Speaker A [00:00:02]:
Welcome to the Paralysis Nutrition Podcast, where changing your eating habits is the key to losing weight, improving bowel health, and feeling your best. I’m your host, Fatima Fakouri. I’m a registered dietitian who’s married to a quadriplegic and specializes in nutrition for paralysis. Get ready to be inspired, educated, and motivated so you can take control of your health using the power of food. Let’s get started. This is the Paralysis Nutrition Podcast. Hello, everyone. Today’s episode is going to be about intermittent fasting.
Speaker A [00:00:36]:
One of the most popular diets, I think, in the sci and paralysis community is intermittent fasting. And so I get a lot of questions about it. People want to know, why don’t you like intermittent fasting? Like, what’s so bad about. It doesn’t seem so, you know, restrictive. It doesn’t seem so extreme, you know, why don’t you like it? So today I’m going to tell you why. Intermittent fasting is not a good choice for people who are living with process. So intermittent fasting, if you are not familiar with it, it’s basically a diet pattern, right? An eating pattern where you get a window of time in which you can eat. So the window of time can depend.
Speaker A [00:01:30]:
Some people fast for 18 hours, some people fast for 12 hours. And so the main thing about intermittent fasting is that you’re going to be eating during that set window of time, and when you’re not in that window of time, you’re not going to eat. So there are more extreme types of intermittent fasting. I’ve heard up to 40 hours. And that, to me, is just not a good idea. So things like water, coffee, anything that doesn’t have calories. So tea, you can have it anytime that you want, but you can’t eat real food or any drinks that contain calories. So, for example, coffee with milk, that wouldn’t be allowed, but black coffee would be allowed during the fasting time.
Speaker A [00:02:26]:
So, for example, if you are on a. What’s a Popular one? The 16 8. 168 is probably the most common or popular type of intermittent fasting. Like I said, it, it varies, you know, but the 168 is, I know, very popular. So in that method, the 16 means that you are not eating for 16 hours. So that’s the fasting part. And then the eight hour, the. The eight of the 16 eight means that that’s your eating window.
Speaker A [00:03:01]:
So you can fit in two meals, three meals, whatever you want during that time. So that I’m going to talk pretty much about that type of intermittent fasting. Because that’s the one that I hear about the most. There are other types. Maybe in a future podcast I’ll talk about them. But everyone that asks me about intermittent fasting or any client that I have in my coaching program that says I was doing intermittent fasting, they’re pretty much all doing 16, 8. So what does that mean? That means essentially they don’t eat breakfast and they eat usually from 12pm till 8pm and then they stop eating. So why is that so bad? Well, I’ll tell you why.
Speaker A [00:03:48]:
One, there is no way that you’re going to get enough protein, fiber, nutrition, you know, like your minerals and all that. There’s no way that you’re getting what you need in eight hours because you’re probably going to eat two meals. Most people are not eating more than two meals. So it’s essentially just skipping breakfast for most people. Eating lunch around 12, eating again probably around three or four, and then maybe eating around eight. So it’s usually a meal, a snack and a meal. So how are you going to, let’s say, for example, say, you know, your calorie number is around 1500 for weight loss. In my coaching program, I do set individual calories and protein goals, carb goals for everyone in the program.
Speaker A [00:04:44]:
So say, for example, you’re in my program and I give you 1500 calories and I tell you, all right, I want you to eat 70 grams of protein a day. This is just hypothetical. 70 grams of protein in just eight hours is tough. It’s really tough because it’s not enough time to get in that protein. One egg has seven grams of protein. How much? You know you have to eat three full meals and a snack worth of food in just those eight hours. Right. And again, I’m going to use the 16, 8 example because it’s the most commonly used or popular type of intermittent f fasting.
Speaker A [00:05:25]:
So the first reason I don’t like this for people with paralysis is because I don’t want you to lose muscle, right? So you need to eat enough protein, otherwise you will lose muscle. You also will be at higher risk for skin breakdown if you’re not eating enough protein. So hypothetically, let’s say your goal, if I set a protein goal for you is 70 grams per day, you’re gonna have to eat that 70 grams of protein in just eight hours. That’s hard. What I usually do for people say, for example, 70 grams of protein is your goal. I would tell you 20 grams at breakfast, 20 grams at lunch, 10 grams for a snack, and then 20 grams at dinner. Of course, not every day is gonna be exactly that. If you’re a little short at breakfast, you could make up for it at lunch.
