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Tag: fasting

Mini Pause #26: Fasting vs. Caloric Restriction: Which One Really Wins?

Posted on by stephanie-estima

TL;DR (Too Long; Didn't Read)

Fasting, it seems, is a very effective tool for caloric restriction. What it does not appear to be is a goal you should aspire to be able to do, say for 16 hours every day, just because the cool cats are doing it. It needs to be discussed so that you can choose whether fasting is an effective tool for you for the purposes of caloric restriction.

WHY

Fasting has been one of the premier topics in weight loss circles for years now. And there have been some extraordinary claims on its benefits.

Most women come to fasting as a tool for fat loss. But it doesn't seem to be the fasting in and of itself that is the trick, but rather fasting can provide a tool for you to reduce your overall calories.

A recent randomized control trial [*] concluded that fasting in and of itself did not confer improved blood sugar management when compared to caloric restriction. Meaning–it isn't the fasting (or the fasting window) that confers benefits to body composition changes–but rather that fasting allows for a reduction in caloric intake in a time-restricted feeding window.

Here is the conclusion of the authors:

“In the setting of isocaloric eating, time restricted eating (TRE) did not decrease weight or improve glucose homeostasis relative to a usual eating pattern (UEP), suggesting that any effects of TRE on weight in prior studies may be due to reductions in caloric intake.”

WHAT

The subjects were 93% women, with an average age of 59 years old.

The researchers split them into two groups: The first group ate throughout the whole day, and the second group consumed 80% of their calories before 1 p.m., with a maximum of a 10-hour eating window (or a 14-hour fast).

It is significant to note that both groups ate the same amount of calories with the same nutrient content. The only difference was when the calories were consumed.

After 12 weeks, there was no significant differences between the two groups in:

  • Bodyweight
  • Fasting glucose
  • HOMA-IR (a measure for insulin resistance)
  • Response to an Oral Glucose Tolerance Test
  • Glycated Albumin

HOW

Now, while this may seem damaging for fasting, we don’t want to throw the baby out with the bathwater.

Fasting can be an effective tool for some for reducing calories. If that is you, then you do you, boo! But I think it might be time for us to stop pretending that fasting has magical powers other than its ability to help restrict calories.

I also think there is something powerful psychologically about fasting. Many of us mindlessly eat and do not sink into our bodies to really see how we’re feeling. Fasting can certainly help with that, especially when your stomach is gnawing at you.

Now, do I think everyone should be fasting? No.

If you are a woman in perimenopause, your primary physical objective should be to build muscle. That means feeding your body proteins in the morning to stave off the catabolic effects of sleep and to make sure you are getting enough total calories to build strong bones and muscles. So for most women in their 40s and beyond, fasting until noon is a terrible idea.

In your 40s, you need to get AHEAD of the net muscle protein breakdown and the net bone loss that accelerates as we age. So caloric restriction, especially the aggressive kind, is not going to bode well for this kind of body recomposition.

That means you have to eat in the morning and sufficiently through the day to meet your caloric and macro requirements.

NOW

If you have found fasting to be an effective tool for controlling your calories, then keep on doing what works for you. No shame in playing the game that works for you.

Fasting is a boss at helping you reduce your calories, which can give rise to many benefits if you need to reduce your calories.

But, let’s stop pretending fasting is the only way we turn over cells (autophagy) and the magic for clearing up every ailment under the sun.

Question of the Week

Q: What time of day do you typically lift weights?

This question came in from withtanya on IG and it’s one I get pretty frequently.

My personal preference has always been to lift in the morning. A few reasons for this:

  • I feel accomplished first thing in the morning
  • Nothing for the rest of my day is going to be as grueling or as difficult as my workout, so it sets up my work day for better productivity, mood and focus.
  • I can close off the “mental tab” of my workout needing to be completed and doesn’t weigh on me over the course of the day and allows me to work on other aspects of my health that can fall by the wayside (like my steps!)

