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fasting.",3,[36,78,175],{"id":37,"data":38,"type":26,"version":26,"maxContentLevel":34,"pages":40},"570ef099-68c1-4845-b41a-8eb51ab4f5cb",{"type":26,"title":39},"Introduction to Intermittent Fasting",[41,47,64],{"id":42,"data":43,"type":25,"maxContentLevel":34,"version":25},"80ee8989-f8fa-4968-83d9-67c4ea50266f",{"type":25,"title":44,"markdownContent":45,"audioMediaId":46},"Introduction","**Please note, this pathway is for informational purposes only, and should not be taken as professional medical advice.**\n\nFasting is not a new concept and has been around for thousands of years. However, intermittent fasting, or the practice of restricting eating to certain times of the day, is relatively new and gaining in popularity. This pathway explains the science behind why it works and how to apply it to your life.\n\nIn a nutshell, intermittent fasting takes the concept of fasting and makes it more accessible and compatible with a broad array of lifestyles. This means that you can reap the potential benefits of fasting without going on prolonged multi-day fasts.\n\nNow, you might be wondering when and how did this whole intermittent fasting thing start? What actually goes on in my body? What is the science behind it and is it safe for me?\n\nIn this tile we’ll take a look at how the history of fasting and how the various approaches and science have progressed. We will also touch on the science behind intermittent fasting, by focusing on the biological effects it has on the body.","e8791902-3472-4b98-a409-bc5f8a26ff34",{"id":48,"data":49,"type":25,"maxContentLevel":34,"version":26,"reviews":53},"799a6d4c-bbb3-425f-bd27-6d39d1a675f9",{"type":25,"title":50,"markdownContent":51,"audioMediaId":52},"Fasting and Ancient Times","Throughout history, humans have fasted for several different reasons; be it for religious reasons, medical reasons, or out of necessity due to food scarcity.\n\nFasting is considered one of the most ancient healing traditions in the world. The Greek physician, **Hippocrates**, recommended abstinence from food or drink for patients who exhibited certain symptoms of illness. Plato and Aristotle also supported fasting as a means of improving physical wellbeing and mental clarity.\n\n![Graph](image://c22b09d8-c74c-483d-9e71-b2c38e19e19e \"Hippocrates - the father of medicine\")\n\nThe ancient Greeks believed that fasting is a natural instinct whereby patients with certain illnesses lose their appetite. It was seen as an important natural part of the recovery process. They were also of the view that it increases cognitive abilities.\n\nFasting has also been practiced in many religions (Islam, Christianity, Hinduism and Buddhism) as a way to cleanse or purify the soul and to reap spiritual benefits, such as growing closer to God. These religious traditions are still followed by millions to this very day.","942a1e0e-23dc-4ed1-9101-98e0c77d4868",[54],{"id":55,"data":56,"type":57,"version":25,"maxContentLevel":34},"3a64a0f3-526f-4248-a0fc-7eb64d6b9124",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":58,"binaryCorrect":60,"binaryIncorrect":62},11,[59],"The ancient Greeks used to fast for physical and mental well-being.",[61],"True",[63],"False",{"id":65,"data":66,"type":25,"maxContentLevel":34,"version":26,"reviews":70},"bb79208a-55db-4185-80ed-f75bacec3d68",{"type":25,"title":67,"markdownContent":68,"audioMediaId":69},"Fasting in the 1800 and 1900s","In the mid-1800s E.H. Dewey stated in his book *The True Science of Living* that most illnesses are dietary. This started a movement of prolonged fasting. Early recorded cases of prolonged fasting found in medical literature include 30-40 day fasts between 1880 and 1890.\n\n![Graph](image://776c0ed7-ee36-422b-abb7-abdb1124bfec \"E.H. Dewey\")\n\nBy the 1900s, researchers began to take a huge interest in the effects fasting had on obesity. *The Fasting Cure*, written by Upton Sinclair in 1911, garnered further public attention on fasting and its potential health benefits.\n\nIn 1915, Folin and Denis recommended multiple short starvation sessions as a form of weight reduction, saving prolonged sessions only for extreme cases of obesity.\n\nThe Scotsman, *Angus Barbieri* (1939-1990) holds the world record for the longest fast to this day: **382 days**, from June 1965 to July 1966, during which he lost a remarkable **125 kg**, or **275 lbs!**\n\n![Graph](image://ba7f7408-0e4a-4b52-8e0c-13a9639967ac \"Angus Barbieri before and after his incredible 382 day fast\")\n\nBy 1945, intermittent fasting, or the practice of restricting eating to limited hours in the day, was being investigated on lab rats.","196981dd-07e7-4f9c-9823-c582c15ec499",[71],{"id":72,"data":73,"type":57,"version":25,"maxContentLevel":34},"244c5d5b-bf9a-44e0-b368-e9379974344d",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":74,"activeRecallAnswers":76},[75],"How long was Angus Barbieri's record-breaking fast? ",[77],"382 days",{"id":79,"data":80,"type":26,"version":25,"maxContentLevel":34,"pages":82},"1a7b4ed8-3760-4b86-a6d8-9c87c56d7e5b",{"type":26,"title":81},"Modern Popularity of Fasting",[83,89,103,118],{"id":84,"data":85,"type":25,"maxContentLevel":34,"version":25},"4cd215ea-eb5f-410b-91f5-5ae0bc170331",{"type":25,"title":86,"markdownContent":87,"audioMediaId":88},"Fasting in Recent Years","Over the past 20 years, interest in intermittent fasting has been steadily increasing, due to an ever-expanding body of scientific research on both animals and humans, as well as growing media attention. Shows such as the BBC2 documentary *Eat, Fast and Live Longer* have further brought intermittent fasting into the limelight.\n\n ![Graph](image://d69694c0-5069-48f6-a599-31706e33fe55 \"Search traffic trend data for the term ‘intermittent fasting’ over the last 18 years\")\n\nOne of the main reasons for intermittent fasting’s rising interest is its accessibility: one doesn’t have to suffer over multiple days of starvation to reap the myriad mental and physical health benefits. \n\nIntermittent fasting’s efficacy in weight loss has also garnered it a lot of attention, particularly because of the public endorsement of celebrities and viral before and after pictures on social media.\n\n ![Graph](image://0f599af2-c65a-48d3-a0b9-523fe74a4e0f \"Jack Dorsey, the founder of Twitter, has experimented with fasting\")\n","f15d7155-e61a-404e-84f8-37af24c70d63",{"id":90,"data":91,"type":25,"maxContentLevel":34,"version":25,"reviews":95},"c7d51f7a-de52-443d-924e-58a872303847",{"type":25,"title":92,"markdownContent":93,"audioMediaId":94},"What is Intermittent Fasting?","Intermittent fasting is being increasingly regarded as the modern-day fasting method.  Intermittent fasting has come a long way and is primarily used to achieve health goals and lose weight.\n\nIn a nutshell, intermittent fasting is **an eating pattern in which you cycle between windows of fasting and normal food consumption.** There are a lot of different intermittent fasting routines to choose from, which mainly differ in the duration of the fast and eating windows. In some cases,  intermittent fasters also restrict their calorie intake in their feeding window or they combine intermittent fasting with other diets such as the keto or Mediterranean diets.\n\nThere are many reasons for starting intermittent fasting. For some it's to lose weight, for others it's to target some of the potential health benefits related to fasting, which will be discussed in tile 3.\n\nThere’s no one-size-fits-all option when it comes to intermittent fasting, the best option for you will come down to your personal preference and situation.  ","5bf25624-7590-4b18-872e-35cd5a338f0e",[96],{"id":97,"data":98,"type":57,"version":25,"maxContentLevel":34},"7e7290cc-0081-484b-b902-8ca903cf8083",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":99,"activeRecallAnswers":101},[100],"What is intermittent fasting?",[102],"It's an eating pattern where you only eat food for a fixed window in the day",{"id":104,"data":105,"type":25,"maxContentLevel":34,"version":25,"reviews":109},"cd5480b2-57c2-4f5d-a0d9-33f36ece67a1",{"type":25,"title":106,"markdownContent":107,"audioMediaId":108},"Events that Occur After Food Consumption","All parts of our body (heart, brain, liver, and muscles) need energy to function. This energy comes from the food that we eat.\n\nOur bodies mix the food we consume with fluids (acid and enzymes) in the stomach to digest it. The carbohydrates (sugar and starches) in food are broken down into glucose, a type of sugar.\n\nThe stomach and intestinal wall absorb the glucose and then release it into the bloodstream. Once in the bloodstream, glucose is transported to various organs where it serves as the primary energy source. The glucose can either be used immediately for energy or stored in our bodies for later use. Excess glucose either is stored in the form of **glycogen** in the liver, smooth muscle cells, adipose tissue (and even in small amounts in the brain and blood cells!) or converted to fat.","17baeb34-6077-49d5-af24-7ee4feb13f76",[110],{"id":111,"data":112,"type":57,"version":25,"maxContentLevel":34},"a7df8f75-1f2a-4c17-81fc-df5916789f66",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":113,"activeRecallAnswers":115},[114],"When we digest food, where is excess glucose stored and in what form?",[116,117],"As glycogen in muscles and the liver","As fat in adipose tissue",{"id":119,"data":120,"type":25,"maxContentLevel":34,"version":25,"reviews":124},"356e4778-580d-4700-ad82-a70233712c14",{"type":25,"title":121,"markdownContent":122,"audioMediaId":123},"Events that Occur When Fasting","In between meals, when the body is in the fasted state, the liver converts glycogen back to glucose to keep supplying the body with energy. Typically, an inactive person takes about **10-12 hours** to deplete their glycogen stores. And someone who exercises will use up their glycogen stores in less time because the body requires more energy when engaged in physical activities.\n\nOnce the reserve of glycogen in the liver is depleted, the body taps into energy stores in adipose tissue (body fat). Adipose tissue is found all over the body. It can be found under the skin (subcutaneous fat), packed around internal organs (visceral fat), between muscles, within bone marrow, and in breast tissue.\n\n ![Graph](image://1632553b-4de0-4cdc-a306-b5a46824d98f \"Visceral fat in the human body\")\n\nWhen the body taps into the energy stores in adipose tissue, fats are broken down into free fatty acids. The fatty acids are then converted into additional metabolic fuel in the liver. Thus, if the fasted state lasts long enough, the body burns fat for energy and loses that extra fat.\n\n\n\n","060493e1-1a53-4af3-b70b-9da58b60128e",[125,132,141,148,155,161,168],{"id":126,"data":127,"type":57,"version":25,"maxContentLevel":34},"031b5f06-55dc-4781-a426-700648849dfa",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":128,"activeRecallAnswers":130},[129],"How long does it typically take to deplete glycogen stores?",[131],"10-12 hours",{"id":133,"data":134,"type":57,"version":25,"maxContentLevel":34},"69b78be1-25b0-4f64-a6d6-93d0d629377f",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":135,"binaryCorrect":137,"binaryIncorrect":139},[136],"Which of these in excess is more unhealthy?",[138],"Visceral fat",[140],"Subcutaneous fat",{"id":142,"data":143,"type":57,"version":25,"maxContentLevel":34},"6b3bd5e8-0295-4514-952c-ce62ab07f343",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":144,"activeRecallAnswers":146},[145],"What is visceral fat?",[147],"Fat packed around internal organs",{"id":149,"data":150,"type":57,"version":25,"maxContentLevel":34},"6c24bbbc-2eb9-49be-822b-a2e2b3c86757",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":151,"clozeWords":153},[152],"When the body taps into the energy stores in adipose tissue, fats are broken down into free fatty acids",[154],"free fatty acids",{"id":156,"data":157,"type":57,"version":25,"maxContentLevel":34},"a69ba0a6-2c36-48e0-8457-2170a955afd3",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":158,"activeRecallAnswers":160},[159],"What is the type of fat that is found under the skin?",[140],{"id":162,"data":163,"type":57,"version":25,"maxContentLevel":34},"aa3faf3f-d509-44b0-b87a-b2b5c98dfaaf",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":164,"binaryCorrect":166,"binaryIncorrect":167},[165],"What is the fat we find around our kidneys?",[138],[140],{"id":169,"data":170,"type":57,"version":25,"maxContentLevel":34},"bd367f9a-e73a-4deb-9824-b715f367c7c2",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":171,"activeRecallAnswers":173},[172],"In prolonged fasts, where does the body get its energy?",[174],"From fat",{"id":176,"data":177,"type":26,"version":25,"maxContentLevel":34,"pages":179},"b0af7d23-0078-4008-943c-532f06739907",{"type":26,"title":178},"Biological Processes in Fasting and Feeding",[180,218,246,284],{"id":181,"data":182,"type":25,"maxContentLevel":34,"version":25,"reviews":186},"40e17e3f-f87b-4054-ab4c-4df64b334037",{"type":25,"title":183,"markdownContent":184,"audioMediaId":185},"Cell Growth in Well-fed States","In a well-fed state, the cells in your body are in growth mode. Certain pathways, namely the insulin signaling and mammalian target of rapamycin (mTOR) pathways, are stimulated when you are well fed. These pathways are what direct the cells of the body to divide and synthesize new proteins, causing growth.\n\nThe mTOR pathway is active when there are plentiful nutrients around, especially carbohydrates and proteins. However, when the mTOR pathway is active, it directs the cells to focus on growth and not bother about cellular ‘housekeeping’. This housekeeping is called autophagy, which is the process where damaged proteins in the body are cleaned up and recycled. The well-fed cell is so busy growing and multiplying that it doesn’t bother getting rid of these potentially harmful cellular components.\n\nWhen your cells are in a well-fed state, it activates genes that focus on growth, called proliferation genes. However, other genes are deactivated in this state, including ones related to fat metabolism, stress resistance, and damage repair. You can’t have your cake and eat it too!","fad8768b-8e65-41df-8219-db59c37cf267",[187,196,203,211],{"id":188,"data":189,"type":57,"version":25,"maxContentLevel":34},"072dba9c-4952-4e87-8874-90e69d6980b6",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":190,"binaryCorrect":192,"binaryIncorrect":194},[191],"Your body is in 'growth mode' when you are:",[193],"In the fed state",[195],"In the fasting state",{"id":197,"data":198,"type":57,"version":25,"maxContentLevel":34},"0a5bb33b-c4cf-45e0-80a8-0a2e584d8bd0",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":199,"activeRecallAnswers":201},[200],"What is autophagy?",[202],"The body's process of cleaning up and recycling damaged proteins",{"id":204,"data":205,"type":57,"version":25,"maxContentLevel":34},"5ba37a9d-1f92-4b41-9254-89f836f5f689",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":206,"activeRecallAnswers":208},[207],"What is the mTOR pathway? When is it activated?",[209,210],"It directs the cells of the body to divide and synthesize new proteins, causing growth","Activated when your body is well-fed",{"id":212,"data":213,"type":57,"version":25,"maxContentLevel":34},"6b3de753-7256-4bb5-b07a-9e5637d49753",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":214,"activeRecallAnswers":216},[215],"When are proliferation genes activated?",[217],"In the well-fed state",{"id":219,"data":220,"type":25,"maxContentLevel":34,"version":25,"reviews":224},"21740981-2e36-4cc3-b5e9-8de2901f4c73",{"type":25,"title":221,"markdownContent":222,"audioMediaId":223},"The Fasted State and Fat as a Biological Battery","Being in a fasted state is often confused with the *Starvation Response* which is when the body begins to break down muscle tissues (or in advanced stages, even organ tissue) to survive. When you practice intermittent fasting, your body is not in a caloric deficit all the time. Because of the alternation between fasting and feeding, your body still gets enough fuel without signaling starvation. Your body simply turns to your stored body fat as fuel, because there is nothing else to use.\n\nRather than dismiss all fat as a scourge to be avoided, fat serves many critical roles in the human body, from hormone regulation to energy storage. In terms of energy storage, you can think of fat as a kind of biological battery that gets replenished when excess calories are present. A battery with an incredibly high energy density. \n\nJust **1kg** of fat contains **7,700 calories**. With ~10kg of body fat, the average healthy adult male can have in excess of 70,000 calories of stored energy, enough to survive a whole month without eating (assuming other nutritional needs were met) or run **28 marathons**. The body is truly remarkable. ","f293d7e8-ed9f-4a8e-8432-1ab3f6844f7e",[225,232,239],{"id":226,"data":227,"type":57,"version":25,"maxContentLevel":34},"aa65a383-61e1-448e-8007-578c2a85c5ea",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":228,"activeRecallAnswers":230},[229],"How many calories (kcal) are in 1kg of fat?",[231],"7,700 calories",{"id":233,"data":234,"type":57,"version":25,"maxContentLevel":34},"d8789c0c-96da-4e49-83a9-ef16f5bce95d",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":235,"activeRecallAnswers":237},[236],"How much energy is stored in fat in the healthy average adult?",[238],"Over 70,000 calories ",{"id":240,"data":241,"type":57,"version":25,"maxContentLevel":34},"f17d830e-d323-463f-a1af-979df5db94ec",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":242,"activeRecallAnswers":244},[243],"What is the starvation response?",[245],"It's when our body breaks down the proteins in our muscles for energy (and eventually, our internal organs)",{"id":247,"data":248,"type":25,"maxContentLevel":34,"version":25,"reviews":252},"91380668-2b38-48c6-a630-4041343884b6",{"type":25,"title":249,"markdownContent":250,"audioMediaId":251},"Appetite-regulating hormones: ghrelin and leptin","There are a plethora of hormones regulating hunger, appetite, and satisfaction after a meal. These hormones, released via the *endocrine system*, have direct effects on appetite and how full we feel - something called *satiety.*\n\nThe 2 important hormones involved in appetite regulation are the gut-derived hormone, *ghrelin*, and another secreted from fat cells known as *leptin*.\n\nLeptin decreases your appetite or level of hunger. People who are overweight or obese typically have high leptin but are resistant to it while leaner individuals may have lower levels but higher sensitivity.\n\nGhrelin is often called the *hunger hormone* as it drives us to eat. Intermittent fasting can lower levels of ghrelin which in turn, can lead to lower feelings of hunger and increased weight loss.","dff1cc83-a206-4d09-a6dd-f7db0b1ef22d",[253,260,268,275],{"id":254,"data":255,"type":57,"version":25,"maxContentLevel":34},"021c4a2e-a223-4c3b-b548-502f54d8b345",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":256,"activeRecallAnswers":258},[257],"Obese people typically have high concentrations of leptin, even though it decreases hunger. How is this possible?",[259],"Their sensitivity to leptin is reduced",{"id":261,"data":262,"type":57,"version":25,"maxContentLevel":34},"0f74a128-5493-4649-8967-984a7d4467cf",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":263,"clozeWords":265},[264],"Leptin is secreted from fat cells, decreasing hunger",[266,267],"fat cells","hunger",{"id":269,"data":270,"type":57,"version":25,"maxContentLevel":34},"20d4d25a-a71d-40a5-ba57-784d589e0c9f",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":271,"activeRecallAnswers":273},[272],"What does 'satiety' mean?",[274],"The perception of 'fullness' after eating or drinking",{"id":276,"data":277,"type":57,"version":25,"maxContentLevel":34},"9c80e8e1-69b0-4775-b5fe-52aa2b59b472",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":278,"binaryCorrect":280,"binaryIncorrect":282},[279],"Which of these increases appetite?",[281],"Ghrelin",[283],"Leptin",{"id":285,"data":286,"type":25,"maxContentLevel":34,"version":25,"reviews":290},"bb4c67cc-623e-4a04-a63f-21153efe6a2a",{"type":25,"title":287,"markdownContent":288,"audioMediaId":289},"How insulin resistance develops","**Insulin** is produced inside the pancreas and helps cells absorb blood glucose to regulate sugar levels. It is also the hormone responsible for dragging glucose into cells. In other words, our bodies need insulin in order to use or store glucose for energy.\n\nOur bodies regulate the insulin level in our blood to match the amount of glucose in the blood, that is, high after a meal and low between meals. Because insulin is secreted after each meal, eating throughout the day keeps insulin levels elevated most of the time.