Over the past decade, intermittent fasting, also known as time restricted fasting, has gained popularity as a way to lose weight and mitigate health risks. Some of this is true, however as with all things that seem too good to be true there are a few things that intermittent fasting can do and a few things it can’t do.

Before you jump on the intermittent fasting bandwagon for either health or weight loss related reasons there are a few things to consider. It is true that intermittent fasting can help lower insulin levels and regulate blood sugar. It can help with appetite suppression and accelerate healing and lower inflammation. However, intermittent fasting isn’t for everyone. As far as weight loss is concerned, consistent lifestyle changes over a period of time, along with time restricted eating schedule has proven to help with weight reduction.

Terms

Leptin– Leptin is known as the appetite suppressant hormone. It is secreted by fat cells in response to an increase in insulin. In a healthy feedback loop, leptin decreases hunger.

Insulin–Insulin is released by beta cells in the pancreas in response to increased blood glucose levels. In a healthy feedback loop, insulin acts like a gatekeeper by attaching to cells and allowing glucose into the cell, thereby providing energy to the cell.

Ghrelin– Ghrelin, also known as the hunger hormone, is primarily secreted in the stomach and gastrointestinal when your stomach is empty. It tells your brain you are hungry. It also regulates insulin secretion and has a role in reducing energy expenditure. Research continues to discover many other roles that ghrelin plays in the body.

Incretin- Incretin hormones are gut peptides that are secreted after nutrient intake and stimulate insulin secretion together with hyperglycemia. GIP (glucose-dependent insulinotropic polypeptide) und GLP-1 (glucagon-like peptide-1) are the known incretin hormones from the upper (GIP, K cells) and lower (GLP-1, L cells) gut.

The healthy leptin insulin feedback loop

In a healthy feedback loop, insulin levels rise due to food intake (which increases blood glucose), triggering fat cells to release leptin. Leptin reduces appetite. In turn, less or no food is eaten, resulting in lower blood glucose, which stabilizes insulin levels.

The unhealthy feedback loop

Persistent high levels of leptin cause cells to not be receptive to the effects of leptin. You continue to be hungry. The leptin, which is stored in your fat cells, doesn’t respond to feelings of satiety and you continue to be hungry. Insulin resistance is caused by persistent high levels of insulin. Cells don’t have gatekeepers(insulin)that allow glucose(energy) into the cell. This results in high circulating blood glucose levels.

Understanding the body weight thermostat

In a healthy feedback loop, the body weight thermostat sets the metabolism by the balance of the insulin-leptin feedback loop. Leptin goes up (reduce hunger) in response to rising insulin levels. This in turn lowers insulin levels because you aren’t eating. In this example, healthy body weight is maintained.

However, the body weight thermostat can malfunction. This happens when increased insulin levels- insulin levels that are increased over a period of months or years, cause insulin resistance. This results in weight gain.

Intermittent fasting/time restricted eating can balance insulin and blood sugar levels- if done right

Insulin is a primary driver of weight gain in many individuals. Correcting the imbalance through diet, exercise, reduced stress, and good quality sleep can reverse insulin and leptin resistance. It takes time, perseverance, education and planning to achieve optimum health and weight.

Talk with your healthcare provider before starting any time restricted fasting. Children, endurance athletes, underweight people, and women who are trying to conceive, pregnant, or breastfeeding should avoid intermittent fasting.

Fasting benefits and considerations

How and when to fast

Research shows that a 16 hour fast with 8 hour eating schedule provides the body with enough time to reset insulin levels, reduce inflammation and help the body turn fat into energy in a process called ketosis. However, it can take a while to get to that eating window. Many people start with a 10 hour fast and gradually work up to the 16/8 schedule. However, there are many ways to do intermittent fasting. Some do alternate days fasting, others have a more time restrictive fasting window. It all depends on your schedule and health status.

There are many benefits to intermittent fasting. During a state of fasting the body has energy to repair since energy isn’t being used for digestion. In addition, human growth hormone (HGH) increases dramatically, which can facilitate fat burning. Inflammatory markers, which cause many health-related problems, such as heart disease and diabetes. Increases levels of BDNF, a brain hormone called brain-derived neurotrophic factor, in which a deficiency has been implicated in depression and other psychiatric illnesses.

Fasting increases OGT enzyme

New research out of Yale University discovered an enzyme (OGT) produced in the hypothalamic region of the brain regulates the body’s homeostatic set point body weight and lipid metabolism. The enzyme, OGT, significantly increased after 24 hour fasting period in mice, leading researchers to speculate this enzyme may have use in obesity prevention.

Intermittent fasting, cortisol, and stress

Any type of stress the body experiences- whether emotional or physical increases cortisol levels.

Cortisol prepares your body to deal with stressful situations by diverting resources, such as blood sugar or glucose, to give your body the energy it needs to respond to a stressor or crisis. Cortisol raises blood sugar levels, even during periods of fasting. This can lead to storing more fat, Once the body adjusts to time restricted eating, many of these stressors will more than likely start to disappear.

