Arthur Agatston, M.D., is an internationally recognized pioneer in coronary disease prevention. Known as the author of the best-selling book The South Beach Diet, Dr. Agatston created his approach to healthy eating to help his patients improve their blood chemistries, lose weight, and prevent diabetes and heart disease. Dr. Agatston believes that intermittent fasting can be a powerful complement to a healthy diet. Below is an excerpt from his most recent book, The New Keto Friendly South Beach Diet:

How to Get Started with Fasting

While there have always been recommendations to not skip breakfast, or to skip meals in general, there was never any solid evidence behind such advice. We do know that there is an important hunger hormone named ghrelin, which travels from your intestine to your brain to stimulate your appetite. It is often associated with a “growling“ abdomen. When you first start intermittent fasting and skipping a meal, ghrelin will be secreted at your regular meal time and induce hunger. But, if you do not eat, that feeling of hunger will not persist.

I became aware of this phenomenon on busy days in the office when I was concentrating on a patient visit or a project and working right through lunch. After a hunger pain, I would forget about lunch and by the time I was no longer distracted and realized I hadn’t eaten, I wasn’t hungry. I am sure many of you have had similar experiences. This pattern occurs because your ghrelin blood levels go back to normal in one hour, if not sooner. You don’t get hungry because you are lacking in energy stores; you have plenty of fat stores to tap into. Fortunately, the regular ghrelin secretion at your usual mealtime subsides in a few days, and so does your hunger. When this happens, it means you are using your stored fat for energy.

We find it best to begin intermittent fasting by skipping just one meal, usually breakfast (although it doesn’t have to be).  Once this is comfortable, you could begin delaying lunch and extending your fast into the afternoon. You will see what works for you.

It is important to keep up your fluid and mineral intake. Stay hydrated with plenty of water, salt, and magnesium supplementation. We find bone broth or bouillon cubes are helpful. Using a “light” salt that contains extra potassium is also helpful to maintain your potassium levels. You can exercise while fasting, but pay special attention to fluids, salt, and potassium and magnesium levels, which are important. To see what your ideal supplementation is, you might have to experiment and discuss this with your doctor.  While I advise finding what works best for you, if you plan to fast more than 24 hours, you should definitely discuss this with your doctor first.

Snacking and Intermittent Fasting

You can still get the benefits of intermittent fasting while enjoying a snack or two if the snack does not significantly raise your insulin levels. The snacks are sometimes referred to as “fasting equivalence.” An example is “bulletproof coffee,” which is black coffee with approximately a tablespoon of butter and a tablespoon of coconut oil added and blended.

Intermittent fasting is certainly the quickest strategy for lowering your insulin levels promptly and tends to work very well for many of our patients. In some, it has been a true diet saver. So feel free to experiment and determine what works best for you. Again, we do suggest that, as with any major change in your diet, you consult with your doctor.  It is prudent to check your electrolyte levels including magnesium periodically.