\n\nChronically high levels of insulin may desensitize body tissues, causing insulin insensitivity/insulin resistance – the hallmark of prediabetes and type 2 diabetes. Insulin resistance occurs when cells do not absorb sugar/glucose from the bloodstream. This leads to elevated blood sugar levels, as your body cannot burn through the sugar stored in your blood.\n\nFasting helps keep insulin levels low and increases insulin sensitivity (the opposite of insulin resistance). This can, among other health benefits, reduce the risk of diabetes.","aa8fa848-d0cf-4601-b6b7-358a254af1e6",[291,299,308,315,324,333],{"id":292,"data":293,"type":57,"version":25,"maxContentLevel":34},"3d686d98-4499-406c-a2e9-ca13af10be33",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":294,"clozeWords":296},[295],"High insulin resistance means your cells do not readily absorb the glucose in your blood so blood sugar levels stay elevated.",[297,298],"insulin resistance","elevated",{"id":300,"data":301,"type":57,"version":25,"maxContentLevel":34},"4b259714-6fad-42aa-a34c-6819624570be",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":302,"binaryCorrect":304,"binaryIncorrect":306},[303],"How does fasting affect insulin levels?",[305],"Keeps levels low, increases sensitivity",[307],"Keeps levels high, decreases sensitivity",{"id":309,"data":310,"type":57,"version":25,"maxContentLevel":34},"591b0a98-d668-46a0-8d4b-73bdcb56b717",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":311,"activeRecallAnswers":313},[312],"What is insulin?",[314],"It's a hormone that helps cells absorb blood glucose",{"id":316,"data":317,"type":57,"version":25,"maxContentLevel":34},"70b9d2d5-543d-43ff-8338-80dfcdd3c6d6",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":318,"binaryCorrect":320,"binaryIncorrect":322},[319],"As blood glucose goes up:",[321],"Insulin goes up",[323],"Insulin goes down",{"id":325,"data":326,"type":57,"version":25,"maxContentLevel":34},"845abffb-eb3a-4f33-af8b-b3d1dfa778e6",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":327,"binaryCorrect":329,"binaryIncorrect":331},[328],"Where is insulin produced?",[330],"Pancreas",[332],"Liver",{"id":334,"data":335,"type":57,"version":25,"maxContentLevel":34},"e744ac89-6974-44ea-981f-9d42c5d02586",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":336,"activeRecallAnswers":338},[337],"If we eat throughout the day, what happens to our insulin levels?",[339],"They remain constantly elevated",{"id":341,"data":342,"type":27,"maxContentLevel":34,"version":25,"orbs":345},"63494556-6a54-4222-a0b5-fd846861d3e7",{"type":27,"title":343,"tagline":344},"The Different Stages of Fasting: What to Expect","Learn exactly what happens in your body and why at the different stages of a fast.",[346,411,510],{"id":347,"data":348,"type":26,"version":25,"maxContentLevel":34,"pages":350},"fb978826-8fc3-4c4d-b61a-90761da35d5a",{"type":26,"title":349},"Introduction to Fasting",[351,356,370],{"id":352,"data":353,"type":25,"maxContentLevel":34,"version":25},"27a1c566-3d8b-4ca1-824a-cfb07d4daca6",{"type":25,"title":44,"markdownContent":354,"audioMediaId":355},"Fasting can have many powerful effects on your body. More than just helping you lose weight, research shows that if you fast, even on a sub-regular basis, you can unlock a vast number of physical and mental health benefits. Intermittent fasting can promote mental clarity and mood, improve immune function and cellular repair, and increase muscle growth. These are only some of the benefits associated with fasting. More of the benefits will be covered in tile 3.\n\nFasting comes in many forms, such as prolonged fasting or different options of intermittent fasting. Each method comes with its own set of benefits, depending on the nature and the length of your fast. To understand how the benefits of each fasting method get unlocked, we’ll need to dive into the various stages our bodies go through, hour by hour when we are fasting.","90cf0f91-c2ff-46c7-9394-9afcaa046a51",{"id":357,"data":358,"type":25,"maxContentLevel":34,"version":25,"reviews":362},"0739e09b-2c4c-421d-9906-77016f6c5086",{"type":25,"title":359,"markdownContent":360,"audioMediaId":361},"Stage 0 or Pre-fasting State (0-8 Hours): Anabolic Growth Phase","Though we’re not actually fasting in this stage, it is still worth understanding what is happening in your body in the pre-fasting state. \n\nThe first 4 hours after you eat are known as the *anabolic growth phase*. In this window, your body uses the food you just ate as fuel to power your current activity and for cellular tissue growth. This is what happens in your body every day after consuming a meal. The exact duration of this window depends on what and how much you ate in your last meal.\n\nThe meal you consume before fasting can also affect your fast as well. Veteran fasters report that they experience higher levels of hunger, and even withdrawal symptoms after eating a lot of sugary foods before entering into a fast.","9427cd4e-06c8-4cb0-b062-8d850a1b2e43",[363],{"id":364,"data":365,"type":57,"version":25,"maxContentLevel":34},"f7e36278-8558-4451-b1d7-9901f8140eb1",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":366,"activeRecallAnswers":368},[367],"When is your body in the 'anabolic growth phase'?",[369],"The 4 hour window after eating",{"id":371,"data":372,"type":25,"maxContentLevel":34,"version":25,"reviews":376},"2caadacb-8fa2-41ae-9389-cb552269c658",{"type":25,"title":373,"markdownContent":374,"audioMediaId":375},"Stage 0 Continued: Food Digestion and Insulin Peak","The blood sugar level in your blood tends to increase after eating a meal, particularly a meal high in carbohydrates. This state of elevated blood sugar can last up to four hours. As a response to this, your pancreas produces a hormone called **insulin**, which allows your body to remove the glucose that was released into your bloodstream after your meal, and convert it into glycogen.\n\n ![Graph](image://8f73c0bd-5c62-4e3c-98a4-03db8c26a75b \"The human pancreas\")\n\nThe dreaded *sugar crash* happens when your blood sugar rises rapidly, which causes a spike of insulin, which in turn leads to a sudden fall in blood glucose levels.\n\nThe higher the *glycemic index* of your meal the greater your sugar crash will be. The glycemic index is a value given to carbohydrate-containing foods that represent their ability to increase blood sugar (glucose in the blood). This will make you feel hungrier if your last meal had a higher sugar content compared to a nutritionally well-balanced meal.\n\nAbout *2 hours* after your last meal, your blood sugar levels should return to normal, bringing us to the first stage of fasting.","b26598cc-77c8-46ac-abe0-b0d1b2503e3f",[377,386,397,404],{"id":378,"data":379,"type":57,"version":25,"maxContentLevel":34},"378fb9b9-f02d-47d2-b4fe-6af39febdb90",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":380,"activeRecallAnswers":382},[381],"What are the 3 stages of 'sugar crashes'?",[383,384,385],"Blood sugar spikes from high carb meals","Insulin spikes","Blood sugar levels fall",{"id":387,"data":388,"type":57,"version":25,"maxContentLevel":34},"47065ae5-9fab-4b6e-a041-161a404af557",{"type":57,"reviewType":34,"spacingBehaviour":25,"multiChoiceQuestion":389,"multiChoiceCorrect":391,"multiChoiceIncorrect":393},[390],"Approximately how long after your last meal will blood sugar levels have returned to normal?",[392],"2 hours",[394,395,396],"4 hours","24 hours","3 days",{"id":398,"data":399,"type":57,"version":25,"maxContentLevel":34},"50ca84e2-f63a-45a2-884a-10ca6e15e892",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":400,"activeRecallAnswers":402},[401],"What is a food's 'glycemic index'?",[403],"It's a value given to carbohydrate-containing foods that corresponds to how much they will raise blood glucose",{"id":405,"data":406,"type":57,"version":25,"maxContentLevel":34},"7c7659f9-9b96-4562-bd88-5b591e6202d4",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":407,"activeRecallAnswers":409},[408],"How does insulin affect blood glucose levels?",[410],"Insulin reduces blood glucose levels",{"id":412,"data":413,"type":26,"version":25,"maxContentLevel":34,"pages":415},"9c448a07-fc90-4074-b846-02ee0f956b66",{"type":26,"title":414},"Early Stages of Fasting",[416,444,479],{"id":417,"data":418,"type":25,"maxContentLevel":34,"version":25,"reviews":422},"48c28212-f10c-4fe0-96e0-7dee64f4a096",{"type":25,"title":419,"markdownContent":420,"audioMediaId":421},"Stage 1 (8-12 Hours): Falling Blood Sugar Levels","Your body begins to enter the fasted state about **8 hours** after consuming your last meal. This stage is characterized by a lowering of your blood sugar levels. For many people, this period can feel a bit uncomfortable. This is why the general practice is to start a fast before bedtime as it allows you to sleep through at least a few hours of this discomfort.\n\nAfter around eight hours, your blood glucose begins to dip and you may experience hunger, fatigue, food cravings, and trouble concentrating. These symptoms usually subside very quickly.\n \nBetween **8 and 12 hours** after your last meal, your body will start to tap into your glycogen stores (sugar stores), and your blood glucose levels will stabilize.\n\nWhen your glycogen stores are depleted, your body needs to turn to an alternative source of fuel – enter **ketosis**, which is a metabolic state that allows your body to burn fat for fuel instead of sugars or glycogen.\n\nIn ketosis, your body produces **ketones** from fatty acids in the liver. Ketones can fuel the vast majority of the cells in your body. However, for the few other types of cells that need glucose, your body will synthesize it from protein, a natural process called **gluconeogenesis.**","387c0f16-15d1-4d54-9159-2a7934f2b615",[423,430,437],{"id":424,"data":425,"type":57,"version":25,"maxContentLevel":34},"cf943358-28f6-45b8-8635-1182c0aec454",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":426,"activeRecallAnswers":428},[427],"How long after your last meal does it take to deplete your glycogen stores?",[429],"12 hours",{"id":431,"data":432,"type":57,"version":25,"maxContentLevel":34},"edc86e26-41a4-4727-9ed7-a1d6a93ccba1",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":433,"activeRecallAnswers":435},[434],"What is gluconeogenesis?",[436],"A metabolic pathway that creates glucose from non-glucose sources, such as protein",{"id":438,"data":439,"type":57,"version":25,"maxContentLevel":34},"f0589e7b-3b26-4f1f-bf0b-8a0608ce1163",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":440,"activeRecallAnswers":442},[441],"What is ketosis?",[443],"A metabolic state where your body burns fat for fuel instead of sugars or glycogen",{"id":445,"data":446,"type":25,"maxContentLevel":34,"version":25,"reviews":450},"c55a3ecc-181a-43cf-9b8d-60da4fc861ae",{"type":25,"title":447,"markdownContent":448,"audioMediaId":449},"Stage 1 continued: Stable Blood Sugar Levels","At around the **12-hour** mark after a meal, the first real benefit of fasting begins. At this stage in your fast, you will enter into the early stages of ketosis, where your body stops relying on carbohydrates for fuels and switches to burning your body fat stores instead. At this point you’re already beginning to lose weight from burning fat.\n\nDuring this period, your body is fueled by both metabolic pathways – Ketosis and **Glycolysis.** Glycolysis is the pathway the body uses to convert glucose from food to energy it can use.\n\nThe time it takes to reach this stage varies a lot depending on the last meal you ate before your fast. If you ate a lot of carbohydrates (sugars or starches) it will take longer than if you ate mainly fats and protein.\n\nAs a side note, short-term fasting (8-12 hours of fasting) may also lower blood pressure and increase insulin sensitivity, making it especially useful for people with type 2 diabetes.","b50bc3b8-3e46-4044-9c2c-1aedcfa0ffdd",[451,459,470],{"id":452,"data":453,"type":57,"version":25,"maxContentLevel":34},"46d74042-40fc-48f2-b343-c80a1190bdf0",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":454,"clozeWords":456},[455],"Even short-term fasting (8-12 hours) may lower blood pressure and increase insulin sensitivity",[457,458],"lower","increase",{"id":460,"data":461,"type":57,"version":25,"maxContentLevel":34},"4752f450-636f-4ce2-aa0c-e3c0918213ee",{"type":57,"reviewType":34,"spacingBehaviour":25,"multiChoiceQuestion":462,"multiChoiceCorrect":464,"multiChoiceIncorrect":466},[463],"Which metabolic pathways are your body using 12 hours after your last meal?",[465],"Ketosis and glycolysis",[467,468,469],"Only ketosis","Only glycolysis"," Insulin burning",{"id":471,"data":472,"type":57,"version":25,"maxContentLevel":34},"5fa3c6db-df5f-4095-924d-a42dbcfc37c5",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":473,"binaryCorrect":475,"binaryIncorrect":477},[474],"What is the metabolic pathway where glucose is used by the body for energy?",[476],"Glycolysis",[478],"Ketosis",{"id":480,"data":481,"type":25,"maxContentLevel":34,"version":25,"reviews":485},"9090d17a-504b-45c4-8bf1-6ccaa4a1a06f",{"type":25,"title":482,"markdownContent":483,"audioMediaId":484},"Stage 2 (12-18 Hours): Partial to Full Ketosis","Depending on your last meal, you should be in full ketosis after about **16 to 18 hours** of fasting. If you had a high-carb meal, this stage might take a little longer to achieve. In Stage 2 of fasting, you start to switch into fat-burning mode. Intermittent fasting for 16-18 hours a day allows you to burn through your body fat which makes it easy to stay in a calorie deficit and lose weight.\n\nEntering a state of full ketosis means that your body primarily utilizes fats for energy. Your liver starts to convert some of this fat into ketone bodies or ketones.\n\nYou can think of ketones as an alternative fuel source produced from fatty acids by the liver. Ketones are only released after glycogen stores are depleted.\n\nAs a result, insulin levels begin to fall, which according to several studies, could be very beneficial for a list of patients that struggle with chronic diseases.\n\nHigh insulin levels are a significant risk factor for chronic diseases. Low insulin levels are therefore favourable for preventing medical conditions such as obesity, metabolic syndrome, type 2 diabetes, cardiovascular disease, cancer, Alzheimer’s disease, and Parkinson’s disease","b6efeaff-3787-4068-8c6c-68da149543d5",[486,493,502],{"id":487,"data":488,"type":57,"version":25,"maxContentLevel":34},"14f2a991-81f4-4022-910c-a3ef38cc6304",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":489,"activeRecallAnswers":491},[490],"How soon after your last meal will your body reach a state of full ketosis?",[492],"16-18 hours (depending on your last meal)",{"id":494,"data":495,"type":57,"version":25,"maxContentLevel":34},"5caf0f6e-3be4-4748-b6c5-f9c0c7ca7645",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":496,"binaryCorrect":498,"binaryIncorrect":500},[497],"In ketosis, insulin levels will typically:",[499],"Decrease",[501],"Increase",{"id":503,"data":504,"type":57,"version":25,"maxContentLevel":34},"d56789dd-d3b4-4def-aaa5-68161f27e679",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":505,"activeRecallAnswers":507},[506],"What are ketones? Where are they produced and under what conditions?",[508,509],"An alternative fuel source for the body","In the liver, once glycogen stores are depleted",{"id":511,"data":512,"type":26,"version":25,"maxContentLevel":34,"pages":514},"9baf9b11-1ae9-41f5-be58-bc49133026da",{"type":26,"title":513},"Benefits of Ketosis",[515,545,560],{"id":516,"data":517,"type":25,"maxContentLevel":34,"version":25,"reviews":521},"cc36b378-d469-402a-837c-fa23ef797fb3",{"type":25,"title":518,"markdownContent":519,"audioMediaId":520},"Stage 2 Continued: Benefits of Ketosis and BDNF","One of the known effects of ketones is that they suppress appetite. In addition to leading to lower levels of ghrelin (the hunger hormone) and stable insulin levels, being in a state of ketosis can lessen food cravings. This means that fasting can actually get easier the longer you fast.\n\nKetosis has another often overlooked benefit that kicks in at this stage of fasting: increased mental clarity. In a state of ketosis, many people report feeling higher alertness and increased mental acuity.\n\nOne explanation for this is thought to be a boost in *brain-derived neurotrophic factor (BDNF)* – a protein produced in your brain to protect existing brain cells. According to medical professionals, BDNF also supports the growth of brain neurons and enhances long-term memory, learning, and boosts mood.\n\nIntermittent fasting practitioners recommend fasting for at least 16 hours to reap these benefits. Note, 16 hours is just a guide - everyone is different and it could take you more or less time to see these benefits.","7b5f6c13-d2df-4d20-8e31-6d1df4f7cf32",[522,529,536],{"id":523,"data":524,"type":57,"version":25,"maxContentLevel":34},"11753543-5c81-402b-8c03-7ba80abb3cb8",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":525,"activeRecallAnswers":527},[526],"What is BDNF?",[528],"It's a protein produced in the brain to protect and nourish brain cells",{"id":530,"data":531,"type":57,"version":25,"maxContentLevel":34},"5b70d4ed-37b6-4911-8ea1-343f2fda049e",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":532,"activeRecallAnswers":534},[533],"What's the shortest fasting duration to reap the benefits of ketosis and an increase in BDNF?",[535],"16 hours (though this may vary between people)",{"id":537,"data":538,"type":57,"version":25,"maxContentLevel":34},"bcbc063f-6e0e-4148-8745-a7b8204f7e1a",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":539,"binaryCorrect":541,"binaryIncorrect":543},[540],"How do ketones affect hunger?",[542],"They decrease hunger",[544],"They increase hunger",{"id":546,"data":547,"type":25,"maxContentLevel":34,"version":25,"reviews":551},"29ac264e-e861-469e-bb4e-199e743b9b17",{"type":25,"title":548,"markdownContent":549,"audioMediaId":550},"Stage 3 (24-54 hours): Autophagy, Growth Hormone, Reduced Insulin Levels","After about 24 hours into your fast, **autophagy** starts to occur, and continues throughout the fast.\n\nAt around the **36 hour** mark, the body goes into a long-term fasting state. As you undertake multiple days of fasting, your *growth hormone* levels begin to rise significantly, which stimulates faster than normal muscle repair and helps preserve lean muscle mass. Studies show that human growth hormone could also speed up the healing process for wounds and other injuries.\n\nAfter fasting for **54 hours**, your insulin levels will be at their lowest. This is especially beneficial for persons struggling with diabetes or people who have been diagnosed with pre-diabetes.\n\nProlonged high levels of insulin can cause insulin resistance, which could lead to diabetes. In contrast, increased insulin sensitivity could lead to a healthier body fat percentage, reduce inflammation and further activate autophagy. Along with autophagy, fat loss and mental clarity continue to increase during this stage.","5a96df8e-35d2-45ec-9387-9cfb78314585",[552],{"id":553,"data":554,"type":57,"version":25,"maxContentLevel":34},"df1ac515-d0db-47c8-95c8-53187ccc3d06",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":555,"activeRecallAnswers":557},[556],"Beyond the 36 hour mark, what happens to growth hormone levels? What benefits does this have?",[558,559],"They rise significantly","Leads to faster muscle and tissue repair",{"id":561,"data":562,"type":25,"maxContentLevel":34,"version":25,"reviews":566},"ab1fd1ca-68eb-4f64-a039-2c22d7f06c49",{"type":25,"title":563,"markdownContent":564,"audioMediaId":565},"Stage 4 (72+ hours): Stem Cells and Immune Function","At stage 4 you will have been fasting for *3 days*. Research shows that in this fasting stage, you may unlock a further array of health benefits, such as stem cell generation and immune cell development. This is caused by a reduction in **insulin-like growth factor (IGF-1)**, a hormone involved in growth and development.