Fasting with a chronic health issue

Fasting is a hot topic in the health and nutrition space. It comes in a number of forms – intermittent fasting, caloric restriction, 5/2 fasting, reduced time window eating etc. 

There’s a great deal of research into the potential impact of some of the above which has promising results for increasing lifespan, healthspan and weight reduction as well as other markers for good health such as glucose control. Keep in mind that much research has been done on male mice, though – and not as much on different sexes and in people! 

In people, there have been indicative studies that show that keeping energy consumption under control, and within time limits, can help enhance health. Again – these don’t often take account of sex, economics and other factors. 

Needless to say – people with chronic health issues aren’t part of health research such as this. So, how do we translate some of the benefits to something meaningful and accessible for people with a chronic health problem, such as Gilbert’s Syndrome, IBS, CFS, arthritis etc etc. 

Key factors that everyone with a health issue needs to consider when setting out on any new health approach:

  1. Are you on medication? Does the new routine affect this? 
  2. When do you have higher energy levels, mood, motivation, mobility and least pain?
  3. How is your sleep?
  4. What triggers your symptoms or sets you on a downward trend?
  5. What is your current lifestyle and pressures?
  6. How much time and money do you have?
  7. What support would you need to engage with a new health approach?

Let’s look at the above in the context of fasting. 

First of all – what is fasting and what does the research say?

Fasting is when you go without food for a period of time that’s more than just the few hours between meals. Overnight is the usual fasting period for most humans, hence the term ‘breakfast’. Here’s a more detailed explanation of the different types 

Recent studies have looked at different ways of fasting. These include reducing the number of hours in the day that are your window for eating – 8, 10 and 12 hours have all been studied. So, for example, if you had your first meal at 8am, and finished your last meal of the day before 8pm you would have had a 12 hour eating window. Some studies have looked at eating normally for 5 days, and then having restricted calories for 2 days – or other combinations of days in the week. Tied into this research has been the inclusion or exclusion of calorie restriction to see if that has a separate or additional effect. 

The US government National Institute of Health website, says:

Hundreds of animal studies and scores of human clinical trials have shown that intermittent fasting can lead to improvements in health conditions such as obesity, diabetes, cardiovascular disease, cancers and neurological disorders. The evidence is less clear for lifespan effects.

Studies show that fasting has the impact of toning up the body’s metabolic response. Recommendations are that no-one should embark on a fasting regime without the support of a medical professional. 

Medical News Today has a good synopsis of some of the research, up to 2022.

As ever, the results aren’t 100% conclusive, but ongoing research seems to underpin the hypothesis that humans eating within a specific daylight window, at regular times, see positive effects on a number of health indicators. The proposition is that you are working with your body clock, and your metabolism is ready and waiting to do its best at particular times. 

Dr Satchin Panda is a prominent researcher in the field of circadian rhythm and eating. You can listen to a recent Huberman podcast, where the most recent findings are discussed

Dr Panda is open about the research to date being mainly in male mice, and the need to increase our understanding of research outcomes in females. 

If you want to explore the topic further, check out the Circadian Code by Dr Satchin Panda, to find out how your body clock has an impact across your whole life experience. 

Key takeaways from the research

There seem to be some key takeaways from research to date, which can be useful to many of us, and which don’t present an extreme change to most people’s lifestyles:

  • Don’t eat just before sleep. Your body’s metabolism is slowing down and will be less efficient in processing nutrients. It will likely disturb your sleep. 
  • Keep meal times regular. Your body sets itself up to process food at the times you usually feed it. This means it is producing more digestive juices, revving up the pancreas and gallbladder to fire off the hormones and chemicals needed to break down food into nutrients, and taking its focus off other activities. 
  • Give your body a good rest between your last meal and your first. This gives your body a chance to sleep, rest and wake at its own pace, getting ready for your first meal of the day with maximum effect. 
  • Don’t overburden your body with too much food in one go. You’ll struggle to digest, you’ll feel bloated and lethargic, your energy levels will be affected. 
  • Don’t eat too few calories to function! If you are active then restricting your eating time could lead to negative effects. Over the long term this could impact hormones, bone density and metabolism. 

If you have a chronic health condition what should you consider?

The impact on people with medical conditions of fasting of any kind could be detrimental, unless carefully planned. 

For example – if you have Gilbert’s Syndrome then fasting for too long will trigger your symptoms. In fact, fasting is one of the ways Gilbert’s Syndrome is diagnoses for that very reason! Your body needs a steady supply of blood sugar for the reduced enzymes to work well. A 12 hour fast may work well for you, if you aren’t challenged by other issues and your liver isn’t over burdened. You will need to carefully monitor how you manage with fasting for your own context, and be aware it may not be the right thing for you.

Medication – you may need to eat before medication in order for it to be absorbed properly or to protect your stomach. This may mean you have to take meds at a certain point before or after you eat. Not eating for a day could of course be damaging. For example, I have to take some meds when I wake up or I’ll experience pain. I then have to eat half an hour later. This is a done deal and so I can’t mess with that without my pain levels being affected. This means I can work with what time I finish eating, rather than when I start eating.  If I have to take medication at the end of the day, but I don’t want to eat late, then I’ll make sure my last meal is really light. 

If you need to balance your energy levels, mood or deal with pain, then eating regularly is really important. You may find regular small, high fibre meals will help balance your energy levels etc. Perhaps a longer 12 hour eating window would work best for you. If you have to eat with medication during the night or later in the day, then keep it light – a yoghurt or a crispbread. 

If your sleep is poor, then you will feel hungry and grumpy! This is not an ideal fasting scenario! Your energy levels and self control will be all over the place. Your metabolism will also be affected. Your pain levels will be higher or other symptoms may flare. Again, a number of small regular meals may help balance things. Eating for the last time 3 hours before bed time might give your body a better chance to get its sleep routine back on track. Try not to snack at night if you have insomnia. If you are really hungry or have to take medication then try something really light. 

If you are on a downward cycle on your symptoms, or other lifestage factors are making your life challenging or stressful, don’t take too restrictive an approach to food. Fasting is not a great approach if your hormones are at certain points in a cycle or if you are facing physical challenges that are taking all your emotional energy. 

Do you have time to prepare simple nutritious meals? Think about what’s coming up in your week ahead and prepare meals ahead of time if possible. This reduces the thinking time about what you might eat and stops you grabbing less nutritious convenient food, or missing meals and eating when isn’t optimum  for your body clock. 

Think about cost, and map out what ingredients you will buy and where they will come from so that you can pre-prepare for assembling your meals easily. Take the brain work and stress out of working out what to eat! 

If you are going to try some of the tactics to eating in the way that is best for your body clock – then let other people know. This isn’t about being smug that you’re doing something good for yourself (although you should definitely feel great about that!), it’s so that people don’t sabotage you with late night pizza or popcorn in front of a boxset binge, or try to make you miss lunch in favour of an urgent meeting. Organising your eating schedule can also involve organising the people you care for in your life, and getting them to comply with and support you

The message here is – if you want to try creating a regular healthy eating pattern that works with your body clock, then get yourself a plan. The more you work it out ahead of time, the more successful you’ll be. 

Even better – with the help of a health coach you can consider in greater detail the barriers ahead, and get an ally in beating the challenges, and achieving success, which = greater health and wellbeing. 

Contact me for health coach support, or sign up to one of the plans here

1 comment

Leave a comment

Your email address will not be published. Required fields are marked *