Intermittent fasting and thyroid hormones

The thyroid gland, releases several hormones that regulate metabolism. Intermittent fasting can lower T3 and T4 levels, which can actually lead to weight gain. This is usually solved by a gradual lengthening of the fasting period. Since the thyroid hormone needs glucose to convert from inactive to active hormones (T4 to T3) the transition to using ketones as fuel (which form after extended time of fasting) can be a challenge. Seek professional guidance when dealing with thyroid dysfunction, either hypo or hyperthroid.

Effects of Intermittent Fasting on reproductive hormones

Hypothalamic Kisspeptin neurons and their receptors are involved with puberty and reproductive hormone regulation. During fasting, these hormones are decreased and can affect fertility.

If no medical care is available-Do all members of your family have a Jase Case?

Melissa Gilbert of Little House on the Prairie, recently posted on Instagram that she had to go to the hospital. 2 days prior, an insect bit her arm. The bite had turned red, swollen, and hot to touch. Her doctor told her to go to the ER, where she was diagnosed with cellulitis. She was put on a IV of antibiotics, Benadryl and Acetaminophen.

Years back, when I worked in a family practice clinic, I received a phone call from one of our patients, a single mom, who was camping with her 4 children outside of Disneyland. (Back then they had camping, more affordable than the hotels.) She had just spent the last 3 days going to the local walk-in clinic where she received IV antibiotics for cellulitis. She went on to tell me that she had saved for years to go on this vacation with her kids by selling Avon to finance the trip. The last Avon order had come in right before her trip. In her excitement to get orders to her customers she ripped open the box, and in doing so cardboard fibers lodged under her thumb. She removed the fibers, but the area had remained very red and swollen. She ignored the injury and went on the planned vacation, where she ended up seeking medical attention for what seemed at the time like a minor injury.

What is cellulitis and what to do if medical attention isn’t readily available?

Cellulitis is a serious infection that spreads to surrounding tissue from a break in the skin. It usually occurs around the arms and legs but can be found in other areas of the body as well. Group A Streptococcus (S. pyogenes), is the most common bacteria that causes cellulitis; however, staphylococcus bacteria can also cause cellulitis.

The bacteria enter through breaks in the skin through:

• Cuts, bites (insect, spider animal)
• Tattoos, piercings
• Chronic skin conditions that compromise skin integrity and the protective barrier- eczema, athletes foot
• Chickenpox, shingles-blisters pop which leaves skin vulnerable to infection
• Chronic edema in lower extremities resulting in skin breakdown
• Injection drug use and
• Puncture wounds

Symptoms include

• Area surrounding the wound – redness, swelling, pain and areas are warm to touch
• Malaise, fatigue
• In more advanced cases fever, swollen lymph glands, and elevated white blood cell count
• If untreated it can lead to sepsis, amputation and even death.
• Redness and swelling usually spreads rapidly-within hours

How diagnosed

Diagnosis is usually through patient history and inspection of the affected area. Wound cultures, etc. are not indicated unless unusual pathogens are suspected.

What if you suspect cellulitis?

Cellulitis can spread rapidly, within a matter of hours. If medical care is available, don’t delay. If caught in time, oral antibiotics can stop the spread in most cases. Warm compresses can help bring infection fighting cells to the area. Apply moist, warm compresses for 20 minutes up to 5 times a day along with seeking medical care.

If in doubt if cellulitis and symptoms (pain, swelling, redness) are mild: Take a marker and draw a line around the edge of the red, swollen area. Check every hour. If the redness spreads outside the boundary, seek immediate medical attention. In addition, if there is any change, necrosis (dead tissue, sometimes black) or any other types of skin breakdown, fever, chills, confusion, dizziness, seek immediate medical attention.

The following images are courtesy of NHS

What if no immediate medical care is available?

Cellulitis can quickly become life threatening. Early intervention can mean the difference between life and death.

• Monitor all skin breaks including scrapes, cuts, insect bites – If you have young children be sure to inspect their skin on a regular basis. Look for the signs of skin infections that may possibly lead to cellulitis.
• Maintain hygienic practices – Group A streptococcus is spread through direct contact with infected fluid/material or droplets or when coughing. Wear disposable gloves when cleansing wound, double bag all dressings and dispose of in garbage. Avoid contact with wound drainage or other fluids from area. Wash your hands thoroughly using soap and water. There is some discussion that cellulitis isn’t contagious, however always err on the side of caution and use gloves and wash hands .
• Draw an outline with a marker around any area you have doubts about. Check hourly for redness, swelling, change in appearance of skin, blisters, necrosis (blackened skin in and surrounding skin break).
• If redness or swelling is noted outside the marked area, contact your care provider for instructions.
• If a care provider is not available for consult, follow the instructions in your Jase Case for skin infections/cellulitis. Doxycycline, included in the Jase Case is one of the most effective antibiotics for cellulitis.

Given all the instability in the world, while the infrastructure is still in place, prioritize and consider what would happen if the medical system went down, even for a week. Take advantage of Jase Daily and get your year supply of prescriptions and order Jase Case for every member of your family if you haven’t done so yet.