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Intermittent fasting: understand if it works in cases of obesity

Intermittent fasting: understand if it works in cases of obesity

Eating fewer times throughout the day helps you lose weight . That phrase seems obvious, does not it? The so-called intermittent fast, a practice in which one or more of a meal of the day is omitted, the practitioner staying for up to 24 hours without food, has gained more and more adepts in Brazil in the wake of the Paleolithic diet fever and also because some celebrities have declared themselves publicly enthusiastic about the method.

To do this, I will echo the position of the American Heart Association (AHA, American Heart Association

), published in February > Circulation , about the relationship between intermittent fasting and obesity. When analyzing this topic it is important not to stick to the question of body weight. After all, by manipulating the number of meals on their day and time, a number of metabolic effects - beneficial or otherwise - can also be produced that need to be taken into account. Examples of this would be changes in blood glucose (blood sugar), cholesterol, and hormonal parameters. That said, we are going to summarize the key points of the AHA positioning that relate to intermittent fasting. Are there studies on the application of intermittent fasting for people with obesity?

It is not today that the practice of fasting is used for the purpose of producing weight loss. This has long been the so-called "spas". When staying at a spa, some patients undergo periods of fasting with a focus on weight loss.

Furthermore, in some religions, periodic fasting has been a common practice for centuries. In this sense, studies done with people who declared themselves to be fasting for religious reasons found a lower risk of developing diabetes mellitus as well as cardiovascular disease. However, such studies are observational in nature, ie of lower scientific quality.

These studies are unable to adjust the groups that were compared (patients who had fasted intermittently versus patients who did not) for factors such as: physical activity level, age and smoking - admittedly related to the risk of diabetes and cardiovascular disease. Some studies, such as the "Malmo Diet and Cancer Study", which have been published in the Journal of the American Medical Association, with 1,355 men and 1,654 women, showed that in men the risk of obesity was 2.42 times higher in those who ate 3 meals or less per day compared to those who ate 6 or more meals a day. Strange, is not it? Those who ate fewer meals a day had a greater risk of obesity.

Did these individuals eat fewer meals a day, but a higher calorie amount after all? This information can not be obtained from these studies. Another question: why only in men this relationship was seen? Was there any gender influence on this issue? We do not know either.

This shows how much of this issue still has many edges to trim. It shows how complicated the subject is. It seems simple, but it is not.

Regarding intervention studies, ie, better designed studies than so-called observational studies, two types of intermittent fasting were analyzed:

Fasting on alternate days

: which consists of eating at most 25% of daily calorie needs in one day (on the day of "fasting") followed by a day at which you can eat at ease for 24 hours Periodic fast

: characterized by fasting for 1 to 2 days in the week while eating normally in the other 5 to 6 days of the week.

  • When comparing one method with another, we observed that fasting on alternate days produces a more pronounced weight loss . However, both methods were able to reduce body weight. One can say that one loses on average 0.75 kg per week with fasting on alternate days while only 0.25 kg per week with periodic fasting. Being weight loss, in periodic fasting, obviously directly related to the number of days of fasting in the week.
  • Benefits of intermittent fasting Other benefits of intermittent fasting were:

Consistent reduction in triglyceride levels, ranging from 16 to 42%. The better the greater the weight loss obtained A decrease in systolic (maximal) and diastolic (minimum) blood pressure, ranging from 3 to 8% and 6 to 10%, respectively. This benefit was only found in studies that achieved a loss of at least 6% of initial body weight Improvement in insulin resistance, ie intermittent fasting

was able to improve the action of insulin in the body of practitioners

. On the other hand, it is worth mentioning that there was no benefit in HDL cholesterol levels (good cholesterol), and the results in terms of total cholesterol, LDL and glycemia were very variable.

  • There were studies that showed benefits while others did not , we can conclude that there are still shortcomings in the available evidence. The existing studies do not present in the majority a control group, that is, a group of patients that have done the treatment by default. In addition, the maximum duration of these works was 52 weeks (about 1 year). What happens after a longer period of observation? Or, what happens after five or even ten years of intermittent fasting? Would there be any harm in prolonging the practice of fasting?
  • Despite all the benefits described, we do not want this article to appear as a stimulus for people to fast intermittently
  • . We believe that diets that stimulate extreme behaviors, which can hardly be maintained in the long term, as well as fads or therapies disclosed as panacea, should be discouraged. The conventional method, ie a balanced diet prescribed by a nutritionist, associated with a regular physical exercise program led by a physical education teacher. Always having the endocrinologist as the center of health actions and head of the multiprofessional team. On the other hand, we believe that continuing to study this interesting subject is of paramount importance. More studies, well designed and with long-term follow-up are very welcome, they can help us better understand the subject and draw lessons that can be applied in the treatment of obesity.


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