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Eleven Tips for Clinicians Interested in Trying Out Intermittent Fasting

When clinicians think about trying intermittent fasting, they often worry about lapses in energy. But one expert says it actually has the opposite effect.

Photo by: Maurer Foundation

Supporters of intermittent fasting often pitch the dietary plan as a cure-all for diabetes risk, inconsistent energy levels, and even cancer. For many of these claims, there is some evidence to back it up, but you might still be skeptical as a clinician.

Another study has found that intermittent fasting contributes to weight loss and can reduce atherogenic lipids, blood pressure, and blood glucose. If this doesn’t pique your interest, would knowing that intermittent fasting boosts human growth hormone and cellular repair processes and reduces the risk of Alzheimer’s and dementia?

According to Cynthia Thurlow, a nurse practitioner, functional nutritionist, and TEDx speaker who runs a wellness-consulting business, these are some of the evidence-based secondary benefits.

Thurlow has worked with many healthcare professionals interested in controlling their health and weight through intermittent fasting. She says their biggest concerns are being unable to think critically and experiencing lapses in energy. But the truth, according to Thurlow, intermittent fasting usually has the opposite effect, making it an ideal strategy for clinicians, especially during long shifts.

How Does Intermittent Fasting Work?

“You either exist in a fed or fasted state, and all the magic happens in that fasted state,” Thurlow says. “Autophagy, when our body scavenges diseased and disordered cells, that’s only evoked in a fasted state … A lot of [the science] relies on how, when we are in this digestive rest, our body can do all his clean-up work.”

For example, during “digestive rest,” we can fully empty our stomach, process nutrients better, improve absorption along the intestinal lining, lower glucose levels, and more, Thurlow explains. In addition, while fasting, the body can more easily break down stored glycogen, which helps maintain blood sugar levels and prevents waxing and waning energy.

Tips for Clinicians Wanting To Try Intermittent Fasting

Healthcare workers interested in starting an intermittent fasting regimen already have an advantage: Thanks to shift work, you’re used to not eating for 12 hours at a time (or drinking water or peeing). That said, many HCPs struggle to adjust to the lifestyle. Here, Thurlow breaks down common challenges and ways around them.

  1. Start With a 12-Hour Fast

“That can be pretty easy if you’re working nights or days,” Thurlow says. “If someone leaves the hospital at 8 PM. and let’s say they had a break at 5 PM, then they go home, go to bed, wake up in the morning, and they’ve already fasted 13-plus hours.”

If you start with 12 hours of not eating and feel great, then you can increase to 13 or 14 hours, Thurlow says.

  1. Eat Before or After Your Shift

There are multiple benefits to this strategy. You don’t count on getting time for a meal, and because you’re fasting, you have another reason not to snack on the unhealthy treats that fill so many break rooms. This could be especially helpful for night-shifters, who often eat to stay awake and experience other physiological challenges.

“The act of sleep deprivation in and of itself will disrupt the endocrine system and circadian rhythm pattern … because our bodies are designed to sleep when it’s dark out,” Thurlow explains. “If melatonin is suppressed because you’re awake, cortisol, the hormone that shifts us into fat storage mode, will go up.”

Overnighters will likely have to try a few different schedules to find the one that works, Thurlow says.

  1. Stick to Healthy, Unprocessed Foods

“You’re not going to be able to get through that fasting window if you’re not fueling your body properly,” Thurlow advises. “That’s a problem not just with healthcare shift workers — it’s throughout the U.S. We’re eating a lot of processed food. That doesn’t mean there’s no place for protein bars or shakes but try to maximize the quality of food you’re eating.”

Some energy-boosting options that come prepackaged (i.e., easy to eat at work) include:

  • Nuts and packets of nut butters
  • Guacamole
  • Hummus
  • Olives
  • Bite-sized cheese
  • Protein drinks — pre-made with your preferred, clean powders

Ideally, every food choice you make will align with your overall goals.

