Fasting 101 - Eatrightmississippi

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4/18/2019Fasting 101Kristin Kirkpatrick, MS, RDNNutrition in theNewsHarvard Takeson FatDavid S. Ludwig, Walter C. Willett, Jeff S. Volek, Marian L. Neuhouser. Dietary fat: From foe tofriend? Science, 2018; 362 (6416): 7641

4/18/2019Fried foods kill2

4/18/2019One or more servings of fried chicken a daywas linked to a 13% higher risk of deathfrom any cause and a 12% higher risk ofheart-related death compared with no friedfood.Similarly, one or more servings of friedfish/shellfish a day was linked to a 7%higher risk of death from any cause and a13% higher risk of heart-related deathcompared with no fried food.FastingMimickingDiet andInflammationPriya Rangan, Inyoung Choi, Min Wei, Gerardo Navarrete, Esra Guen, Sebastian Brandhorst, Nobel Enyati, GabPasia, Daral Maesincee, Vanessa Ocon, Maya Abdulridha, Valter D. Longo. Fasting-Mimicking Diet ModulatesMicrobiota and Promotes Intestinal Regeneration to Reduce Inflammatory Bowel Disease Pathology. CellReports, 2019; 26 (10): 2704A clinical trialshows reductionof inflammationin humans and inmice, the dietappears toreverse Crohn'sand colitispathology FMD cycles partially reverseIBD-related pathologycompared to water-onlyfasting FMD cycles promote theexpansion ofLactobacillaceae andBifidobacteriaceae FMD cycles reduce intestinalinflammatory and immuneand increase regenerativemarkers FMD cycles can reducesystemic inflammation andconsequent leukocytosis inhumans3

4/18/2019Food andMood:supplementsnot the sameas foodMooDFOODprevention trial(the largestrandomized clinicaltrial to study theeffects of nutritionalstrategies on theprevention of majordepressive disorder).Food behavioral therapyonly works if theparticipants get sufficientexposure and are able tosufficiently improve theirdiet and dietary behavior.In a largeobservationalstudy, womenwho reporteddrinking morethan one dietsoda or otherartificiallysweetened drinka day had ahigher risk ofstrokes caused bya blood clot.Artificially Sweetened Beverages and Stroke, Coronary Heart Disease, and All-Cause Mortalityin the Women’s Health Initiative. Stroke, 20194

4/18/2019Emmanuel Stamatakis, Nathan A Johnson, Lauren Powell, Mark Hamer, Vegar Rangul, Andreas Holtermann. Short and sporadic bouts in the 2018 US physicalactivity guidelines: is high-intensity incidental physical activity the new HIIT?British Journal of Sports Medicine, 2019; bjsports-2018-100397High IntensityIncidentalPhysicalActivity (HIIPA)Prevalence of Self-Reported Obesity Among U.S. Adultsby State and Territory, BRFSS, 2016The CurrentState of theNationSource: Behavioral Risk Factor Surveillance System5

4/18/2019Aging well isdependent onlifestylechoices 1. Something thatcomes from nature2. Was fed fromnature3. Will eventually rot-Michael PollanFoodNot Food6

4/18/2019FoodNot FoodFASTING 101Calorierestriction letsmonkeys livelong andprosper7

4/18/2019One-Third of Consumers Follow a Specific Eating PatternA higher number of younger consumers (18 to 34) followed a specific eating pattern/dietThe International Food Information Council (IFIC) Foundation’s222018 Food and Health SurveyAll fasting has benefits“There is considerablesimilarity between howcells respond to the stressof exercise and how cellsrespond to intermittentfasting”– Mark Mattson(Collier, 2013)Longo VD, Mattson MP. Fasting: Molecular Mechanisms and Clinical Applications. Cell metabolism.2014;19(2):181-192. doi:10.1016/j.cmet.2013.12.008.1173 2000 - commons.wikimedia.orgSteady Streamof Sugar andRefined CarbsAlso Contributeto Disease8

4/18/2019Our culture is oneof overeating,obesity, diseaseand increasedmortalityThe most recentNHANES statisticsshow that almost40% of Americansare obese and over70% of Americans areoverweightThe Western dietarypattern acceleratesaging pathways(US Census National Population Projections 2012CDC, National Center for Health Statistics, National Health Interview Survey2010CDC, National Center for Chronic Disease Prevention & Health Promotion 2012)A History ofFasting9

4/18/2019 Absence of food for a specificperiod of timeWhat isFasting? Comparison of Fasting andstarvation What is a Biologic FastFasting is theForgottenBalance forLivingHealthier,Longer“the body has everything in it to fix itself.Due to the rejuvenation and regenerationaspects of fasting, it is clear that a fastingregimen, and especially a fastingmimicking diet can help to prolong lifeand “fix” the body.”-Valter Longo, PhD, one of the world’s preeminent fastingand longevity experts and TIME Magazines 50 MostInfluential People in Health Care of 2018How diet leads torapid acceleration ofaging10

