Intermittent fasting (IF) continues to gain popularity. There is some science to it, but when this is mixed up with opinion, and people trying to sell you a specific product to achieve your intermittent fasting dreams, it can be hard to decipher what’s fact and what’s not.
Intermittent fasting can seem a particularly attractive solution to tackling unwanted weight gain associated with the menopause.
By our perimenopausal years, we may be juggling indicators and signs of increased health risk, for example high cholesterol or raised blood pressure alongside hormonal fluctuations that are playing havoc with our weight control. So, is Intermittent Fasting the answer?
Before we delve in, let’s start with some definitions.
The term intermittent fasting (IF) can mean different things so one person’s version of it might differ to another’s. Generally, it means fasting (low or no food consumption) for shorter periods of time, as opposed to longer, prolonged fasts. Here are some common terms and ways of doing it that you may have come across:
What is Intermittent Fasting?
- The 5:2 diet: This involves limiting intake to 500-600 kcals per day on two days each week and eating normally on the remaining 5 days.
- Alternate day fasting (ADF): 24-hour fasts (or limiting intake to 500 kcals max) every other day.
- Time-restricted feeding (TRF): Having a specific window of time where eating occurs, for example the 16:8 protocol that balances an 8-hour eating window with a 16hr fast. The eating window can be picked to suit the individual for example 12-8pm or 8am- 4pm. Other common blends are 12:12 or 14:10.
Which is the Best Way to Fast?
There is no one superior way to fast because it depends on the individual and what is realistic for them. Some people report they feel better and more alert. Others may experience fatigue, headaches, dizziness, mood, and sleep issues.
Menopause may be a contributing factor to many of these symptoms anyway, so we certainly don’t want our eating habits to augment these challenges.
Let’s look at the research then, to help us decide what the right way forward for ourselves might be.
Is Intermittent Fasting Better for Health Generally?
There are different mechanisms by which intermittent fasting could impact health. These vary in terms of how much evidence is behind them, and some of them are more theoretical. A fellow dietitian compiled this list below which I think is a good summary:
Possible mechanisms include:
- Autophagy i.e., removing and recycling damaged parts of cells to boost cell repair.
- Reduced nutrient signalling pathways may impact stress response and longevity genes.
- Reduced inflammation and oxidative stress.
- Synchronising with our body clock.
- Ketosis i.e., a starvation mechanism where the body starts to rely on fat for fuel which increases levels of ‘ketone bodies’.
- Release of brain-derived neurotrophic factor (BDNF) which is a protein involved in brain repair and developing new connections in the brain.
- Impacting immune system function.
- Impact on gut bacteria and metabolic markers like blood glucose and cholesterol.
Why Does Weight Gain Occur in Menopause?
We can see from research comparing the diets of pre-menopausal women to post-menopausal women, that the post-menopausal women have higher levels of glucose, insulin, and inflammation in their bloodstreams after eating. We’re more primed for ‘storage’ post-menopausally.
Our body is just not as efficient at ‘clearing up’ after eating, and this combined with a lower level of oestrogen which essentially offers anti-inflammatory protection, puts us at higher risk of weight gain.
There is also a theory that fat cells will multiple to produce their own supply of oestrogen, in response to lowering levels in the body.
There’s lots going on and you can read more about weight gain in menopause here.
Not surprisingly, strategies that claim to produce weight loss are going to sound appealing, but how does intermittent fasting stack up against more traditional methods of weight loss?
Is Intermittent Fasting Superior for Achieving Weight Loss During Menopause?
The research would suggest not. Intermittent fasting however you choose to do it, doesn’t add anything really compared to conventional calorie restricted dieting. More on this approach later.
Not surprisingly when you compare intermittent fasting to ‘normal’ eating like a recent review looking at 43 studies did, IF comes out with better outcomes. By outcomes I mean things like weight, cholesterol, triglycerides, and waist circumference.
IF also seems to favour insulin concentrations although there was no difference in fasting blood glucose concentrations between participants. So, some of these things feel like they could be of benefit to the menopausal woman.
Here’s the thing though, these studies were anywhere from 1 month to 3 months duration. And these were highly motivated individuals taking part in an official trial. Despite this dropout rates were still high. What this tells us is that doing this stuff is hard, and we’re only looking at the impact over a short period of time. I’m more interested in the long game and sustainable changes.