  1. Be Prepared

Practicing intermittent fasting should mean not eating as much stuff that comes “in a box, bag or can,” Thurlow says. You can go to the grocery store and prep some food before each shift, but pre-cut fruits, veggies, or pre-cooked meat are good options if you’re too tired.

“There’s nothing worse than realizing you haven’t eaten in ten hours, you’ve got a full bladder … and don’t have time to prepare a meal,” Thurlow says. “You have to be ready to grab and go.”

  1. Try Different Schedules for Work and off Days

This is a popular strategy for beginners, Thurlow says.

“You don’t need to jump in and say, ‘I’m fasting 16 hours every day right away,’” she adds. “On the days you work, you can go conservatively and just do a 12-hour fast. On the days you’re not working, you can do longer. Be flexible and give yourself some grace.”

  1. Take Advantage of What You Can Consume

While fasting, you can drink water, black coffee, or tea. So, take advantage of the things that help you power through a shift, Thurlow recommends. Drink coffee (but not to excess), and green tea is a great option.

  1. Stay Hydrated

Some of your daily water intake comes from food, so when fasting, you need to make up for this loss. Plus, the need becomes greater when your work involves lots of physical activity. As a busy clinician, Thurlow knows the challenge of staying hydrated and recommends drinking 20 ounces of water every shift.

If you struggle to remember to drink water, bring a reusable bottle to work, and every time you see it, take a slug. For people who don’t like the taste of “plain water,” Thurlow says adding a little lemon, lime, or herbs won’t break your fast.

  1. Treat Yourself Well During Days Off

It’s easier said than done, but Thurlow’s approach makes it quite simple. On days when you’re not working (at the very least), sleep seven to eight hours a night.

“If you don’t, it’ll reduce your ability to control your blood sugar by up to 60%, which makes it harder to lose weight,” Thurlow explains.

Some other tips: Do something that brings you joy to reduce stress and cortisol levels. If you can, get some sun because it resets your circadian rhythm. And move your body a little bit every day.

  1. Recognize When It’s Not Working for You

For some people, intermittent fasting feels horrible, even if they try every tip and trick Thurlow offers. It’s unusual, she says, but it happens because individuals have unique health needs.

“Just like I couldn’t prescribe the same drug for every hypertensive patient, I can’t prescribe the same dietary recommendations,” Thurlow explains. “It just doesn’t work.”

Some signs that you’re on the wrong dietary plan include:

  • Lack of energy after doing it for a while.
  • Mental fogginess.
  • Sustained, bad headaches.
  • Abnormally sleepy.
  • Abdominal cramping.

If after 30 days you don’t see an improvement, talk to a nutritionist or switch strategies.

  1. Understand Your Own Bio-Individuality

Beginners need to learn to interpret the signals from their body and act on them, Thurlow says. Intermittent fasting shouldn’t be an all-or-nothing mentality.

Clinicians are so focused on the needs of others that they can become especially disconnected from their bodies, she adds. As you ramp up, ask yourself: How are my energy levels? How am I sleeping? How do I feel after I eat a particular food? How do I feel after I try a new dietary strategy?

For example, “It’s not normal to eat a meal and want to go take a nap,” Thurlow says. “It means you put the wrong combination of foods together. You should have energy after a meal.”

  1. Be Consistent

Once you’ve found what works best for you, stick with it.

“Some people want to start their fast when heading into their shift. Others prefer to start their fast after they’ve ended their shift and had a meal,” Thurlow says. Both are fine, but “consistency is key.”

Who Shouldn’t Practice Intermittent Fasting?

Thurlow calls out that intermittent fasting poses risks for certain groups, particularly brittle diabetes or anyone who can’t acknowledge when they’re hypoglycemic. In addition, she discourages children and teens, anyone pregnant or breastfeeding, who has significant chronic health problems or a disordered relationship with food.

Contact your healthcare provider if you want to learn more about intermittent fasting but have chronic health conditions.

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