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Intermittent fasting is as effective as counting calories, new study finds (npr.org)
82 points by gnicholas on June 27, 2023 | hide | past | favorite | 73 comments


> New research finds that people who try time-restricted eating can keep it up longer than people who count calories.

This is consistent with my experience. IF makes eating a binary choice: either it's eating time or it's not. That simplifies the decision tree in a way that is helpful for me.


Same here - it's much easier for me to not eat than to eat less. Though after almost 6mo of OMAD I better recognize when I feel full (and my stomach is has shrunk?) so I can actually eat less now which is a big deal. All my life I've been a big eater, and eating a normal portion always left me feeling unsatisfied after a meal.

Now a normal portion feels right and me weight is under control, yay!


Do you have any tips for OMAD? Which meal/time do you go for? I do this accidentally sometimes and I always feel either awful all day before I eat or late in the day after I eat.


I focused on dinner only, and would start eating around 4pm and stop at 8pm - 2hrs before bedtime (technically that's 20/4 fasting and not OMAD).

I have coffee in the morning, 1-2 cups, then just water the rest of the day. If you're fasting for true fasting effect (autophagy, etc.) then you can't eat more than 50cal or you'll "break" the fast.

If you're fasting for dieting/reduced calories, then having a protein shake (100-200cal) is OK if it helps you get through the day.

I'm lucky in that my body responds will to fasting, but you may need to ease into it - aim for not eating until 12pm (12-8pm), then push that later each week as you feel better until you get to 4pm or 6pm and are doing OMAD.

Also very important when fasting is food quality. OMAD is marketed as "eat anything you like and lose weight!", and while that may be true you'll feel like crap if the only meal you have pizza and ice cream and beer. Start with a salad, then get some good protein & fat in your entree, with a side of carbs. Dessert is OK, but it should be a treat - not a full serving/second meal.


One note from experience.

Its better to stay under 50kcals (bit of milk with coffee), than to have small amounts of food (breaking autophagy). Small amount of food will cause hunger triggers making you hungry all the time.

With no calories my hunger fades away and its only mental experience of your brain saying 'you should be eating now' rather than physical one of your stomach rumbling.

Its a very interesting physical vs mental experience.

One more thing. To make most of OMAD its better to switch to Keto diet and focus on eating proteins.


Also, the non-alcoholic beers from Athletic Brewing are great and low-calorie. Their "Athletic Lite" is only 20cal, or their gluten-free is 45cal. The IPA is 65cal, IIRC.


Black coffee?


Yes, black, unless you can keep the cream+sugar <50cal or are not pursuing strict fasting. Tea is good too, but same caveats about milk+sugar.


Not who you asked, but I do OMAD some days and IF on others. I find it easier physiologically to eat a lunch for OMAD; maybe because it's "opposite" of the day from sleep time.

However, I live with my wife and son, and socially it's much easier to skip lunch and have dinner with the family.

Either works for me, and I don't generally OMAD more than 2 days in a row.

In general I kind of IF (I always skip breakfast) most days, OMAD a couple every couple weeks, do a 24 hour fast every month or so, and a 48 hour one every quarter or so.


OMAD can be effective with many patients for weight loss but it probably isn't optimal for protein metabolism. I wouldn't recommend staying on it permanently. While we don't have any good clinical studies on this issue, over the long run I would be concerned about a higher risk of sarcopenia.

https://peterattiamd.com/ama40/


Yeah but hunger is a spectrum. The longer you get hungry, the worse the effects.

I get brainfog immediately when I don't eat, I cannot think properly (affects my work) and I'm irritable.

How do you manage that?

And before you say "drink", I easily drink 2L of water just in the morning


Many people point to the Minnesota Starvation experiment post WWII, and for the wrong reasons. Many don't realize that experiment was on a restricted calorie diet, and people's bodies react differently to (more or less) steady drip of food than they do to fasting.


