Is intermittent fasting the key to aging well for midlife women?

You may have heard the buzz that intermittent fasting can help you lose weight easily and live longer. At the same time, you may also be questioning the validity of fasting for aging well and whether to try fasting yourself. 

To help you decide whether intermittent fasting is for you, we did a deep dive into the literature (and there’s a lot). More research will be published on this hot topic, so our views may evolve as we learn more. 

Why the interest in intermittent fasting? Healthcare has extended length of lives, but not necessarily health and quality of years. The decline in health experienced with aging is influenced by biological and metabolic changes (such as blood sugar, insulin, waist circumference, lean body mass, blood pressure, cholesterol, and triglycerides) that occur during aging. The scientific interest in exploring whether intermittent fasting can improve how we age is increasing. And, if you’re like us, your interest is piqued because you want to age well while living longer. 

Some studies have shown that calorie restriction and increased exercise improved healthspan and delayed the onset of aging-associated declines. Intermittent fasting has been shown to stimulate similar biological pathways at a cellular level as caloric restriction and has emerged as a potential regimen for preventing or reducing the risk for certain diseases such as heart disease, cancer, neurodegenerative diseases, and obesity, as well as for improving brain function and mental clarity.

Types of Intermittent Fasting

Let’s start by defining the types of fasting being studied and discussed in the literature and online. 

• Alternate day fasting is eating a normal diet one day and fasting completely or moderately (consuming ~25% of daily calories or approximately 500-800 calories, called moderate alternate day fasting) the next.

• Fasting on some days of the week. The most popular application is called a 5:2 approach—where a normal diet is consumed for five days, and a fast is done for two days each week. The fasting days tend to be limited to approximately 25% of energy needs (500-800 calories).

• Time-restricted eating limits eating time to 4 to 12 hours during the day. 

• A fasting-mimicking diet is a period of a water-only or very low-calorie diet for two or more days separated from the next cycle by one week or longer. It was developed to be used in periodic cycles.

Research To Date 

It’s important to acknowledge that relatively few studies have explored the different intermittent fasting routines in middle-aged and older adults, and many of these studies were less than one year in length. More long-term research is needed to confirm the promoted health benefits for midlife adults. 

With that said, when reviewing studies conducted with broader populations, some have suggested that fasting regimens can aid in mild to moderate weight loss through consistent reductions in energy intake. However, recent literature reviews have not seen a significant difference over simply reducing calories throughout the day to control weight loss, glucose, and blood lipids. Reducing calories throughout the day or trying intermittent fasting can be viable options for reducing intake. Choose the approach that is easier to adhere to long-term, some people have found intermittent fasting easier than daily monitoring of caloric intake. With either approach, losing weight can improve health, especially in individuals who are overweight or obese.

Time-restricted eating has emerged as an eating approach that may support circadian rhythms. Most studies to date have been done in mice and supported by largely observational studies in humans, but they have shown benefits such as a reduction in fat mass, increased lean mass, reduction of inflammation, improved heart function, and improved natural body repair processes. 

Research done with rodents has also suggested that the health benefits of restricting eating windows without restricting calories were similar to the benefits of calorie restriction.  A few studies have shown that eating the same number of calories earlier in the day compared to late at night aids in weight loss without differences in caloric intake, macronutrient distribution, or energy expenditure furthering the interest in whether intermittent fasting, especially time-restricted eating, could be a practical approach for weight loss. It also has been proposed that time-restricted eating may increase metabolic flexibility enabling the body to fluctuate between burning carbohydrates and fat more easily. 

Metabolism may function more optimally in the morning, which suggests that eating earlier in the day may produce better weight outcomes.  Eating at night (between 5 pm and midnight) can often lead to eating too many calories, which can increase markers of inflammation. More research is needed to understand eating times, fasting periods, and health outcomes. Shorter eating windows (e.g., 12 hours) or consistent first and last meal times may be practical approaches for midlife women to use to control calorie intake without negatively impacting eating in social settings. 