When IF was compared to calorie restricted dieting there were no significant differences between the groups apart from a reduced waist circumference in the IF group.
When comparing the drop-out rates of intermittent fasting versus calorie restriction, people seem to find it ‘easier’ to do traditional calorie restriction as compared to alternate day fasting. Again, this isn’t really that surprising.
Does Fasting Offer any Advantages to Menopausal Women Specifically?
Some studies show fasting does have a greater effect on a post-menopausal woman’s weight loss, but other data looking at a bigger collection of studies found no significant differences between pre and post-menopausal women.
I should point out that the type of fasting they were looking at involved alternate day fasting with a 500-600 calorie intake on fasting days, which is pretty hardcore in my opinion. Indeed, the drop out rates from the trials show how tough it is to actually stick to this way of eating (and these trials were only short term).
So, Does Traditional Calorie Restricted Dieting Remain the Best Way to Lose Weight?
You could spend an entire week delving into all the research around the best way to lose weight and keep it off. We only have to look at the multi-million-pound diet industry to know that there is more than one person that claims they hold the key to success.
The menopausal woman often feels trapped – lectured about health risks associated with weight gain, whilst living with the realities of a changing body and the psychological impacts of this phase of life. It’s complex!
Weight gain does not automatically link to poorer health, because weight itself is not a behaviour and doesn’t tell you anything about how that woman eats, moves, or thinks – all of which DO play a role in physical and mental health.
For me, I think it fundamentally comes down to the individual – the real woman behind the scenes getting up every morning and getting sh*t done.
We’ve learnt that to-do lists and stressors of daily life, don’t miraculously disappear just because you happen to be on a fasting day. That others that we live with, not following such strict dieting regimes still require feeding and whilst there is now a huge amount of equality, certainly in the clients I see, it is generally still the woman that makes most of the decisions around meal planning.
Practical tips for eating in menopause.
If you would like to try alternate day fasting, short term data suggests it could help you achieve weight loss. Have a think about what you would need to put in place to help you stick to it successfully. As I’ve said I’m not a big fan of excessive restriction and rules. In my clinical experience, it creates negative relationships with food and body and worsens our psychological health and coping strategies day to day. The evidence also backs this up.
Interestingly, most of the research I found seemed to focus on alternate day fasting with various add-ons such as low fat or low carb, all of which sound pretty brutal.
A gentler approach might be to consider time restricted feeding. Again, you must consider what works with your daily routine and listening to body cues is really important. We’ve yet to prove eating in an 8-hr window is superior for health and therefore probably simply supports weight loss by restricting the period over which you can eat.
A simple starting point is to look at your eating habits with curiosity and see over what time frame you are eating in a 24-hr period. I know for many of my clients, the reality is snacking late into the evening as they claw back some ‘me’ time or continue to work through the endless midlife admin. To begin with consider whether you allow your body a 12 hr fast as a minimum?
We know that we are less capable of processing a meal as we age, so eating over a large time span and late into the evening, doesn’t give our bodies the opportunity to ‘spring clean’ everything inside. When we look at fasting in relation to aging, there’s some evidence that intermittent fasting may reduce inflammation, boost cell and brain cell repair. However, most of the research related to this has been carried out in petri dishes or animals, so ongoing human research is needed.
Other Things to Consider About Fasting in Menopause.
With all the other changes menopause brings with it, manipulating our food intake to such an extent that it starts to impact on our mood, stress, or anxiety levels damages more than it achieves. With fluctuating and then declining levels of reproductive hormones, we lose part of the scaffolding that supports our body’s response to stress. Remaining in a fasted state for extended periods of time, will actually create a stress response in the body by raising cortisol levels.
There’s also our body composition to consider. Some data suggests it contributes to muscle loss, which is the exact opposite of what we want to be achieving.
We do not need to put ourselves through gruelling dietary regimes, as punishment for gaining weight in later life. The reasons this happens are multi-factorial and we have yet to see that extreme dietary change is sustainable or indeed superior when we look at the outcomes for health in menopause.
For nourishing support with your diet through the menopause transition get in touch to see how I can help.
To read related articles on this subject, please check out How Do You Get Rid of Menopause Belly Fat and Menopausal Weight Gain – is this where we’re going wrong?