Now, is this the ideal time to workout? Research seems to agree that the ideal time for a workout is sometime between 12 and 4 p.m. This allows for your core body temperature to rise, and for appropriate lubrication of joints and tendons through natural movement. There’s also the likelihood you’ll have eaten one or two meals by that point, which allows for appropriate substrate to fuel your workouts.

I just make it work when I can make it work, and for me, that is the morning. Is it ideal, according to science? No. But it works for me.

I tried working out one day this past week at 2 p.m. because I wasn’t able to get to the gym in the morning. I had a good workout, but truthfully, I struggled. For no reason other than psychologically, I felt like I was “behind,” and it felt like a break in my cognitive rhythm of the day.

So for me, I have figured out that the morning works best with the commitments I have as a mother, and I have some marginal flexibility to move it if need be.

YOUR TURN!

I’ll be answering your questions every week right here in the Mini Pause! Let me know what’s on your mind. I’ll be checking for both questions and feedback at support@drstephanieestima.com.

What I Recommend

Annmarie Gianni Skincare

I frequently receive requests from my Bettys for natural skincare products that work hard for you and work with all skin types. Now, I’m so pleased to welcome you to Annmarie Gianni skincare!

I rotate through products of several brands depending on the time of year, where I am in my cycle, my skin condition due to stress or tiredness, and a host of other factors that contribute to what’s going on with my skin at any given time. I know you can relate!

Annmarie's products are clean, organic, and wild-crafted. They nourish skin and are full of supportive activated ingredients. They’re third-party certified through MADE SAFE®, which means their products have none of the more than 6,500 substances prohibited or restricted from use in MADE SAFE® Certified products.

Since summer offers unique skin challenges, Annmarie put together a Clean Beauty Trial Kit for you that includes Aloe Herb Cleanser, Anti-Aging Serum, Anti-Aging Facial Oil, and samples of Sun Love sunscreen and antioxidant lip balm. Click here to try it! You’ll find the ingredient list, botanical infusion process, and videos on how to use each product. Here’s to a summer of great skin!

P.S.

Requesting input from the Bettyverse! We're midway through the year with this newsletter and I'd love to hear if you find the information valuable and how you're using it. Also, what topics would you like to know more about, focus on, or have me dig up research on? Send your thoughts and ideas to support@drstephanieestima.com.

Mini Pause #5: What’s Better: Fasted or Fed Workouts?

Posted on by stephanie-estima

Fasted or Fed Exercise?

TL,DR (too long, didn't read)

Most evidence suggests that fuelling before a workout is better for performance in the gym, and has the same outcome on body composition as fasted workouts. That is not to say that working out fasted is pointless and ineffective. As long as you are fuelling appropriately in the peri-exercise time around your lifts — your body is a genius and knows what to do with the stimulus.

WHY

There are so many of you who struggle with not only what to do in the gym, but what to do in the window that surrounds your workouts.

Fasted or fed training?
Fasted or fed cardio?
What to eat?
When to eat it?
How much to eat?

With conflicting evidence abounding, it can get overwhelming really fast. And based on the comments from a recent Instagram post, you're also trying to figure out what works, too.

Personally, I used to train fasted (both my lift sessions and cardio) for years, and have since changed my approach.

At the beginning of my fasting journey (when I was completely discounting the fact that I was female) I would work out in the morning and then continue my fast until noon. Needless to say, I was starving, and angry, and as soon as noon came around, I had a very large meal. Larger than what was necessary. The same continued at each subsequent feeding. It was hard for me to admit, but fasting until noon was not working the way I had hoped and the way it seemed to be for many others (mainly men) I admired and respected.

Over time, begrudgingly admitting this was not working well for me, I shifted my fasting window to eat immediately after my workout. I was still fasting for long lengths of time, but the phasic shift to earlier in the day was helpful. This worked well for me for years.

It was only until one of my kid’s soccer practices was moved early in the morning on the weekend that I changed things up again. Since I wasn’t able to get to the gym before his practice, I had the opportunity to experience fed training sessions.

I had breakfast, took him to practice, had another snack, and worked out afterward.

