Fasting Away Heartburn

Day 27, Fast Day #13

Ever since I turned 22, it seems like I have been at war with my GI tract. I am not sure if this was due to some gene switching on or off, or if years of stomach abuse caught up with me in college. Perhaps it might be a long-term effect of eating the 15% butterfat University of Maryland ice cream. (For me, the Fear the Turtle flavor is a spiritual experience, so if you ever are in Maryland, make the trip to eat at the dairy's ice cream.) Either way, it has not been a fun war and I lose to my gut most of the time.

Where my freshman 15 (lbs) came from, but probably not where all of my tummy troubles come from. Genetics is more likely, especially in the case of my lactose-intolerance.

One of continuous digestive wars that is being waged in my body is an acid attack. I have regularly experienced heartburn and acid reflux (gastroesophageal reflux disease or GERD) in some combination for almost a year. I blame the stress of wedding planning. 

Don't get me wrong, I am well aware that a lot of the foods I love to eat are commonly labeled as "heartburn triggers." All the yummy spicy, garlicky, oniony, citrusy, minty, fatty, and chocolatey ones I love are labeled "triggers." Plus I drink caffeine and alcohol, also supposedly heartburn triggers. However, what I have learned from researching heartburn for this blog post is that the first-line recommendations for acid reflux might be the result of medical practice being trigger happy.

Contrary to what one would think after reading through lists of foods and drinks to avoid if you have heartburn (like this one), there isn't an large or overwhelming body of evidence showing that quitting these foods or drinks will help with GERD even if they influence stomach pH (according to this meta-analysis of common heartburn first-line recommendations). Basically everything I was told or have read about heartburn is based on little or no evidence.

This doesn't really surprise me, since I have tried removing all those yummy foods and drinks by going on a BRAT diet to try to solve my heartburn. Removing "trigger foods" did NOT help me at all. I am sure there are many people that benefit from not eating heartburn trigger foods for one reason or another. I also know there are foods I know make my heartburn worse. The thing is, I don't have causal heartburn. My heartburn is already there whether I ate or not.

So, I still had acid indigestion without any trigger foods while on a BRAT diet and would still wake up early in the morning because of horrible stomach pain. I tried the usual antacids, OTC medications, and herbal remedies (peppermint and papaya) to deal with my sour stomach. Using omeprazole daily for a bit was my only relief from the stabby, debilitating heartburn pain at my worst point early last December. If I skipped a day, I was in trouble. No I did not have an ulcer---this was really bad heartburn.

The good news is my heartburn has improved since I started alternate day fasting and I have not needed to take any daily heartburn medication since. I still chew some Tums as a source of calcium with a meal, if I am lacking it that day, but no omeprazole and only ranitidine on occasion. The heartburn hasn't gone away completely, but it is so much better than it was. I have heard from other intermittent fasters that their heartburn worsened from fasting though, so fasting doesn't seem like a universal miracle treatment for heartburn or acid reflux.

I haven't found any specific research published on alternate day fasting (or just fasting) and its effect on acid indigestion, however, I have two theories on why ADF is helping with my stomach acid issues:

Research shows that at least in an overweight population (which can describe me right now), weight loss is an independent factor in reducing acid indigestion. My Body Mass Index (I am not claiming BMI is the most accurate method of determining healthy weight, I am using it as a unit of measurement) has dropped about 2.2 points in the last 27 days, including the additional pound I lost yesterday for 13 total pounds lost. Perhaps even just losing this amount of weight from ADF has pleased my stomach acid gremlins.

My second theory is that I am producing less stomach acid because I am eating smaller meals and eating less often ("shrinking my stomach" or at least its capacity). In the same meta-analysis where Kaltenbach looks at the body of research around first-line heartburn remedies, she emphasizes that acid exposure increased with volume of food, whether it is has high or low fat content. Controlling my food portions and being conscious of servings sizes due to starting ADF may also be helping with my heartburn problems.

Even though I am not entirely sure why my heartburn has lessened or if it related to intermittent fasting, I am happy about it. On that note I hope everyone has a great weekend and if you celebrate Cinco de Mayo, like I will be, have fun!

What I Wish I'd Known Before Starting ADF

Day 25, Fast Day #12

This morning I woke up hungry, so I had a feeling it would be a tougher fast day. Since eating a lunch of a reduced fat string cheese (50 calories), my low-calorie tuna salad (72 calories), a can of Progresso Light soup (120 calories), and a whole cucumber (45 calories) and celery stalk (9 calories) with Newman's Own Balsamic Vinaigrette Lite (45 calories), I feel quite full. I also have some calories left for an evening snack. 

Despite almost eating half of a pepperoni pizza for breakfast yesterday (haters gonna hate), I have somehow managed to defy physics and stay at a total of 12 lbs lost.

