Study: Time-Restricted Eating Improves Cardiovascular Health for Firefighters
today.ucsd.edu
today.ucsd.edu
But there are mental "downsides" to reckon with.
It's not grumpiness, but rather a "predatory" state. Not quite aggression - a little more of the warrior mode circuits seems switched on. Plus general heightened emotion and general willingness to speak the truth, fight/defend others, take risks.... Working out how to deal with that and integrate it positively is my present challenge.
Anyone else getting that?
Since you already called this "warrior mode", I'd recommend reading the warrior literature for tools and techniques to help deal with this in a positive way. If you're new to it, The Way of the Peaceful Warrior by Dan Millman is a great introduction and there should be enough references on it to start digging deeper.
There is a movie for the book as well but I don't recommend it.
[1] https://www.goodreads.com/book/show/2255.Way_of_the_Peaceful...
I say false sense of sharpness, because you're actually not that alert. Yes, you can push yourself more, but your brain is in flight/fright mode and not thinking rationally.
Good cautious advice. Thank you.
May I point to one paper of many that show proinflammatory cytokines to be reduced due to intermittent fasting?
“Under controlled conditions, [diurnal intermittent fasting] led to significantly decreased plasma levels of cytokines (IL-1β, IL-6, and IL-8), particularly IL-1β and IL-6 across 24 h.” – The effects of diurnal intermittent fasting on proinflammatory cytokine levels while controlling for sleep/wake pattern, meal composition and energy expenditure, 2019: https://journals.plos.org/plosone/article?id=10.1371/journal...
There are a bunch more. “intermittent fasting il-6” is a decent search to start with: https://scholar.google.com/scholar?hl=en&as_sdt=7%2C39&q=int...
A classic example is the “antinutrients in plants” mechanistic fad while plants in a diet actually increase all health outcomes when put to the test.
Exercise causes a huge inflammatory response too. Thankfully we know better than to stop the analysis there.
I deeply encourage people to read the science. And indeed all of it.
As you said: Maybe they exist. They probably do – if the substrate of under-funding things has allowed them to come into existence. There are studies that show general health benefits from intermittent fasting as I recall.
It’s also worth paying attention to one’s experience of the world, and to not discredit it. There’s a distinction between following a fad, preferring a lifestyle, wanting to feel good about it – in a social sense I guess? …versus, say, noticing a sense of clarity whole watching one’s bloodwork results improve.
Read papers. Mostly science. Not too carefully.
Mechanistic ones too. Mechanistic ones too! From personal experience, I ask you to believe me when I give insulin glargine as a clear example of the molecular biology of something clearly showing that a certain medicine is literally dangerous. The zoomed-out general health studies smooth over the substance’s obvious capacity to abruptly flow out of bolus sites and dump 24 hours’ worth of insulin into the bloodstream. It’s obvious from the molecular biology and the anecdotes of horrible blood sugar crashes and people dying in their sleep. Please don’t take too much salt with the mechanistic studies. It’s mechanics all the way down.
But the physical ones definitely! I feel way healthier and my bloodwork just came back much improved as well.
For me, though, I don't think it has anything at all to do with the time restriction so much as the inadvertent calorie restriction. I've lost 30 lbs since I started, mostly because intermittent fasting has caused me to cut out my late night snacking and my greasy breakfasts.
Now let's find a way to put this in a pill so manufacturer reps will provide literature to doctors to prescribe it and insurance companies will pay the drug makers so everyone can go to pill maker conferences in Hawaii for education.
What was the change in blood reports?
I am surprised somone can simply reverse their 'serious' metabolic disease state in mere 6 months.
Then what would be the point of living a healthy lifestyle everyday if you can simply 'get healthy' in a matter of months when you need it.
I've wondered about this for a while. My friends don't give a shit about health and barely do any physical activity. They can get to 'outstanding' equivalent level in 6 months at the time of their choosing? That doesn't seem fair,lol.