4/18/2019Food andAgingExcess protein,especially animalprotein associatedwith an increase inmortalityProtein andIGF-1Protein intake and mortality High animal protein intake positivelyassociated with mortality High plant protein intake was inverselyassociated with mortality Substitution of plant protein for animalprotein, especially from processed redmeat, was associated with lowermortalitySong M, Fung TT, Hu FB, et al. Association of Animal andPlant Protein Intake With All-Cause and Cause-SpecificMortality. JAMA Intern Med. .2016.418211

4/18/2019Types offastingTypes of Fasting Time Restricted Feeding (TRF) A type of intermittent fasting,refers to studies in mice Time Restricted Eating (TRE) A type of intermittent fasting,refers to studies in humans Intermittent Fasting (IF) Fasting for 24 hours but less than2 days Short Term Fast (ST) 2-3 consecutive days Alternate Day Fasting (ADA): Fasting every other day Prolonged Fasting Fasting for 4 days or longer Fasting Mimicking Diet (FMD) Mimics prolonged Fasting, done withfood and supplementsTime restricted eatingSutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CM. Early Time-Restricted Feeding Improves InsulinSensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. CellMetabolism. 2018;27(6):212-221. doi:10.1016/j.cmet.2018.04.01012

4/18/2019Time restricted eatingChaix A, Zarrinpar A, Miu P, Panda S. Time-restricted feeding is a preventative and therapeutic interventionagainst diverse nutritional challenges. Cell metabolism. 2014;20(6):991-1005. doi:10.1016/j.cmet.2014.11.001.Time restricted eatingJeff Rothschild, Kristin K Hoddy, Pera Jambazian, Krista A Varady; Time-restricted feeding and risk of metabolicdisease: a review of human and animal studies, Nutrition Reviews, Volume 72, Issue 5, 1 May 2014, Pages 308–318, https://doi.org/10.1111/nure.12104Time restricted eating: impact on skipping breakfastSkipping breakfast isassociated with increasing riskof mortality from circulatorydiseases and all causes amongmen and all causes mortalityamong women in JapanYokoyama Y, Onishi K, Hosoda T, et al. Skipping Breakfast and Risk of Mortality from Cancer, CirculatoryDiseases and All Causes: Findings from the Japan Collaborative Cohort Study. Yonago Acta Medica. 2016;59(1):5560.13

4/18/2019Delayingbreakfast by90 minutes /eating dinner30 minutesearly led toloss of fatTimedrestrictedeating: gutmicrobialdiversityKaczmarek JL, Thompson SV, Holscher HD. Complex interactions of circadian rhythms, eating behaviors, and thegastrointestinal microbiota and their potential impact on health. Nutrition Reviews. mittent Fasting Alternate Day Fasting or the “5:2” diet is an example Most clinical trials comparing 60-70% of kcal restriction on alternative days or 2consecutive days To be followed continuously week after weekHealth effects of IF:3 weeks of alternate-day fasting has been shown to reduce: body weight, body fat, and plasma insulin concentrations 2 days / week of 500 calories has been shown to improve insulin sensitivity May lowers abdominal fat and blood pressure(Heilbronn et al.,2005; Harvie et(Rothschschildet.al.,al; 2010)2014)14

4/18/2019Intermittentfasting:performanceMarosi K 1, Moehl K1, Navas-Enamorado I2, Mitchell SJ3, Zhang Y4, Lehrmann E4, Aon MA5, Cortassa S5, BeckerKG4, Mattson MP1. Metabolic and molecular framework for the enhancement of endurance by intermittent fooddeprivation. FASEB J. 2018 Jul;32(7):3844-3858. doi: 10.1096/fj.201701378RRIntermittent fasting:cardiac benefitsFasting may be associated with lowerprevalence of cardiovascular diseaseand and diabetes diagnosisIntermittent fasting may improvehealth; however, substantial additionalclinical research is needed beforeadvocating its use for health purposes.Benjamin D Horne, Joseph B Muhlestein, Jeffrey L Anderson; Health effects of intermittent fasting: hormesis orharm? A systematic review, The American Journal of Clinical Nutrition, Volume 102, Issue 2, 1 August 2015, Pages464–470, https://doi.org/10.3945/ajcn.115.109553Prolonged fasting:anti-inflammatorybenefitsYoum Y-H, Nguyen KY, Grant RW, et al. Ketone body β-hydroxybutyrate blocks the NLRP3 inflammasomemediated inflammatory disease. Nature medicine. 2015;21(3):263-269. doi:10.1038/nm.3804.15

4/18/2019Prolonged fastingand cancerStudy Suggests thatmultiple cycles of fastingmay promote differentialstress sensitization andcould potentially replaceor augment the efficacyof certain chemotherapydrugs in the treatment ofvarious cancersLee C, Raffaghello L, Longo VD. Starvation, detoxification, and multidrug resistance in cancer therapy. Drugresistance updates : reviews and commentaries in antimicrobial and anticancer chemotherapy. 4.Fasting Mimicking Diets (FMDs) FMDs are a form of periodic prolonged fasting that combine very specific ratios ofProtein Restriction, Mild Calorie Restriction, and Low-Glycemic Index Ingredients This combination downregulates the body’s nutrient-sensing pathways(mTOR/PKA/PKB), while stimulating anti-aging pathways to promote cellularregeneration & rejuvenation FMDs mimic the beneficial effects of fasting without the challenges Benefits of fasting mimicking diet (FMD) will be covered in section 2Induced stress onto the cell stem cell regeneration/rejuvenation autophagyComparison of Dietary RegimensCategoryWesternCaloric RestrictionAnimalProteinPlant ohydratesHighLowHighLowHighLowLow/Normal Low/Normal Low/Normal Low/Normal Low/Normal Low/NormalNormalLow ModerateLowHighModerateFasting MimickingDietNoneLowVery LowHighVery LowHighProtein neanHigh16