\n\nHowever, a 3-day fast is a serious undertaking, fasts of this duration require adequate preparation. Staying hydrated is key as is consuming supplemental electrolytes like sodium, magnesium, and potassium to prevent possible complications during a fast of this length, such as light-headedness, dizziness, and excessive fatigue. \n\nAs always, you should consult your healthcare professional before embarking on a fast of this length.","1112f018-b1a5-47a1-ae30-4b62dd779665",[567,575,583],{"id":568,"data":569,"type":57,"version":25,"maxContentLevel":34},"1af914cf-3e18-468f-af68-64d67750434e",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":570,"clozeWords":572},[571],"After 72 hours (3 days) of fasting, stem cell generation and immune cell development are triggered.",[573,574],"stem cell","immune cell",{"id":576,"data":577,"type":57,"version":25,"maxContentLevel":34},"31723745-6395-4c23-bcf3-44ce6ebb46bc",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":578,"activeRecallAnswers":580},[579],"What measures can you take to reduce the likelihood of possible complications during a 3-day fast?",[581,582],"Stay hydrated","Consume supplemental electrolytes",{"id":584,"data":585,"type":57,"version":25,"maxContentLevel":34},"e352a490-de29-48c4-af4d-8c4fe6727511",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":586,"activeRecallAnswers":588},[587],"What should you do before embarking on a 3-day fast?",[589],"Consult with a medical health professional",{"id":591,"data":592,"type":27,"maxContentLevel":34,"version":25,"orbs":595},"30f4942b-0c6b-489b-90d7-6eadcb7381c6",{"type":27,"title":593,"tagline":594},"The Potential Health Benefits of Intermittent Fasting","Learn about the numerous science-backed health benefits of intermittent fasting that go beyond mere weight loss. These include mental health, brain health, reduced inflammation, and cell repair, to name a few.",[596,641,706],{"id":597,"data":598,"type":26,"version":25,"maxContentLevel":34,"pages":599},"1b3d230c-091f-408f-be2e-324adb9b4d59",{"type":26,"title":39},[600,605,635],{"id":601,"data":602,"type":25,"maxContentLevel":34,"version":25},"763e8b92-967f-4986-8afa-f406100d6b7f",{"type":25,"title":44,"markdownContent":603,"audioMediaId":604},"Intermittent fasting has gained a lot of popularity in recent years. Although weight-loss appears to be the primary driver of this, there is growing interest in IF’s other health benefits as well.\n\nAlthough it’s often referred to as a diet, IF is more correctly understood as an eating pattern that could activate certain benefits for practitioners, such as weight loss, if done correctly.\n\nSo are there other health benefits associated with this lifestyle? Actually, yes. There are numerous science-backed health benefits of intermittent fasting that go beyond mere weight loss. These include mental health, brain health, reduced inflammation, and cell repair, to name but a few.\n\nIn the subsequent tiles we’ll take a closer look at some of these evidence-backed benefits of intermittent fasting.","bb0ef1c9-c323-480b-bce7-2f5dd3176908",{"id":606,"data":607,"type":25,"maxContentLevel":34,"version":25,"reviews":611},"ef6fc0cc-4ac7-4cf0-bc03-440b92af16f8",{"type":25,"title":608,"markdownContent":609,"audioMediaId":610},"Weight Loss and Visceral Fat","The main reason why many people choose to do intermittent fasting is for weight loss. When practiced over time, the secret to the weight loss success of intermittent fasting lies in the fact that you eat fewer meals, which results in a lower calorie intake (assuming you don’t overindulge in the feeding window).\n\nIntermittent fasting also enhances hormone function which facilitates weight loss. The breakdown of body fat to use as energy is increased due to a decrease in insulin, and an increase in two key hormones: human growth hormone (HGH), and norepinephrine (noradrenaline). The presence of HGH and noradrenaline in the body increases metabolic rate, which results in more calories that are burnt.\n\nAccording to a 2014 study, intermittent fasting could cause weight loss of 3-8% within 3-24 weeks, which is more than many diets. The same study also found that visceral fat was also markedly reduced.","e0e6e73b-5f42-4368-aa92-0e100609339d",[612,619,627],{"id":613,"data":614,"type":57,"version":25,"maxContentLevel":34},"1435586e-b308-4c64-a261-4cb948a1aa94",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":615,"activeRecallAnswers":617},[616],"Over the long run, how does intermittent fasting help you lose weight?",[618],"It makes it harder to consume excessive calories by restricting your eating window.",{"id":620,"data":621,"type":57,"version":25,"maxContentLevel":34},"992d529f-5398-415f-8ff4-85b8d8c8e799",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":622,"activeRecallAnswers":624},[623],"Which two hormones are increased during fasting, leading to an enhanced metabolic rate?",[625,626],"HGH (Human Growth Hormone)","Norepinephrine (noradrenaline)",{"id":628,"data":629,"type":57,"version":25,"maxContentLevel":34},"b5cd6883-8d4e-461d-bc02-1c2710bb38a0",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":630,"clozeWords":632},[631],"While fasting, the breakdown of body fat to use as energy is increased due to a decrease in insulin.",[633,634],"increased","decrease",{"id":636,"data":637,"type":25,"maxContentLevel":34,"version":25},"cf98ea01-510d-4ba8-ac1c-2d90407634cb",{"type":25,"title":638,"markdownContent":639,"audioMediaId":640},"Molecular changes","During a fast, there are a lot of things that happen in your body. For one, the hormone levels in your body change to make your stored body fat more accessible and to initiate a cellular repair process.\n\nMany of the health benefits of intermittent fasting are related to changes in hormones, the functioning of cells, and gene expression.\n\nWe’ve already covered how an increase in HGH and noradrenaline, along with a drop in insulin helps the body to burn fat. Besides that, the hunger hormone, ghrelin, decreases, causing your appetite to be suppressed.\n\nOn a cellular level, the cellular repair process of autophagy is activated. We explain more about autophagy later in this tile. One study also found beneficial changes in several genes and molecules related to longevity and protection against disease.","1eb7430e-489f-46cc-9df6-6fbafdae2a5a",{"id":642,"data":643,"type":26,"version":25,"maxContentLevel":34,"pages":645},"1c5c48d1-4b2f-4e3c-95f1-6a46f8e8d316",{"type":26,"title":644},"Health Benefits of Intermittent Fasting",[646,670,692],{"id":647,"data":648,"type":25,"maxContentLevel":34,"version":25,"reviews":652},"246ff08f-cbe6-46e0-9cfb-0687daf43278",{"type":25,"title":649,"markdownContent":650,"audioMediaId":651},"Increased insulin sensitivity","To understand how and why fasting can be effective for people with diabetes, it will be helpful to explain what type 2 diabetes is. People with Type 2 diabetes typically have chronically elevated levels of blood glucose along with a decreased sensitivity to insulin. While genetic predisposition can increase the risk of Type 2 Diabetes, lifestyle factors such as poor diet, little exercise, poor sleep and chronic stress can increase the likelihood of developing the disease.\n\nIn a 2014 study on intermittent fasting, individuals with prediabetes that fasted had their fasting blood sugar reduced by 3–6% over the course of 8–12 weeks. Fasting insulin is reduced by 20–31%. This suggests that intermittent fasting may be beneficial for people who are at risk of developing type 2 diabetes.","d4da5975-4909-47c6-babc-deb4b8dc8dd3",[653,663],{"id":654,"data":655,"type":57,"version":25,"maxContentLevel":34},"29b66dfe-59e4-46a8-a213-9803ab56895c",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":656,"activeRecallAnswers":658},[657],"What 4 lifestyle factors increase the risk of type 2 diabetes?",[659,660,661,662],"Poor diet","Little exercise","Poor sleep","Chronic stress",{"id":664,"data":665,"type":57,"version":25,"maxContentLevel":34},"2b74c1f7-4f77-47fc-8600-fd04b783ada3",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":666,"binaryCorrect":668,"binaryIncorrect":669},[667],"Lifestyle factors play no role in increasing likelihood of developing type 2 diabetes",[63],[61],{"id":671,"data":672,"type":25,"maxContentLevel":34,"version":25,"reviews":676},"d0b4b63b-2e7a-4bb3-bdf7-bb40132cbe0a",{"type":25,"title":673,"markdownContent":674,"audioMediaId":675},"Reduced oxidative stress and inflammation","Oxidative stress in the body occurs when unstable molecules called free radicals are produced. These react with other important molecules, such as protein and DNA, and damage them, leading to accelerated aging and increased risk of various chronic diseases.\n\nSeveral studies have shown that intermittent fasting could enhance the body’s response to oxidative stress.\n\nOther studies show that intermittent fasting could be helpful in fighting inflammation, a condition that can lead to various diseases such as diabetes, multiple sclerosis, and inflammatory bowel syndrome.\n\nIntermittent fasting may also influence the gut microbiome: the complex and diverse microbial community that resides in the intestinal tract and whose health plays a significant role in affecting our immunity, weight, stress, and overall well-being.\n\nIf the gut microbiome is out of balance, it could result in numerous negative effects, for example, weight gain and obesity. Intermittent fasting could play a role in restoring your gut microbiome by giving your gut a rest. Research shows that it could help prevent inflammatory toxins from leaking into your bloodstream through your gut lining, as is the case with individuals diagnosed with leaky gut syndrome (ulcerative colitis).","1f968257-08c0-4529-9ceb-6335b343c045",[677,685],{"id":678,"data":679,"type":57,"version":25,"maxContentLevel":34},"1afa5041-9f4c-4afd-8bd7-e79903ac2c73",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":680,"activeRecallAnswers":682},[681],"What causes oxidative stress in the body? What can this lead to?",[683,684],"Free radicals","Accelerated aging and risk of chronic disease",{"id":686,"data":687,"type":57,"version":25,"maxContentLevel":34},"3eea0242-7fb4-46d4-858b-b1bca192f507",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":688,"activeRecallAnswers":690},[689],"How might intermittent fasting help your gut microbiome?",[691],"By giving your gut a 'rest' and the chance to restore balance",{"id":693,"data":694,"type":25,"maxContentLevel":34,"version":25,"reviews":698},"0b41881a-7ef0-4cca-9d78-f6d79c6a727a",{"type":25,"title":695,"markdownContent":696,"audioMediaId":697},"Heart Health","According to the World Health Organization, heart disease is number one on the list of the top causes of death worldwide. Intermittent fasting may be beneficial for heart health. It has been shown to improve several risk factors, such as blood sugar levels, blood pressure, blood triglycerides, cholesterol, and inflammation markers in the body.\n\nIt should, however, be noted that most of these studies have been conducted on animals and that the effect of fasting should be studied more in-depth in humans before recommendations can be made.\n\nHowever, recent studies on humans on this topic have produced promising results. Although the exact mechanisms remain unclear, intermittent fasting appears to positively impact multiple cardiovascular risk factors including obesity, hypertension, dyslipidemia, and diabetes.\n\nFurthermore, intermittent fasting has been associated with improved outcomes after a cardiac event.","966ef2cb-3c5e-4b51-9303-b1cf9cd5817e",[699],{"id":700,"data":701,"type":57,"version":25,"maxContentLevel":34},"731311ad-5975-4a1c-b138-752cda26b186",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":702,"activeRecallAnswers":704},[703],"What is the number 1 cause of death worldwide?",[705],"Heart disease",{"id":707,"data":708,"type":26,"version":25,"maxContentLevel":34,"pages":710},"42bb98f6-5999-4f19-9712-e9c439594568",{"type":26,"title":709},"Cellular and Molecular Effects of Fasting",[711,733,739],{"id":712,"data":713,"type":25,"maxContentLevel":34,"version":25,"reviews":717},"9d4910cf-2100-4504-9e9e-6df4b9a9c8bd",{"type":25,"title":714,"markdownContent":715,"audioMediaId":716},"Autophagy","After a full-day fast, your body starts to repair itself through a magical process called autophagy. The term is Greek for “self-eating,” and that’s exactly what happens. During autophagy, your cells break down and metabolize broken and dysfunctional proteins that build up over time. A positive health benefit of autophagy is a reduction in inflammation which can be harmful when left unchecked. \n\nBesides fighting inflammation, autophagy has a set of health benefits. Autophagy declines naturally as you age, which is connected to a variety of diseases. It is therefore, very important to ‘help’ this process along as much as possible, and especially as you start to age. Studies have shown that fasting could combat general age-related decline and increase longevity. Autophagy also clears out damaged and misfolded proteins which have been linked to Alzheimer’s disease. Early research even suggests that fasting-related autophagy may help kill cancer cells.\n\nTo enjoy the benefits of autophagy and its anti-aging or anti-inflammatory benefits, a 24-hour fast is a good option.","72001b10-6889-424c-ad5e-6793f082ed96",[718,726],{"id":719,"data":720,"type":57,"version":25,"maxContentLevel":34},"4593a6d1-7738-4e6d-bd9c-0289170a1330",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":721,"clozeWords":723},[722],"Early research suggests intermittent fasting might help reduce the risk of Alzheimer's disease and even kill cancer cells.",[724,725],"Alzheimer's","cancer",{"id":727,"data":728,"type":57,"version":25,"maxContentLevel":34},"5a8b3a1d-f35d-47df-bcfb-71f72b078e82",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":729,"activeRecallAnswers":731},[730],"What does 'autophagy' mean in Greek?",[732],"Self-eating",{"id":734,"data":735,"type":25,"maxContentLevel":34,"version":25},"9c7efed9-a8b6-45c6-a46f-eaff91a5dbb5",{"type":25,"title":736,"markdownContent":737,"audioMediaId":738},"Fasting and Cancer","Fasting or diets that mimic fasting have been reported to have several beneficial effects on metabolism that may lead to a reduced risk of cancer.\n\nA systematic review that included 8 studies of intermittent fasting ranging from 24 to 72 hours found that 63% of the studies inhibited tumor growth; the others found no significant difference in comparison with animals that were on a normal diet.\n\nEarly studies on humans also show similar results when it comes to intermittent fasting and cancer. This area of research is in its infancy and more studies should be conducted before a proper conclusion can be drawn. Preliminary results are, however, promising.\n\nIn the domain of cancer treatment, fasting or intermittent fasting has been proven, in several studies, to help deal with the toxicity of chemotherapy. Patients who fasted before and/or after chemotherapy found that the adverse effects of chemotherapy were lower compared to when they didn’t fast.","de35bbe7-3ab7-4d65-a5d2-6d05d6cfe020",{"id":740,"data":741,"type":25,"maxContentLevel":34,"version":25},"971e62af-4f31-4484-bb2a-ec11577772c1",{"type":25,"title":742,"markdownContent":743,"audioMediaId":744},"Brain Benefits and Neurodegenerative Diseases","Fasting increases levels of brain-derived neurotrophic factor (BDNF) – a protein that your brain produces to protect existing brain cells. BDNF also supports the growth of new neurons, enhances long-term memory, learning, and boosts mood.\n\nStudies have also proven that intermittent fasting improves mitochondrial function, which plays a central role in brain aging and neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, and Huntington's disease. \n\nAlzheimer’s disease is the world’s most common neurodegenerative disease. Currently there is no known cure for this disease, so prevention is crucial. In a series of case reports, a lifestyle intervention that included daily short-term fasts was able to significantly improve Alzheimer’s symptoms in 9 out of 10 people.","25a196e8-bff2-4d65-8c5b-2a2300b3b99f",{"id":746,"data":747,"type":27,"maxContentLevel":34,"version":25,"orbs":750},"b4a9bdaa-fca0-4999-aace-3e01009d57cb",{"type":27,"title":748,"tagline":749},"The Potential Side Effects of Intermittent Fasting","While intermittent fasting is generally regarded as safe, it is not entirely without risk. In this tile we will cover what some of those risks are.",[751,800,893],{"id":752,"data":753,"type":26,"version":25,"maxContentLevel":34,"pages":754},"b10a2920-56cc-48a9-8b99-015d90bcd255",{"type":26,"title":39},[755,760,773],{"id":756,"data":757,"type":25,"maxContentLevel":34,"version":25},"e739c988-ba1c-48f9-b9b6-310e3fde5585",{"type":25,"title":44,"markdownContent":758,"audioMediaId":759},"While intermittent fasting is generally regarded as safe, it is not entirely without risk. In this tile we will cover what some of those risks are and which groups of people should seek extra advice and information.\n\nAs always, this pathway is not medical advice, so please speak with your doctor to see if intermittent fasting is right for you.","f6ef65ed-3814-41c2-b4be-49f26228335b",{"id":761,"data":762,"type":25,"maxContentLevel":34,"version":25,"reviews":766},"2b318c4e-a975-4b9f-b78e-e925c8d80c20",{"type":25,"title":763,"markdownContent":764,"audioMediaId":765},"Hunger and Cravings","Possibly the most obvious and common side effect related to intermittent fasting is, you’ve guessed it, hunger! After eight hours of fasting your blood glucose begins to dip and you may experience hunger, fatigue, food cravings, and trouble concentrating.\n\nA study including 112 people assigned some participants to an intermittent fasting (referred to as intermittent energy restriction in the study) group. This group of people consumed 400 or 600 calories on 2 non-consecutive days every week for a year. They reported higher hunger scores than those who consumed a low-calorie diet with constant calorie restriction.\n\nIndividuals who fast on a regular basis say that hunger is a symptom typically experienced during the first few days of fasting. However, some individuals report reduced hunger after 24 hours. \n\nA 2020 study observed 1422 people who participated in fasts lasting 4–21 days. They reported only experiencing hunger symptoms during the first few days and thereafter the hunger subsided, which does indicate that the hunger pangs might only be a temporary inconvenience.","10d6e612-4544-4bc6-b894-561efff2eff5",[767],{"id":768,"data":769,"type":57,"version":25,"maxContentLevel":34},"1c375491-653b-40b2-9f9a-f123518bca03",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":770,"clozeWords":772},[771],"While fasting can increase hunger, many practitioners report decreased levels of hunger after 24 hours.",[395],{"id":774,"data":775,"type":25,"maxContentLevel":34,"version":25,"reviews":779},"3d0699f3-49cf-4f18-828d-eb91bcf2ec1e",{"type":25,"title":776,"markdownContent":777,"audioMediaId":778},"Headaches and Light-headedness","Headaches are a common side effect of intermittent fasting, which typically occur during the first few days of fasting. However, of the people who experience headaches, most report only experiencing mild ones.\n\nBecause your body moves into a metabolic state where your fat reserves are burned for fuel, called ketosis, many individuals that do intermittent fasting also experience what’s known as ‘keto-flu’. Typical symptoms include insomnia, fatigue, nausea or vomiting, endurance issues when exercising, headaches, constipation, and dizziness. Headaches are also a symptom of the detoxifying effect that intermittent fasting has on the body. Researchers have suggested that low blood sugar and caffeine withdrawal may also contribute to headaches during intermittent fasting.\n\nResearchers have found that “fasting headaches” are usually located in the frontal region of the brain and that the pain is typically mild or moderate in intensity. What’s more, people who are prone to getting headaches are also more likely to experience headaches during fasting.","c41337b0-8fb8-4213-babb-e4019010daa7",[780,789],{"id":781,"data":782,"type":57,"version":25,"maxContentLevel":34},"2df95ce6-685c-410a-a9c4-ac79e9acab55",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":783,"activeRecallAnswers":785},[784],"What are 3 symptoms of keto flu?",[786,787,788],"Insomnia","fatigue","nausea",{"id":790,"data":791,"type":57,"version":25,"maxContentLevel":34},"9943d07c-357a-46d6-ae51-eb86905aecdb",{"type":57,"reviewType":34,"spacingBehaviour":25,"multiChoiceQuestion":792,"multiChoiceCorrect":794,"multiChoiceIncorrect":796},[793],"Who should you consult before considering fasting?",[795],"Medical healthcare professional",[797,798,799],"Online forums","Magazines","Friends and family",{"id":801,"data":802,"type":26,"version":25,"maxContentLevel":34,"pages":804},"03c74153-5632-4c68-b3d5-90f74810121d",{"type":26,"title":803},"Common Side Effects of Fasting",[805,819,850,878],{"id":806,"data":807,"type":25,"maxContentLevel":34,"version":25,"reviews":811},"ceba10cb-e193-46e5-897c-0ba9964a6c0e",{"type":25,"title":808,"markdownContent":809,"audioMediaId":810},"Digestive Issues","Another commonly reported issue experienced during intermittent fasting is digestive issues. These include constipation, diarrhea, nausea, and bloating.\n\nSimilar to headaches, digestive issues during a fasting period can also be ascribed to the metabolic process, ketosis, which is activated during fasting. These symptoms all form part of the well-known ‘keto-flu’ that is also experienced during the popular fat-centric ketogenic diet.