I was shocked at how well I performed. Was it the food? That I had more time to limber up my joints? My core body temperature? I wanted to figure this all out.

WHAT

So in examining this topic, let's review the literature on the effectiveness of fasted versus fed workouts. Is there a difference?

Fasted Workouts

This meta analysis looked at several studies where the intervention was either:

  • fasted exercise with a standardized post-exercise meal
  • fasted exercise without a standardized post-exercise meal
  • fed exercise with a standardized post-exercise meal
  • fed exercise without a standardized post-exercise meal

What they found was the second intervention (fasted exercise and no post meal) appeared to be the most effective strategy to produce a short-term decrease in energy intake. But there was a catch: it also resulted in increased hunger and lowered energy expenditure afterward.

This is known as metabolic adaptation. If you have a higher energetic expenditure but are not fuelling properly either pre -or post-workout, you might be able to temporarily decrease caloric intake. But, the body will compensate over time by increasing hunger and/or lowering your total energy expenditure. This is the “calories out” part of “calories in, calories out.”

Said another way, aerobic exercise performed in the fasted state with no post-workout fuel induces higher fat burning WHILE DOING THE EXERCISE, but will then correct for energy output after the exercise is finished. This means, there is nothing inherently superior to fasted workouts.

Another study looked at 20 healthy young females and looked at the difference between fasted exercise on body composition. They kept calories constant between the two groups and either gave them a meal before exercise or had them work out fasted and fed them after the exercise was completed. Again, no significant difference was noted between the two groups in terms of body composition. They both demonstrated equivalent weight and fat loss.

Fed State

So here is where it gets interesting! Even though body composition seems to be agnostic to whether you are in a fed or fasted state, there's a significant difference in performance and repair of muscles when you are fed before exercising.

Specifically, when you consume carbohydrates and protein before a workout, this positively affects muscle glycogen stores. This is going to give you the oomph you need to maintain energy and execution during your lifts. It's also going to improve the repair of muscles and help to improve the short-term and long-term adaptations to training.

Said another way — being fed before a training session helps with the performance during that session and the repair afterward. I would argue that this speeds up changes in body composition over the long term because it is going to favor muscle tissue performance and repair. The faster you can put on muscles, the better your body composition is going to be.

For those of you wanting to go even deeper, check out this article on nutrient timing, and listen to one of the authors of the paper, Alan Aragon, on my Better! podcast.

HOW

If you want to try fueling before a workout and have been training fasted for years, start small!

Here is a short list of pre-training meals you can experiment with:

  • Add protein to your coffee. I often add a Core Power to my coffee, or I will blend Equip Foods or Schinoussa protein powder into my coffee.
  • Have a banana. It is light enough to avoid that “brick in the stomach” feeling.
  • Have a Protein Shake. (½ banana, scoop of whey protein powder and water)
  • My overnight oats recipe (check it out here)
  • Greek yogurt with some honey and walnuts
  • A few rice cakes with peanut butter and jelly

Personally, I am a creature of habit so it's either my overnight oats or I add one scoop of whey protein to oats and mix. I eat either one of these options before every lift. When it's leg day, I will also add a banana into the mix.

This clocks in somewhere between 350-400 calories, which is about right for the length and intensity of my workouts. I would say the bare minimum calories should be around 200, especially if you just starting to experiment with food intake early in the morning.

Many of you work out early, and I do as well. I eat my oats and protein of choice almost immediately after waking and then I get dressed and get to the gym. This buffer gives me about 30-45 minutes from the time I eat to the time I am in the weight room. Precisely about the time those glorious amino acids and glucose are spilling into the blood so I can drive them into my muscles to werk. Not work. WERK.

NOW

Decide on what small meal you are going to try. Tomorrow (or your next planned lift session), wake up and march into your kitchen to eat. Naked if need be — we're talking about better muscle performance and recovery here! Then go about your regular morning schedule and head to the gym.

Be patient with yourself. It may take a few weeks to adapt to eating on a new schedule. I would choose one food and just have that before your workout for two to four weeks to see if you notice a difference in your performance at the gym.