4/18/2019Impact on Health FactorsCategoryWeightLossLean coseRejuvenation &RegenerationCalorie Restriction Intermittent Fasting Time-Restricted Feeding Periodic Fasting Fasting Mimicking Diet Water only fast limit all food andDrink except water. Usually done overThe course of 24 hours or more, thisFast is difficult to sustain and requiresWater OnlyFastsMedical supervisionHealth benefits:Triggers autophagyReduces risk for certain chronic diseases Loss of Lean Muscle DehydrationRisks of WaterOnly Fasts Unsafe drop in blood pressure Can make existing conditions worse Slows metabolism Malnourishment17

4/18/20195 Day FastingBenefits5 Day ing MimickingDiet may triggerstem cell-basedrejuvenation andautophagy, (theclean up of aging &damaged cells) &promote stem cellbased renewal18

4/18/20191. Determine if fasting is a good option for yourpatientConsumerApplication ofFasting2. Determine which fasting type would make themost sense given the following factors Overall goals Risk factors Social factorsSECTION 3ContraindicationsSymptomsLabsProtocolsCertain Populations Should Abstain from Fasting Mimicking Diets Pregnant Women People who areunderweight, have very lowbody mass 18.5 or sufferfrom anorexia People over the age of 70,WHO LOOK FRAGILE ORHAVE SOME COMORBIDITY(unless in superior health) Type 1 Diabetes Heart failure People with liver or kidneydisease People affected by pathologies,unless they have prior approvalfrom their specialized Doctor19

4/18/2019Certain Populations Should Abstain from Fasting Mimicking Diets In the cases of serious or relativelyserious illness (cancer, diabetes,autoimmune disease, cardiovasculardisease, neurodegenerative disease) individuals on medication Individuals with certain rare geneticmutations Patients with low blood pressure or onmedication for hypertension Athletes during training or competitionPossible Side Effects of Prolonged Fasting / FMDPlease be aware of and inform the user of all potential side-effectsassociated with a low calorie, low carbohydrate and low proteinmeal program, which may include: FatigueWeaknessHeadache (including caffeine withdrawal)Dry mouthMemory impairmentMuscle painLaboratory Testing Before / After Fasting RegimenTesting can be done before and after 3 cycles of FMDBlood Tests Cholesterol (total, HDL, LDL) Triglycerides hs-CRP Insulin Like Growth Factor(IGF) fasting blood glucose Insulin resistance (HOMA test)Non Blood Tests Weight Blood pressure Waist circumference Body Mass Index (or a proxy for waistcircumference)Other subjective measurements whichreflects the stem cell spike are high levelof energy which starts by end of day 4and increase on day 5-10); sharp mentalfocus, physical performance20

4/18/2019Patient ProtocolsMetabolicPatient ProtocolsHealthy Connectwith me!www.kristinkirkpatrick.com21

A type of intermittent fasting, refers to studies in mice Time Restricted Eating (TRE) A type of intermittent fasting, refers to studies in humans Intermittent Fasting (IF) Fasting for 24 hours but less than 2 days Short Term Fast (ST) 2-3 consecutive days Alternate Day

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Fasting Guide . Introduction to Fasting Technically, fasting is abstaining from food, or not eating certain kinds of food over a period of time. Biblically, fasting is a deliberate abstinence from something for a spiritual purpose. For a believer, fasting is a form of self-denial for the sake of pursuing our relationship with God. Therefore, fasting can also be abstaining from activities that .

Fasting is a very emotional and volatile subject. Views about fasting usually go to extremes! Some have exalted religious fasting beyond all Scripture and reason, and others have utterly disregarded it. Some consider fasting unnecessary, undesirable, and therefore to be ignored. Others think fasting is to be

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5 REALLY GOOD REASONS TO FAST: God is inviting you to change directions/perspective on one or more key areas of life (fasting fosters repentance). God has given you a desire for more of Jesus (fasting fosters experi- encing and expressing affection for him) God is drawn to the humble (fasting fosters humility!) God’s strength is made great in your weakness (fasting fosters

What is Intermittent Fasting? Intermittent Fasting is an eating pattern not a diet. Where an individual will alternate between periods of eating and fasting. A common type of intermittent fasting involves not eating for 16 hours and feeding for an 8 hour window on a daily basis. This is referred to the 16:8.

While the word fasting may sound scary, it merely refers to any time you are not eating. It is the flip side or ‘B’ side of eating. You are either eating or fasting. When you sleep, for example, you are fasting. The word breakfast refers to the meal that breaks our fast, indicating that fasting is truly a part of everyday life.

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