I've been mostly doing this, I typically skip breakfast and lunch and eat dinner with my family. The first week or so I was really hungry between meals but it's not so bad anymore. When I get a craving a sip of water usually helps and I like to chew gum to help as well. The weight isn't falling off but I was losing about a pound a week. It's slowed down a bit to maybe a pound every two weeks but at the same time, I'm keeping a consistent weight without having to go to the gym and only walking about 3 miles (sometimes more) a day


Chewing gum triggers digestive processes which expect food. It fills your stomach with acid, enzymes, etc which then have nothing to do. I don’t think it’s a useful habit.


Yeah, it's apparently more useful to skip dinner, but I've found that for social purposes it's much easier to skip breakfast instead.


Some time ago I was through a stage of depression, anxiety attacks and I couldn't eat a thing, my brain was simply refusing to accept a food. I lost a lot of weight then... But this is the worst way of losing weight IMHO. Every now and then I read about intermittent fasting and it reminds me of those days. When simply not eating lead to losing weight.


Not eating as a consequence of deep depression is not the same as not eating for personal choice


The reason IF works is because it over time restores insulin sensitivity. Calorie restrictive eating without IF does not do that. Any style of eating that restores insulin sensitivity becomes a baseline lifestyle as you aren't fighting hormones. Any style that does not means you are going to constantly fight hormones. At the end, hormones will win.


Yeah, well, the problem with time-restricted eating (for me) was that I couldn't get enough protein to my muscles: I got weaker and weaker during the 1.5 years or so that I was doing it. I was eating plenty of meat, but cramming all my calories into 2 meals separated by 3 or 4 hours didn't give me enough protein even though I (unlike the average American) I was eating just as much protein in the first meal of the day as the other meals.

I still try to have been fasting at least 12 hours when I wake up in the morning, but I also try to get 40 g of protein 3 times a day and to separate those meals by at least 3 or 4 hours, and my muscles are back to being able to benefit from strength training like they are supposed to be.


I tried IF for 3 months after hearing all the hype, and also recorded bodyfat and muscle mass figures from weekly scans.

Consistent with your experience I lost weight but it was almost all lean mass -fat was reduced only slightly.

I switched to a ketogenic diet after that and watched the fat melt away. IF clearly works for some people but it sure didn't for me.


Were you doing maintenance workouts at the same time? The human body, counterintuitively, consumes muscle mass first before fat when it is not in active use. Thus to maintain musculature you need to maintain not just protein but activity.

A ketogenic diet, from the literature I have read, has no actual benefit in terms of body fat loss. This is due to the fact that the metabolic pathways shift, but towards dietary fats first and foremost. The pathways that eat muscle and then body fat continue to exist, meaning muscle tone is still at risk without a proper workout regime.

However, I am glad to hear it worked for you! At the end of the day what matters is you reached your fitness goals and can maintain them in a healthy lifestyle.


> I switched to a ketogenic diet after that and watched the fat melt away.

I can't IF with high carbs. It has to be keto for me. I wonder how many other people who can't make IF work have the same issue. I'd wager it's most of them.


I was eating very low-carb when I ran into the aforementioned problem.


Can you say more about these weekly scans? Specifically, I am curious if they involve any x-rays.


They are probably referring to DEXA scans:

https://en.wikipedia.org/wiki/Dual-energy_X-ray_absorptiomet...


Aren't those like 100 bucks a pop?


There's a Dexa scan truck in my area that does them for $60, with discounts for multiple scans (e.g. quarterly).

https://www.bodyspec.com/pricing


the thing is that IF is a keto diet.

The theory is that during IF period your body depletes all carbs stores and is forced into ketosis o produce energy.


55+ vegan OMAD here. Experienced positive recomposition (17% BF to 11%) according to the DEXA scans: grew muscle and lost fat over the same period (1 year) with the same diet (no bulking and cutting phases). Didn't measure for the previous 6 months period, where I lost ~20kg (probably from 25+% to 17%) with the same diet.

