Krista wanted to know was whether ADF would also work if her subjects were allowed to eat a typical American high-fat diet. So she asked 33 obese volunteers, most of them women, to go on ADF for eight weeks. Before starting, the volunteers were divided into two groups. One group was put on a low-fat diet, eating low-fat cheeses and dairies, very lean meats and a lot of fruit and vegetables. The other group was allowed to eat high-fat lasagnes, pizza, the sort of diet a typical American might consume. Americans consume somewhere between 35 and 45% fat in their diet.
As Krista explained, the results were unexpected. The researchers and volunteers had assumed that the people on the low-fat diet would lose more weight than those on the high-fat diet. But, if anything, it was the otherway around. The volunteers on the high-fat diet lost an average of 5.6kg, while those on the low-fat diet lost 4.2kg. They both lost about seven centimetres around their waists.
Krista thinks that the main reason this happened was compliance. The volunteers randomised to the high-fat diet were more likely to stick to it than those on the low-fat diet simply because they found it a lot more palatable. And it wasn’t just weight loss. Both groups saw impressive falls in low-density lipoprotein (LDL) cholesterol, the bad cholesterol, and in blood pressure. This meant that they had reduced their risk of cardiovascular disease, of having a heart attack or stroke.
Krista doesn’t want to encourage people to binge on rubbish. She would much rather that people on ADF ate healthily, increased their fruit and vegetable intake, and generally ate less. The trouble is, as she pointed out rather exasperatedly, doctors have been encouraging people to embrace a healthy lifestyle for decades, and not enough of us are doing it. She thinks dieticians should take into account what people actually do rather than what we would like them to do.
One other significant benefit to Intermittent Fasting is that you don’t seem to lose muscle, which you would on a normal calorie-restricted regime. Krista herself is not sure why that is and wants to do further research.
The two-day fast
One of the problems with ADF, which is why I am not so keen on it, is that you have to do it every other day. In my experience this can be socially inconvenient as well as emotionally demanding. There is no pattern to your week and other people, friends and family, find it hard to keep track of when your fast and feed days are. Unlike Krista’s subjects, I was not particularly overweight to start with, so I also worried about losing too much weight too rapidly. That is why, having tried ADF for a short while, I decided to cut back to fasting two days a week.
I now have my own experience of this to fall back on (see page 60), together with the experiences of hundreds of others who have written to me over the last few months. But what trials have been done on two-day fasts in humans?
Well, Dr Michelle Harvie, a dietician based at the Genesis Breast Cancer Prevention Centre at the Wythenshawe Hospital in Manchester, has done a number of studies assessing the effects of a two-day fast on female volunteers. In a recent study, she divided 115 women into three groups. One group was asked to stick to a 1500-calorie Mediterranean diet, and was also encouraged to avoid high-fat foods and alcohol. 6 Another group was asked to eat normally five days a week, but to eat a 650-calorie , low-carbohydrate diet on the other two days. A final group was asked to avoid carbohydrates for two daysa week, but was otherwise not calorie-restricted.
After three months, the women on the two-day diets had lost an average of 4kg, which was almost twice as much as the full-time dieters, who had lost an average of just 2.4kg. Insulin resistance had also improved significantly in the two-day diet groups (see more on insulin on page 54).
The focus of Michelle’s work is trying to reduce breast cancer risk through