Re: Calorie Counting
Assuming lack of formal experimental evidence either way, can you think of any credible theoretical reason why targeted fasting would be a good strategy?
I assume you mean good strategy as in weight loss strategy. I think the data is quite limited in that aspect which is why I would not make that argument in the literature or to colleague without further study, especially clinically. I make a clear and specific distinction between things I actively recommend (FDA approved medication for its intended use, Mediterranean diet for stroke prevention) vs things there is no convincing evidence for but is likely safe in the right setting (where I think intermittent fasting in falls in). With few exceptions, I do not bring up the latter when talking to patients unless specifically asked.
This review is an OK collection of some of the studies. There is a huge problem of validity and reproducibility in the diet/nutrition literature so all of this has to be taken with a grain of salt. To answer your question, they propose that intermittent fasting
may lead to decreased caloric intake overall, although personally I have not been convinced with the data as of yet. There is also a paucity of long term data as previously mentioned by Deutsche Gopher Fan.
https://www.annualreviews.org/doi/f...id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed
I started to "accidentally" fast during the first year of residency. On an average day, I would get to work at 6 or 7, drink coffee, and work basically non-stop until I would leave around 7 or 8PM. I would have one large meal at home and go to sleep. Rinse and repeat. I ended up losing around 30 lbs which was nice and felt OK. I looked into the data at that time to make sure I wasn't actively hurting myself and now continue to do it basically when I feel like it. If I feel my thinking is slow or have other symptoms, I eat. I would not use this as evidence for anything. As most people have mentioned, you kind of have to find what works for you.
Fasting is not my hill to die on. One well designed study could change my entire opinion on it.
Could fasting have a similar effect, exploiting a "market inefficiency" in how the body deals with lack of energy?
In a way, yes. You are probably more likely to go into brief ketosis depending on your meal choice and duration of fast. That, however, is quite the can of worms and will probably bring out some diet cultists
My experience with the ketogenic diet is mostly limited to epilepsy treatment. In those cases, I work closely with a dietician. Ketosis can be quite miserable, especially at the beginning.
I have a loose, quasi-crackpot opinion that processed foods create fats that are very hard to break down whereas natural foods create easy to break down fats.
There are too many loaded words in this for me to comment in the exact spirit of the statement
Chemically, fats are fats, carbs are carbs (yes there are differences within those categories). "Processed foods" as a whole are just more likely to have higher salt content, higher simple carb content, and less fruit/vegetable content. They are not, by themselves, "unhealthy" but will change the proportion of fats/carbs that you get compared other foods. You lose control over their content, whereas if you cook every meal yourself you know what is going into it and have more control. We can say a lot of bull**** from an evolutionary standpoint, but one truth I will stand by is we evolved to be efficient in processing and storing our calories.
"Natural" is a word that comes close to rupturing an aneurysm for me. It is about as meaningless, individually defined, and inconsistent word that is put out there in health care discussions.
Any MDs or nutritionists out there want to take a swing at what the actual science is?
Remember...a nutritionist is just someone who wants to call themselves a nutritionist
There is a reason that a thread like this can have everyone come in telling a different thing that works. They probably all do.
If you take the "Standard American Diet" and put it up against nearly any diet (especially ones that are restrictive in some way like Atkins, Mediterranean, gluten free, etc), the latter will likely show weight loss. There are hundreds of studies showing this which is why you can find support for whatever pet diet you have.