Speaker A [00:06:16]:
Say you’re 15 for breakfast, you could do 25 at lunch, whatever. But do you know What I’m saying? 70 grams of protein split between three meals or three meals in a snack, totally doable. 70 grams of protein in eight hours in just two meals. That’s tough. Okay, so the first reason I don’t like intermittent fasting is because I don’t think that you can get enough of what you need, namely protein and also fiber. Okay? So if you’re not eating enough fiber, you are not going to be getting enough fruits and vegetables and whole grains, which also contain a lot of vitamins and minerals. You’re also not going to be able to feel full in a calorie deficit, which is what we need to be in a calorie deficit for weight loss. So if your body burns 1600 calories a day, you need to eat less than that, not a ton less, but say 1,400.
Speaker A [00:07:13]:
Okay? That’s a, that’s a moderate 200 calorie deficit. So you need to eat of that 1400 calories. You need to get all the protein in, you need to get the healthy fats in, you need to get the fiber rich carbs in. How are you going to do that in just eight hours? That’s going to be really hard. The second reason I don’t like intermittent fasting is because like I said, almost Everybody does the 16, 8, which means that they’re not going to eat till at least probably noon. Okay, so maybe some people start a little early, maybe they do 11 to 7 is their eating window. Whatever it is though, it’s skipping breakfast, right? That that morning meal is not eaten on a typical intermittent fasting schedule. The problem with skipping breakfast, other than, you know, what I just said, number one, is that you’re not going to be able to get enough of what you need, namely protein and fiber.
Speaker A [00:08:08]:
The other reason is because if you’re skipping breakfast, that means that for the vast majority of people that I work with, they do a morning bowel program. So if you’re doing a morning bowel program on an empty stomach, it is taking you longer than it needs to. I have done, I don’t know what episode it was, but I have done an episode about this before about bowel health and why breakfast is important. But I’ll just kind of summarize here. If you have a, if you have paralysis, you Have a slower digestive system. You have slow gut motility. So that doesn’t mean that your gut doesn’t move at all, which is what some people think it means that your gut moves slower. Okay, what can we do to stimulate the gut to move and, you know, make those pulses, Peristalsis, it’s called, so that the stool can move through and you can poop.
Speaker A [00:09:13]:
What can we do to stimulate that? Eat a meal. So I always recommend eating a meal 20 to 30 minutes before your bowel program. The vast majority of people that I work with and that I speak to on social media, they do a morning bowel program. So if you’re doing intermittent fasting and you’re not eating till 11, 12 o’clock, that means that your bowel program is not as good as it could be. Your bowel program is taking longer than it should or than it could. Right? If it takes you an hour, an hour and a half to go to the bathroom every morning and you don’t eat breakfast, start eating breakfast and see what happens. People see awesome results when they start eating a meal before their bowel program. So with intermittent fasting, you are essentially, if you’re doing morning bowel program, you’re essentially trying to poop on an empty stomach.
Speaker A [00:10:04]:
And that’s going to be really hard. If you have slow gut motility, if you have neurogenic bowel, which everyone with a spinal cord injury, everybody that I work with has neurogenic bowel and bladder, you’re not going to be able to have as good a bowel program as you could. You’re not going to feel empty. You’re not going to have as easy of a time if you’re not eating before your bowel program. So that’s the second reason I don’t like intermittent fasting. The third reason is because a lot of people that I work with have crazy bloating and indigestion. And a big reason why they’re bloated is because they don’t space their meals three to four hours apart. We need to space our meals three to four hours apart so that our migrating motor complex can do its job.
Speaker A [00:11:01]:
What is a migrating motor complex? It is a series of patterns of. What’s the word? How can I describe this? So your migrating motor complex is something that helps clear out your intestines, but it needs three to four hours between meals to actually start working. So imagine your say you ate a meal, okay, and two hours later you’re obviously done eating, but there’s little crumbs there’s little, little crummies left in your intestines at the three hour, three and a half hour, four hour mark. Somewhere around there, somewhere between three and four hours, your migrating motor complex kicks in. Imagine it’s like a street sweeper, okay? It’s coming in and it’s sweeping all the crumbs out. So it’s a series of like, I don’t know why I keep thinking of like waves. But it’s, it’s basically contractions in your intestines that move things along. So any crumbs that are left in your intestines get cleared out at the three to four hour mark by your migrating motor complex.
Speaker A [00:12:11]:
If you’re only allowed to eat for eight hours in the day, you’re probably not going to wait three to four hours before you eat again. You’re probably just not going to because you know that you, you have this like, you know, you’re going to, you’re going to turn into Cinderella, you know, and your coach is going to turn into a pumpkin or whatever at a certain time, right? Not at midnight for you. It’s probably 7 or 8pm, right? If you’re doing 16, 8. So a lot of people who have slow gut motility, who have paralysis, complain of things like bloating and acid reflux and indigestion. And a big reason for this is because they’re not spacing their meals properly. And you cannot space your meals properly with intermittent fasting. You only got eight hours in the case of 16, eight, right? So for someone who already kind of deals with bloating, I would never recommend it to remittance fasting because there’s no respect for that three to four hour window in between meals. And also to go along with the bloating and indigestion, if you didn’t eat from 7:00pm till the next day at 11:00am, okay, because that would be your 16 hours, you’d be quite hungry.