I am quickly approaching a month into this ADF adventure and we all know hindsight is 20/20. This is why I have some words of advice for my past self who was considering jumping into alternate day fasting, and anyone else thinking about radically changing their eating pattern through intermittent fasting:

1) Make sure fasting is appropriate for you - If you have diabetes, have an eating disorder, are pregnant, are underweight, or are under 21 you should not fast. If you have any other known medical issues or are on medications, you should also be cautious before doing any diet not prescribed by your doctor. If given the option, I probably would have done this first instead of deciding with Zach one day before running errands that today is now a "fast day."

2) Know what and how you are eating normally - I was not trying to eat healthy at all prior to starting ADF, so the transition was pretty rough for me. I would recommend prior to fasting to start tracking your caloric and nutrient intakes. Calorie tracking alone has been an eye-opening realization for me as to how I ate and what my diet was missing to begin with.

3) Make a plan - Come up with a plan on how you are going to get in as many nutritional requirements as you can on both fast days and feast days. If you can't reach them just through food alone, figure out supplements that are effective and safe that you can take. For me, the struggle is always calcium since I have issues with dairy. I also usually plan out and prepare (if necessary) my food for fast days in advance. I feel like if I have a plan and the food is ready, I can stick to the 500 calorie limit and avoid temptation and slip-ups easier.

4) Prepare your gut -  I also highly recommend getting your body used to a lot of fiber if you aren't already. You will be eating a lot of veggies alternate day fasting. A lot of people have bowel movement issues (too much or lack thereof) when starting alternate day fasting. I think this is largely due to the change in the amount of fiber, if you didn't eat enough before. I also take probiotics supplements regularly (which I did before ADF) since it helps me with dairy and consequent tummy troubles. Probiotics are awesome.

5) Accept the fact that hunger is uncomfortable and you will be hungry - Since fasting involves not eating for longer periods than a lot of people are used to, or not as much food as people are used to in a day, you will more than likely experience hunger. Hunger is not fun. Your body will become more accustomed to the eating schedule if you stick with it though. Start a hobby (for me, blogging) or catch up on to-dos on fast days. Staying busy keeps your mind off of being hungry. Drink lots of fluids and eat food with lots of fiber to stay fuller, longer. Remind yourself on fast days that in 24 hours you can eat bacon if you want.

6) Be prepared for side effects of hunger - Zach says he never experienced any side effects from ADF. However, I know I did early on. I had a nagging headache on my feast days for the first week. I have read that other people, when starting ADF, also have gotten these headaches on fast days. They are most likely a side effect of hunger. If you get migraines, you should probably have any medication you take for them handy, or maybe start fasting on non-work days so you can lay in the dark for awhile if you need to (or whatever else you need to for migraines). Hunger might also make you light-headed and irritable. I know I can feel "hangry" at times. You also might feel tired or fatigued from fasting. Some people even get nauseous. I felt a little dizzy my late in my first couple of fast days and was tired. But now I am usually more productive and usually at least as energetic on my fast days as my feast days, if not more so.

7) Be okay with a little failure - Failure is human. A lot of us are used to the feeling of failure since "lose weight" is often on the New Year's resolutions list (this has been on my list since college). I have already failed a lot. I have missed fast day and feast day calorie goals (eaten way too much on both). I have also eaten junk food, had to totally guesstimate portions to track calories, and have probably forgotten to include here and there to add to my food diary. This is okay. I have accepted I will fail, do fail, and am not getting disappointed about it. It is important to keep long-term health goals in mind and just keep working on them.

Fasting as Detox: Debunked

Day 24, Feast Day #13

One of the most common claims made about the benefits of fasting (whether it be dry fasting, water fasting, juice fasting, etc.) is that the process releases "toxins" stored in your body so your body can dispose of them. This process is usually called "detox" by the marketers of various detox systems including: food, drinks, supplements, herbs, cookbooks, saunas, foot pads (that turn color when exposed to any type of moisture), various spa products, enemas (even ones involving coffee), and more. Most of these detox systems make claims not evaluated by any safety or health regulatory institution.

There is a lot of dubious information about health in the media and on the internet in general, not just about fasting as a form of detox. Most of these unsubstantiated claims are based on pseudoscience and are meant to either get you to spend your money, join something (and then probably spend your money on something), or scare you (and use your fear to get you to spend your money on something, sometimes instead of something else you spent your money on previously). 

Lucky for marketers, humans can be incredibly gullible when it comes to accepting bad or false health science. A well-known example is when there was widespread panic in the US in 2011 about apple juice because TV personality and celebrity Dr. Oz (who apparently does not practice the scientific method) claimed apple juice contained unsafe levels of arsenic. This was based on misleading data he had a lab run for him (total arsenic which includes harmless organic arsenic instead of only harmful inorganic arsenic). The FDA and many other scientists and doctors called him out for his misleading and false claims. Yet, there are still people that cite Dr. Oz in their belief that apple juice could kill them because it is a cocktail of poison containing dangerous levels of pesticides from China. Perhaps some of these people are the same ones doing coffee enemas for health.

