Intermittent fasting (IF) has become a very popular method for losing weight and improving health. Advocates of intermittent fasting claim that it lowers diabetes risk by decreasing insulin resistance, enhances growth hormone production, which is good for anti-ageing and improves cognition through the release of dopamine.

Intermittent fasting is a way of eating that focuses on WHEN you eat and not so much on WHAT you eat. It involves going without food for a determined period of time.  Popular approaches are the 16:8, where you fast for 16 hours (say between the hours of 7pm and 11am), and then eat within an 8-hour window or the  5:2 method where you restrict calories to about 500 calories for two days a week and eat normally the other five days. Others prefer a 24-hour fast once or twice a week and there are a few other variations.  As trendy as fasting has become, is fasting beneficial for everyone and more specifically, should women be fasting? It seems the answer is a little more complicated than a simple “Yes” or “No”.

What do the experts say?

Dr Jason Fung, a nephrologist and a world-leading expert on intermittent fasting and low carb diets explains that fasting isn’t a new idea. Both men and women have been fasting for religious reasons for thousands of years, with usually only pregnant women, the sick and children being exempt from this practice.  He further states that in his own clinic, where they have treated close to 1,000 patients using fasting protocols, he hasn’t noticed any significant difference in results and outcomes between men and women.   If anything, he says, “the women tend to do better – men, it seems, are sometimes just big babies“.

Dr Amy Myers, a globally renowned leader in Functional Medicine, offers a cautionary warning saying that IF isn’t for everyone, despite its potential benefits for autoimmunity and chronic disease. In her view, if you are a woman or are dealing with hormonal imbalances, thyroid issues, or adrenal fatigue, IF may not be the best option for you. Fasting can throw your hormones out of balance and mess with your menstrual cycle and sleep patterns.

Unfortunately, specific research into women and fasting is sketchy at this point in time, but there is some evidence to indicate that women should approach it with caution. Keeping that in mind, individual self-experimentation and common sense must prevail when trying to figure out whether it is the right strategy for you. Be well informed on how best to do it and have a good idea of your current state of health, especially in the hormones department. Even when executed wisely, IF might not be what your body needs – and that’s OK. What isn’t ok is pushing ahead regardless just because everyone else is doing it.

On a positive note, IF is a simple and easy dieting strategy. Skipping meals means less time in the kitchen and there is no need to count calories or macronutrient ratios.  It is just another way of eating less, improving insulin sensitivity and encouraging your body to burn its own fat stores for energy.  Of course, what is important to remember is that if you over-consume calories and/or eat all the wrong foods in your eating window, any benefit that might have been gained during the fasting period will be lost and fat loss hindered.

What could go wrong and why?

A woman’s hormones are very sensitive to external stressors. This protective mechanism has, from an evolutionary perspective, ensured that procreation is hindered when conditions are less than ideal to bring a baby into the world.  Attempting to fast for too long or too frequently can trigger a stress response since the body interprets the lack of food as starvation. Your body doesn’t know that you are fasting by choice and not famine. During times of stress, the stress hormone cortisol becomes elevated and the production of estrogen and progesterone starts to decrease. Imagine a domino effect – when one hormone is thrown off balance, the rest are also affected. If the stress persists, cortisol can then become too low resulting in adrenal fatigue.  Hormonal imbalance has implications for fertility, mood, energy levels and weight management.

For some women, adding a fasting protocol on top of their daily routine of too little sleep, overly intense workouts, a stressful job, emotional/relationship stress and even the toxic load of chemicals from cleaning and beauty products, can literally be the straw that breaks the camel’s back. You need to evaluate your personal situation carefully. Ask yourself whether your body can handle the additional stress of fasting right now or whether you need to find ways to reduce your other stressors before attempting to fast.

How should women approach IF?

In general, women are better off adopting a more relaxed approach to IF than men. A man’s hormones are more robust and they seem to gain all the benefits of IF with hardly any drawbacks because of this.  It’s difficult to accurately define exactly what a more relaxed approach is since study data is sparse but here are some guidelines to help you on your way if you are a woman:

1. Start slowly.
2. Ideally keep a fast to between 12 and 16 hours.
3. Don’t fast longer than 24 hours.
4. Don’t fast on consecutive days.
5. Drink plenty of fluids such as water, bone broth and herbal teas while fasting.
6. Opt for gentler exercises such as yoga, walking or Pilates on your fasting days.

Those new to low carb dieting should ideally eat this way for at least three months before incorporating intermittent fasting.  Fasting in a fat-adapted state is much easier for the body to handle.  If your attempts at IF lead to intensified hunger or cravings, changes in your menstrual cycle, disturbed sleep, a drop in energy levels, poor concentration or just generally not feeling good – stop fasting.  If you currently struggle with or have a history of disordered eating due to conditions such as bulimia or anorexia, it is probably best to give IF a pass altogether.

Lynne Maccallum, a Clinical Nutrionist and Functional Medicine Practioner based in the Western Cape, says that in her clinical practice she has seen positive benefits when IF is implemented in the correct way. This means the protocol needs to be personalised for the individual, he/she should be eased into it gently and must be monitored. Through intermittent fasting, her clients have experienced weight loss as well as resolution of medical conditions such as insulin resistance, leptin resistance, polycystic ovarian syndrome, blood sugar imbalances and type 2 diabetes. She is of the opinion that IF can definitely help kickstart a sluggish metabolism, which is very helpful for those battling with stubborn weight gain. For women, Lynne prefers to recommend the Crescendo Fasting protocol, which starts off slowly with a 12-hour fast twice a week and builds up from there. She states that fasting can be prescribed as a safe medical intervention and lifestyle regimen, which can improve women’s health in many ways but should be avoided when there is an existing thyroid condition and/or adrenal or circadian rhythm dysfunction.

Article written by Nicky Perks for Lose It magazine (Volume 30)

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