\n\nThe reduced food intake that comes along with intermittent fasting can negatively affect your digestion, which could lead to constipation and other side effects. And dietary changes associated with intermittent fasting programs/schedules may also cause bloating and diarrhea.\n\nWhat’s more, dehydration, another common side effect linked to intermittent fasting, can worsen constipation. This is why it is very important to stay well hydrated when fasting. Adding nutrient-dense foods that are rich in fiber to your diet may help prevent or alleviate constipation.","ec7fba13-f4c3-4137-9a8d-b10cced469c2",[812],{"id":813,"data":814,"type":57,"version":25,"maxContentLevel":34},"0a56c65a-e747-4fd8-acd3-2192aff8b64b",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":815,"activeRecallAnswers":817},[816],"Apart from eating fiber-rich foods, how else can you alleviate constipation while fasting?",[818],"Staying well hydrated",{"id":820,"data":821,"type":25,"maxContentLevel":34,"version":25,"reviews":825},"6cd7d6f1-123f-4127-8d22-914741a14fc9",{"type":25,"title":822,"markdownContent":823,"audioMediaId":824},"Irritability and Other Mood Changes","Low blood sugar (hypoglycemia) can occur during periods of calorie restriction or fasting. This may lead to irritability, anxiety, and poor concentration. Plus, dealing with food cravings and caffeine withdrawal could add to a person’s irritability.\n\nIf a person enters the metabolic state where the body’s fat reserves are burned for fuel, rather than glucose, toxins stored in the fat reserves get released as the fat is being burned for energy. This could lead to symptoms like irritability among others.\n\nA 2016 study observed 52 women over an 18-hour fast period. Their findings reported that the participants were significantly more irritable during the fasting period than they were during a non-fasting state. Interestingly, the researchers found that, even though the women reported being more irritable, they also experienced a greater sense of achievement, being proud, and self-control at the end of the fasting period than before the fast.","4937df76-9851-4f41-8061-3809de1ccf42",[826,833,842],{"id":827,"data":828,"type":57,"version":25,"maxContentLevel":34},"30e73411-fd41-4bea-8753-7c714f32d490",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":829,"clozeWords":831},[830],"When the body is burning fat for fuel, toxins stored in fat might be released, leading to irritability.",[832],"toxins",{"id":834,"data":835,"type":57,"version":25,"maxContentLevel":34},"9daa0742-6cf1-4c78-aa29-bf624199c970",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":836,"activeRecallAnswers":838},[837],"What are 3 symptoms of hypoglycemia (or low blood sugar)?",[839,840,841],"Irritability","Anxiety","Trouble concentrating",{"id":843,"data":844,"type":57,"version":25,"maxContentLevel":34},"ed04400f-f864-4323-89ef-4325c6ff8ac0",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":845,"clozeWords":847},[846],"In a study of 52 women, many reported a feeling of pride and achievement after powering through the ill-effects of fasting.",[848,849],"pride","ill-effects",{"id":851,"data":852,"type":25,"maxContentLevel":34,"version":25,"reviews":856},"fc5da223-ae33-4bc1-b60f-7cdf0c05ea11",{"type":25,"title":853,"markdownContent":854,"audioMediaId":855},"Lethargy and Low Energy","During intermittent fasting, it’s normal to feel groggy, especially if you are new to intermittent fasting. This is because low blood sugar related to intermittent fasting can cause you to feel tired and weak. Because intermittent fasting may lead to sleep disturbances in some people, it may also cause fatigue during the day.\n\nOne reason fatigue may be greater earlier in a fast is because your body excretes large amounts of salt and water through urine. This may lead to dehydration and low salt levels.\n\nThere is some controversy regarding fatigue and energy levels. Some people practicing various methods of intermittent fasting experience fatigue and low energy levels, while others report having reduced fatigue. According to researchers, fatigue decreases as your body becomes adapted to regular fasting periods. This was confirmed in a study that was aimed at young healthy males and females during Ramadan fasting.\n\nFatigue can also decrease as your body becomes fat adapted (switching to ketones as fuel) and after the detoxifying effect of fasting subsides.","4441a985-e0b0-4302-a567-0734220e5618",[857,864,871],{"id":858,"data":859,"type":57,"version":25,"maxContentLevel":34},"34f3f450-b310-4c74-b8c5-404d37582cc7",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":860,"activeRecallAnswers":862},[861],"Why might you feel more fatigue earlier in a fast?",[863],"Dehydration and lower salt levels",{"id":865,"data":866,"type":57,"version":25,"maxContentLevel":34},"5a8c8d65-8a69-42e8-b16a-30a91f7a1995",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":867,"binaryCorrect":869,"binaryIncorrect":870},[868],"As your body adapts to fasting, you can expect your fatigue levels to:",[499],[501],{"id":872,"data":873,"type":57,"version":25,"maxContentLevel":34},"614c2c83-6495-4aeb-b3be-64f1abdc30a7",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":874,"clozeWords":876},[875],"Fatigue tends to decrease as your body becomes fat-adapted (switching to ketones as fuel).",[877],"fat-adapted",{"id":879,"data":880,"type":25,"maxContentLevel":34,"version":25,"reviews":884},"bb7df9cd-d6c2-448e-b6a6-1efa9296bf7c",{"type":25,"title":881,"markdownContent":882,"audioMediaId":883},"Bad Breath","Bad breath is an unpleasant side effect that can occur in some people during fasting. Some people report only being made aware by comments of people around them, so take note!\n\nBad breath from fasting is caused by a lack of salivary flow and the rise of acetone in the breath, a byproduct of ketosis. \n\nThis is different from ordinary halitosis or bad breath and has a very distinct taste and smell, which some describe as fruity (like rotting apples) and smell like nail polish remover (acetone). \n\nYou can alleviate this by staying hydrated, which is generally beneficial while fasting anyway!","cc6992a7-080f-44eb-9070-f616778e479a",[885],{"id":886,"data":887,"type":57,"version":25,"maxContentLevel":34},"737bcc85-363c-48cb-8fcc-564b951fbbab",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":888,"activeRecallAnswers":890},[889],"What causes 'keto breath'?",[891,892],"Decreased saliva production","Acetone in the breath, a byproduct of ketosis",{"id":894,"data":895,"type":26,"version":25,"maxContentLevel":34,"pages":897},"d0bbc1df-6b58-446e-9078-d5cd4d129df2",{"type":26,"title":896},"Managing Fasting Challenges",[898,912,940,946],{"id":899,"data":900,"type":25,"maxContentLevel":34,"version":25,"reviews":904},"b8122d4e-8966-40e1-b752-13e8a890fd39",{"type":25,"title":901,"markdownContent":902,"audioMediaId":903},"Sleep Disturbances","Some research studies suggest that sleep disturbances might be among the most common side effects related to intermittent fasting. The reason for this is thought to be a response to your body being under the stress of not having enough food. Note it’s the adaptive compensation to this stress that leads to fasting’s health benefits – there’s no free lunch.\n\nIn a 2020 study, they observed 1,422 people who participated in fasts lasting 4–21 days. Around 15% of the participants reported sleep disturbances related to their fast and reported this more frequently than other side effects.\n\nHowever, other studies have shown that intermittent fasting had little to no effect on sleep.\n\nIn a 2021 study, they observed 31 people with obesity who participated in alternate-day fasting, while simultaneously following a low-carb diet for 6 months. The study found that alternate-day fasting did not affect the group’s sleep quality or duration, or insomnia severity. Another study showed similar results.\n\nThe results of the different studies are a bit ambiguous and might depend on the nature and duration of your fast.","67043a8a-a9a9-4134-b158-fd6082a7fc7c",[905],{"id":906,"data":907,"type":57,"version":25,"maxContentLevel":34},"cdbed0b5-6cc4-40dc-9718-5e10c9080750",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":908,"activeRecallAnswers":910},[909],"Why might fasting disturb your sleep?",[911],"Your body is under stress from not having enough calories",{"id":913,"data":914,"type":25,"maxContentLevel":34,"version":25,"reviews":918},"c720550d-c018-4ede-a828-899286fa951d",{"type":25,"title":915,"markdownContent":916,"audioMediaId":917},"Dehydration","Dehydration is another common symptom related to intermittent fasting. During the initial days of fasting, our bodies release a large amount of water through our urine - a process called diuresis. Natriuresis, the process of excreting sodium through our urine, also increases.\n\nWithout adequate replenishment of fluids and electrolytes, our risk of dehydration can increase. \n\nSome people who practice intermittent fasting may also forget to drink or may not drink enough water, something observed more commonly at the beginning of an intermittent fasting schedule.\n\nTo stay properly hydrated, drink water throughout the day and pay attention to the color of your urine. Ideally, it should be a pale lemonade color. Dark-colored yellow or orange urine might be an indication that you’re dehydrated.","26dded74-1f8d-48f0-b1bc-f1c73f710e14",[919,926,933],{"id":920,"data":921,"type":57,"version":25,"maxContentLevel":34},"52974120-e81d-4016-adc3-a86eef920339",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":922,"activeRecallAnswers":924},[923],"What is diuresis?",[925],"Increased urination",{"id":927,"data":928,"type":57,"version":25,"maxContentLevel":34},"772f3cd2-bdb7-4f05-9a12-f4c009698791",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":929,"activeRecallAnswers":931},[930],"What should the colour of your urine be?",[932],"Pale lemonade",{"id":934,"data":935,"type":57,"version":25,"maxContentLevel":34},"91e5e84a-44c6-43ae-85db-234c01a9caab",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":936,"activeRecallAnswers":938},[937],"What is natriuresis?",[939],"The process of sodium excretion in the urine",{"id":941,"data":942,"type":25,"maxContentLevel":34,"version":25},"6ed1d370-c9d9-4158-a143-1399204a54d6",{"type":25,"title":943,"markdownContent":944,"audioMediaId":945},"Malnutrition","Intermittent fasting could lead to malnutrition if not done properly and is one of most important reasons to consult a healthcare professional before fasting. \n\nCompared to other forms of caloric restriction, the risk of malnutrition might be increased with fasting due to its more extreme nature and the fact that fasting can actually get easier over time, masking any potential health consequences.\n\nThis is one more reason to make sure the food you do eat during your feeding window is as healthy as possible. ","5e89c00f-b9a8-405e-bb7c-ad86b9aa09bb",{"id":947,"data":948,"type":25,"maxContentLevel":34,"version":25,"reviews":952},"529cc16d-e737-4ea9-8304-172fbe3bf330",{"type":25,"title":949,"markdownContent":950,"audioMediaId":951},"Who Should Avoid Intermittent Fasting?","The general guidance from healthcare professionals is that certain people should avoid intermittent fasting altogether. These include pregnant and breastfeeding women, young children, teens, older adults with pre-existing conditions, and those suffering from immunodeficiencies.\n\nThey also advise that individuals with a history of eating disorders, dementia, a history of traumatic brain injury or post-concussive syndrome to stay away from intermittent fasting. \n\nThere may be exceptions. For example, healthcare professionals have used fasting to treat epilepsy in children.\n\nNote, not every body is the same, and some otherwise healthy people don’t respond well to fasting. If side effects such as extreme hunger, nausea, irritability, headaches, fatigue, or faintness occur, it may be a sign that it isn’t for you and again you should speak with a healthcare professional.","7b29ed97-52e7-46cb-bea2-68b9fefff046",[953],{"id":954,"data":955,"type":57,"version":25,"maxContentLevel":34},"22a1bec9-901d-4755-9196-a5532fa21050",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":956,"binaryCorrect":958,"binaryIncorrect":960},[957],"All healthy people, given enough time, will be able to fast without any side effects.",[959],"False: Some people never adapt to fasting",[961],"True: It just takes time",{"id":963,"data":964,"type":27,"maxContentLevel":34,"version":25,"orbs":967},"af6b3bd2-60f0-4b1d-882d-53789fc9e453",{"type":27,"title":965,"tagline":966},"The Different Types of Intermittent Fasting","There isn't just one way to practice intermittent fasting. This tile will explore the options to help you choose whats best for you.",[968,1004,1052,1091],{"id":969,"data":970,"type":26,"version":25,"maxContentLevel":34,"pages":971},"1bcf5f26-817e-4c45-a0e0-24333af1d070",{"type":26,"title":39},[972,977,991],{"id":973,"data":974,"type":25,"maxContentLevel":34,"version":25},"664c5f9b-3861-4e4d-b162-a29e9f2d8456",{"type":25,"title":44,"markdownContent":975,"audioMediaId":976},"There are many different ways to practice intermittent fasting. Most will have defined fasting windows (when you don’t eat) and feeding windows (when you do eat). Others might specify additional calorie restrictions.\n\nThough there are several options to choose from, the right option for you will come down to your personal objectives (e.g. weight loss or other health benefits) and what fits in your life. The great thing about intermittent fasting is the myriad ways it can be adapted to anyone’s lifestyle.\n\nIn this tile, we will take a closer look at the main types of intermittent fasting protocols and how to practice them.","67288674-2fc9-4c07-8294-2e5f71bed41f",{"id":978,"data":979,"type":25,"maxContentLevel":34,"version":25,"reviews":983},"ca56d452-be44-4abd-bca4-0d617b316cbd",{"type":25,"title":980,"markdownContent":981,"audioMediaId":982},"Meal Skipping","**Meal Skipping** is exactly what it says on the tin. Meal skipping allows for a bit more flexibility; you can choose which meal(s) you’d like to skip and on which days. This protocol works well for people whose daily schedules vary a lot.\n\nIt should be noted that meal skipping is only a way to experiment with your body and to see how it reacts to longer periods of time without eating. Due to the relatively large feeding windows, it’s harder to unlock the true benefits of intermittent fasting with this approach.\n\nThis method can be approached in two different ways:\n\nThe first is to only eat when you are hungry. For example, if you wake up and you are not hungry yet, instead of following your normal morning pattern, skip breakfast until you feel hungry.\n\nThe second will be to choose a meal to skip. Try skipping a meal intentionally once or twice a week to see how your body reacts to hunger and fasting.","69576078-d106-43bf-9f10-e0e8b55d4aea",[984],{"id":985,"data":986,"type":57,"version":25,"maxContentLevel":34},"897fdd50-316f-4e08-b5b1-86b473f59005",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":987,"binaryCorrect":989,"binaryIncorrect":990},[988],"Skipping a meal is sufficient to reap the full medical benefits of fasting.",[63],[61],{"id":992,"data":993,"type":25,"maxContentLevel":34,"version":25,"reviews":997},"301db711-2a02-4571-881d-b48da45601b1",{"type":25,"title":994,"markdownContent":995,"audioMediaId":996},"Overnight Fast or 12:12","An **overnight fast** is a fast that takes place overnight. Note however, that the duration of your fast is not equal to the number of hours that you are asleep. \n\nThis protocol is easiest to follow if the same 12-hour window is used everyday, for example: If you choose to stop eating after dinner by 8 p.m. and then resume eating at 8 a.m. with breakfast the next morning.\n\nBecause the fasting window with this protocol is also relatively short, this method also doesn’t truly maximize the advantages of fasting. Autophagy does still happen at the 12-hour mark, but the benefits won’t be as prominent were you to extend the fast for another 4 hours. Additionally, if you’re fasting for weight loss, a smaller fasting window means more time to eat, and it may not be as effective in reducing the number of calories you consume.","7b1e4ecb-427d-4a00-ac97-12e8da68e42b",[998],{"id":999,"data":1000,"type":57,"version":25,"maxContentLevel":34},"ff1882a4-b6a6-4e8b-b70e-ca73d5c73e72",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1001,"activeRecallAnswers":1003},[1002],"How long is your feeding window in the 12:12 protocol?",[429],{"id":1005,"data":1006,"type":26,"version":25,"maxContentLevel":34,"pages":1008},"09e49afd-cff8-4ac7-82c0-2d308507089a",{"type":26,"title":1007},"Time-Restricted Eating Methods",[1009,1032,1046],{"id":1010,"data":1011,"type":25,"maxContentLevel":34,"version":25,"reviews":1015},"906015fe-3e52-4f8c-ae6f-64d18d686e99",{"type":25,"title":1012,"markdownContent":1013,"audioMediaId":1014},"Time-Restricted Eating Protocols and 16:8","**Time-restricted eating** simply means that you have fasting windows where you don’t eat and feeding windows where you do. This method allows for a lot of flexibility, as you will be able to set the fasting and eating windows, and how often you repeat the fast in a weekly cycle.\n\nExperts suggest a fasting window of around 14 to 16 hours to enjoy some of the benefits of intermittent fasting. The highly popular **16:8** protocol is one where the fasting window is 16 hours.\n\nThis protocol strikes an ideal balance between adherability, as the fasting window is not that long, while still unlocking many health benefits. As with the overnight fast, the hours spent fasting while sleeping are ‘free’ as you’re not awake when you’re hungry!\n\nOther popular time-restricted protocols include **20:4** and **OMAD or One Meal A Day**. \n\nYou should note that if you’re eating for the whole 4 hours in, for example, a 20:4 program, you aren’t actually fasted for 20 hours, because food is still in your digestive system. It takes 3-4 hours for the food to go through your system, so while you may be following 20:4, you’re in a fasted state for only 16 hours.","fedff171-ce67-44f4-a605-08b58d9f205e",[1016,1023],{"id":1017,"data":1018,"type":57,"version":25,"maxContentLevel":34},"1475d3d2-2db2-487a-ba1a-4052850c6717",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1019,"activeRecallAnswers":1021},[1020],"In a 20:4 fast, how long is your body in a true fasted state?",[1022],"16-17 hours as food is still in the digestive system when you stop eating",{"id":1024,"data":1025,"type":57,"version":25,"maxContentLevel":34},"96fe0a76-c5e6-4353-8ef2-3d58412846ab",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1026,"binaryCorrect":1028,"binaryIncorrect":1030},[1027],"How long is the fasting window in the 16:8 protocol?",[1029],"16 hours",[1031],"8 hours",{"id":1033,"data":1034,"type":25,"maxContentLevel":34,"version":25,"reviews":1038},"4fcf8d3f-1c7e-4aea-ba02-81b7e9352b6a",{"type":25,"title":1035,"markdownContent":1036,"audioMediaId":1037},"Time-Restricted Eating Protocols – Timing and Tips","A 16:8 fast simply means that you will fast for 16 hours and eat within a **8 hour feeding window**. There are, however, two popular options within this method of fasting, namely early and late intermittent fasting.\n\nIn a 16:8 (Early) intermittent fast, you will fast for 16 hours and eat for 8 hours, with no breakfast. It is recommended to eat two meals between 12:00 and 20:00. \n\nIn a 16:8 (Late) intermittent fast, you fast for 16 hours and eat for 8 hours, with no dinner. It is recommended to eat two meals between 06:00 and 14:00. \n\nYou can, of course, also choose the hours for fasting that best fit your everyday lifestyle. Generally people find the *early* approach easier to follow because it’s generally harder to skip dinner, and dinner is more intimately entwined with the joys and obligations of our social groups.\n\nIt can be surprising how much you can eat in just a few hours, so pay attention to not overindulge in this period!\n\nSome studies have shown that breaking a fast with a low glycemic index or even ketogenic meal (one with almost no carbs and lots of fats) can synthetically extend the fasting window and derive the benefits of fasting a little longer.","967e2abc-a507-4afb-8182-8c03cbd39b21",[1039],{"id":1040,"data":1041,"type":57,"version":25,"maxContentLevel":34},"529c1274-3c17-4281-936b-f017b60172a7",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1042,"activeRecallAnswers":1044},[1043],"What kind of meal allows you to extend the 'fasting window'?",[1045],"A low-carb or ketogenic meal when you break a fast",{"id":1047,"data":1048,"type":25,"maxContentLevel":34,"version":25},"d0f78103-bb3e-4336-a3a1-ab6c101230ea",{"type":25,"title":1049,"markdownContent":1050,"audioMediaId":1051},"14:10 Fasting","The **14:10** method is an alternative to the 16:8 method for people who might find fasting for 16 hours difficult. This method of fasting is similar to the 16:8 method, but instead of fasting for 16 hours you only fast for 14 hours, and the remaining 10 hours of the day will then be your feeding  window. You can eat your usual meals during the 10-hour window, but you can’t consume any calories during a 14-hour fast. However, you are allowed to drink unsweetened tea or coffee, preferably without any milk, and of course, water.