On TV, you can drop 30 pounds in a few weeks. In real life and clinical trials, 5-10 pounds over the course of a year is more realistic and actually quite impressive, Christopher Labos writes. Trent Penny / THE CANADIAN PRESS
The other day, over dinner, I got into a debate with some friends about intermittent fasting. Its a new diet strategy where you eat restrictively on some days but then eat freely, almost indulgently, on others. Although many forms of intermittent fasting exist, the most common form Ive seen is whats called alternate day fasting.
With alternate day fasting, you can eat very little on one day (usually one 500 calorie meal at lunch time, or about one-quarterof what a regular diet includes) and then essentially eat to your hearts content on the next day before repeating the two-day cycle.
The idea has an obvious appeal. Dieting is hard because eventually, people find the restrictive nature of most diets impossible to stick with and revert to their old ways. But alternate day fasting seems easier because most people can summon enough will power for one day if they know they can be libertines tomorrow.
The obvious question becomes, does intermittent fasting work? Will it help you lose weight? And perhaps most important, does it outperform a standard diet where you just eat a little bit less every day?
That question was answered recently in a study published in JAMA Internal Medicine. Researchers took 100 obese adults and divided them into threegroups. The first group was told to continue their regular habits. The second intermittent fasting group ate a single 500-calorie meal on fasting days while on feasting days they could eat up to 25per cent more than they usually did. The third group was told to follow a conventional diet where they simply ate less every day.
The results were a surprise to the researchers. There was no difference between intermittent fasting and conventional diets. Both groups did equally well. Or if you are a nihilist, both groups did equally badly. At sixmonths, both groups had lost just under sevenpounds. By one year, the number had slipped back to about sixpounds.
These numbers probably dont seem that impressive. On TV, you can drop 30 pounds in a few weeks. In real life and clinical trials, 5-10 pounds over the course of a year is more realistic and actually quite impressive.
But intermittent fasting proved to be a disappointment in this trial. It did not outperform its conventional counterpart. In terms of weight loss, visceral fat, blood pressure, blood sugar, insulin levels and inflammatory markers, there was no difference between intermittent fast and simply eating a little less on a daily basis. In fact the intermittent fasting group had slightly higher cholesterol levels at oneyear, although the difference was minimal.
Here, intermittent fasting underperformed because rather than being easier to stick with, it ended up being harder. More people abandoned the intermittent fast (38per cent vs. 29per cent) and ended up switching to conventional diets.
In the end, intermittent fasting is not better than a standard diet. It wont help you lose more weight and it wont make you any healthier. Though to be fair, its not much worse, either. And contrary to the hype, it actually seems to be harder to stick with long term, not easier.
Im sure some people will swear by intermittent fasting and say that it works for them. The point here though is not that one diet is better than other. Its that dietswork only if they get you to eat less. Eating less is really the only way you can lose weight (although regular exercise certainly wont hurt). How you do it isnt really as important as whether you do it. Fad diets fail because they are unsustainable and people abandon them. So when Im asked whats the best type of diet, the answer is clear. The best diet is the one you can stick with.
Christopher Labos is a Montreal doctor who writes about medicine and health issues.
Christopher.labos@mail.mcgill.ca
twitter.com/drlabos
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Opinion: Alternate-day fasting vs. a classic weight loss diet - Montreal Gazette
