• Intermittent Fasting

What is it?

Cycles between periods of fasting and unrestricted eating

 Alternate-day fasting: alternate eating days and fasting days.

On fasting days, have one meal that provides ~25% of daily caloric needs

Whole-day fasting: 1-2 days per week full fasting

Time-restricted feeding: designated daily time frame for fasting, for example, no food between 8 AM and 3 PM

  • Very Low Calorie Diet ( VLCD)

A VLCD is a diet under 800 kcal/day

  • Many commercial formulas are available to physicians; usual composition per day :

Protein: 75-105 g

  • For men: 1.5 g/kg ideal body weight (IBW)
  • For women: 1.2 g/kg IBW to minimize nitrogen losses

Carbohydrates: 50-100 gm; if <50 gm, ketosis likely

Fats: 10-20 g including essential fatty acids

  • Can also be done with store bought foods (protein sparing modified fast)

VLCD VLCD Complications

VLCD complications :

GI (nausea, vomiting, change in BMs)

  • Constitutional (cold intolerance, dizziness, fatigue)
  • Skin, hair, nail changes
  • Amenorrhea
  • Psych (insomnia, euphoria, apathy, depression, irritability, anxiety)
  • Electrolyte imbalances (K+, Na – muscle cramps, arrhythmias)
  • Essential fatty acid deficiency
  • Gout (pre-treat with allopurinol)
  • Gallstones, arrhythmias
  • Obesity and sleep disorders
  • Obesity and chronic stress