\n\nAlso similar to the 16:8 method, you can categorize this method into late and early intermittent fasting.\n\nFor 14:10 intermittent fasting, you will fast for 14 hours and have a 10-hour window for eating.\n\nWith 14:10 early fasting, you will skip breakfast and with 14:10 late fasting, you'll skip dinner.  \n\nThese protocols are flexible, so try experimenting with different fasting windows to fit your lifestyle.","544ca243-fa50-4e93-86ae-d245fdcb3c58",{"id":1053,"data":1054,"type":26,"version":25,"maxContentLevel":34,"pages":1056},"25ae5b17-1080-4ccd-94f9-9c4189a6fc79",{"type":26,"title":1055},"Advanced Fasting Protocols",[1057,1071,1085],{"id":1058,"data":1059,"type":25,"maxContentLevel":34,"version":25,"reviews":1063},"23b054af-74ea-479e-a671-2436ac387224",{"type":25,"title":1060,"markdownContent":1061,"audioMediaId":1062},"The Warrior Diet (20:4 Method)","During the **Warrior Diet**, participants follow a **20-hour fasting window**, with a minimal to zero-calorie intake, and a 4-hour eating window, where they are allowed to eat what they like. The key component of this schedule is timing. The plan is based on the idea that long periods of fasting and short windows of eating lead to optimal health, fitness, and body composition.\n\nThe times that you eat are flexible and you can choose your 4-hour eating window based on your personal preference or schedule. But most people save their feast for the evening hours.\n\nThis fasting method was developed by health and fitness author *Ori Hofmekler*. He formed the Warrior Diet in 2001. This was after years of observing himself and his colleagues in the Israeli Special Forces. \n\nDuring your eating window, Hofmekler suggests basing your meals on healthy fats and large portions of protein, specifically dairy protein sources such as cheese and yogurt.\n\nBecause there aren’t any modifications to the Warrior Diet, if you deviate off of the 20:4 cycle, you wouldn’t be on the Warrior Diet anymore.","5bedcb22-2d63-4a46-91c1-1797b0357913",[1064],{"id":1065,"data":1066,"type":57,"version":25,"maxContentLevel":34},"e3cab871-a8e3-4cd6-bef6-de76602cd2a1",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1067,"activeRecallAnswers":1069},[1068],"The eating pattern of which military unit inspired the Warrior Diet?",[1070],"Israeli Special Forces",{"id":1072,"data":1073,"type":25,"maxContentLevel":34,"version":25,"reviews":1077},"da62843b-d0d7-4d28-9785-45490ad1d40d",{"type":25,"title":1074,"markdownContent":1075,"audioMediaId":1076},"One Meal a Day (OMAD)","**OMAD**, or one meal a day fasting, refers to an intermittent eating cycle where a person fasts for 23 hours in a day, with a **1-hour eating window.**\n\nIn terms of intermittent fasting, this is one of the most extreme forms. This is because, in prolonged fasting, your body starts to move from burning calories to using your body fat as fuel. During ketosis, your appetite is suppressed and feelings of hunger start to dissipate. However, in the OMAD diet, before your body starts getting into the rhythm of fasting, you may experience extreme hunger before you enter ketosis, only to start the process again the next day. \n\nThis cycling can make OMAD difficult for beginners, and is thus advised for people with more experience fasting.\n\nThat being said, this method works **exceptionally well** for losing weight and improving body composition.","8f362368-994e-4c0c-88fe-c391a47156c6",[1078],{"id":1079,"data":1080,"type":57,"version":25,"maxContentLevel":34},"6b42c689-bd5a-4a2f-bb60-7038f706fff3",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1081,"activeRecallAnswers":1083},[1082],"What does OMAD stand for?",[1084],"One Meal A Day - a more extreme form of time-restricted eating",{"id":1086,"data":1087,"type":25,"maxContentLevel":34,"version":25},"022549fd-00f9-4b9e-a167-091f27b3b125",{"type":25,"title":1088,"markdownContent":1089,"audioMediaId":1090},"Whole-Day Fasting","This method goes by many names, such as **eat-stop-eat fasting**, **24-hour fasting**, and **whole-day fasting**. It involves fasting where your fasting period is essentially 24 hours. This means if you’ve had dinner at 7 p.m. you are only allowed to eat again on the following day, also at 7 p.m. Although, most people fast from breakfast to breakfast or lunch to lunch. This method is flexible since you can choose which 24 hours to fast.\n\nThis method of fasting is usually only done once or twice a week. An example of a whole-day fasting schedule is the **6:1 method**, which involves fasting for 1 day and eating normally for 6 days in a week. With this version of intermittent fasting, as with the OMAD method, the side effects can be quite extreme, such as fatigue, headaches, irritability, hunger, and low energy.\n\nThe advantage of whole-day fasting, if done for weight loss, is that it’s unlikely to eat an entire day’s worth of calories in one sitting.","aa5100df-89d5-42e0-a746-f3955fab20d5",{"id":1092,"data":1093,"type":26,"version":25,"maxContentLevel":34,"pages":1095},"7bd99603-6433-4ee4-b6aa-0110f69102ca",{"type":26,"title":1094},"Alternate Fasting Schedules",[1096,1111],{"id":1097,"data":1098,"type":25,"maxContentLevel":34,"version":25,"reviews":1102},"c3e7963d-bc09-46b8-90e4-786b0a827660",{"type":25,"title":1099,"markdownContent":1100,"audioMediaId":1101},"The Twice-a-week Method (The 5:2 Diet)","According to some, the **5:2 Diet**, also known as **The Fast Diet**, is currently the most popular intermittent fasting diet. This diet was popularized by British journalist *Michael Mosley*.\n\nThis intermittent fasting schedule focuses on restricting your calorie intake to **500-600 calories** for two days a week. During the other five days of the week, you maintain a healthy and normal diet. \n\nYou can choose which two fasting days (say, Monday and Wednesday) as long as there is a non-fasting day between them. It’s important to **not overeat on non-fasting days** and to stick to the same amount of food you would normally eat.\n\nBecause there are no requirements about which foods to eat but rather when you should eat them, this diet is more of a lifestyle choice.\n\nMany people find this way of eating to be easier to stick to than a traditional calorie-restricted diet.","d31070f2-c7cd-4c19-8b75-94e49fc70afd",[1103],{"id":1104,"data":1105,"type":57,"version":25,"maxContentLevel":34},"6b7837e2-0fd3-4907-b340-529ac0fcb5bb",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1106,"clozeWords":1108},[1107],"In the 5:2 diet, you consume 500-600 calories for two days a week, and eat regularly on the other days.",[1109,1110],"500-600","two",{"id":1112,"data":1113,"type":25,"maxContentLevel":34,"version":25,"reviews":1117},"f709be41-d7ae-46ee-a91c-95d91b92122b",{"type":25,"title":1114,"markdownContent":1115,"audioMediaId":1116},"Alternate-day fasting (ADF)","This approach was popularized by *Krista Varady*, a nutrition professor at the University of Illinois in Chicago. During alternate day fasting, participants alternate between a fasting day and one eating day. In this approach, non-fasting days are normal eating days.\n\nThis method is popular for weight loss. In fact, studies found that, in overweight adults, alternate-day fasting significantly reduced body mass index, weight, fat mass, and total cholesterol.\n\nStudies performed by Dr. Varaday and her colleagues found that side effects, like hunger, decreased or subsided completely by week 2 of alternate-day fasting. And the participants started feeling more satisfied with the diet after week four. The downside was that during the eight weeks of the experiment, study participants said that they were never really satiated which can make adhering to this schedule very challenging.","f947b8ec-0ffe-4ca4-a876-680aa6567b97",[1118,1125],{"id":1119,"data":1120,"type":57,"version":25,"maxContentLevel":34},"449c714c-b030-458a-9c3f-909b2bbc7259",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1121,"activeRecallAnswers":1123},[1122],"What is one commonly reported downside of the ADF protocol?",[1124],"Some practitioners report never being fully satisfied",{"id":1126,"data":1127,"type":57,"version":25,"maxContentLevel":34},"83452749-3d32-47e4-88fc-59a1118540eb",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1128,"activeRecallAnswers":1130},[1129],"How does the ADF (alternate day fast) work?",[1131],"You alternate days of fasting and eating normally",{"id":1133,"data":1134,"type":27,"maxContentLevel":34,"version":25,"orbs":1137},"3c32022f-79df-4b36-85ff-442ae6a617ba",{"type":27,"title":1135,"tagline":1136},"The Practical Application of Intermittent Fasting","This tile goes into more detail about how exactly you can incorporate intermittent fasting into your life.",[1138,1197,1259,1323],{"id":1139,"data":1140,"type":26,"version":25,"maxContentLevel":34,"pages":1141},"6891fa87-0199-434f-bad2-d8025aa4a75a",{"type":26,"title":39},[1142,1147,1163,1178],{"id":1143,"data":1144,"type":25,"maxContentLevel":34,"version":25},"e1c9eb84-11be-469f-8953-27f2be639b30",{"type":25,"title":44,"markdownContent":1145,"audioMediaId":1146},"Intermittent fasting does not actually require you to count your calorie intake or strictly forbid you from eating certain foods, making this more of a lifestyle choice than a diet. However, there are still a lot of unwritten ‘rules’ to this lifestyle that you should take into consideration to ensure that you reap all of the benefits.\n\nAnd although intermittent fasting is gaining popularity, it can be quite confusing and daunting to know where to start. From knowing which fasting protocol to choose, to knowing what foods will best complement your fast, whether you are allowed to exercise, and everything in between. In this tile, we will take a look at the practical side of implementing a lifestyle of intermittent fasting into your everyday life.\n\nFrom starting a fast to ending it, we’ll cover all the bases so you’ll properly understand all the hows and whys of intermittent fasting, in order to make the best decision for your practice.","b0afe762-2259-46e9-b148-bb6a6e083b5f",{"id":1148,"data":1149,"type":25,"maxContentLevel":34,"version":25,"reviews":1153},"c2abe473-277c-4ef0-8305-e6ddc408f6b3",{"type":25,"title":1150,"markdownContent":1151,"audioMediaId":1152},"The Do’s of Intermittent Fasting","Firstly, make sure you are not going into intermittent fasting without **planning ahead of time**, and without researching different intermittent fasting protocols. If you are new to intermittent fasting, you might want to transition into it slowly. Following the 16:8 method a few days a week instead of every day, or trying a 12-hour fast might be a better choice at first. You can gradually work your way up to other more advanced fasting protocols.\n\nIt is also important to listen to your body when you start intermittent fasting. You may be following a method that simply isn’t working for you. **Don’t force it**, rather try another method instead. While you do want to give each protocol a good amount of time to see whether it is a good fit, don’t go months being uncomfortable and miserable.","085b4eb0-7473-488f-9726-e9a9ded55cea",[1154],{"id":1155,"data":1156,"type":57,"version":25,"maxContentLevel":34},"700c7f95-b8ab-4792-b6c6-b87b9174ed09",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1157,"binaryCorrect":1159,"binaryIncorrect":1161},[1158],"What should you do if a fasting protocol isn't working for you?",[1160],"Experiment with other protocols",[1162],"Stick with it regardless",{"id":1164,"data":1165,"type":25,"maxContentLevel":34,"version":25,"reviews":1169},"5f977a1a-40af-4213-bc4a-503a6596435a",{"type":25,"title":1166,"markdownContent":1167,"audioMediaId":1168},"The Don’ts of Intermittent Fasting","When you’re fasting, your body is lacking the normal amount of energy you typically get from your daily meals. So, don’t push your body beyond its limits. While exercising during intermittent fasting is healthy, it’s important to not overexert your body to the point of exhaustion. \n\nThe whole purpose of having a feeding window is to give your body the energy it needs to function. This is why it is important not to over-restrict your body on its calorie intake. It can be tempting to restrict calories during this period but that can actually derail your progress and cause your body to crave more food and break your fast before you’re ready.\n\nIt is also important **not to binge eat** or overindulge during the eating window. The opposite of restricting calories is binging and it can slow down or even erase the benefits of fasting altogether.  What’s more, overeating and eating the wrong foods (e.g. high in sugar or starch) can make your fast more difficult by increasing hunger during your fasting periods.","9da213ea-4c48-4b6a-8a7f-bdcb7a562d0c",[1170],{"id":1171,"data":1172,"type":57,"version":25,"maxContentLevel":34},"83141d0c-85ba-4f32-9624-f77a28908cde",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1173,"activeRecallAnswers":1175},[1174],"What are 2 reasons you shouldn't binge when you break a fast?",[1176,1177],"It might erase the health benefits of your fast","It might increase hunger during your fasting window",{"id":1179,"data":1180,"type":25,"maxContentLevel":34,"version":25,"reviews":1184},"13638e73-f614-4501-8a34-9c040df4a84f",{"type":25,"title":1181,"markdownContent":1182,"audioMediaId":1183},"How to Choose an Intermittent Fasting Protocol","This is a common question, but the answer depends on your fat-adapted state and your goals. \n\nThe ketogenic diet helps with fasting because it helps transition your body in utilizing stored fats for energy.\n\nStarting with the 16:8 fasting is easiest for both keto and fasting beginners when you’re not yet fat-adapted as it can be achieved by simply skipping breakfast (and maybe delaying lunch a bit). Once your body gets used to fasting you can extend your fasting windows.\n\nIn the end, the best plan is the one you can stick to, so be realistic with yourself about what protocol to follow.\n\nFasting goals come into play when you’ve mastered fasting or keto. Perhaps your goal is to get back into ketosis after a particularly bad cheat day (we’ve all been there). In this case, a 24-hour fast may help get you back on track and into ketosis. For many, the goal is breaking through a weight loss plateau.\n\nTake note that whatever method of intermittent fasting you choose, it’s important to apply the same fundamental nutrition principles to intermittent fasting as to other healthy eating plans.\n\nA great thing about the protocols and methods in this pathway is you can think of them as tools in your toolbox to help you achieve your health goals.","dd5699be-5929-4a1b-9437-5b989b9c2f30",[1185],{"id":1186,"data":1187,"type":57,"version":25,"maxContentLevel":34},"98f7e7ad-4be0-4a58-b254-20731225f16a",{"type":57,"reviewType":34,"spacingBehaviour":25,"multiChoiceQuestion":1188,"multiChoiceCorrect":1190,"multiChoiceIncorrect":1192},[1189],"Which is the best intermittent fasting protocol?",[1191],"One you can stick to",[1193,1194,1195,1196],"16:8","20","4","OMAD",{"id":1198,"data":1199,"type":26,"version":25,"maxContentLevel":34,"pages":1201},"fadd23ea-2a8f-42aa-837b-7af23f7bf9a3",{"type":26,"title":1200},"Understanding Ketosis",[1202,1208,1238],{"id":1203,"data":1204,"type":25,"maxContentLevel":34,"version":25},"fe77d859-2766-485f-826a-91e6a30b89c1",{"type":25,"title":1205,"markdownContent":1206,"audioMediaId":1207},"How to Know If You Are in Ketosis","It can be hard to know whether you have entered into ketosis or not, but there are several signs to look out for. The most obvious of these is increased ketones in your blood. Blood tests measure the amount of **beta-hydroxybutyrate (BHB)** in your blood, which is the primary ketone present in your bloodstream.\n\nA common side effect that can happen when you reach full ketosis is bad breath. Some other common symptoms of ketosis include, suppressed appetite, rapid weight loss in the first week, short-term fatigue in the early transitioning stages of ketosis, and at a later stage, increased focus and energy. A less common side effect of ketosis is digestive issues and insomnia.","e814d408-6ee5-49c8-a4fe-4027a178a6da",{"id":1209,"data":1210,"type":25,"maxContentLevel":34,"version":25,"reviews":1214},"22ff5abf-1f78-4c74-b67b-a4d3d6833c57",{"type":25,"title":1211,"markdownContent":1212,"audioMediaId":1213},"How to Measure Ketones","Testing ketone level in the blood, glucose levels, and other measurements can be an engaging way to quantify changes in your body while fasting. It’s fun and motivating!\n\nKetones going up during your fasting, (assuming you’re not supplementing with exogenous ketones), means that your body has entered into ketosis; burning your stored fats and turning them into ketones for fuel.\n\nThere are several ways to measure your ketones, including blood tests, urine tests, and breath tests. Each of these methods has its own set of pros and cons and applications.\n\nThe urine test makes use of strips that measure **acetoacetate (a ketone body)**. When your body enters into a state of ketosis not all of the ketones are used and instead of storing the ketones as fat, your body gets rid of them in urine. The biggest advantage of this method is that it is readily affordable. The disadvantage is that this method of measuring ketones is very limited in terms of accuracy when compared to something like a blood test.","67453109-635e-4586-b8a8-87933f674f2f",[1215,1222,1231],{"id":1216,"data":1217,"type":57,"version":25,"maxContentLevel":34},"19ce94d8-6a54-4d3b-a9f3-97472d31779f",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1218,"activeRecallAnswers":1220},[1219],"What is the ketone body that urine test strips are designed to detect?",[1221],"Acetoacetate",{"id":1223,"data":1224,"type":57,"version":25,"maxContentLevel":34},"58ff3abb-da33-46c5-8908-db0c0e6740db",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1225,"activeRecallAnswers":1227},[1226],"What are 3 ways to measure ketone levels?",[1228,1229,1230],"Urine test","Blood test","Breath test",{"id":1232,"data":1233,"type":57,"version":25,"maxContentLevel":34},"ae838d9d-816e-454e-a84b-6d6e7828eb5e",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1234,"activeRecallAnswers":1236},[1235],"What is one measurable sign you are entering ketosis?",[1237],"Your ketone levels are increasing",{"id":1239,"data":1240,"type":25,"maxContentLevel":34,"version":25,"reviews":1244},"a0e96ab3-a313-4b38-a8a2-00947d096427",{"type":25,"title":1241,"markdownContent":1242,"audioMediaId":1243},"How to Measure Ketones - Continued","*Blood test*\n\nBlood tests to measure ketones are readily available at pharmacies and online. These tests require you to prick your finger and dab a drop of blood on a blood meter. It measures the **beta-hydroxybutyrate (BHB)** levels in your blood, which is the primary ketone body that shuttles energy throughout your body during ketosis. This method is the most accurate method to measure ketones, but it might not be for everyone.\n\n*Breath test*\n\nDuring a breath test, a Ketonix meter is used. This meter is also easily obtainable from many pharmacies. This meter measures **acetate/acetone** in your breath, which is a ketone body produced from the metabolism of BHB to acetoacetate and into acetate. Acetate/acetone levels are therefore related to your BHB levels. More acetate means more BHB. BHB is the primary ketone body.\n\nUnlike blood and urine tests, the Ketonix meter is reusable, but the readings are indirect and can be inaccurate.