Fast Forward: Is Fasting Good for Health?

Madhavankutty Pillai has no specialisations whatsoever. He is among the last of the generalists. And also Open chief of bureau, Mumbai  
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Intermittent fasting finds takers in India as a fitness regimen

AFTER HER SON was born three-and-a-half years ago, Smita Hirlekar, a yoga teacher from Mumbai, realised that she had some weight to lose. Always in the range of 55 kg, the scales now tipped at 70 for her. Hirlekar, who is 38 now, started on a disciplined yoga and workout regimen and managed to get down to 55 again. The fat around the stomach, however, remained recalcitrant despite the crunches and lunges. She knew it was an issue that all women faced post pregnancy, but that was little consolation. Last year, she went on a keto diet that reduced carbohydrate consumption to a bare minimum. After two months, she also started doing Intermittent Fasting, a regimen that tweaks the hours of eating to small periods.

She began by having her last meal at 8 pm and trying to push breakfast as late as possible, at least until 10 am. This she did for the first four or five days. Then it became easier. She started fasting for 16 hours and had two meals in an eight-hour window. Soon she found her hunger diminishing so much that even this wasn’t needed. Hirlekar then pushed it to one meal a day, with the fasting hours going from 16 to at least 20 hours. She would puree green vegetables, add a large tablespoon of ghee to it and take that, besides eggs or a little bit of fish and maybe a cube of cheese. Hirlekar thinks it wouldn’t have been more than 600 to 800 calories that she was consuming daily.

And yet, instead of being famished and tired, she had never felt stronger. Her flat abdomen was back in no time. Earlier, she couldn’t lug a 20-litre Bisleri jar to her kitchen platform and now it was easily done. Her clothes started to loosen and she had to alter or buy new ones even though her weight hadn’t dropped much after a point. “I am about one to two kilos less, but my muscle tone and strength has increased. Fat loss has happened, but there is no muscle loss,” she says.

In addition, she noticed changes in her mental make-up. There was a drastic uptake in energy levels. Her sleep cycle and general mood became better. In the last week of January, Hirlekar decided to do a three-day fast, drinking only water. By the end of the 30th hour, she felt a craving for food, but it only lasted an hour or two. Once that was overcome, she sailed along. Whenever she felt a little nauseous, she would drink water with a little lime and pink Himalayan salt added to it. Towards the end of the third day, Hirlekar went to visit her mother, who took a look and asked why her complexion was so fair. “My skin had become much clearer,” she says.

Much of what Hirlekar experienced is de rigueur in Intermittent Fasting, a fitness trend that is widely prevalent in the West and is now seeing a number of adherents in India. In Silicon Valley, they call it ‘biohacking’, manipulating the body into a state where it starts releasing beneficial hormones, leading to health and energy. A Guardian article reported that as many as 20 CEOs of tech companies there were following this diet. In Canada, Dr Jason Fung, a nephrologist who is one of the leading proponents of fasting, has successfully treated and reversed conditions like Type 2 diabetes and Polycystic Ovarian Syndrome by making patients go on extended fasts under careful monitoring. In The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate- Day, and Extended, published last year, he listed the benefits of fasting, noting that it ‘improves mental clarity and concentration, induces weight and body fat loss, lowers blood sugar levels, improves insulin sensitivity, increases energy, improves fat-burning, lowers blood cholesterol, prevents Alzheimer’s disease, extends life, reverses the aging process, decreases inflammation’.

Bengaluru-based 33-year-old Prashanth HN saw first-hand one of these effects last year. After almost a decade, he had decided to get back into an active lifestyle mode. In about six months, he had clocked 3,000 km cycling, but when he went to take an insurance policy from LIC, the results of the mandatory physical check-up showed that a marker of heart health, triglycerides, was in the 850 region whereas the normal count was under 150. LIC refused to give him a policy. This came as a shock to him. The usual treatment to bring down triglycerides is a medicine called a statin, but he didn’t want to be dependent on it. “Being active did not help and that is when I started digging more about Intermittent Fasting,” he says. “I realised it is actually the diet that makes a massive amount of difference than the activities you do.”

He started on a 16-hour daily fasting routine. He would have his first meal around 1 pm and the last by 8 pm. He had always been a heavy breakfast person, and in the initial days, felt a little weak. But by the end of a week, he was fine. A month-and-a-half later, when he checked his triglyceride level, it had come down to 700 without any medication. “Even the doctors said it was a good improvement,” he says.

INTERMITTENT FASTING WORKS mainly on two hormones. One is insulin, levels of which fall while fasting. As Dr Fung writes in his book, ‘Regularly lowering insulin levels leads to improved insulin sensitivity—your body becomes more responsive to insulin. The opposite of insulin sensitivity, high insulin resistance, is the root problem in type 2 diabetes and has also been linked to a number of diseases, including: Heart disease, Stroke, Alzheimer’s disease, High cholesterol, High blood pressure, Abdominal obesity, Nonalcoholic Steatohepatitis (fatty liver disease), Polycystic Ovary Syndrome, Gout.’