My OMAD is technically 2 sub-meals over 4 hours: 4pm: protein shake pre-workout, 5-6pm, weighted calisthenics, 6-8pm, dinner and dessert (protein ice creams).

Could be newbie gains, as I never exercised consistently before 50s: from zero pull-ups to 20+ (+40kg 1RM) over a year; zero dip to weighted (+30kg) RTO dips. zero full (ATG) squat to 10+ pistol squats.

The vegan OMAD has been easy for me, but I've never done other diet and exercise regimens before for comparisons.


I eat 2-3 hard boiled eggs (very high PDCAAS score) a day (intermittent fasting 16:8). I’ve done this for 7 years. My muscle mass seems to have stayed the same.


What do you do about the cholesterol? I love eggs as well, they're very filling for the calories and I can feel the protein going to my muscles... but when I ate them most days, my blood work showed high cholesterol (and I have a family history of heart attacks), so I felt I had to back off on that.


Everybody’s physiology is different of course but I found that even when I was eating 5 eggs a day, my LDL actually dropped. (HDL is more a function of exercise)

I don’t think it’s that clear that dietary cholesterol is highly correlated with serum cholesterol in everyone. For me my LDL seems to be more correlated with excess carbs and sugar — when I cut back on those while maintaining my egg diet my LDL actually got better. (But this is not medical advice, please consult your doctor. May not be true for people with underlying conditions that require Lipitor)

My experience matches this guy’s (but please discount this type of bro science appropriately — YMMV)

https://youtu.be/1Hh25TRG8p4


  I don’t think it’s that clear that dietary cholesterol is highly correlated with serum cholesterol in everyone.
I thought it was clear, by now? There are 4 types of LDL: Small Dense LDL is the stuff that clogs arteries. This doesn't come from food, it is produced by your liver in response to carbs (and NNTs)!

LDL in eggs is the big fluffy LDL. This LDL does not clog arteries, in fact, it CLEANS them! It grabs on to the small LDL and removes them, reducing clogged arteries and heart disease.

But most health professionals still do not make the distinction. Leading to the wrong advice being doled out to patients.


Come on man you gotta tell us how big they are. I am semi-serious, this doesn't seem like a common problem are you a powerlifter or?


The older you get the harder it is to maintain muscle mass, and I am in my 60s.


I do one meal a day (OMAD).

The guideline is approximately 0.5g-1g per pound of lean body mass. 0.5g minimum to maintain mass, 1g to body build. Anything more than 1 isn't useful unless you're trying to hypertrophy like Arnold and live in the gym 8 hours a day.

Example: I'm 6 foot tall and male and about 180 pounds, with the Hume and James formulas, thats 131 to 142 pounds of lean mass; I should be aiming for 65g to 142g of protein. WHO's formula approximates this, CDC's formula has a slightly wider range at 59-208g.

A pound of raw bone-in chicken thighs with skin on is about 60g of protein, and only about 600 calories. I can base a meal around 1 to 1.5 pounds of chicken thighs easily.

All of that said, I'm wondering what you were doing that you were unable to hit your requirements, since it seems to be alarmingly easy.


Timing matters as much as quantity. If you eat that much protein in one large meal then you may not metabolize it effectively. The latest research indicates that it should be split into at least two meals.

https://peterattiamd.com/donlayman/


Scoop of protein powder here and there can do wonders.


I do find it annoying that it's just assumed that weight loss followed by weight maintenance is _the_ goal against which we should measure "effectiveness". _Everyone_ has to eat, and make choices about what and how they eat, but not everyone needs to lose weight, and even among people who should lose weight, other factors like insulin resistance are sometimes more important measures for picking a strategy than weight loss/maintenance alone.

Comparing effectiveness of ways of eating without first identifying (and critically evaluating) goals is meaningless, in the same way it would be meaningless to declare that jogging and weight-lifting are equally effective without specifying a goal.