\n\nThe method that you choose for measuring your ketones will boil down to your budget and personal preference.","a00113d2-194c-49f8-94df-bc5ab8a5d174",[1245,1252],{"id":1246,"data":1247,"type":57,"version":25,"maxContentLevel":34},"a74362ad-22dd-48a2-abbf-c6f76ca2add2",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1248,"activeRecallAnswers":1250},[1249],"What is the most accurate way to test ketone levels? What ketone body does it detect?",[1229,1251],"beta-hydroxybutyrate (BHB) ",{"id":1253,"data":1254,"type":57,"version":25,"maxContentLevel":34},"b75249ec-4b68-4a8a-a4b9-000c4f28cd85",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1255,"binaryCorrect":1257,"binaryIncorrect":1258},[1256],"Which of these is more accurate at testing ketone level?",[1229],[1230],{"id":1260,"data":1261,"type":26,"version":25,"maxContentLevel":34,"pages":1263},"85a5a935-9ea1-438e-978b-a4f5c1d8ee45",{"type":26,"title":1262},"Exercise and Fasting",[1264,1287,1302],{"id":1265,"data":1266,"type":25,"maxContentLevel":34,"version":25,"reviews":1270},"15a94d0b-d9ff-4ec7-ad28-7ce75fd035fe",{"type":25,"title":1267,"markdownContent":1268,"audioMediaId":1269},"Pros and Cons of Exercising While Intermittent Fasting","Some research shows that exercising while fasting may affect muscle biochemistry and metabolism that are linked to insulin sensitivity and the steady management of blood sugar levels. \n\nEvidence shows that it is best to exercise fairly soon **after** a meal – before digestion or absorption occurs. This is particularly important for anyone with type 2 diabetes or metabolic syndrome. Wait for 30 minutes to an hour, and you should be good to go! \n\nProbably the best benefit of exercising while fasting is that your stored carbohydrates, known as glycogen, are very likely depleted, so you’ll be **burning more fat** when you work out. \n\nWhile it is technically possible for your body to begin breaking down muscle protein while exercising on a fast, in reality this only happens with very strenuous exercise bouts during extended fasts. In addition, the release of **HGH (human growth hormone)** while fasting serves to preserve muscle mass even while in caloric deficit (up to a point). A far more common downside to exercising while fasting is one might feel they have less energy and thus won’t be able to exercise as vigorously as they might be used to.","8567d92d-ee94-482f-b046-85cfbaffbcc7",[1271,1280],{"id":1272,"data":1273,"type":57,"version":25,"maxContentLevel":34},"02649e6b-bb2e-4ea7-8875-e5994554cd8e",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1274,"binaryCorrect":1276,"binaryIncorrect":1278},[1275],"When following an intermittent fasting protocol, when is the best time to exercise?",[1277],"After eating",[1279],"Before eating",{"id":1281,"data":1282,"type":57,"version":25,"maxContentLevel":34},"7701210b-3851-46af-bdc2-cb6980f5bcd6",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1283,"activeRecallAnswers":1285},[1284],"What is the main benefit of exercising while fasting?",[1286],"You burn more fat as glycogen stores are depleted",{"id":1288,"data":1289,"type":25,"maxContentLevel":34,"version":25,"reviews":1293},"008ad725-a349-4152-8700-2b035d821a93",{"type":25,"title":1290,"markdownContent":1291,"audioMediaId":1292},"Difference Between a Long and Short Fast","Every night when we stop eating and then go to bed, we go through a short-term fast until our first meal of the next day. Depending on when you ate dinner and when you consume your first meal after you wake up, you can easily go through a 12 to 16-hour fast — with no physiological change to digestive functions.\n\nAlthough there is no clear accepted delineation between a short- and long-term fast, a general rule of thumb can be used to distinguish between the two: In general, anything **less than 24 hours** is considered time-restricted eating, fasts **between 24 and 36 hours** as a short-term fast, and anything longer than **36 hours** a long-term fast.\n\nTime-restricted eating and short-term fasts don’t require specific precautions when breaking the fast. Just remember it is a good idea not to binge on highly-processed, sugary, or high-carb foods because you may undo some of the advantages of the fast, particularly those linked to hormonal changes. Plan to eat a well-balanced, nutritious meal and you’ll be just fine.","7d969fb4-ad6f-41e9-9181-88963e521ff7",[1294],{"id":1295,"data":1296,"type":57,"version":25,"maxContentLevel":34},"6cfb8a0f-b399-4bd6-b2d4-22cd5730294a",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1297,"clozeWords":1299},[1298],"Fasts between 24 - 36 hours are considered short-term fasts, and anything longer is considered a long-term fast.",[1300,1301],"24","36",{"id":1303,"data":1304,"type":25,"maxContentLevel":34,"version":25,"reviews":1308},"03a1e8d4-ad09-45d1-abf2-ca5bf314b13f",{"type":25,"title":1305,"markdownContent":1306,"audioMediaId":1307},"Potential Side Effects of Breaking a Long Term Fast","If you’ve been fasting long enough for your body to slow down its production of **digestive enzymes**, then you may be at risk of experiencing some gastrointestinal distress when you start to eat again. This may come in the form of diarrhea or loose stools, passing of undigested foods, gas pains, bloating, and, in rare cases, nausea and vomiting. \n\nThis happens because your body doesn’t have the necessary digestive enzymes and juices available to break down your food, which can cause the food to sit in your stomach for much longer. It can take a few hours or more for your body to start to produce what it needs to break down the food. It’s during this period that you may start to experience unwanted stomach pains.\n\nApart from shortening the duration of your fast, the best way to minimize these side effects is to eat food that will help reduce these symptoms when you break your fast. Smoothies, fermented foods, and soups are all gentle foods that can help your body ease back into its normal working state.","6a129ca1-8029-44fc-bccc-175acf2c4c01",[1309,1316],{"id":1310,"data":1311,"type":57,"version":25,"maxContentLevel":34},"1a5be754-3d44-4391-99de-9921b264dbd7",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1312,"activeRecallAnswers":1314},[1313],"What is the main cause of digestive stress from fasting?",[1315],"Insufficient digestive enzymes and juices in your stomach delays the break down of food",{"id":1317,"data":1318,"type":57,"version":25,"maxContentLevel":34},"3f7bc4d2-c313-4d36-9167-7cdb7a3a5b3f",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1319,"activeRecallAnswers":1321},[1320],"What kind of foods can help with digestive stress from fasting?",[1322],"Smoothies, soups, and fermented foods ",{"id":1324,"data":1325,"type":26,"version":25,"maxContentLevel":34,"pages":1327},"c8e4c245-eba4-46e0-b8e3-4254adb72532",{"type":26,"title":1326},"Managing Long-Term Fasting",[1328,1368],{"id":1329,"data":1330,"type":25,"maxContentLevel":34,"version":25,"reviews":1334},"70d4815f-2cc4-4f32-8e0e-ae23318174dc",{"type":25,"title":1331,"markdownContent":1332,"audioMediaId":1333},"Refeeding Syndrome","**Refeeding Syndrome** is a metabolic disturbance that, though very rare, can occur when resuming food consumption after periods of malnutrition or extended times without eating (fasting). \n\nThe primary clinical markers of refeeding syndrome are very low blood phosphorus levels, or hypophosphatemia, as well as low blood serum levels of potassium, calcium, and magnesium (electrolytes).\n\nThese shifts can cause heart rhythm abnormalities (arrhythmias), cardiac failure, respiratory problems, convulsions, or even a coma.\n\nDuring the refeeding period, insulin and counterregulatory hormones such as cortisol and noradrenaline are suddenly reactivated. This leads to the movement of the major intracellular ions like phosphorus, potassium, calcium, and magnesium into our cells. However, due to the overall depletion of our body stores, this becomes quite excessive and leaves us with too little of these ions in the blood.\n\nFatigue, weakness and confusion, difficulty breathing and high blood pressure are all some of the milder symptoms that these nutrient imbalances cause. In severe cases these shifts can cause seizures, and even death.\n\nThese symptoms typically appear within **2-4 days** of the start of refeeding.","58cf6e45-0bf3-4bce-bb0d-d856d55edccf",[1335,1342,1352,1359],{"id":1336,"data":1337,"type":57,"version":25,"maxContentLevel":34},"7bb97a57-2071-40d5-a16b-995a7a0e7f8a",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1338,"activeRecallAnswers":1340},[1339],"What is refeeding syndrome?",[1341],"A metabolic disturbance that can occur when resuming food consumption after periods of malnutrition or fasting.",{"id":1343,"data":1344,"type":57,"version":25,"maxContentLevel":34},"7dba1738-f45e-4c87-882d-0504b1e3e123",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1345,"activeRecallAnswers":1347},[1346],"What are 4 effects of refeeding syndrome?",[1348,1349,1350,1351],"Heart rhythm abnormalities (arrhythmias)","Cardiac failure","Respiratory problems","Convulsions",{"id":1353,"data":1354,"type":57,"version":25,"maxContentLevel":34},"b0eb94d9-1367-4b73-b308-7cd799c3bf8d",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1355,"activeRecallAnswers":1357},[1356],"When would the effects of refeeding syndrome typically appear?",[1358],"2 to 4 days after refeeding",{"id":1360,"data":1361,"type":57,"version":25,"maxContentLevel":34},"b0fd9b6d-3634-408b-8dbf-39301e90fc24",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1362,"binaryCorrect":1364,"binaryIncorrect":1366},[1363],"Refeeding syndrome is ",[1365],"Very rare",[1367],"Quite common",{"id":1369,"data":1370,"type":25,"maxContentLevel":34,"version":25,"reviews":1374},"366d2325-9778-4c6b-8e43-d5b23b7069f6",{"type":25,"title":1371,"markdownContent":1372,"audioMediaId":1373},"How to Avoid Refeeding Syndrome","Refeeding syndrome is **very rare**. It normally only occurs in severe cases where people have experienced intense malnutrition or starvation. But if this concerns you and you want to be extra careful, there are several things that you can do to reduce your risk of developing refeeding issues when you do break your fast. You should avoid breaking your fast with a meal that is high in carbohydrates; stick to low-carb, high-fat meals. Avoid meals that surge insulin and blood sugar.\n\nIt is also important to stay hydrated during your fast and to ease back into eating (especially after a fast extending past 3 days). Consume plenty of electrolytes like sodium, magnesium, and potassium to prevent complications during your fast and do not overeat when you break your fast. You can supplement with a pinch of natural salt such as Himalayan salt a few times throughout the day.\n\n**It is important to consult with your healthcare provider before attempting an extended fast.**","865d3fa4-872d-4855-8067-ccce22fa6078",[1375],{"id":1376,"data":1377,"type":57,"version":25,"maxContentLevel":34},"a1873190-7f37-4e06-b018-ba1c4c335775",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1378,"activeRecallAnswers":1380},[1379],"What are two ways you can reduce the risk of refeeding syndrome?",[1381,1382],"Break your fast with a low-carb meal","Supplement with electrolytes during your fast",{"id":1384,"data":1385,"type":27,"maxContentLevel":34,"version":25,"orbs":1388},"2da0c1d2-21ed-4b43-9f58-2eeeb5eb1b5d",{"type":27,"title":1386,"tagline":1387},"Intermittent Fasting in Men and Women","Learn about the biological differences and similarities between the male and female metabolic response to fasting.",[1389,1492],{"id":1390,"data":1391,"type":26,"version":25,"maxContentLevel":34,"pages":1393},"d281f061-25f8-4015-8392-b161232eec37",{"type":26,"title":1392},"Intermittent Fasting and Gender Differences",[1394,1409,1423,1453,1478],{"id":1395,"data":1396,"type":25,"maxContentLevel":34,"version":25,"reviews":1400},"6be7988b-3c77-4811-8bba-ac0f6ee6f673",{"type":25,"title":1397,"markdownContent":1398,"audioMediaId":1399},"Intermittent Fasting Differences in Men and Women","Biology has played a part in shaping male and female metabolic responses to exercise, carbohydrates, sleep deprivation, and (you’ve guessed it) fasting.\n\nWhile intermittent fasting can benefit both sexes, it may affect men and women differently. The discrepancies may be the result of hormonal differences. Besides influencing insulin, norepinephrine, and HGH levels, intermittent fasting may affect female sex and hunger hormones in specific ways. There are possible risks for women to consider regarding reproductive health, bone health, and overall well-being. Research involving female intermittent fasting is in its early days, and large scale studies are sorely missing.\n\nStudies performed on rodents suggest that intermittent fasting may cause changes in estrogen levels and negatively affect reproductive functions, such as menstrual regularity, fertility, pregnancy, and lactation. Although the hormone levels of male rodents were affected, their reproductive functions were not affected as much. One possible reason for this is that some aspects of reproduction in women require more energy than those in men. ","312d6608-5f4e-48ab-aa85-6417151a4b10",[1401],{"id":1402,"data":1403,"type":57,"version":25,"maxContentLevel":34},"3b90db01-eefa-4021-a8b0-cf5feaae97cc",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1404,"clozeWords":1406},[1405],"Intermittent fasting may influence estrogen levels and negatively affect reproductive functions, such as menstrual regularity, fertility, pregnancy, and lactation.",[1407,1408],"estrogen","reproductive",{"id":1410,"data":1411,"type":25,"maxContentLevel":34,"version":25,"reviews":1415},"a8351a2c-e75b-46a1-be58-c96369bcaa63",{"type":25,"title":1412,"markdownContent":1413,"audioMediaId":1414},"The Similarities Between the Sexes","Though many claim otherwise, there is research that suggests that men and women respond similarly to alternate-day fasting (ADF) and time-restricted eating. Though the data are limited, scientific findings suggest that both men and women have similar adherence rates, weight loss, and body composition changes in both alternate-day fasting and time-restricted eating.\n\nOne key study found no notable difference between men and women that tried alternate day fasting for 12 weeks. Though “bad” cholesterol (LDL) decreased slightly more in premenopausal women versus post-menopausal women, but there were no significant differences in weight loss, fasting glucose, HDL cholesterol, and triglycerides.\n\nAnother recent study focused on factors like age, sex, race/ethnicity, and baseline body weight/BMI. It found that white males and people between the age of 50 and 59 years lost slightly more weight. Though 60 percent of all 121 participants **lost 4 to 8 percent of their body weight**, sex didn’t seem to make a difference.","baf7f6f2-e0e2-42fe-82ac-6e4878ab3bc0",[1416],{"id":1417,"data":1418,"type":57,"version":25,"maxContentLevel":34},"c152b884-f5bb-42d0-8240-8b950548da2e",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1419,"binaryCorrect":1421,"binaryIncorrect":1422},[1420],"Generally, men and women react similarly to ADF and time-restricted eating",[61],[63],{"id":1424,"data":1425,"type":25,"maxContentLevel":34,"version":25,"reviews":1429},"a7683418-2e46-4480-b2a1-0d72aec7f380",{"type":25,"title":1426,"markdownContent":1427,"audioMediaId":1428},"The Differences Across Sexes","Though there are similarities between both genders when it comes to intermittent fasting, there are also a lot of differences. During alternate day fasting, researchers found that after three weeks, women had a slightly worse glucose response than men. The men, on the other hand, had a worse insulin response. Interestingly, there were no changes in muscle-related genes.\n\nOther studies also suggest that, overall, women may experience more issues with glucose clearance. Some experts think this may have to do with the difference in male and female body compositions, while others think women may be more prone to insulin issues because of differences in carbohydrate metabolism. \n\nEvidence suggests that male and female livers may also perform differently when regulating glucose while fasting. Women may release less glucagon (a hormone released to help raise blood sugar levels when they are low) to fuel them through exercise compared to men.\n\nIt is also common for women to feel more hungry during a fast than men.","1eac0991-47cf-40bb-ab69-a652136b566e",[1430,1439,1446],{"id":1431,"data":1432,"type":57,"version":25,"maxContentLevel":34},"112c639f-4d3f-49e7-8ed4-e73391e83f6d",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1433,"binaryCorrect":1435,"binaryIncorrect":1437},[1434],"Who typically report more sensations of hunger when fasting?",[1436],"Women",[1438],"Men",{"id":1440,"data":1441,"type":57,"version":25,"maxContentLevel":34},"1db422cb-d539-4930-880d-1c4125b0c347",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1442,"binaryCorrect":1444,"binaryIncorrect":1445},[1443],"During alternate day fasting (ADF), who experience a slightly worse glucose response?",[1436],[1438],{"id":1447,"data":1448,"type":57,"version":25,"maxContentLevel":34},"eadd5222-4f7c-4371-b782-f54295b738e8",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1449,"activeRecallAnswers":1451},[1450],"What is glucagon?",[1452],"A hormone released to help raise blood sugar levels when they are low",{"id":1454,"data":1455,"type":25,"maxContentLevel":34,"version":25,"reviews":1459},"94df12fd-1f3c-4b2d-bf04-a5a310321edd",{"type":25,"title":1456,"markdownContent":1457,"audioMediaId":1458},"Intermittent Fasting and the Male Body","Fasting has a huge role to play in **testosterone levels**. For men, testosterone supports and increases muscle mass and strength through improved protein synthesis. It blocks fat uptake and storage and burns fat instead. Testosterone also promotes healthy kidney function and bone growth and density. Testosterone also has positive effects on cognition and mental health.\n\nIntermittent fasting has several ties with testosterone levels. Firstly, it elevates growth hormone levels; supporting muscle growth, penile function, and better cognition. Secondly, it increases LH (luteinizing hormone) levels. And lastly, it regulates leptin levels, which in turn, stimulates testosterone secretion from the hypothalamus.\n\nDuring short periods of fasting (12-24 hours), one study showed that men’s metabolism **increases up to 14%.** \n\nIn addition, another study reports that the male body improves testosterone utilization, growth hormone production (100-200%), and an improvement in blood lipids to support the increased hormonal production and decreased risk factors for cardiovascular disease.","717c6422-f842-49d0-a7d6-f5547f5fd317",[1460,1469],{"id":1461,"data":1462,"type":57,"version":25,"maxContentLevel":34},"23a47fc6-1114-4f8f-84fd-e616cf35ca98",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1463,"binaryCorrect":1465,"binaryIncorrect":1467},[1464],"How does fasting affect testosterone and growth hormone levels in men?",[1466],"Increases levels",[1468],"Decreases levels",{"id":1470,"data":1471,"type":57,"version":25,"maxContentLevel":34},"74263faa-429e-414e-ad4b-db37ed92d41c",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1472,"activeRecallAnswers":1474},[1473],"What are 3 effects of testosterone on the male body?",[1475,1476,1477],"Increases muscle mass","Blocks fat uptake","Improves cognition",{"id":1479,"data":1480,"type":25,"maxContentLevel":34,"version":25,"reviews":1484},"2c6db64b-ccd4-4133-becc-78e094b93682",{"type":25,"title":1481,"markdownContent":1482,"audioMediaId":1483},"Intermittent Fasting and the Female Body  ","Some evidence suggests that intermittent fasting may not be as beneficial for some women as it is for men. One study showed that, after three weeks of alternate-day fasting, the blood sugar control in women worsened. Plus, many anecdotal stories claim that menstrual cycles may be affected.\n\nSuch shifts occur because female bodies are extremely sensitive to calorie restriction. If your calorie intake is too low the hypothalamus (a small area in the brain that plays an important role in hormone production) is affected. \n\nThis may disrupt the secretion of gonadotropin-releasing hormone (GnRH), a hormone that helps release two reproductive hormones: luteinizing hormone (LH) and follicle-stimulating hormone (FSH). If these hormones cannot communicate with the ovaries, you run the risk of irregular periods, infertility, poor bone health, and other health effects.\n\nStudies in rats have shown that 3–6 months of alternate-day fasting caused a reduction in ovary size and irregular reproductive cycles. Similar studies have not been conducted on humans yet.","8594305c-c24f-49ce-a2bf-39c133b59aee",[1485],{"id":1486,"data":1487,"type":57,"version":25,"maxContentLevel":34},"5698e161-1cad-43be-80a9-bcc6c4086b84",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1488,"activeRecallAnswers":1490},[1489],"Why is it especially important for women to consult a healthcare professional before embarking on a fast? ",[1491],"Because some studies suggest fasting might affect women more adversely than men ",{"id":1493,"data":1494,"type":26,"version":25,"maxContentLevel":34,"pages":1496},"683b0c9a-90b5-48c3-866f-015dfab2ad9f",{"type":26,"title":1495},"Considerations for Women in Intermittent Fasting",[1497,1511],{"id":1498,"data":1499,"type":25,"maxContentLevel":34,"version":25,"reviews":1503},"1bd7289b-735e-48af-86d7-4a2c2deae377",{"type":25,"title":1500,"markdownContent":1501,"audioMediaId":1502},"Why Do Women Respond Differently? A Few Theories","There are some theories as to why men and women respond differently to intermittent fasting. Firstly, the **hypothalamic-pituitary-gonadal (HPG) axis**, responsible for regulating key hormones that are involved in key functions, including appetite control and reproduction, is incredibly sensitive to energy intake.