Speaker A [00:13:36]:
You’d probably eat too fast, right? You might not even be making a healthy food choice because you’re so hungry. And you’re probably gonna eat till you’re full, like more than full. What is that gonna do? That’s gonna make you even more bloated. So I do not like intermittent fasting for anyone with paralysis, but especially if you experience bloating, which, I mean, I’m going to say, like 80% of my clients do report some sort of bloating. So not eating slowly, you know, like gobbling up your food and you know, not chewing enough, that’s called meal hygiene. So that’s poor meal hygiene. Meal hygiene is something that we talk about in my Poop Easy with Paralysis program, because in that program, people are trying to improve their gut health so that they can have an easier, more productive, shorter bowel program. So if you’re really, really hungry and you don’t have a lot of time because you know the clock’s going to strike and you’re going to have to stop eating and you’re super hungry, you’re not going to be practicing good meal hygiene.
Speaker A [00:14:48]:
You’re going to eat too fast. You’re not going to chew your food thoroughly. You probably won’t make the best decisions, right, because you’re so hungry. You’re probably just going to eat something that you want because you’re on this diet, right? Intermittent fasting is a diet. So there’s another reason now, another reason. I don’t like intermittent fasting. What is this number four? But I don’t even. I don’t know.
Speaker A [00:15:10]:
As you guys can probably tell. I don’t make notes for this podcast. I just like to get on here and. And talk to you guys. So I think it’s reason number four. The thing with intermittent fasting is the time. So so many people that start working with me say that they’re doing intermittent fasting, and I say, okay, are you tracking your meals? And they almost always say, no, because the focus is on the clock. The focus is I’m only eating for this window of time.
Speaker A [00:15:45]:
What happens when we only focus on the time is that you’re not focusing on anything else. So, like I had mentioned before about the protein and fiber, intermittent fasting doesn’t tell you how many calories to eat. It doesn’t tell you how many grams of protein you need per day. It doesn’t tell you how many grams of carbs or how many grams of fat or how many grams of fiber. It just tells you what time to start and what time to stop. So to me, that’s like a huge missed opportunity for getting what your body needs. Like I mentioned before about the protein, that really is a big deal, you know, for people with paralysis and for anyone who wants to lose weight. You know, our macros need to be in order.
Speaker A [00:16:32]:
Macros are proteins, fats, and carbs. Macronutrients. That’s what that macros stands for or is short for. So when you do intermittent fasting, you’re focused on the eating window. You’re not necessarily tracking your meals to see how many calories am I getting? Do I did I Get enough protein. Like, am I hitting my fiber goal? You’re just looking at the clock. So to me, there’s just a lot to be desired, you know, in terms of what are you eating? So the quality of the food is not the focus. How many, you know, servings of vegetables, how many servings of fruit? This is not any part of basic intermittent fasting.
Speaker A [00:17:17]:
Now, I know that there are a lot of people who are doing intermittent fasting and do track. Those people don’t come to work with me. Those people probably do okay and are okay with intermittent fasting, but that’s usually, I think, more experience person. And that’s not typically who I work with. Typically, the people that I work with are just, you know, trying to lose weight and they don’t know what to do. And so they’re usually not tracking their meals and doing intermittent fasting. I do get people who know how to track their meals, but usually their numbers are wrong, like their calories, their macros are all off. They’re not eating in a calorie deficit.
Speaker A [00:18:00]:
They’re not eating enough protein so that they can burn fat and not lose muscle. If you don’t eat enough calories, you will lose weight, but you will lose mostly muscle. So this is why, you know, I’m very much in favor of, like, an eating pattern, a diet that’s appropriate for wheelchair users, for people who have paralysis who are dealing with not just weight gain. They’re dealing with things like muscle. Right. Like muscle loss. And. And the want or the desire to maintain muscle mass is huge.
Speaker A [00:18:35]:
Right. Because not easy to build muscle. So anyway, so that’s another reason why I don’t like the intermittent fasting. Because we are not focusing on calories and macros, which is what results in weight loss, permanent weight loss with paralysis, we’re just focusing on the clock. Let’s see. Another reason I don’t like intermittent fasting, and this kind of goes along with the last reason, is because the vibe around intermittent fasting is very much like a diet. It comes from a place of no. Like, no, you cannot eat breakfast.
Speaker A [00:19:16]:
No, you cannot eat after your window is closed. No, you cannot eat if you’re hungry. To me, that’s an absolute no. It’s an absolute no. And if you’re not hungry at, you know, 7:00am when you wake up, that’s okay. But I’m sure around 8:30, if I brought you a breakfast, you’d eat it. But people are so, I think, intent on losing weight. And I’m so here for that.