> but not everyone needs to lose weight

We're getting close to 80% obesity/overweight in the US with many other countries following closely. The majority of people in the west need to lose weight, we just got used to everyone being overweight


Goals are important sure. As the commenter above mentioned, most people are above what would be considered an ideal weight for their body. It's a fair assumption that these people would want to lose weight.

As somebody who finds it harder to gain weight, I still recognise that most have the opposite problem and understand that most content will be tailored to the average Joe, which is fine.


Alongside the above’s other points, there’s various evidence that intermittent fasting and caloric deficits are actually beneficial to the longevity of the human body. Okinawans are a prime example, as they have some of if not the longest lifespans due in part to this.

And while science cannot definitively say whether obesity causes problems, or some underlying problems cause obesity, it’s a fairly well understood fact that even if in your prime you’re healthy while being obese, your joints won’t be further into your life. Arthritis and general immobility are things I wouldn’t wish on my worst enemy.


Another way to do this is 600 total for breakfast+lunch, snack on zero-calorie, walk 2 miles, and save your calories for a nice big dinner. You wind up with 12-1500 calories to play with at night when willpower is lower and snacks are handier.


Intermittent fasting helps me roughly estimate how much I'm eating, which I would say is enough accuracy for most people.


This.

I haven’t lost any weight from IF because going down to 2 meals just meant I ate larger meals — because I’m one of those people who can eat a lot before feeling full. But I’m the exception. Most people feel full more easily.


I've deduced I have about a 20 minute lag between eating and feeling the effects of it.


That’s a useful thing to know! Eating slower does help with calorie intake if you know the satiation signal has a lag time.

For me though the satiation signal has low lag but my satiation threshold is just very high.


Chew thoroughly instead. That will force you to eat slower too and it's easier on the stomach.


Only because most people who count calories actually don't.

They cheat or miscalculate, because the US "serving" system is an insane way to measure nutrients.

Also 3% of body weight over 8 weeks is a nothing burger. Did they control for water intake? It's not in the abstract.

You can lose roughly 1-2% of your body weight in less than 24 hours, simply by sweating.


While I agree with your other points...

"They cheat or miscalculate, because the US "serving" system is an insane way to measure nutrients."

I'm not sure how many people who count calories use the "serving" system. Almost everyone I know, myself included, goes by weight of the food and calories.

Eg. 15g of Peanut butter is 90 Cals


> I'm not sure how many people who could calories use the "serving" system. Almost everyone I know, myself included, goes by weight of the food and calories.

I bet those who actually use the weight of the food (in a standardized 100g increment, for example) have much better compliance and success in weight control, like yourself.


Yeah. My calorie count success has always involved a kitchen scale. It's a pain for the first week but pretty soon you know the kCal/g and you're off to the races.


> Only because most people who count calories actually don't.

There are two slightly different questions:

- how much weight is lost assuming perfect compliance

- how much weight is lost assuming the compliance of the average people

If I am interested in losing weight, I want to know what will work for me, a measly sack of meat with imperfect discipline, imperfect information and so on.

It’s like saying walking on a tight rope though a canyon is not dangerous - assuming you perfectly go through one edge to another. Sure, it’s trivially true. Not very informative though.


I've definitely seen that first-hand.

A girl I dated years ago started counting calories but not including the 3-5 cans of Coke she drank each day, or sometimes she'd only record one or two of them. I tried to point it out, and she insisted she only drank one or two cans/day and they were recorded. I pointed out that we bought a 12-pack of Coke on Sunday, and it was now Tuesday and there were only 2 cans left, so do the math, because I wasn't drinking any of it.

Or she'd buy Oreos and snack on them while gaming and after an hour not realize she's eaten a third of the package.

I don't think she was serious about wanting to lose weight, because anybody really wanting to lose weight probably wouldn't be buying Coke and Oreos. A single can of Coke and 3 Oreos is 300 calories. That's half a meal's calorie budget for someone trying to stick to 1800 calories/day with 3 meals/day.


