16/8 Intermittent Fasting and the risk of Cardiovascular Death

​What is Intermittent Fasting?
 
We humans suffer from a chronic aversion to hard work of any kind, and are always on the lookout for ‘easier’ ways to do things. Weight loss is no exception. While most of us understand the need to keep our weight under control, not so many of us are willing to go about the right way of achieving this. How hard it is to remember to exercise or to relinquish a favorite food that has suddenly been branded unhealthy! Sadly, doctors and dietitians are creatures utterly devoid of empathy. They make no effort to understand our pains, but go on preaching their health dogma. Thankfully though, the market rarely lets any demand – no matter how silly – go uncatered. Thus emerged the ‘fad diets’ with their plentiful promises of results at minimal effort. Intermittent fasting is one of them.
 
Intermittent Fasting is a time regulated eating regime based on an alternation between periods of fasting and non-fasting. This could mean fasting every alternate day, periodically, or for a few hours every day. The most common type of intermittent fasting is the 16/8 practice in which people limit their daily food intake to an 8-hour time window, and fast for the remaining 16 hours. Consumption of only water and non-caloric beverages like tea  or coffee is allowed in the period of fasting. This method is supposed to work by giving the body more time to burn calories. The mechanism is simple – after hours of going without food, the body runs out of ready sugar and begins to attack fat reserves, leading to weight loss.
 
A lot of people find intermittent fasting easier to follow as compared to calorie restricted diets. This is because they are allowed a normal calorie intake as long as they restrict it within a particular time period – they don't have to bother about ‘what’ to eat as much as ‘when’ to eat. With this ease of following and a myriad of celebrity endorsements, intermittent fasting has garnered a lot of popularity worldwide.
 
Until recently, it was believed that intermittent fasting could improve health by lowering blood sugar, blood pressure and cholesterol. It was also endorsed as an effective way to lose weight. Some studies have gone so far to say that it boosts memory and brain health.  However, it is important to keep in mind that all these claims are backed only by short-term trials (the longest of them being only 1 year). This means that there is no conclusive evidence to suggest that intermittent is beneficial, or even safe in the long run.
 
A New Study
 
The American Heart Association (AHA) recently conducted a study to analyze the long-term effects of 8-hour time restricted eating. It was performed on 20,000 adults with an average age of 49 years. The study included data for NHANES participants who were at least 20 years old at enrollment, between 2003-2018, and had completed two 24-hour dietary recall questionnaires within the first year of enrollment. The participants were followed for a median duration of 8 years, with some being followed as long as 17 years. The researchers reviewed information about dietary patterns for participants in the annual 2003-2018 National Health and Nutrition Examination Surveys (NHANES) in comparison to data about people who died in the U.S., from 2003 through December 2019, from the Centers for Disease Control and Prevention’s National Death Index database.
The results are quite thought-provoking. It was found that:
 

1. People who followed the 16/8 eating pattern were 91% (that's no small number) more likely to die of cardiovascular disease.
2. Those who already had cardiovascular disease were also at a 66% higher risk of death from heart disease or stroke.
3. Intermittent Fasting did not lower the overall risk of death from any cause.
4. There was no evidence to show that those eating within 8 hours per day would live longer than those who followed a standard schedule of 12-16 hours. In other words, intermittent fasting does not contribute to longevity. (Disappointing, but true.) In fact, the traditional eating practice was associated with lower mortality among cancer patients.

 
Future research is expected to reveal the exact biological mechanisms behind this association of time-restricted eating and adverse cardiovascular outcomes.
 
Conclusion
 
All this goes to suggest that while intermittent fasting may have its benefits, in the long run it adversely affects our health. Even before this study, medical practitioners have highlighted several drawbacks associated with this regime. It has been known to cause hunger, consumption difficulties, fatigue and dizziness. In the elderly, it has been linked to an increased risk of arrhythmia, stroke and diabetic ketoacidosis. The sharp fluctuations in blood glucose levels caused by it may lead to severe hypoglycemia, making it particularly fatal for diabetics on medication. Consequently, intermittent fasting is strictly not advised for children and teens under 18, pregnant and breastfeeding women, diabetics, those doing heavy physical work, and those with eating disorders.
 
Additionally, an earlier study by AHA, though not specifically about intermittent fasting, found that time restricted eating does not prevent weight gain over time, or even yield better weight loss results than any other healthier alternative.
 
It is necessary to educate ourselves of the health risks posed by any such regime before incorporating it in our lifestyle. As is seen in most cases, the benefits of these seemingly-lucrative practices are heavily outweighed by the potential hazards. When it comes to health, it is wrong to choose short-cuts. They may be easier but are rarely safer.  The best option available to those seeking to lose weight or improve health is to follow a balanced diet, replete with all vital nutrients and plenty of exercise. The simple practice of eating large amounts of vegetables, fruits, fish, whole grains and cutting down on red meat and processed foods can work unacknowledged wonders. At all times, the most effective approach is to adopt personalized dietary recommendations, specifically curated in accordance with individual health status and latest scientific evidence.