I have been doing a considerable amount of research and I am coming up short, so I thought it would be best to seek advice here. My intention and motivation for water fasting is not for weight loss, but to reduce symptoms of my autoimmune disease. I have been under a considerable amount of stress this year with studying and working both full time, which has seen to the increase of inflammation and limited mobility in my lower back and external rotation of my left femur. Upon my research (in avoidance of doctors recommendation of medication) water fasting for a minimum of 5 days can alleviate inflammation and back pain. Practitioners have advised me against this, as according to the BMI, I fall into the underweight category (only just). I am fit, healthy and have followed a plant-based diet for over 25 years.
Considering these factors, is it advised that I still go ahead with the 5-day water fasting? Or should I consider some form of calorie intake? If so, what is recommended?
Advice needed: 5 day fasting for inflammation (BMI borders just within the underweight section)
I dispute:
- the assertion you make that you are healthy if you have been experiencing autoimmune conditions.
- that you are fit if your BMI is under 20
Practitioners are right to warn you against fasting if your BMI is under 20. You risk refeeding syndrome.
I worry that the plants aren’t agreeing with you anymore if you are having autoimmune conditions.
Thank you for your feedback Ellenor2000.
The autoimmune condition is a genetic predisposition, I showed no signs nor symptoms until this year. I thought it was my body recovering from changing up my workout routine. What I initially perceived to be muscle discomfort, gradually developed into pain, then demobilisation over the course of a couple of months. Blood test confirmed it was AS, doctors and I believe the main trigger is environmental stress.
BMI is not an accurate measure for fitness levels, nor does it reflect a high metabolisms. I merely point this out, as it has been practitioners stance to discourage fasting. I don’t want to lose weight. But the benefits and reduction in inflammation and pain has made it appealing.
My decision to I stop eating meat at the age of 6, was for ethical reasons. I have had zero health concerns until now.
I am open to any alternative suggestions or advice. I refuse to go down the path of medication.
If you are still under a lot of stress then I strongly suggest working to get that down rather than attempting fasting. For all it’s benefits, fasting is a stressor to the body so can be extremely negative for people who are already under stress - not to mention, when you’re already stressed, that makes fasting much more difficult.
I wouldn’t, I’ll echo what @Shortstuff said, it’s a stress snowball and given what you’ve said you’re already stressed enough. I’ll also add, being plant based will make it even worse as the way you eat doesn’t leave a lot in the tank to begin with, your body knows that it doesn’t have any real reserves and that stress level for you will probably be even higher than it would of somebody that regularly eats meat and animal fats and can go a lot longer without meals than you can. Have you been checked for any deficiencies? (Most) people that are plant based are pretty deficient on a list of nutrients unless you’re really up on your supplement game.
For the low back pain and duck feet (or foot). Now you’re talking my world. For starters a good chiropractor is a great tool. They won’t “fix” the problem but they can temporarily set you back straight which makes fixing it a lot smoother of a process. I have an inversion table which is great at spinal decompression which is great for us regardless of pain, for the twisted out leg two things help huge. First a good and regular piriformis stretch.
That’ll loosen it up, Once that’s done try something like this to pull that thing into alignment.
I hate to say this, but this might be part of your problem. Don’t kill the messenger (me), but just know that I’ve heard so many anecdotes that eliminating plants eliminated autoimmune and joint pain, including arthritis, that it can’t just be anecdotal. One person had to eliminate coffee also.
Anyway, I think fasting does help these issues. How much it helps is up to speculation. Could you do it? You could try it to see what happens. It might be a challenge though. Even for me, and I am no longer “obese” by BMI but close, I have been having a harder time fasting 4.5 days. It used to be a piece of cake when I was 30+ pounds heavier. Now, it’s tough.
Try a 36 hour fast to see what happens.
All of us have genetic predispositions for something (or many somethings); the trick is in finding a way to eat and live that doesn’t activate that predisposition.
If you do attempt fasting, you might want to look into short dry fasts. There are some pretty neat stories of folks dropping their inflammation levels (as measured by CRP as well as by subjective measures) rather dramatically. Also it seems to actually be easier than water fasting for many people.
But I agree with other folks that it’s worth a close look at your current diet, and you may find a path where ethical concerns and WOE for your health line up for you (e.g. if you’re eating grains and beans that are now causing you problems are also very rough on the ecosystem of the plains that have been turned into monocrop nightmares…). At some point I realized that I preferred to make my peace with the humane killing of one cow than to be responsible for thousands of smaller critters butchered to turn grasslands into endless fields of wheat, soy or corn.
I do not think low BMI or being plant-based make you unfit for fasting per se. Also I think refeeding syndrome can easily be prevented.
I am overweight nor underweight. I do eat meat. I use fasting for inflammation / auto-immune problems. From reading and hearing other’s experiences, I find fasting seems to be more difficult for me than for overweight people. I settled with doing one 36 hour a week. I do not get into the easy part if I do 5-day fasts, but I still plan to keep doing those 4 times a year.