And I definitely wouldn't let myself go out of shape like that again thinking it would be an easy ride home. Basically I stomped my A1C almost in half, from 50 (knocking on the door of diabetic) down to 30 (complete remission to decent health) - so totally mullahed it. Doc says that's at the limits of medical science, so I was pretty chuffed. Need to maintain now with IF and regular workout.
What it cost me was:
IF, 12 or 18 hour sessions once (occasionally twice) per week.
Diet change to 80% plant based, more raw veg, nuts, fish
Setting a reminder to drink water
Walking 20 miles twice a week with a full pack (that's where most people will wobble a bit).
Cold water sea swimming (you get used to it)
I added two tricks. One is to walk on sand. Other is replace lost weight by stuffing a modular armour jacket with little sand bags in the plate pockets. When I dropped from 95kg to 90kg I just added 5 kilos of sand and so on. This happens gradually. When you carry around the weight you lost it keeps the calorie burn the same per mile and really motivates you because you can literally feel how much lighter you are when you take the vest off. Also you can just drop weight if you get exhausted on a long yomp.
Yes I am lucky too. I live in a place with opportunity for outdoor activity. Probably good metabolic genetics. Made time to do the health work by dropping some contracts (I consider it an investment in myself like college etc) Also I took the diagnosis seriously and researched an action plan.
> The doc basically said my latest bloods are outstanding
But I am not clear if you've had any lasting damage from the past or is everything is simply reversed. Is there anything that cannot be reversed with any amount of effort?
It's got me more interested in health and biology for sure. The human body is remarkably hackable.
Things like bone density and tendon health definitely change slowly. Superficial organ fat, the most dangerous type, is apparently the first thing to go, and you can get so it won't go on quickly again. That's what the cold swimming is for, something to do with types of fat metabolics. I think being overweight for a considerable time (a few years) may have given me joint damage, knees maybe, but TBH I've not pushed myself into injuries and I think it's all strengthening well. I may move to some light strength training soon, but I prefer bodyweight only. Getting to the state where you can even do bodyweight, like 20 press-ups, is a great target.
If you're thinking about doing this... DO IT. I wish I could be beside you on some long walks. Maybe talk to the doc first and set a reasonable plan. But the fasting is not as hard as you think. After the first couple times it gets old and you start to make friends with hunger.
And what ever you improve, whether it's lasting or not, that's gotta be good right?
Because the labs are just indicators of whether or not damage is being done.
If you have high LDL for example, disease state is correlated to how long, and how high LDL levels have been. (The evidence for that is robust.) So for example, while you can improve those levels in 6 months, that doesn't mean you weren't racking up damage for the previous 10 years.
This is a common thing with most health indicators actually: blood pressure, LDL, blood sugar, etc. End organ damage, and risk of adverse events are correlated to how high and how long levels were maintained.
> and risk of adverse events are correlated to how high and how long levels were maintained.
Is there a way to measure this though. How can I tell what my current level of damage is.
GP got the usual indicators into shape. Is all the 'racking up damage' reversed in OPs case ?
It's a cumulative thing. There are ways to ascertain the damage, but not through routine tests.
>GP got the usual indicators into shape. Is all the 'racking up damage' reversed in OPs case ?
Particularly in the case of cardiovascular damage like atherosclerosis and resulting kidney damage, narrowing arteries, etc, no it's not reversed.
Well, what are these ways.
Coronary calcium scan to check for the progress of atherosclerosis in the coronary arteries, ultrasound of the kidneys, maybe the heart to check for left ventricular hypertrophy (or do you need an echocardiogram for that?), ultrasound for the carotid arteries, etc.
That isn't to say there isn't accrued/long term damage, I think most people going through this sort of change will tell you that they are still dealing w/ health issues long term. I've notice that years after my initial interventions, my body still seems much more predisposed to weight gain for example - but trust me though, not feeling like crap is it's own reward. You can basically get used to anything and you don't really realize just how bad you were feeling (slowly getting worse over the course of a decade or so for me) until you turn it around.
