken vigorously without harming it, e.g. root vegetables) chop the food, and put it in a tub (or a pan with a lid) with about a tablespoon of olive oil. Don’t worry if that looks like it’s not nearly enough—it will be! Now’s a great time to add your seasonings* too, by the way. Put the lid on, and holding the lid firmly in place, shake the tub/pan/whatever vigorously. Open it, and you’ll find the oil has now distributed itself into a very thin layer all over the food.
*About those seasonings…
Obviously not everything will go with everything, but some very healthful seasonings to consider adding are:
- Garlic minced/granules/powder (great for the heart and immune health)
- Black pepper (boosts absorption of other nutrients, and provides more benefits of its own than we can list here)
- Turmeric (slows aging and has anti-cancer properties)
- Cinnamon (great for the heart and has anti-inflammatory properties)
Garlic and black pepper can go with almost anything (and in this writer’s house, they usually do!)
Turmeric has a sweet nutty taste, and will add its color anything it touches. So if you want beautiful golden fries, perfect! If you don’t want yellow eggplant, maybe skip it.
Cinnamon is, of course, great as part of breakfast and dessert dishes
On which note, things most people don’t think of air-frying:
- Breakfast frittata—the healthy way!
- Omelets—no more accidental scrambled egg and you don’t have to babysit it! Just take out the tray that things normally sit on, and build it directly onto the (spray-oiled) bottom of the air-fryer pan. If you’re worried it’ll burn: a) it won’t, because the heat is coming from above, not below b) you can always use greaseproof paper or even a small heatproof plate
- French toast—again with no cooking skills required
- Fish cakes—make the patties as normal, spray-oil and lightly bread them
- Cauliflower bites—spray oil or do the pan-jiggle we described; for seasonings, we recommend adding smoked paprika and, if you like heat, your preferred kind of hot pepper! These are delicious, and an amazing healthy snack that feels like junk food.
- Falafel—make the balls as usual, spray-oil (do not jiggle violently; they won’t have the structural integrity for that) and air-fry!
- Calamari (vegan option: onion rings!)—cut the squid (or onions) into rings, and lightly coat in batter and refrigerate for about an hour before air-frying at the highest heat your fryer does. This is critical, because air-fryers don’t like wet things, and if you don’t refrigerate it and then use a high heat, the batter will just drip, and you don’t want that. But with those two tips, it’ll work just great.
Want more ideas?
Check out EatingWell’s 65+ Healthy Air-Fryer Recipes ← the recipes are right there, no need to fight one’s way to them in any fashion!
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52 Ways to Walk – by Annabel Streets
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Most of us learned to walk at a very young age and probably haven’t thought much about it since, except perhaps in a case where some injury made it difficult.
Annabel Streets provides a wonderful guide to not just taking up (or perhaps reclaiming) the joy of walking, but also the science of it in more aspects than most of us have considered:
- The physical mechanics of walking—what’s best?
- Boots or shoes? Barefoot?
- Roads, grass, rougher vegetation… Mud?
- Flora & fauna down to the microbiota that affect us
- How much walking is needed, to be healthy?
- Is there such a thing as too much walking?
- What are the health benefits (or risks) of various kinds of weather?
- Is it better to walk quickly or to walk far?
- What about if we’re carrying some injury?
- What’s going on physiologically when we walk?
- And so much more…
Streets writes with a captivating blend of poetic joie-de-vivre coupled with scientific references.
One moment the book is talking about neuroradiology reports of NO-levels in our blood, the impact of Mycobacterium vaccae, and the studied relationship between daily steps taken and production of oligosaccharide 3′-sialyllactose, and the next it’s all:
“As if the newfound lightness in our limbs has crept into our minds, loosening our everyday cares and constraints…”
And all in all, this book helps remind us that sometimes, science and a sense of wonder can and do (and should!) walk hand-in-hand.
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