These are some claims I have run into about fasting as a form of detox:

"Fasting also allows for the body's enzyme system to focus on detoxifying and breaking down toxins in the body quickly and efficiently without the job of heavy food digestion. During fasts, toxins are being circulated in the body in order for our organs to de-arm them." - Chicago Tribune (Health)

"And this is what the body will do during a fast. It will take advantage of that time and energy to do some housecleaning. The overloaded, overworked system, unable to properly handle all the toxins, has been storing any excesses in the tissues where they can be dealt with later. This is one of the great health benefits of fasting in that it offers this opportunity to play "catch up". - All About Fasting

"Juice fasting provides many of the benefits of water fasting without most of these problems. A gentle, controlled juice fast doesn’t create a healing crisis, releasing toxins into the bloodstream more slowly and at a rate your body can handle more comfortably" - Raw Food Life

What on Earth are these claims based off of? What credible research shows a correlation between fasting and detoxification of the human body? Well the short answer to these questions is that there is currently no scientific basis for these claims. 

The only account I have even seen referenced (on the unreliable WebMD) about anyone measuring a decline in body toxins through fasting turns out to be an incorrect reference about Jack Goldstein used by the psychological researcher Chris Strychacz. I looked at the text of Jack Goldstein's book Triumph Over Disease by Fasting And Natural Diet, and there is no mention of him accurately measuring his toxic output in tongue scrapings (or anything else) and certainly no mention of him reducing DDT in his body (or other toxins) from his body while fasting. Goldstein does mention a foul-smelling coating on his tongue and bad breath during his fast. I am 100% positive this is caused by acetones created during ketosis. Goldstein was scraping his tongue to get the nasty, smelly coating off. He wasn't measuring anything. He chalks everything up to his body leaching out toxins, which there is no proof of.

Your kidneys and liver are your body's 24/7 detox system. Take care of those organs if you want to filter out your body's toxins, Fasting could theoretically help some people with reducing risk factors of liver disease and kidney disease if fasting indeed reduces insulin sensitivity (which has been seen in mice). It can also help people maintain a healthy weight, since being overweight is a risk factor for diabetes. Diabetes can really mess up your kidney and liver. Liver disease and diabetes led to my grandfather being on dialysis when his kidneys gave out,

My opinion is that if fasting makes you feel better and you are able to safely do it, then good for you. However, until proven otherwise, I wouldn't get your hopes up about fasting being the key to "detox." There is nothing wrong with enjoying a fruit and veggie smoothie just because they are yummy and have lots of good nutrients, however.

Week 3 Summary

Day 23, Fast Day #11

I lost another 2 lbs for a total of 12 lbs. Today was harder to stay motivated just because neither Zach or I got enough sleep since we stayed out late last night and had to get up early (for us on a Sunday) to volunteer at our church today. Also, I might have had a chocolate hangover from two different desserts for my birthday happy hour/eating & drinking fest with friends. It was a good birthday week. Next weekend may be a repeat of bad eating behavior since we have some friends from out of town staying over next weekend.

I skipped a summary last week due to being out of town. So I spent some time last night looking at the numbers from all three weeks since I started alternate day fasting:

Calories
Week 1: 1,437 kcal or 76% of baseline calories
Week 2: 1,938 kcal or 102% of baseline calories
Week 3: 1,680 kcal or 89% of baseline calories

While ADFing: 1,685 kcal or 89% of baseline calories
Baseline Days: 1,896 kcal

All Feast Days: 2,756 kcal or 145% of baseline calories
All Fast Days*: 507 kcal or 26% of baseline calories

For reference
Week 1: 4 fast days, 3 feast days
Week 2: 3 fast days, 4 feast days
Week 3: 3 fast days*, 4 feast days


*Includes faux-fast day that was my mama's birthday dinner.

Alternate day fasting has reduced my average calorie intake overall, despite me being very bad about sticking to it this past week due to birthday festivities. It is clear to me that one of the things I need to work on is not using my feast day as an excuse to eat everything. More importantly, not as an excuse to drink whatever I want. It is amazing how many empty calories from sugar one can consume in the form of cocktails. I feel like my food decisions have improved over the last couple of weeks because I am more aware of the calorie and nutrient value of foods. I am basically retraining my mind and body on how to eat.

Some other things I need to watch and lower for a healthier diet is my sugar, fat, cholesterol, and sodium intake. I finally managed to meet the DRV of potassium on one day this week by eating a large volume of tomato soup. However, this also had a lot of sodium in it too, so I am sure a lot of that was neutralized.

I also expect the rise and fall of average calories every other week (so far) to be due to the number of fast versus feast days I have on a given week.

I also ordered and received a copy of Dr, Michael Mosley's The FastDiet, so that should be useful and hopefully motivating. I am already liking the calorie guide in the back.