Speaker A [00:19:42]:
You guys because, you know, my husband’s quadriplegic. I know that, you know, 10 years ago when I met him, he was probably 15, 20 pounds heavier. Now he’s at a heavy. He’s at a healthier weight. I know that it’s harder to transfer. I know that you don’t like the way the clothes fit you. I know that it’s harder to push your wheelchair. I get, you know, I guess a, A glance into this because I live with someone who’s quadriplegic, so I understand that deep desire to want to lose weight so that you can feel better in your body.
Speaker A [00:20:18]:
Right. Fit in your chair better, transfer better, do the adaptive stuff that you want to do a little easier. Right. But I don’t want to take things away or coach people from a place of. No, that to me, that’s not my vibe at all. I want you to focus on adequacy. Are you getting enough protein? Probably not. Are you getting enough magnesium? Definitely not.
Speaker A [00:20:45]:
Are you getting enough fiber? Probably not. I want you to think about abundance, not, can’t have this, can’t have that, can’t eat at this time. That’s messed up. And it can be sort of like, I mean, people react a certain way when I say it’s disordered. It is, though. It’s disordered behavior to only eat according to the rules of some diet. That, by the way, isn’t designed for people with paralysis. Does intermittent fasting have favorable results for certain populations in literature, in research? Yes, it does.
Speaker A [00:21:23]:
I do not think that the people that I work with, for example, the kind of people that follow me on social media, you guys who listen to my podcast. I don’t think that intermittent fasting is the answer for the majority of full time wheelchair users who have paralysis. I really don’t. Because of the bowels, because of the protein, because of the fiber, because of the. The lack of focus on what you’re eating and the focus on just the time. That’s why I don’t like it. And I’ll tell you, I would say one in every, I don’t know, one in every five, one in every four coaching clients that I get has either been doing intermittent fasting and not really seeing a ton of results, or did intermittent fasting in the past and didn’t have great results. Could you potentially be in a calorie deficit because you’re only eating it eight hours? Yes.
Speaker A [00:22:25]:
Will you get your adequate protein? Probably not. Will you maybe reach for things that are high carb, high sugar, give you energy because you Are so hungry, probably. So I don’t like intermittent fasting. And that’s not to say that it’s the worst ever, because it’s not. Keto is the worst ever. I have a whole podcast episode on that you can check out. I think it was a few months ago. So intermittent fasting is not the worst, but it is certainly not, in my professional opinion, an appropriate choice for someone who is trying to lose weight and keep it off for good, maintain their muscle mass, have an easy bowel program, you know, maintain good skin, and also maintain a healthy relationship with food.
Speaker A [00:23:16]:
I mean, if you’re hungry, you should eat. If you’re genuinely hungry, you should eat. And I do think that it’s harmful to have these rules, you know, around food. And if you’ve ever worked with me or you follow me on social, you know that I always say all foods can fit into a healthy diet. Do you love a slice of pizza? Then you should have it. Should you have three slices of pizza for dinner? No. Can you have one slice of pizza? A nice grilled chicken Caesar salad? Yes. That’s great.
Speaker A [00:23:54]:
All foods can fit into a healthy diet. You have to figure out, though, how many calories you need, how much protein you need, how much fiber you need to be able to be in a calorie deficit, moderate calorie deficit, so that you can burn fat and maintain muscle mass. Because a lot of people don’t realize this, but when you lose weight, you lose fat and muscle. Everybody does. No matter what you do, you will always lose a little muscle. When you lose weight, you’re not going to burn. You’re not going to burn. Just fat.
Speaker A [00:24:27]:
So when you’re focused on things like the clock and you’re not focused on tracking your meals and tracking macros, you probably will be losing more muscle than you need to. And that’s just. That’s no good. So that is why I do not like intermittent fasting. I do not recommend intermittent fasting for anyone in my program, for anyone with sci, anyone with paralysis who’s a wheelchair user. I hope that this answered this burning question that I get multiple times per week. And you guys, I will catch you on the next episode. Thank you for listening.
Speaker A [00:25:08]:
Until next time. That’s our episode for today. Thanks for listening. I hope you enjoyed it and that you learned something new. Remember, if you want to lose weight with paralysis, improve your bowel health and feel your best you can. It’s possible you just have to change your eating habits. If you need inspiration on how to get started, check out The Paralysis Nutrition Cookbook 101 Recipes to Help you lose weight and improve bowel health. The cookbook comes with a bonus 30 day meal plan and is the perfect way to start eating healthier.
Speaker A [00:25:38]:
You can find it online at paralysisnutrition.com cookbook I’ll talk to you again soon.
