Supporters of intermittent fasting often pitch the dietary plan as a cure-all for diabetes risk, inconsistent energy levels and even cancer. For many of these claims, there is some evidence to back it up — but as a clinician, you might still be skeptical.
Well, another study has found that intermittent fasting contributes to weight loss and can reduce atherogenic lipids, blood pressure, and blood glucose. If this doesn’t pique your interest, would knowing that intermittent fasting boosts human growth hormone and cellular repair processes and reduces risk of Alzheimer’s and dementia?
Thurlow has worked with many healthcare professionals interested in getting their health and weight under control through intermittent fasting. She says their biggest concerns are not being able to think critically and experiencing lapses in energy. But the truth, according to Thurlow, is that intermittent fasting usually has the opposite effect, making it an ideal strategy for clinicians, especially during long shifts.
How Does Intermittent Fasting Work?
“You either exist in a fed or fasted state, and all the magic happens in that fasted state,” Thurlow tells Florence Health. “Autophagy, when our body scavenges up diseased and disordered cells, that’s only evoked in fasted state … A lot of [the science] relies on how, when we are in this digestive rest, our body has the ability to do all his clean-up work.”
For example, during “digestive rest,” we can fully empty our stomach, process nutrients better, improve absorption along the intestinal lining, lower glucose levels, and more, Thurlow explains. In addition, while fasting, the body can more easily break down stored glycogen, which helps maintain blood sugar levels and prevents waxing and waning energy.
Tips for Clinicians to Try Intermittent Fasting
Healthcare workers interested in starting an intermittent fasting regimen already have an advantage: Thanks to shift work, you’re used to not eating for 12 hours at a time (or drinking water, or peeing…). That said, many HCPs struggle to adjust to the lifestyle. Here, Thurlow breaks down common challenges and ways around them.
Start with a 12-hour fast.
“That can be pretty easy, if you’re working nights or days,” Thurlow says. “If someone leaves the hospital at 8 p.m. and let’s say they had a break at 5 p.m., then they go home, go to bed, wake up in the morning, and they’ve already fasted 13-plus hours.”
If you start with 12 hours of not eating and feel great, then you can increase to 13 or 14 hours, Thurlow says.
Eat before or after your shift.
There are multiple benefits to this strategy. You don’t count on getting time for a meal, and because you’re fasting, you have another reason not to snack on the unhealthy treats that fill so many break rooms. This could be especially helpful for night-shifters, who often eat to stay awake and experience other physiological challenges.
“The act of sleep deprivation in and of itself will disrupt the endocrine system and circadian rhythm pattern … because our bodies are designed to sleep when it’s dark out,” Thurlow explains. “If melatonin is suppressed because you’re awake, cortisol, the hormone that shifts us into fat storage mode, will go up.”
Over-nighters especially will likely have to try a few different schedules to find the one that works, Thurlow says.
Stick to healthy, unprocessed foods.
“You’re not going to be able to get through that fasting window if you’re not fueling your body properly,” Thurlow advises. “That’s a problem not just with healthcare shift workers — it’s throughout the U.S. We’re eating a lot of processed food. That doesn’t mean there’s not a place for protein bars or shakes … but try to maximize the quality of food you’re eating.”
Some energy-boosting options that come prepackaged (i.e. easy to eat at work!) include:
- Good-quality beef jerky, like Paleovalley
- Clean protein bars, like Bulletproof
- Nuts and packets of nut butters
- Bite-sized cheese
- Protein drinks — pre-made with your preferred, clean powders
Ideally, every food choice you make will align with your overall goals.
Practicing intermittent fasting should mean that you’re not eating as much stuff that comes “in a box, bag or can,” Thurlow says. You can certainly go to the grocery store and prep some food before each shift, but pre-cut fruits and veggies or pre-cooked meat are good options, if you’re too tired.
“There’s nothing worse than realizing you haven’t eaten in ten hours, you’ve got a full bladder … and don’t have time to prepare a meal,” Thurlow says. “You have to be ready to grab and go.”
Try different schedules for work and off days.
This is a popular strategy for beginners, Thurlow says.
“You don’t need to jump in and say, ‘I’m doing 16 hours fasted every day right away,'” she adds. “On the days you work, you can go conservatively, and just do a 12-hours fast. On the days you’re not working you can do longer. Be flexible and give yourself some grace.”
Take advantage of what you CAN consume.
While fasting, you can drink water, black coffee or tea. So, take advantage of the things that help you power through a shift, Thurlow recommends. Drink coffee (but not to excess), and green tea is a great option.
Some of your daily water intake comes from food, so when fasting, you need to make up for this loss. Plus, when your work involves lots of physical activity, the need becomes greater. As a busy clinician herself, Thurlow knows the challenge of staying hydrated and recommends trying to drink 20 ounces of water every shift.
If you struggle to remember to drink water, bring a reusable bottle to work, and every time you see it, take a slug. For people who don’t like the taste of “plain water,” Thurlow says adding a little lemon or lime or herbs won’t break your fast.
Treat yourself well during days off.
It’s easier said than done, but Thurlow’s approach makes it quite simple. On days when you’re not working (at the very least), sleep seven to eight hours a night.
“If you don’t, it’ll reduce your ability to control your blood sugar by up to 60 percent, which makes it harder to lose weight,” Thurlow explains.
Some other tips: Do something that brings you joy to reduce your stress and cortisol levels. Get some sun, if you can, because it resets your circadian rhythm. And try to move your body a little bit every day.
Recognize when it’s not working for you.
For some people, intermittent fasting feels horrible, even if they try every tip and trick Thurlow has to offer. It’s unusual, she says, but it happens because individuals have unique health needs.
“Just like I couldn’t prescribe the same drug for every hypertensive patient, I can’t prescribe the same dietary recommendations,” Thurlow explains. “It just doesn’t work.”
Some signs that you’re on the wrong dietary plan include:
- Lack of energy after doing it for a while
- Mental fogginess
- Sustained, bad headaches
- Abnormally sleepy
- Abdominal cramping
If after 30 days you don’t see an improvement, talk to a nutritionist or switch strategies.
Understand your own bioindividuality.
Beginners need to learn to interpret the signals from their body and act on them, Thurlow says. Intermittent fasting shouldn’t be an all-or-nothing mentality.
Clinicians are so focused on the needs of other that they can become especially disconnected from their own bodies, she adds. As you ramp up, take time to ask yourself questions like: How are my energy levels? How am I sleeping? How do I feel after I eat a particular food? How do I feel after I try a new dietary strategy?
For example, “it’s not normal to eat a meal and want to go take a nap,” Thurlow says. “It means you put the wrong combination of foods together. You should have energy after a meal.”
Once you’ve found what works best for you, stick with it.
“Some people want to start their fast when they’re heading into their shift. Others prefer to start their fast after they’ve ended their shift and had a meal,” Thurlow says. Both are fine, but “consistency is key.”
Who Shouldn’t Practice Intermittent Fasting?
Thurlow calls out that intermittent fasting poses risks for certain groups, in particular, brittle diabetes or anyone who can’t acknowledge when they’re hypoglycemic. In addition, she discourages children and teens, anyone pregnant or breastfeeding, has significant chronic, health problems or a disordered relationship with food.
If you’re interested in learning more about intermittent fasting but you have chronic health conditions, contact your own provider.