I clearly feel fasting is a stress to the body, but in some other ways fasting also is resting. After 4 months of weekly 36 hour fasts I still keep learning every time. Slowly I find out how to do it best. I like that. So @Kara_O you can also build up slowly: learn as you go. Also, if you have the money, you can try to find a coach with good knowledge (IDM comes to mind) about it.
As of next week I will be back into my normal routine and top priority is self care. I don’t intend to embark on any form of fasting in the next month or so. Thank you for your advice
Thank you the links, these are fabulous stretches and have been a staple fixture in my warm up and cool down routine. Past history with chiropractors doing more harm than good, has deterred me from using their services. I have never used an inversion table before, have you noticed significant changes? Do you use it daily? Have you tried the Feldenkrais method? After finally moving on from gymnastic due to wear and tear on lower back and joints. This was the only practice that aided my recovery and taught me a lot about fluid movements, body awareness and easy modified ways to function. Unfortunately this, physio, acupuncture, cryotherapy and other alternative methods have not been able to alleviate the inflammation I have caused.
As for deficiencies, I have check ups every 6 months, I take B12 supplements religiously. All my levels have always been within the healthy range (some higher) and well maintained (besides the B12) through diet, which has shocked numerous doctors over the years.
You are not the first person to say this and definitely wont be the last. There is a vast amount of research in support of plant based diets and the positive outcomes in reducing the risks numerous diseases and reducing inflammation. There is evidence to support both sides of this debate, but we are yet to see longitudinal plant based studies and with so many variables to be taken into consideration (eg; genetics, wholesome diet, sleep, exercise etc), comparing is all the more difficult. Regardless of evidence and the grass possibly being greener on the other side, plant based diet is solid and cannot be wavered.
I do the odd 24 hrs fast a couple of times a year, mainly when flying abroad (high carbs, preservatives and food coma/sugar prolongs my jet lag symptoms).
Thank you for the suggestion, I think you are correct 5 days is overly ambitious and the 36 hours would be a good and reasonable test.
What do you find most difficult about fasting now?
Thank you for the feedback and insight Annja.
Is your weekly fast a preventative measure or inflammation reduction? How long have you been using this method? Have you found it highly beneficial?
After reading your recommendation, I reached out to a friend of friends who is a nutritionist, competes in ironmen and triathlons and religiously uses fasting at the begin and end of competition seasons. He is more than willing to be a mentor and has already sent through journals and related dietary guidelines to aid inflammation reduction and preparation before fasting. Again thank you, I would have never thought about looking into coach/mentor.
Ya, they definitely stretch your back out, not as quick as a chiro can decompress you, but the next best thing for sure. I always say I will use it daily… and I do when I’m in pain but realistically for me 4-5 times a week for about 10min or so. At first they screw with you a little but you adjust and then being upside down doesn’t feel weird anymore. Plus you technically don’t have to be fully inverted for the benefits, it’s just I had a couple crappy ones over the years, then I said screw it and went with the king of inversion tables (Teeter), cost me almost $400 and after trying some others after the fact I could have got away with something just as good for a lot less. Something like this
would have been just as good. If you get one only thing I’d make as a non-negotiable is a racheting foot adjustment, the ones that click into place never grab you at the right spot and if it’s not comfortable you won’t use it for long.
Autoimmune issues are no fun.
As far as a 5 day fast experiment goes, there is essentially 0% chance of refeeding syndrome on a fast this short. Having spent hundreds of hours (literally) researching fasting, I’ve never seen anything that suggests refeeding syndrome is a risk on a 5 day fast. Even if the fast was much longer in duration, it can be mitigated by salt supplementation and basic refeed procedures.
As far as being underweight, I don’t see that as much of an issue either. Your BMI is 20, which depending on age would either be in the healthy range or in the “underweight” range. I’m not questioning that it’s quite low, but I sincerely doubt that a short fast poses a legitimate health risk unless there is something you haven’t disclosed (i.e. type 1 diabetic). What it will mean is that you will lose more muscle during the fast than someone who was more obese. We’re talking about a 5 day fast, so I’d expect you to lose around 2.5lbs of fat and lean mass (also quite a bit of water weight). In your case it will probably be around 35% lean mass and 65% fat. Nothing to really worry about.
If you want to experiment with a 5 day fast, I say go for it and see what happens. If it feels good, lowers inflammation for a long time afterwards, great. If you feel lousy and it does nothing for your inflammation, you’ll know it’s not a useful tool for you.
If it does work well for you, gaining 2.5lbs of fat in each month to prep for a monthly fast won’t be very hard to do.
I’ve done dozens of 3-5 day fasts and I’m a big fan. Do a search for Zornfast here on the site to get some more info on supplementing with salt and basic refeed rules of thumb. Fasting isn’t right for everyone, but there is very little risk in doing a 5 day fast to see whether it helps with your inflammation issues.
Good luck!
Paleomedicina might have some good advice for you. They treat many people with rather serious health issues. However, they use an animal based ketogenic diet.
Correction: they use an animal-only (plant-exclusive) ketogenic diet, at the most extreme phase.