Although some people find fasting difficult to adhere to long-term, others find intermittent fasting approaches easier to follow, making adoption and adherence to these approaches easier. Most people don’t have to overhaul their eating, avoid certain food groups, or monitor calories to follow a fasting approach, especially when doing time-restrictive eating. However, more research is needed to understand hunger, satiety, and long-term success with any fasting regimen. 

While intermittent fasting regimens appear to be safe for short periods, more research on humans is needed to assess safety for long-term use,  Most research has been done on people who are overweight or obese. More research needs to be conducted to determine whether fasting is safe for people at a healthy weight. 

In our experience, with any type of restrictive rule-based eating plan, women may miss out on important nutrients in their diets when they restrict food to a small eating window or fast on alternate days. As we age, getting the nutrients needed to maintain muscle mass and stay nourished can be more difficult, and adding a fasting regimen may make that even more challenging. 

When energy and nutrients are restricted, women may experience symptoms such as hunger, temperature changes, fatigue, headache, low energy, irritability, and gastrointestinal issues. Eating healthfully during any restricted eating plan is important to maintain energy, support mental health, and optimize healthspan. 

We’d love to say intermittent fasting is a key to aging well. Some studies done with lab animals show promising results, but the studies with humans are sparse, short-term, and therefore not yet conclusive. Plus, there’s a lack of consistency regarding an ideal regimen. 

Bottom Line

If you’re interested in trying intermittent fasting,  a shorter eating window (~12 hours) or consistent first and last meal times may be practical places to start for most healthy midlife women as we all wait for more evidence.

Small calorie reductions can be fine, but it’s important to get the nutrients, especially protein, you need to feel great, have the energy to participate in the activities you enjoy, and eat from all food groups. Being too restrictive can prove detrimental to aging well, especially if you lose lean body mass or you fall into an overly  “restrictive” eating pattern that impacts your joy of eating or your ability to eat with family or friends. 

Lastly, work with your healthcare provider if you have a chronic disease or are on any medications to ensure your chosen approach will work for you and not be counterproductive to your current medical regimen. 

Ditch Fad Diets: Become a Conscious and Intentional Eater in Midlife

Have you ever finished a meal so quickly that you don’t remember the taste or consumed popcorn while watching a movie, and suddenly the bowl is empty? Most midlife women can relate to mindless eating at some point. 

Your emotions, thoughts, beliefs, and environment influence what and how much you eat.   Add to the fact that the extreme diet culture penetrating society today (positively or negatively) influences your food beliefs, and how you comply with those beliefs may impact how you feel about yourself.

Whether it’s vegan, paleo, keto, Whole 30, flexitarian, or even “nondiet” diet beliefs, the ideology of ONE WAY of eating versus another can leave you feeling in control one day and frustrated the next, or on the “team” today and kicked out of the club tomorrow. Diet culture promotes the idea that there is one right way to eat, and you must follow strict food rules to be a part of the team. 

It’s time to be done with diets and restrictive thinking! Over our 50-plus years, we have not seen friends or family sustain weight loss or positive health outcomes by complying with one particular fad diet over another. Plus, diets foster a loss of joy in eating and rigid black-and-white thinking around food. We wrote about it here. Yet, we continue to witness new fad diets hit the landscape every year, and the divisive culture followers promote is not helping anyone improve their health and flourish. 

You’ve told us midlife weight gain is one of your biggest challenges, yet you don’t want to jump on another fad plan only to be disappointed again. So what do you do? 

Start with conscious, intentional eating to develop an awareness of the relationship between what and how much you eat and your body, feelings, mind, and interconnectedness. 

It’s assumed we only eat in response to hunger, which we all know isn’t accurate. Our social (who we surround ourselves with) and physical environment (food accessibility, price, and portion size) influence our behaviors including what and how much we eat. 

That’s why developing mindful or intuitive eating principles can help you ditch diets, control how much you eat, and find joy in food, traditions, and culture again.  