\n\nThe effect of a negative energy balance is thought to work through **kisspeptin**. Kisspeptin is a protein-like molecule that neurons use to communicate with each other. It has an important role in the regulation of reproductive functions and, according to recent studies, metabolism. Research suggests that women have more kisspeptin than males, meaning greater sensitivity to changes in energy balance.\n\nSecondly, it also seems that male and female livers are different when it comes to energy metabolism. A study that observed the livers of mice following intermittent fasting indicates livers of male mice stopped producing energy storage molecules. The livers of the female mice, on the other hand, made use of all available resources in an effort to store the energy necessary to maintain their reproductive capacities.","3cfa0fe3-1e9b-495d-96b9-432b8d0f5ca3",[1504],{"id":1505,"data":1506,"type":57,"version":25,"maxContentLevel":34},"353e08e2-3829-4912-8fca-91116aff0635",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1507,"activeRecallAnswers":1509},[1508],"What protein-like molecule involved in neuronal communication do women have more of than men?",[1510],"Kisspeptin",{"id":1512,"data":1513,"type":25,"maxContentLevel":34,"version":25,"reviews":1517},"3bd5cdaf-3ee2-4ba4-ad20-a58dca6c16ec",{"type":25,"title":1514,"markdownContent":1515,"audioMediaId":1516},"Particular Considerations for Women","While there are many possible benefits of intermittent fasting, some women should avoid it unless cleared by their doctor. The first group of women that should consult their doctor is women who want to conceive, who are pregnant, or breastfeeding. Intermittent fasting is generally not recommended for women who are pregnant, as it may impact the growth of the baby and cause other negative side effects.\n\nThe other set of women that should take caution is those with medical conditions, including diabetes, women who are on medication that should be taken with food, and women with autoimmune diseases.\n\nIt is not advised to do intermittent fasting if you have a history of eating disorders. Fasting is also not considered safe for children or pre-adolescent girls.\n\nThough males and females might be different when it comes to intermittent fasting, it doesn’t mean that females will not experience the benefits related to intermittent fasting. The fasting schedules that women should follow compared to men might just be different. Women are advised to follow less-strict intermittent fasting schedules with a well-balanced diet in their eating windows.","30446aad-b1c5-409a-b8cc-edf4a8d946f0",[1518],{"id":1519,"data":1520,"type":57,"version":25,"maxContentLevel":34},"6dc5aaa3-933d-4237-b87c-bfba46185dc6",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1521,"clozeWords":1523},[1522],"Intermittent fasting is generally not recommended for women who are pregnant, want to conceive, or are breastfeeding.",[1524,1525],"pregnant","breastfeeding",{"id":1527,"data":1528,"type":27,"maxContentLevel":34,"version":25,"orbs":1531},"7004b8f8-d5d8-45a9-b491-239528065157",{"type":27,"title":1529,"tagline":1530},"Intermittent Fasting vs Conventional Diets","how does intermittent fasting compare with other diets? Learn about the similarities and differences in this tile.",[1532,1554,1606],{"id":1533,"data":1534,"type":26,"version":25,"maxContentLevel":34,"pages":1536},"49c3212b-f6ad-4220-a02c-209942e56777",{"type":26,"title":1535},"Introduction to Diets",[1537,1542,1548],{"id":1538,"data":1539,"type":25,"maxContentLevel":34,"version":25},"e433ec53-0328-4de0-821b-7688b1592b3b",{"type":25,"title":44,"markdownContent":1540,"audioMediaId":1541},"If you’re interested in trying intermittent fasting, you might have wondered how it compares to other diets. You might also have some questions regarding intermittent fasting if you haven’t heard much about it before, such as: what makes intermittent fasting different from other diets? Is it better than other diets? How effective is it for weight loss? Is it easy to follow?\n\nEvery diet is different. Some focus on reducing your appetite, while others restrict calories, and dietary ‘macros’ like carbs, or fat. However, no one diet is best for everyone — what works for you may not work for someone else.\n\nBecause intermittent fasting is less a diet, and rather a lifestyle, you can couple it with a diet. Experts do, however, advise that if you do pair intermittent fasting with another diet that you choose one that focuses on eating healthy food and reducing carbohydrates.\n\nSo how do the different diets compare to intermittent fasting?","e34e192f-6cf3-4f28-b440-9c5e82a1df99",{"id":1543,"data":1544,"type":25,"maxContentLevel":34,"version":25},"6d057ab5-99a0-4f0e-849d-c5c6b7b8b7ae",{"type":25,"title":1545,"markdownContent":1546,"audioMediaId":1547},"Low-Carbohydrate Diets","Low-carb diets are popular for weight loss. Though there are a lot of different low-carb diets out there, they all have one thing in common; restricting carbohydrate intake, in some cases to as little as **20-150 grams** per day.\n\nThis diet’s main aim is to force your body to utilize your fat for fuel instead of carbs as your primary energy source. Fatty acids are moved into your blood and transported to your liver, where some are turned into ketones. Ketones and fatty acids are then used as your body’s primary energy source instead.\n\nThis diet has had some profound results in weight loss, especially in patients that were overweight or obese. It seems to be particularly effective at reducing dangerous visceral fat, which can accumulate around your organs.\n\nLow-carb diets have other health benefits related to blood triglycerides, cholesterol levels, blood sugar levels, insulin levels, and blood pressure.\n\nHowever, some people may experience an increase in “bad” LDL cholesterol. In extremely rare cases, nondiabetic ketoacidosis could occur, which could be fatal if left untreated.","bc11c32a-bbfc-4c6c-9a6b-c89cd07774cc",{"id":1549,"data":1550,"type":25,"maxContentLevel":34,"version":25},"9518b550-f564-4e55-9196-b0447f023835",{"type":25,"title":1551,"markdownContent":1552,"audioMediaId":1553},"Low-fat/Ultra-low-fat diet","A low-fat diet restricts your consumption of fat to around 30% of daily calories, whereas an ultra-low-fat diet only allows for a fat percentage of **under 10%**. This diet is typically mostly plant-based with a limited amount of animal products. This means that it is a diet that is very high in carbs (roughly 80% of calories) and low in protein.\n\nThis diet has had a lot of success in weight loss for obese individuals. However, studies have shown that this method is less effective for weight loss in the long term.\n\nEvidence shows that this dieting method can be helpful in improving heart health, including factors such as high blood pressure, high cholesterol, and inflammation markers. Surprisingly it can also lead to improvements in type 2 diabetes and slow the progression of multiple sclerosis (an autoimmune disease).\n\nOn the downside, restricting fat intake can cause problems in the long run. Fat has an important role to play in aiding cell membrane growth and hormones.","3fbb600f-df41-4364-8064-6090f4e81b04",{"id":1555,"data":1556,"type":26,"version":25,"maxContentLevel":34,"pages":1558},"4e7d6c68-d9b7-437b-aceb-9181c609b850",{"type":26,"title":1557},"Popular Low-Carb Diets",[1559,1575,1590],{"id":1560,"data":1561,"type":25,"maxContentLevel":34,"version":25,"reviews":1565},"5da8268c-a36b-4dc5-8824-7375eb9c1ccb",{"type":25,"title":1562,"markdownContent":1563,"audioMediaId":1564},"The Atkins Diet ","The **Atkins Diet** involves eating as much protein and fat as you’d like, while avoiding carbohydrates.\n\nIt has 4 phases: The first is an induction phase, where you eat under 20 g of carbs for 2 weeks. The remaining phases involve slowly introducing healthy carbs back into your diet as you near your ideal weight.\n\nMany studies found that it leads to faster weight loss than low-fat diets. It is especially successful in reducing stubborn belly fat.\n\nSimilar to other low-carb diets, the Atkins diet has shown success in reducing many risk factors for disease, such as blood triglycerides, cholesterol, blood sugar, insulin resistance and sensitivity, and blood pressure.\n\nThough the Atkins diet is safe and healthy for most people, there might be some unpleasant side effects. As your body switches to fat as a fuel source, involving ketosis, you may experience typical ‘keto flu” which involves fatigue, nausea, headaches, and brain fog.  Some report that this diet can be hard to adhere to.","c5ca7582-9766-4b83-9c97-ab4659b03fd1",[1566],{"id":1567,"data":1568,"type":57,"version":25,"maxContentLevel":34},"df93c678-8055-4b20-9649-88599dc54e8d",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1569,"clozeWords":1571},[1570],"The Atkins diet involves eating as much protein and fat as you like, while avoiding carbohydrates.",[1572,1573,1574],"protein","fat","carbohydrates",{"id":1576,"data":1577,"type":25,"maxContentLevel":34,"version":25,"reviews":1581},"c82009b2-2c5e-4f21-ae0c-92d44cb92d8a",{"type":25,"title":1578,"markdownContent":1579,"audioMediaId":1580},"The Dukan Diet","The **Dukan Diet** is a high-protein, low–carb weight loss diet that has 2 weight loss phases and 2 maintenance phases. The length of each phase is determined by the amount of weight you want to lose.\n\nThe weight loss phases involve eating unlimited high-protein foods. The maintenance phases involve adding non-starchy vegetables, some carbs, and fat. As you progress, pure protein days will become less and less to maintain your new weight.\n\nMany studies show this diet to be effective in weight loss. This is purportedly due to increased metabolic rate, a decrease in ghrelin (the hunger hormone), and an increase in fullness hormones.\n\nOn the downside, there is very little quality research available on the Dukan diet. The Dukan diet limits both fat and carbs — a strategy that is not clearly supported by peer-reviewed science. What’s more, fast weight loss achieved by severe calorie restriction tends to be accompanied by significant muscle loss.\n\nThese factors, in conjunction with severe calorie restriction may also cause your body to conserve energy, leading to rapid regaining of lost weight.","dad535ee-a9e0-423c-aacd-1c059b5693ad",[1582],{"id":1583,"data":1584,"type":57,"version":25,"maxContentLevel":34},"761b5347-7a29-4ea5-9282-6a0f0eacc1fd",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1585,"clozeWords":1587},[1586],"The Dukan diet is a high protein, low carb weight loss diet, whose fundamentals are not based in scientific evidence.",[1572,1588,1589],"carb","scientific evidence",{"id":1591,"data":1592,"type":25,"maxContentLevel":34,"version":25,"reviews":1596},"f6f899c9-d311-4919-9f69-6d354a1e2318",{"type":25,"title":1593,"markdownContent":1594,"audioMediaId":1595},"The HCG diet","The **HCG diet** (HCG stands for Human Chorionic Gonadotropin, a type of hormone) is a very extreme weight loss diet. It is meant to cause weight loss of up to 0.45-1 kg per day.\n\nIt is typically split into three phases:\n\nStep 1 involves taking HCG supplements.\n\nStep 2 is an ultra-low-calorie diet of only 500 calories per day, along with HCG supplement drops, pellets, injections, or sprays. The duration of this phase is 3-6 weeks at a time.\n\nIn stage 3, you stop with the HCG supplements and slowly increase your food intake.\n\nThough this diet does cause weight loss, studies have shown that the weight loss is solely attributed to the ultra-low-calorie diet, and not the HCG hormone.\n\nAside from weight loss, no other benefits have been documented. There are, however, numerous cons associated with this diet, such as muscle loss, headaches, fatigue, and depression. There have also been reports of blood clots likely originating from the diet.\n\nWhat’s more, the FDA does not approve of this diet, labeling it as *dangerous and illegal*.","dabca58c-9d4a-49a3-af49-3b57964204cb",[1597],{"id":1598,"data":1599,"type":57,"version":25,"maxContentLevel":34},"009307de-a93a-4a45-b6bc-c89f7222eddd",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1600,"binaryCorrect":1602,"binaryIncorrect":1604},[1601],"The supplement-based HCG diet is ",[1603],"Not recommended by the FDA",[1605],"Supported by science",{"id":1607,"data":1608,"type":26,"version":25,"maxContentLevel":34,"pages":1610},"3585bd55-c6b3-46c2-a5ef-de3847e55960",{"type":26,"title":1609},"Specialized Diet Plans",[1611,1626,1647],{"id":1612,"data":1613,"type":25,"maxContentLevel":34,"version":25,"reviews":1617},"bd8348cb-3ffc-4426-9514-d4480f02e967",{"type":25,"title":1614,"markdownContent":1615,"audioMediaId":1616},"The Zone Diet","The Zone diet is a low-glycemic-load diet, which limits carbs to around **35-45%** and protein and fat to **30%** of your daily calories. If you follow the diet, it is recommended to eat carbs with a low glycemic index (GI). The idea behind the Zone diet is to balance each meal with 1/3 protein, 2/3 colorful fruits and vegetables, and a little bit of fat (e.g. monounsaturated oil, such as olive oil, avocado, or almonds).\n\nThe weight loss results in studies are a bit contradictory. Some claim that the diet promotes weight loss and suppresses appetite, whilst other studies report very little weight loss compared to other diets.\n\nIn terms of benefits, the diet seems to help reduce risk factors related to heart disease and lower chronic inflammation in an overweight individual with type 2 diabetes.\n\nOne downside to this diet is that it limits the consumption of healthy carbs, such as bananas and potatoes.","346fb1b1-b6e5-4fdf-a5bd-44b76f0a0d6a",[1618],{"id":1619,"data":1620,"type":57,"version":25,"maxContentLevel":34},"3e17c09b-596a-4bb1-a80c-1f6c31fac0c0",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1621,"clozeWords":1623},[1622],"The Zone Diet is a low GI diet, which limits carbs to around 35-45% and protein and fat to 30% of your daily calories.",[1624,1625,1573],"GI","35-45%",{"id":1627,"data":1628,"type":25,"maxContentLevel":34,"version":25,"reviews":1632},"4f581658-ed75-45c5-912a-32ee75be7902",{"type":25,"title":1629,"markdownContent":1630,"audioMediaId":1631},"The Paleo Diet","The **Paleo Diet** emphasizes the consumption of whole foods such as lean protein, vegetables, fruits, nuts, and seeds, and to avoid processed foods, such as sugar, dairy, and grains. The theory is that many modern diseases can be linked to the modern Western diet.\n\nMore flexible versions of the paleo diet allow for foods that contain dairy, such as cheeses and butter. They also allow tubers like potatoes and sweet potatoes.\n\nIn terms of weight loss, several studies have proven that the paleo diet can cause significant weight loss. This is thought to be because paleo dieters eat fewer carbs, and more proteins, and reduce their calorie intake by **300-900 calories per day**. This diet has shown some good results in terms of other health benefits; it seems effective in reducing risks related to heart disease, for example, cholesterol, blood sugar, blood triglycerides, and blood pressure.\n\nSimilar to other diets that exclude food groups, one possible downside of this diet is that it eliminates whole grains and legumes which are generally considered as healthy and nutritious.","9a98128a-058f-4c0c-881a-c3f78a837cce",[1633,1640],{"id":1634,"data":1635,"type":57,"version":25,"maxContentLevel":34},"3e82efe9-f00e-423e-8127-cb9072262b57",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1636,"clozeWords":1638},[1637],"Eating only unprocessed foods can lead people to eat between 300-900 less calories per day.",[1639],"300-900",{"id":1641,"data":1642,"type":57,"version":25,"maxContentLevel":34},"8572717b-2157-4c38-b262-974019839798",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1643,"activeRecallAnswers":1645},[1644],"What is the main reason the paleo diet leads to weight loss?",[1646],"Eating unprocessed foods leads to lower overall calories consumed ",{"id":1648,"data":1649,"type":25,"maxContentLevel":34,"version":25,"reviews":1653},"6c76262f-98c6-49aa-a778-3842e7e88b69",{"type":25,"title":1650,"markdownContent":1651,"audioMediaId":1652},"The Vegan Diet","The **Vegan Diet** is another diet that is very popular in today’s day and age. This diet restricts all animal products for reasons that could be ethical, environmental-related, or health-related.\n\nIn addition to eliminating meat, the vegan diet also eliminates any animal products, which include dairy and eggs, and animal-derived products, such as gelatin, honey, albumin, whey, casein, and some forms of vitamin D3. In essence, vegans use plant-based products as their sole source of nutrients.\n\nIn terms of weight loss, the vegan diet seems to be very effective. In fact, the vegan diet is linked to lower body weight and BMI compared to other diets.\n\nPlant-based diets are also associated with a reduced risk of heart disease, type 2 diabetes, and premature death. What’s more, limiting processed meat may reduce your risk of Alzheimer’s disease and dying from heart disease or cancer.\n\nOn the downside, vegans may experience some nutritional deficiencies, such as vitamin B12, iron, calcium, zinc, and possibly omega-3 fatty acids.","5c25b2bb-3700-4af1-9ec0-96ad745629c1",[1654],{"id":1655,"data":1656,"type":57,"version":25,"maxContentLevel":34},"89c18bfb-a31e-4b6b-b89e-a58fcf805fc0",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1657,"activeRecallAnswers":1659},[1658],"What are 4 possible nutritional deficiencies of a vegan diet?",[1660,1661,1662,1663],"Vitamin B12","Iron","Calcium","Zinc",{"id":1665,"data":1666,"type":27,"maxContentLevel":34,"version":25,"orbs":1669},"91ee0d87-a95f-479f-82f5-878420a1a3ea",{"type":27,"title":1667,"tagline":1668},"Intermittent Fasting and the Keto Diet","The Keto diet is a popular diet that also makes use of the body's ability to enter ketosis. But should they be combined? Let's take a look.",[1670,1733,1798],{"id":1671,"data":1672,"type":26,"version":25,"maxContentLevel":34,"pages":1674},"5a2ba5d0-8b74-4814-aa06-b3e37da54ab4",{"type":26,"title":1673},"Introduction to Keto and Intermittent Fasting",[1675,1688,1719],{"id":1676,"data":1677,"type":25,"maxContentLevel":34,"version":25,"reviews":1680},"ea90b575-1335-46e6-940e-998331408de4",{"type":25,"title":44,"markdownContent":1678,"audioMediaId":1679},"The keto diet and intermittent fasting are two of the most popular health trends at the moment. Many health-conscious people follow these methods to drop weight or to control certain health issues. Intermittent fasting is also popular in bodybuilding circles, as a means to improve bodily composition.\n\nBoth keto and intermittent fasting make use of the body’s ability to enter ketosis. \n\nHowever, since both diets are based on ketosis, it begs the question, is it worthwhile or even healthy to combine the two? Let’s take a look at both of these health fads, what they’re about, and also what the science says about combining them. ","50f4be76-cdba-4a42-9130-cbdb68a89b49",[1681],{"id":1682,"data":1683,"type":57,"version":25,"maxContentLevel":34},"f3f129ba-c046-4307-8943-2f8af77791b8",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1684,"clozeWords":1686},[1685],"Both the keto diet and intermittent fasting make use of the body’s ability to enter ketosis.",[1687],"ketosis",{"id":1689,"data":1690,"type":25,"maxContentLevel":34,"version":25,"reviews":1694},"525d286d-1c27-49dd-a4cc-fe5fab63722e",{"type":25,"title":1691,"markdownContent":1692,"audioMediaId":1693},"What is the Keto Diet?","Simply put, the **ketogenic diet** (or keto) involves high-fat, low-carb consumption. Ideally, the carb consumption should be reduced to **20 to 50 grams** per day. This forces your body to rely on fats as its main energy source instead of glucose. During ketosis, your body will break down fats to form ketones, which serve as an alternative fuel source.\n\nThe calorie breakdown of a ketogenic diet typically involves **70-80%** of calories from fat, **15-30%** calories from protein, and **0-10%** calories from carbohydrates. \n\nAlthough the keto diet, just like intermittent fasting, is mainly used for weight loss, it also has a lot of extra health benefits. The keto diet has been used for nearly a century to treat epilepsy and shows a lot of potential for treating other neurological disorders, such as improved mental symptoms in patients with Alzheimer’s disease.