It may or may not work for you. Either outcome is fine. That you are willing to try different things is what makes you the champion you are.

In this article, I mentioned my two favorite protein powders. Take a look and choose the one that's right for you: Equip (use code DRSTEPHANIE to save 15%) or Schinoussa.

Question of the Week

Q: What does it mean when I'm spotting before my period?

Spotting outside your bleed week can be unsettling and there are a few explanations for it.

Before we dive in, consider your age, where you are in your cycle, and if you could be pregnant. And a word to the wise: I've had several friends in their late 40s get pregnant, so this is something to always rule out!

EVALUATING

Menstrual Cycle:  

  • Ovulation: Not all, but some women will notice some light pink blood mid-cycle around the time of ovulation. The pink color most likely is a mixing of the blood and cervical fluid. It should not be heavy enough to warrant a tampon, a cup or a pad, and this is considered uncommon, but normal.
  • Luteal Phase: This is most common in perimenopause when we see falling levels of total progesterone and estrogen. Lowered progesterone is unable to maintain the endometrial lining and premature shedding of the tissue can occur as it becomes ischemic and dies. Discussing hormone replacement with your provider might be in order here.
  • The spotting prior to bleeding might also be due to an estrogen deficiency or luteal phase defect where the luteal phase is shorter than the follicular phase. Typical diagnostic criteria consider 10 days as a luteal phase defect coupled with elevated FSH and LH. This can be confirmed on a blood test.

Hormonal Birth Control: If you have recently started on any kind of hormonal birth control like pills, patches, injections, or intrauterine devices, you may find you are spotting for the first few month as your body adjusts to its new hormonal environment.

Implantation Bleeding (Pregnancy): If you are pregnant, implantation bleeding often happens in the six- to eight-week mark of your pregnancy. This is right around the time you “should” be getting your period. The fertilized egg is burrowing itself into the womb and can cause noticeable spotting. This is normal, although you might mistake this for your period!

Sex: Penetrative sex can cause some spotting afterward, especially if you are experiencing vaginal dryness. This happens most commonly in perimenopause with declining levels of estrogen leading to reduced lubrication. The friction from sex can cause microtearing in the walls of the vagina. So, either ramp up the foreplay, grab some lubrication, or both.

You can also see some post-coital bleeding from cervical polyps. These are benign growths on the muscular wall of the cervix.

In all of these cases, keep a log of what is happening so you can discuss the specifics with your doctor. You'll want to note where you are your cycle, how much, how consistent, what colour, and duration of the spotting.

TESTING & NEXT STEPS

I love to run lab tests on myself and patients every six months. This is ESPECIALLY true in perimenopause when your sex hormones can drastically change from visit to visit.

YOUR TURN!

‘ll be answering your questions every week right here in the Mini Pause! Let me know what's on your mind. I'll be checking for both questions and feedback at support@drstephanieestima.com.

WHAT I RECOMMEND: Living Libations

As your hormones fluctuate in mid-life and your skin begins to change, you want products that deeply nourish.

Best Skin Ever-Rose is crafted to bring all skin types into balance and uses Rose Otto to replenish your skin. Use it as a cleanser, a gentle exfoliator, or a luscious face and body moisturizer.

It’s been a favorite face oil of mine for YEARS and for good reason. It is pure luxury. This is my “special” night oil when I want to up the glow and dewiness of my skin.

I also love the lightweight Rose Glow Serum that's rich with ingredients like jojoba, seabuckthorn, and geranium. It makes my skin feel silky soft while soothing and protecting.

Visit Living Libations link and save 15% off. (The discount is automatically applied at checkout.)

P.S.

MISSING LINK: In last week's Mini Pause, I included a link to a hand-held vacuum I like to use on my mattresses, but the link wasn't functional. Here it is!

HEALTH TOOLKIT: I've put together a toolkit for you on my brand new website. I designed these resources for my Bettys who are menstruating, experiencing perimenopause or have gone through menopause. There are commonalities between the categories and also specifics for each one. Everything I recommend, I use myself. That's my rule. I invite you to take a look!