My wife counted calories for about a year. It was total OCD to get correct numbers. Would get out the scale, so exact measurements. Calculate ever ingredient. Was shocking how much more calories we were eating without realizing it.

Drove the whole family nuts. However, She lost 90 pounds from it all. So can’t complain.


Calorie counting is a great exercise whether you stick to it or not. It's shocking to see how calorie dense are some processed foods and how easy it is to overeat. You get a feel for the portions you should be eating.

Another cool thing is that calorie counting doesn't make you crazy hungry like some diets where the calories have been miscalculated.

However, it is a chore. Apps help.


Calorie counting isn't very precise to start with, even if you're serious about it

https://www.insidescience.org/news/calories-count-only-when-...


Can anyone recommend the best books on this topic? I’m not as interested in weight loss as I am the mental health effects and other physiological factors.


> "Mainly we're cutting out, I think, after-dinner snacks."

I would agree based on my personal experience.


Did the weight maintenance part actually work? Did extending the eating window to 10 hours pause the weight loss?


They measured 4hr and 6hr eating windows versus eat whenever.

I think it’s a scooby-do moment where instead of calculating calories you let your stomach do it based on fullness. Drinking zero calorie drinks is essential through the day and having dessert less often helps of course.

I mostly follow one meal per day and have lost about a pound per week. The mostly part is drinking 1/4-1/2 cup of some oat milk or almond milk with medicine once or twice per day for a few weeks. I didn’t notice any difference in weight loss.


The study with abstract is here: https://pubmed.ncbi.nlm.nih.gov/32673591/


intermittent fasting got me flexing


The headline here feels like a category error.

It literally cannot be as effective, because some people can eat a large amount of food in a short period of time.

What I suspect they mean is that the average person is more likely to stick to IF than they are to calorie counting. This feels intuitively obvious to me - it's a lot less work. Even on a bulking diet it can be really hard sometimes to figure out how many calories are in foods, small restaurants don't have a clue for example.


> It literally cannot be as effective

If you're assuming perfect adherence on one side and gaming on the other, then of course not.

People who don't want to adhere won't in either case and will find ways to cheat or game the process.

Also, IF (and calorie counting) helps shrink your stomach making giant meals less likely over time.

People are terrible at calorie counting too. Even when they don't give up. They stick to it they get sloppy over time. They'll estimate and round numbers, so they can have one more cookie, etc.


With perfect adherence on both sides counting calories cannot be inferior.

IF does not specify a calorie count. If it did, it would be a subset of calorie counting. There is nothing preventing me from eating 3-5k cals in 8 hours, I do it all the time when bulking.

There is nothing wrong with the idea of IF, it just relies on the fact that you will intuitively eat fewer calories if you restrict your eating to a shorter period. By definition then, it cannot be superior to just actually eating less.


You know unless you take into account humans aren’t machines and are terrible at precision and consistency.


I don't understand what we are discussing anymore.

Perfect adherence ignores those things by definition.

I think it's actionably useful to distinguish between "this doesn't work" and "people find it hard/impossible to do this".


Except perfect adherence is a fantasy even in 99.9% of studies.

I feel like we’re in a transition period where science is staring to take the human into account as part of what is possible. And I encourage that. Form nutrition to economics.

Humans are not fully rational. This is normal and expected. Except in science apparently.

Yes, if you are NASA you can fully account for calories perfectly, but outside of at least a hospital environment is it a fantasy.


In the long run your body adapts, physically and hormonaly. Your stomachs shrinks, your ghrelin/insulin get back to normal levels, &c.

It's very hard to over eat in a single meal unless you eat absolute junk food. It's relatively easy to over eat even on healthy food if you eat 3 meals per day + snacks here an there


And to your point, counting calories lost 12 lbs on average, IF 10 lbs ... so quite literally not as effective.

I feel like NPR has gone down in quality in the last few years.


"The difference between the two groups wasn't statistically significant."


n=1




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