\n\nWhat’s more, studies suggest that it may improve blood sugar, improve insulin resistance, and lower heart disease risk factors.","7f66eb52-0176-4619-a733-1669d2436402",[1695,1703,1712],{"id":1696,"data":1697,"type":57,"version":25,"maxContentLevel":34},"477af979-70a2-462d-bb56-5c9bb51367ca",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1698,"clozeWords":1700},[1699],"In a keto diet: 70-80% calories from fat, 15-30% from protein,  0-10% from carbs",[1701,1573,1572,1702],"70-80%","carbs",{"id":1704,"data":1705,"type":57,"version":25,"maxContentLevel":34},"de40abb6-ab42-4d39-b3ab-2692439cc39f",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1706,"binaryCorrect":1708,"binaryIncorrect":1710},[1707],"What best describes the keto diet?",[1709],"High-fat, Low-carb",[1711],"High-protein, Low-fat",{"id":1713,"data":1714,"type":57,"version":25,"maxContentLevel":34},"f2cbd370-ed8b-42f9-afe1-e178b19398e3",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1715,"clozeWords":1717},[1716],"Like with fasting, the keto diet might improve blood sugar levels and insulin resistance",[1718,297],"keto diet",{"id":1720,"data":1721,"type":25,"maxContentLevel":34,"version":25,"reviews":1725},"2d137d99-d17d-4e31-9b2a-eb00c6ed8683",{"type":25,"title":1722,"markdownContent":1723,"audioMediaId":1724},"What is Keto Cycling?","Because the keto diet is sometimes accompanied by “keto flu”, many find this diet hard to stick to. Enter keto cycling as a way to mitigate this.\n\n**Keto cycling**, also referred to as cyclical keto diet, involves following a ketogenic diet for a few consecutive days, then having a day (or more) off and repeating. This is similar but not the same thing as carb cycling.\n\n**Carb cycling** is more about high protein, moderate fat intake, so you are not really in ketosis in the same way that you would be on keto cycling, where you’d eat moderate protein and high fat. Also during keto cycling, your carb intake is lower than it would be on carb cycling.","8778314d-ccb8-420d-863c-b0ccc90622fa",[1726],{"id":1727,"data":1728,"type":57,"version":25,"maxContentLevel":34},"3a561734-22c3-4bd4-b7ef-bc5737f3f68c",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1729,"activeRecallAnswers":1731},[1730],"What is keto cycling?",[1732],"It's following a keto diet for a few days, then switching to a normal diet for a day and repeating",{"id":1734,"data":1735,"type":26,"version":25,"maxContentLevel":34,"pages":1737},"61828230-4913-4be0-84f4-ca95d6a3c603",{"type":26,"title":1736},"Health Impacts of the Keto Diet",[1738,1761,1782],{"id":1739,"data":1740,"type":25,"maxContentLevel":34,"version":25,"reviews":1744},"0bb3bf94-a970-43f3-821b-2aad989abbbf",{"type":25,"title":1741,"markdownContent":1742,"audioMediaId":1743},"The Health Benefits of the Keto Diet","With its growing popularity, keto has received a lot of attention from researchers. In human observation and studies, scientists found that the keto diet has a bunch of health benefits. It has shown improved cholesterol levels, improved insulin sensitivity, and in some cases, lower blood pressure. \n\nCommon benefits of the keto diet include significant weight loss in initial stages, making meals more satiating, and reducing cravings for processed and high-carb foods. Ketosis also suppresses appetite, regulates inflammation, and increases immune function. \n\nThe keto diet has also helped to reduce symptoms of various medical conditions, such as reducing the severity of type 2 diabetes, reduction in blood triglycerides, and treating numerous types of cancer. It is also effective against metabolic syndrome, which is a collection of symptoms that include abdominal obesity, elevated blood pressure, elevated fasting blood sugar levels, high triglycerides, and low “good” HDL cholesterol levels. \n\nIn addition some studies suggest it reduces and slows the progression of neurological disorders like epilepsy, Alzheimer’s, and Parkinson’s disease, as well as polycystic ovary syndrome (PCOS), a hormonal disorder. ","854252bf-abc6-4ccf-a4d6-c9248a26717b",[1745,1754],{"id":1746,"data":1747,"type":57,"version":25,"maxContentLevel":34},"a2505437-805a-4632-a990-818e3399de64",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1748,"activeRecallAnswers":1750},[1749],"Some studies suggest that the keto diet might slow the progression of which 3 neurological disorders?",[1751,1752,1753],"Epilepsy","Alzheimer’s","Parkinson’s disease",{"id":1755,"data":1756,"type":57,"version":25,"maxContentLevel":34},"e95cde2f-af55-4fbf-a9e6-0770a4dda5a1",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1757,"clozeWords":1759},[1758],"Keto diets tend to reduce cravings for high-carb food",[1760],"reduce",{"id":1762,"data":1763,"type":25,"maxContentLevel":34,"version":25,"reviews":1767},"d96702d8-d0c5-42c9-b2f3-83c59996b86d",{"type":25,"title":1764,"markdownContent":1765,"audioMediaId":1766},"The Negative Effects of the Keto Diet","Apart from the aforementioned ‘keto flu’, researchers still do not know much about the long-term effects of the ketogenic diet (beyond the first 2 years).\n\nOne possible risk of any restrictive diet includes vitamin and mineral deficiencies. Other potential risks of a high fat, high protein diet include an increased likelihood of developing kidney stones, fatty liver, hypoproteinemia, or low levels of protein in the blood.\n\nAlso, because your fiber intake in the keto diet is so low, another common symptom that individuals who follow a keto lifestyle have reported is being constipated.\n\nThe high-fat nature of the diet could also have negative impacts on heart health. This is due to the high levels of \"bad\" low-density lipoprotein (LDL) cholesterol. Some people also experience dehydration because they’re eradicating glycogen, which holds water, from their bloodstream.","5bcd6ed1-2eec-4cc2-ab2e-95b9e078fcb1",[1768,1775],{"id":1769,"data":1770,"type":57,"version":25,"maxContentLevel":34},"8b387f1f-0de1-43a8-9c45-0ff199f396e2",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1771,"activeRecallAnswers":1773},[1772],"Why do some people feel dehydrated on the keto diet?",[1774],"Because it depletes glycogen stores, which holds water in the body",{"id":1776,"data":1777,"type":57,"version":25,"maxContentLevel":34},"a6b2e108-a6af-4651-9678-323aa105c79d",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1778,"activeRecallAnswers":1780},[1779],"Which diet might increase the risk of kidney stones?",[1781],"Keto diet",{"id":1783,"data":1784,"type":25,"maxContentLevel":34,"version":25,"reviews":1788},"f3d156ce-16e9-4ca8-8821-5a30e929699f",{"type":25,"title":1785,"markdownContent":1786,"audioMediaId":1787},"Could Combining Keto and Intermittent Fasting Help You Lose Weight?","The keto diet and intermittent fasting are both reported to promote weight loss as one of their benefits. \n\nPairing intermittent fasting with the keto diet may make these weight loss benefits much more pronounced, since fasting can help you reach ketosis quicker. Once ketosis is reached via fasting, the state can be maintained by adhering to a keto diet.  As every person is different in terms of how long it takes their body to reach ketosis, adding the keto diet to intermittent fasting can help ensure your body has the maximum opportunity to reach this state.\n\nIntermittent fasting can be paired with any diet relatively easily. The diet of choice decides which food may be eaten, while the introduction of intermittent fasting simply dictates the window in which you are allowed to eat.","2d3f23e7-9b0e-4bb9-959e-de0fe647972d",[1789],{"id":1790,"data":1791,"type":57,"version":25,"maxContentLevel":34},"3b9e39e5-f652-4478-abba-229574830c2e",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1792,"binaryCorrect":1794,"binaryIncorrect":1796},[1793],"Can combining the keto diet and fasting help you lose weight?",[1795],"Yes, they leverage ketosis harmoniously",[1797],"No, they cancel out",{"id":1799,"data":1800,"type":26,"version":25,"maxContentLevel":34,"pages":1802},"68b08f4e-5ecf-4f5d-a934-5ea6e0116420",{"type":26,"title":1801},"Combining Keto and Intermittent Fasting",[1803,1823],{"id":1804,"data":1805,"type":25,"maxContentLevel":34,"version":25,"reviews":1809},"25508914-705b-47e9-ad59-de8abee70c03",{"type":25,"title":1806,"markdownContent":1807,"audioMediaId":1808},"The Health Benefits of Combining Intermittent Fasting and Keto","Intermittent fasting and the keto diet have a host of reported health benefits when practiced in isolation, but some of these benefits are heightened when combining the two.\n\nThe main advantage of pairing these two methods is that ketosis is reached faster, and may be more pronounced. This leads to increased weight loss, reduced hunger, sustained energy, and increased cellular renewal, as reported in numerous studies.\n\nIt has been suggested that adding intermittent fasting to the keto diet may cause the transition into ketosis to be made much quicker and smoother, limiting the effects of keto flu.\n\nAccording to studies, the keto diet may also aid in health benefits brought on by intermittent fasting. One of these add-on benefits is that a keto diet provides protection and a healthy fuel source for stem cells, which are produced in larger quantities when fasting.\n\nIn much the same way, it is reported that fasting and the keto diet combine to combat cancer-cells by drastically reducing sugar levels in the body, which cancer cells use as fuel.","93f8965a-2c92-40f1-b03c-f660fb129c1d",[1810,1816],{"id":1811,"data":1812,"type":57,"version":25,"maxContentLevel":34},"5d60a3c5-434a-4cc5-b6d6-c2b05eef4895",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1813,"clozeWords":1815},[1814],"Combining intermittent fasting with the keto diet may ease the transition into ketosis, limiting the effects of keto flu.",[1687],{"id":1817,"data":1818,"type":57,"version":25,"maxContentLevel":34},"cd950e67-8b0f-45ae-a4ca-e58c68cd1e21",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1819,"clozeWords":1821},[1820],"The keto diet may slow the growth of cancer cells by starving them of sugar.",[1822],"sugar",{"id":1824,"data":1825,"type":25,"maxContentLevel":34,"version":25},"7c8a5d4f-5978-4ced-a2a1-9d57e1c4ca97",{"type":25,"title":1826,"markdownContent":1827,"audioMediaId":1828},"Are There Any Health Risks?","Both Keto and Intermittent Fasting do have their fair share of pros and cons. So, following two diets at once could mean that you end up with the worst of both worlds as you have a risk of double the side-effects. This is especially something to consider if you are a beginner in either “diets”.\n\nExperiencing low blood sugar, nausea, mood swings, fatigue, and constipation are all common symptoms that have been reported in the starting days. This is dubbed the *keto flu*. This is due to the detoxifying effect that both these diets have on your body.\n\nAlso, do remember that trying the two diets together also requires a lot more patience and commitment, since it's a very strict way of eating.\n\nHowever, if you do decide to try the diets, the best would be to ease into them, rather than going all-in. Add foods in your diet that release energy slowly, and don't completely cut out carbs. If you have a history of eating disorders, this method is not advised by medical professionals.","0137034c-47c3-4586-8956-85a8fbceb6a1",{"id":1830,"data":1831,"type":27,"maxContentLevel":34,"version":25,"orbs":1834},"63593b0e-b12d-4e8c-94fa-6b0d7b0904d6",{"type":27,"title":1832,"tagline":1833}," Other Types of Fasting","Fasting has a very long history and can be used for all sorts of purposes. Learn more about the different types of fasting and their history and uses.",[1835,1912],{"id":1836,"data":1837,"type":26,"version":25,"maxContentLevel":34,"pages":1839},"26948bb3-1cc0-4a98-b26b-fe192d672d2c",{"type":26,"title":1838},"Medical Diagnostic Fasting",[1840,1861,1867,1896],{"id":1841,"data":1842,"type":25,"maxContentLevel":34,"version":25,"reviews":1846},"aa13faf0-0928-4f4e-8b54-d60faa1d7da0",{"type":25,"title":1843,"markdownContent":1844,"audioMediaId":1845},"Diagnostic Fasting","Diagnostic fasting falls in the category of medical fasting, however, the reason for fasting is not geared towards health benefits, but rather towards determining the cause behind a person’s (usually a child’s) low blood pressure. This method is used when low blood sugar levels are causing other health problems that need to be investigated. This fasting method is helpful because it can indicate whether the problems are caused by an endocrine or a metabolic problem. The endocrine is the system of glands and organs that make hormones and release them directly into the blood so they can travel to tissues and organs all over the body.\n\nDuring this type of test, you are only allowed to drink water. Every hour, a sample of blood will be taken and the blood sugar levels will be monitored. The process is continued until the blood sugar levels drop to an acceptably low level, or for a set period (determined by the doctor).","e4afa10d-818c-4b75-8b00-d7d1d62b673b",[1847,1854],{"id":1848,"data":1849,"type":57,"version":25,"maxContentLevel":34},"8d1cae44-4031-4de1-bf30-2f8f275f392e",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1850,"activeRecallAnswers":1852},[1851],"What is the endocrine system?",[1853],"The system of glands and organs that make hormones and release them into the blood",{"id":1855,"data":1856,"type":57,"version":25,"maxContentLevel":34},"db597d36-ea8d-4047-adb8-3060f55d7585",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1857,"activeRecallAnswers":1859},[1858],"What is diagnostic fasting typically used for?",[1860],"To understand why one's blood sugar is low",{"id":1862,"data":1863,"type":25,"maxContentLevel":34,"version":25},"5eb81faa-e35f-47b9-a85e-599fabdc6ad1",{"type":25,"title":1864,"markdownContent":1865,"audioMediaId":1866},"Fasting for a Blood Test","Similar to diagnostic fasting, this type of fasting is also in the category of medical fasting. Though this is not necessarily blood sugar related, as with diagnostic fasting, it still involves fasting (usually between 8-12 hours) to succeed in a certain blood test. In this type of fast, you usually should abstain from food and fluids (except water) for the given period to have an accurate test result. The vitamins, minerals, fats, carbohydrates, and proteins that make up all food and beverages can impact blood-level readings, clouding the results of your test.\n\nCases, where this type of fasting is necessary for blood testing, include diabetes tests, tests to check your cholesterol levels, tests for liver and kidney functioning, vitamin B-12 testing, iron test, triglyceride level test, basic metabolic panel, renal function panel, lipoprotein panel, and Gamma-glutamyltranferase. Though this summarizes the main tests where this type of fasting is necessary, there could be other cases where your doctor will require you to fast for accurate blood test results.","8e5185ae-91c3-4f70-a05d-7d65d896745e",{"id":1868,"data":1869,"type":25,"maxContentLevel":34,"version":25,"reviews":1873},"9fdf3336-6080-42f7-a1d3-1376b5d7b82f",{"type":25,"title":1870,"markdownContent":1871,"audioMediaId":1872},"Fasting for Religion","Fasting for religious reasons is not new to this day and age. Fasting is, and has been, an essential part of many religions, including Christianity, Islam, and Buddhism.\n\nChristians fast as a means to grow in their relationship with God. Christian fasts can vary in length, and it typically involves abstaining from food for a set time period, or abstaining from certain types of food. For example, the biblical Daniel Fast prohibits the consumption of animal products, refined carbohydrates, food additives, preservatives, sweeteners, flavorings, caffeine, and alcohol.\n\nIslamic Ramadan, the Muslim holy month of fasting, is a 29-30 day fast where you are not allowed to eat or drink from dawn to dusk, or smoke and engage in sexual activity for the duration of the fast. This tradition has existed for more than a millennium. The day starts with a pre-dawn meal called Suhoor and is broken at dusk with a meal called Iftar (often in the form of a feast with family and friends).","19ba3dbb-51e2-46a8-85bf-d3702592d0bd",[1874,1881,1888],{"id":1875,"data":1876,"type":57,"version":25,"maxContentLevel":34},"3333d6e6-33b0-4ee2-9514-a843bfda14b5",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1877,"activeRecallAnswers":1879},[1878],"What is Ramadan?",[1880],"The Islamic holy month of fasting where for 28-30 days you cannot eat or drink between dawn and dusk",{"id":1882,"data":1883,"type":57,"version":25,"maxContentLevel":34},"7e1b49c4-b4a7-4e47-a15f-c130c36c78b6",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1884,"activeRecallAnswers":1886},[1885],"What is the name of the Christian religious fast which prohibits the consumption of animal products, refined carbohydrates, caffeine and alcohol?",[1887],"Daniel Fast",{"id":1889,"data":1890,"type":57,"version":25,"maxContentLevel":34},"c99a484f-1244-4fc3-bbda-da340e805bf5",{"type":57,"reviewType":21,"spacingBehaviour":25,"clozeQuestion":1891,"clozeWords":1893},[1892],"In Ramadan, the day starts with a pre-dawn meal called Suhoor and is broken at dusk with a meal called Iftar.",[1894,1895],"Suhoor","Iftar",{"id":1897,"data":1898,"type":25,"maxContentLevel":34,"version":25,"reviews":1902},"2a4c7bb6-536a-4f74-b64f-1d0ffb21fd19",{"type":25,"title":1899,"markdownContent":1900,"audioMediaId":1901},"Dry Fasts","Dry fasting is also known as absolute fasting. While water fasts allows the intake of water (and sometimes even certain teas), a dry fast restricts both food and liquid intake. This fast doesn’t allow any liquid intake, including water, broth, and tea. This is very different from most fasts, which encourages water intake.\n\nThere are many ways to dry fast. Dry fasting is mostly done in conjunction with intermittent fasting options. This means that during your ‘off’ window (fasting window) you will neither consume any foods nor drink any liquids.\n\nThough fasting is associated with many health benefits, dry fasting, especially for a prolonged time, could be very dangerous. You can run the risk of dehydration and other complications. This is especially risky if you are dry fasting and working out simultaneously, because your chances for dehydration is increased when you exercise.","a3786096-ac98-477b-b987-9b7df26af840",[1903],{"id":1904,"data":1905,"type":57,"version":25,"maxContentLevel":34},"9a804c5f-2e0d-4122-8b7b-a0f3fc207ea3",{"type":57,"reviewType":26,"spacingBehaviour":25,"binaryQuestion":1906,"binaryCorrect":1908,"binaryIncorrect":1910},[1907],"Which type of fasting restricts both consumption of food and water?",[1909],"Dry fast",[1911],"Wet fast",{"id":1913,"data":1914,"type":26,"version":25,"maxContentLevel":34,"pages":1916},"8c0480d6-4e17-4181-b1ad-15e01274235d",{"type":26,"title":1915},"Religious and Dry Fasting",[1917],{"id":1918,"data":1919,"type":25,"maxContentLevel":34,"version":25,"reviews":1923},"6c90f1e1-915e-4ded-b53c-cf2a4fb0baf3",{"type":25,"title":1920,"markdownContent":1921,"audioMediaId":1922},"Water Fasts","A water fast is also known as the zero-calorie diet and is one of the most intense forms of fasting. As the name implies, during a water fast you can only drink water while consuming zero calories. This fast is mainly used as a way to detoxify your body. Though other fasting methods also have a detoxifying effect to some extent, according to experts, a water fast is the fastest way to rid your body of unwanted toxins. Just like with many other fasts, the length of this fast can vary, from 1 day to over a month.\n\nOne obvious benefit of a water fast is rapid weight loss. The amount of weight loss will be dependent on the length of your fast. However, there is a point where your body reaches a ‘fasting plateau’, so fasting for extended periods will not necessarily guarantee more weight loss.\n\nThe most important thing during this fast is to stay hydrated (9-13 glasses of water daily).","a8670595-c7ec-423c-a180-732290c1c5ac",[1924],{"id":1925,"data":1926,"type":57,"version":25,"maxContentLevel":34},"7e2061a4-d13a-4f6b-80e2-f84e5bf83dd8",{"type":57,"reviewType":25,"spacingBehaviour":25,"activeRecallQuestion":1927,"activeRecallAnswers":1929},[1928],"What is the one and only thing you can consume in a wet fast?",[1930],"Water",{"left":4,"top":4,"width":1932,"height":1932,"rotate":4,"vFlip":6,"hFlip":6,"body":1933},24,"\u003Cpath fill=\"none\" stroke=\"currentColor\" stroke-linecap=\"round\" stroke-linejoin=\"round\" stroke-width=\"2\" d=\"m9 18l6-6l-6-6\"/>",{"left":4,"top":4,"width":1932,"height":1932,"rotate":4,"vFlip":6,"hFlip":6,"body":1935},"\u003Cg fill=\"none\" stroke=\"currentColor\" stroke-linecap=\"round\" stroke-linejoin=\"round\" stroke-width=\"2\">\u003Cpath d=\"M12.586 2.586A2 2 0 0 0 11.172 2H4a2 2 0 0 0-2 2v7.172a2 2 0 0 0 .586 1.414l8.704 8.704a2.426 2.426 0 0 0 3.42 0l6.58-6.58a2.426 2.426 0 0 0 0-3.42z\"/>\u003Ccircle cx=\"7.5\" cy=\"7.5\" r=\".5\" fill=\"currentColor\"/>\u003C/g>",1778179478452]