Sometimes I've gone to sleep a bit hungry, and I've had dramatic dreams of being weak and emaciated. When I woke up I felt anxious, but just needed to go to the mirror, talk to my subconscious as if it was a child, and show him that we still have a long road to go, but in a few hours there will be a generous breakfast. We're not dying of hunger anytime soon. The anxiety simply vanishes.
These days there's no feeding anxiety anymore, but the subconscious is a very interesting companion. Another night I dreamed that somehow I was at my intended goal, and I didn't know how that happened so fast, and then felt an overwhelming happiness because now I could eat at any hour again! I woke up, and said "Nice try, subconscious", and happily resumed my sleep.
The brain in survival mode acts in funny ways.
> Or is this less important than the immediate-protein-shake crowd suggests?
From what I've read, this may be not as important as originally thought.
Overall, I believe the schedule that most holistically supports metabolism would be to exercise early and also eat early in the day. This would thereby keep the taxing metabolic activities aligned to your circadian clock, which expects a lot of early day stressors and fewer as the day progresses. This may be specifically true for protein which is especially metabolically taxing, so eating it early in the day is probably the time when it creates the most benefit at lowest risk.
Of course, people have to do what works for their schedules and lifestyles.
This is slightly contrary to what I’ve learned from Rhonda Patrick. Exercise in the morning, sure, but while still fasting from overnight (black coffee or plain tea ok… does not break the fast).
Eat after exercise so that your fast lasts longer. Also, cardio exercise blunts the hunger feeling in many people.
But is there a difference between having your day's large meal at 8am or 11am? Those are both pretty 'early', so it might not matter; I don't think we know. However, as the day winds on, more data comes to light which suggests that earlier is better.
I have not seen studies like that. All the ones I’ve seen have participants stop eating 3 hours (minimum) before sleep. For example, With an 8 hour eating window and 10:00 sleep, that means eating between 11:00-7:00 giving you a 16 hour fast.
This study in particular looked at early TR (6am-2pm) vs mid afternoon (1pm-8pm) TR vs no TR; and early TR had the greatest metabolic benefits by a long shot:
> "Furthermore, eTRF (early TR), but not mTRF (mid-day TR), improved fasting glucose, reduced total body mass and adiposity, ameliorated inflammation, and increased gut microbial diversity. No serious adverse events were reported during the trial. In conclusion, eTRF showed greater benefits for insulin resistance and related metabolic parameters compared with mTRF"
Now, I don’t know what effect all that has on other metabolic processes. I doubt the effect is universal. But it is interesting that the revived wisdom about black coffee being okay is not universally true.
(Ie if you had pumped the liquid directly into her stomach, without telling her whether it's black coffee or some substitute, would the outcome still have been the same?)
Something I wonder about though is that if blood glucose is rising after black coffee, that energy must becoming from somewhere. i.e. stored fat, stored glycogen or stored protein.
Given that she's about do some fasted exercise that will burn that blood glucose as its fuel source, is this a bad thing if the energy is coming from stored fat?
For a healthy person, this might be good. For someone with various health issues (like the person in question), I don't know.
There's apparently some significant variation between people. Some don't see a glucose spike at all, some see it vanish if they consume protein first, and some see it regardless.
Wouldn’t the glucose have to come from somewhere?
A continuous glucose monitor checks the level of glucose in your blood. Glucose can be stored in your body as glycogen (e.g. in the liver, or muscle tissue).
Your pancreas produces glucagon, which influences the process of converting it back into glucose, released into your blood.
That's generally accepted basic science, but from my own anecdotal friends/family experience, the pancreas also seems like a pretty buggy organ generally, prone to glitches both temporary (like perhaps in this coffee drinker) and chronic (type 1 diabetes), leading to undefined behavior, crashes, and even fatally bricking the system permanently.