Mindful eating refers to being fully present and paying attention to the food you eat, the experience, and your environment with minimal distractions. Jon Kabat- Zinn is considered the founder of mindfulness, which includes mindful eating. Mindful eating (i.e., paying attention to our food on purpose, moment by moment, without judgment) is an approach to food where you focus on the taste, smell, sound, and feelings of what you’re eating when you’re eating it. 

It sounds like common sense, but our lives are full of distractions (television, computers, phones, etc.), which we often use when we’re eating and these distractions can cause us to eat too fast, too much, and without pleasure. 

Mindful Eating

Mindful eating is a philosophy and lifestyle behavior, not a trademarked diet program or strictly defined principles. Common practices include:

• Eliminate eating distractions, such as the TV, phone, or computer.

• Eat while sitting down versus standing in the kitchen.

• Be curious about where your food comes from, who made it, and how it was prepared.

• Be grateful and offer thanks before meals. 

• Take small bites, chew intentionally, and slow down when you eat.

• Savor the food's smell, taste, and texture. Engage all your senses.

• Pay close attention to how hungry or full your body feels. What cues is it giving you to start, slow down, or stop eating?

• Eat without judgment such as thinking about a particular food being good or bad. When black and white thinking persists, acknowledge your feelings.

• Notice internal and external cues that affect how much you eat. 

• Acknowledge how you feel after a meal or snack.

Mindfulness is intended to cultivate a nonreactive attitude to your feelings towards food and eating, which can help break cycles of over and under-eating. Our eating culture doesn’t promote these principles, so being conscious, intentional, and mindful can help you slow down, eat less, appreciate healthful foods that nourish your body, and find joy in food again. 

Intuitive Eating

Intuitive eating, on the other hand, is a specific philosophy aiming to free people from the confines of damaging beliefs around food (and often themselves), with the goal of establishing judgment-free eating.  Developed by registered dietitians Elyse Resch and Evelyn Tribole, intuitive eating involves ten core principles which include:

• Reject the diet mentality

• Honor your hunger

• Make peace with food

• Challenge the food police

• Discover the satiation factor

• Feel your fullness

• Cope with your emotions with kindness

• Respect your body

• Movement—feel the difference

• Honor your health—gentle nutrition

Intuitive eating is a pattern of eating that focuses on positive psychological and physical well-being first. The focus is to reconnect with your inner hunger and fullness cues, understand external influences such as mood, social, and food availability, disconnect from strict dieting food rules and unrealistic expectations, and love your body regardless of size or shape. There are no good or bad foods, just food. 

You’ll notice neither of these approaches focuses on the health of the food first. They both promote paying attention to physiological signs of hunger and fullness to control eating, how your body feels, enjoying your food, and eating without judgment. It is easier said than done, so we strongly recommend checking out the resources below if you’re struggling with eating mindfully or intuitively.  We believe it’s hard to focus on what to eat to live well and flourish unless you can first eat in a way that brings you joy, fills you up, and frees you from the black-and-white diet culture. 

Midlife Zest

However, we do believe in choosing foods and beverages that optimize your health and eating them in a way that maximizes your well-being. What eating pattern do we recommend?

Our recommendations vary based on you, your history, and your goals. Eating to maximize your health when you’re in a state of good health is different than eating when you’re in a state of sickness or dis-ease, and your goal is to restore health; therefore, our recommendations change accordingly.

Recommended Resources:

Intuitive Eating: A Revolutionary Anti-Diet Approach by Evelyn Tribole, MS, RDN, CEDRD-S, and Elyse Resch, MS, RDN, CEDRD-S, FAND

The Intuitive Eating Workbook by Evelyn Tribole, MS, RDN, CEDRD-S, and Elyse Resch, MS, RDN, CEDRD-S, FAND

Mindful Eating: A Guide For Rediscovering a Healthy and Joyful Relationship with Food by Jan Chozen Bays, MD

The Body is Not An Apology: The Power of Radical Self-Love by Sonya Renee Taylor