“Intermittent fasting helps in increasing the speed of weight loss when you are already doing exercise and following a good diet” - Samarth Kagdiyal fasting practitioner

Fasting has the opposite effect on a second hormone. It spikes the Human Growth Hormone, which can slow down ageing. Dr Fung writes, ‘Many of the effects of aging may result from low growth hormone levels. Replacing growth hormone in older people with low levels has significant anti-aging benefits… Meals very effectively suppress the secretion of growth hormone, so if we’re eating three meals per day, we get effectively no growth hormone during the day. Worse, overeating suppresses growth hormone levels by as much as 80 percent. The most potent natural stimulus to growth hormone secretion is fasting. In one study, over a five-day fasting period, growth hormone secretion more than doubled… A study of a religious forty-day fast found that baseline growth hormone levels increased from 0.73 ng/mL to peak at 9.86 ng/mL. That is a 1,250 percent increase in growth hormone, all done without drugs. And a 1992 study showed a fivefold increase in growth hormone in response to a two-day fast.’ A key benefit of fasting is also the triggering of a process called ‘autophagy’, in which damaged cells are repaired so that the body renews itself.

AN ADVANTAGE INTERMITTENT Fasting has over diets is in flexibility—you can choose how you want to fast based on some broad parameters. One thumb rule is that the minimum number of hours to fast in a day must be at least 16 and this must be in one stretch. Beyond that, it is mostly your choice when and what to eat, so long as it is within reasonable limits.

Many fast for a specific number of hours in a day, others space it out over the week. Like Bengaluru-based 41-year-old food writer Nandita Iyer, who started doing Intermittent Fasting five years ago. She began with a 16-hour daily fast, but found that it didn’t suit her. So she began to fast for two days in a week, something known as the 5:2 diet. On fasting days, she would eat below 500 calories, which is permitted.

Iyer had never fasted before, but found it agreeable. Her career revolved around food and it was a welcome break to not eat two days every week. The rewards were also disproportionate to effort. “Assuming a person consumes 2,000 calories a day, you cut it down to 500 on two days, which means you have saved 3,000 calories. To lose half a kilo you need to lose 3,500 calories somehow. It is pretty much impossible for a working person to lose 3,500 calories in two days by running or something, unless you run like two marathons. It is much easier to do it via food,” she says.

A few strategies helped Iyer stick to the routine. “Choose your busy days to fast, not a day when you are sitting at home or a Sunday when you expect someone to come or you go out somewhere. And then just ride that hunger wave. It is actually fun to experience hunger. Hunger is just a wave. Once you drink water, divert your mind or go to the gym, you forget about it,” she says.

The days Iyer fasted were Mondays and Thursdays, which the 5:2 fasting community often follows. “Monday, because after a weekend binge, we could all do with a fast. Thursday is also a more convenient date because on Friday again you may have some social commitment and you need like a two-day gap,” she says. About a month after starting, she began to notice salutary changes. “I used to work out to the point of exhaustion and see absolutely no results. And this gave me more results without much effort,” she says.

Two years ago, Samarth Kagdiyal, a 27-year-old working in a Gurugram startup, got fed up with his friends jibing him about his weight with questions like, ‘Are you pregnant?’ Ideally, he should have been 70 kg, but was now 90. Through exercise and diet, Samarth lost 10 kg in two months, but then it wouldn’t come down further. While looking up the internet, he came across Intermittent Fasting and was sceptical because all his life he had been taught to eat three to four times every day and that breakfast was the most important meal. But he decided to try it anyway.

He started having his first meal at 6 or 7 in the evening after returning from work. He would have two more meals up to midnight and then fast until the next evening. He lost 10 kg in one month, which was about double the speed of his earlier weight loss. There were other effects too. His time in office was during the fasting window and he noticed that he was more productive with higher energy levels

Kagdiyal says that for quick results, Intermittent Fasting should be approached as a catalyst over and above a regular fitness regimen. “It helps in increasing the speed of weight loss when you are already doing exercise and following a good diet,” he says.

The prevailing theory for the body’s response to Intermittent Fasting takes it back to mankind’s hunter gatherer times. “You couldn’t go to a supermarket or order food on Zomato. You had to go hunt and it was never predictable when you will find your next food. There used to be considerable periods of fasting,” says Iyer. The longer people stayed without food, the more alert they needed to be to hunt or not get killed as prey. The body thus optimised itself under those conditions. As Michael Mosley, a leading proponent of the 5:2 diet, writes in his book, The Fast Diet, ‘We evolved at a time when food was scarce; we are the product of millennia of feast and famine. The reason we respond so well to intermittent fasting is that it mimics, far more accurately than three meals a day, the environment in which modern humans were shaped.’