So this anecdote isn't particularly surprising to me.
(Also, for those reasons, I would definitely wear a continuous glucose monitor myself if it wasn't so expensive and difficult to arrange when you don't actually have anything known to be wrong with your blood sugar levels. I predict that within a decade or two, they will be a fairly ubiquitous piece of human body instrumentation, like the sleep-tracking wristwatches and rings we have today.)
My caloric window is 1-8pm and I exercise in the mornings with just a few essential amino-acids.
My understanding is that protein can be rate-limiting for hypertrophy if you don't have enough in general, but timing is not as largely important. I believe there is a rough window for anabolic signaling / net-positive muscle protein synthesis that lasts up to 48 hours after exercise
Sources:
Aragon, Alan Albert, and Brad Jon Schoenfeld. “Nutrient Timing Revisited: Is There a Post-Exercise Anabolic Window?” Journal of the International Society of Sports Nutrition 10 (January 29, 2013): 5. https://doi.org/10.1186/1550-2783-10-5.
Schoenfeld, Brad Jon, Alan Aragon, Colin Wilborn, Stacie L. Urbina, Sara E. Hayward, and James Krieger. “Pre- versus Post-Exercise Protein Intake Has Similar Effects on Muscular Adaptations.” PeerJ 5 (January 3, 2017): e2825. https://doi.org/10.7717/peerj.2825.
Schoenfeld, Brad Jon, Alan Albert Aragon, and James W Krieger. “The Effect of Protein Timing on Muscle Strength and Hypertrophy: A Meta-Analysis.” Journal of the International Society of Sports Nutrition 10 (December 3, 2013): 53. https://doi.org/10.1186/1550-2783-10-53.
Schoenfeld, Brad Jon, and Alan Albert Aragon. “How Much Protein Can the Body Use in a Single Meal for Muscle-Building? Implications for Daily Protein Distribution.” Journal of the International Society of Sports Nutrition 15 (February 27, 2018). https://doi.org/10.1186/s12970-018-0215-1.
There are some interesting wrinkles (like Leucine intake in particular), and I'd recommend looking at what Stuart M Phillips and Donald K Layman have published as additional places to spelunk from for anyone that's particularly interested in the topic.
Plus if you're training but want to lose at the same time, you need a caloric surplus for a while to have your muscle regenerate and grow, but it's totally possible to gain muscle and lose weight at the same time. But basically each calory that you're in deficit will make your muscles grow more slowly, so it's definitely harder than being on an overall surplus.
I also heard somewhere it could take like 24~48 hours for all protein sources to be digested and extracted from your bloodstream so you might have like a constant amino acids drip into your bloodstream but i never really checked this.
Ive spent a lot of heartache and headache over research around these type of questions. The best answer is to learn what works best for your own body. Eat enough protein as a starter in any case.
This is probably the case for a lot of health issues.
But we always want a pill that will fix the issues while allowing us not to change our habits.
Saw a study recently that showed broad, dose dependent health effects.
Personally it really seems to help when I’m overloaded with stress, in a direct immediate way.
In any case, how long does sauna's supposed deleterious effect last? Probably not more than a few days?
I use sauna 20 minutes per day about 5 times per week (helps to have a small one in the home. Don’t get infrared if you get one).
I would not call it pleasant. If done correctly, your heart rate is elevated (130-135 bpm for me), and you are sweating profusely.
Sauna is fun, but it's not a panacea. It can't replace exercise, for example.
I can imagine it's kind of like being a parent or manager. After advising perfect behavior and rarely getting it, you give up and settle for easy, less perfect but achievable advice.
does doctors prescribing lifestyle change have any noticeable effects though. I assume everyone already knows they need to 'eat better and exercise'. I am not convinced that doctor telling them this will finally make it sink in for anyone.
Also, most doctors have layman level understanding of nutrition and excercise and many of them are not in best shape themselves.
Having said that, I still do 18/6 IF with cream in my coffee and in my personal experience I still feel great and have had many positive benefits from continuing IF.
I limit my coffee creamers to about 25-100 calories depending on number of cups pre-meal. I’m in better shape than most hardcore IF practitioners.
CICO.
So, I sleep 9h, which means, I'm awake 15h.
If I don't eat 2,5h before and after sleeping, would this be enough?
Who knows!
This seems like one of the things that makes it hard to test intermittent fasting: there are a bunch of variables other than just the length of the window.
Some researchers think so, yes. I don't think anyone knows what is optimal. Research is ongoing.
There are other people doing 4 hour windows for IF in which case it's more like a single meal, but that's not what this study tested.
(This is just explaining the idea, not advocating IF)
>In analysis of secondary outcomes, we found a significant reduction in lean mass in the TRE group. In the in-person cohort, the average weight loss in the TRE group was 1.70 kg. Of this, 1.10 kg (approximately 65% of weight lost) was lean mass; only 0.51 kg of weight loss was fat mass. Loss of lean mass during weight loss typically accounts for 20% to 30% of total weight loss.16,17,18,19,20,21,22 The proportion of lean mass loss in this study (approximately 65%) far exceeds the normal range of 20% to 30%.
These results were damning, and to such a degree that one of the study's lead authors, Ethan Weiss, who practiced IF himself and was in the study's IF intervention group, completely abandoned IF after the study's completion.
The ADF study is paywalled, but the results are similar (disproportionate loss of leanmass in the fasting group), and there's a good breakdown of it here: youtube.com/watch?v=HaZmhuonGIs
It's astounding how many HN brainlets still cling to this idiotic practice, and on the flimsiest of evidence. Probably the same brainlets who think saturated fat is healthy.
That's the brainletism I was referring to. You could have easily verified your assumption by looking at remaining hunter-gather populations, who serve as a good proxy for you ancestors, and had you done that, you would have discovered that--surprise, surprise--they don't fast:
youtu.be/Ci70YYaVHeQ?t=2807
How in the world is a remaining hunter gatherer population in 2022 a proxy for what happened tens of thousands of years ago. That's an assumption you're expected to justify, first off.
Secondly, how is food abundance being modern a 'brainletism' or whatever you're enjoying repeating as a sort of provocation.
That's an interview with Herman Pontzer, PhD, the lead author of the most import papers published to date studying the energy expenditure of the Hadza of Tanzania, one of the few remaining hunter-gather populations. By all means, keep believing that your ancestors subsisted off of 100% Woolly Mammoth meat in between days of starvation, if it makes you happy.
It may be the case that these two processes lead to similar outcomes. But for me, it is much easier to stay faithful to an IF lifestyle than a "continuously calorically restricted" lifestyle. I find the binary aspect of the IF system to be very helpful. If the other system is easier for other folks to maintain, that's great, and they should do that.
But the fact that IF doesn't lead to better results than a different system doesn't mean that people who practice IF are clinging to an idiotic practice, as you put it.
In the 8-16 IF study I linked to, the IF/TRE group actually had worse adherence:
> Self-reported adherence to the diets was 1002 of 1088 (92.1%) in the CMT group (did not miss any meals) and 1128 of 1351 (83.50%) in the TRE group
From the study you linked:
> Participants were randomized such that the consistent meal timing (CMT) group was instructed to eat 3 structured meals per day, and the time-restricted eating (TRE) group was instructed to eat ad libitum from 12:00 pm until 8:00 pm
> A follow-up study showed that when calorie intake and protein intake were matched to prestudy consumption, no change in lean mass was observed.
> Ad libitum feeding during TRE leads to reduced calorie intake and might also reduce protein intake.9 Together, these data highlight the importance of adequate protein consumption while adhering to a TRE diet. Many studies have shown that adequate/excessive protein consumption during weight loss can mitigate losses in lean mass.