I was diagnosed with prediabetes and hepatic steatosis 8 months ago. As per my doctor's recomendation, I followed by 3 months a ketogenic diet combined to a time restricted kind of intermittent fasting, which basically means that I started to skip breakfast. My glycose and insulin levels normalized and the liver fat went away.

I can't pinpoint which factor contributed the most, but I continue to do intermittent fasting skipping breakfasts. When I feel like it, I try to fast for 24h, usually 2 to 3 times a month. It really isn't that difficult, it just takes discipline and focus.

Regarding your advice, I'd like to add just a point: drink more water, true, but also try to increase your salt intake. It seems to make a lot of difference in the beginning, alleviating possible side effects.

I've never eaten breakfast, even when I was a child. Just not something my family has ever done. I somewhat often accidentally forget to eat for 24 hours. I wonder why I find this comparatively easy compared to what others have expressed?

Great to hear you had good results!!

Can't agree more. I have been following the LCHF movement, and the Intermittent Fasting by some prominent doctors (including Dr. Jason Fung). Fasting was difficult when I tried going without food for a day for the first time. However, now, when I have a busy day ahead and want to be energetic the following day, I just skip dinner the prior evening. I have also tried a full day fast and have felt good enough that I do this whenever my schedule permits. This [1] video convinced me to try fasting, and I am happy I tried.

[1]: https://www.youtube.com/watch?v=gBACh6c4zNY

Edit: Though the video starts off talking about a vegetarian diet, the main talk by Dr. Alan Goldhamer is about fasting, and has nothing to do with one's dietary choices.

I think the mental blockage is the main issue with dieting (what else should it be, really?). I've seen so many diets that try to be super smart and as a result complex. They are these "lifestyle" changes, comparable to becoming a vegan or something and I always figured that this is what dieting _is_ and, as a result, that I couldn't do it.

Turns out, simply cutting your calorie intake (while generally eating whatever type of food you like) works out fine and has minimal drawbacks. In fact, I felt less "bloated" (I know, that's a health food buzzword but it's kinda real), which more than counter-weighted the lack of comfort food. You also have to get used to the idea that "hunger" is a normal, everyday feeling and not an alarm signal (first world problems, right?). Usually, you can actually still _eat_ whenever you're hungry, anyway, and it even tastes better!

25-50% off is easy. You can eat a full meal, generally, and still be below your 50% daily calorie intake, there's still room for a snack. All supermarket foods have calorie labels now and the rest you can look up online and quickly get a hang for. We all know the worst offenders (chocolate, soft drinks, fried stuff,...) but once you look it up it forces you to face the reality of it. I never wrote down any lists, just a rough, rounded number in the back of my head.

Generally, it was way harder to start than to keep going. After a week or two, it's easy. Lost 10+ kilos that way over the course of a few months (like 4 or 5?), which put me within my personal weight goal.

Subjectively, I find it much easier to cut total calories by intermittent fasting than by willing myself to eat less once I've started a meal. And it also makes meals more rewarding and enjoyable for me, personally.

I don't know if it's the healthiest or most ideal way of going about it, but it's what works best for me.

That's one of Dr. Fung's arguments, there are a lot of creative diets that become reasonably complex etc and are hard to follow over the long run. He also points out the difficulty of portion control in the midst of a meal. Fasting is pretty simple as far as all of that goes. You don't eat.

In short, cut out the crap and you're most of the way there (to the reduction total). But if you think of sugar, etc. as necessary and natural then you're more or less doomed, as you deserve to be.

> Glucose is a ubiquitous fuel in biology. It is used as an energy source in most

> organisms, from bacteria to humans, through either aerobic respiration,

> anaerobic respiration, or fermentation. Glucose is the human body's key source

> of energy, through aerobic respiration, providing about 3.75 kilocalories (16

> kilojoules) of food energy per gram. Breakdown of carbohydrates (e.g. starch)

> yields mono- and disaccharides, most of which is glucose. Through glycolysis and

> later in the reactions of the citric acid cycle and oxidative phosphorylation,

> glucose is oxidized to eventually form CO2 and water, yielding energy mostly in

> the form of ATP. The insulin reaction, and other mechanisms, regulate the

> concentration of glucose in the blood.

Sugar breaks down to equal parts glucose and fructose though. And fructose is treated very differently from glucose in our bodies.

Do you care to elaborate on how they're differently treated?

Glucose is used as fuel, whereas fructose doesn't have a direct pathway to be used as fuel, it must first be stored as fat.

You then have to have an absence of glucose in your body before you may metabolize your body fat. This doesn't happen often for most people, hence, the obesity epidemic from overconsumption of sugar.

That's the short version. The long, detailed version is available from YouTube, search for Dr. Robert Lustig's videos.

I'm sorry, but I don't understand the point of your comment.

Mine was, in short, reducing isn't so hard if you simply remove the unnecessary. That's it. Speaking for myself, as fit as I might be, I do know I consume unnecessaries.

No, you went on to say:

> But if you think of sugar, etc. as necessary and natural then you're more or less doomed, as you deserve to be.

Which, apart from being wildly unnecessary color commentary, is the equivalent of saying the earth is flat. Sugar is literally one of the core building blocks of aerobic life, which is over 99.9999999% of multicellular organisms.

The thing I learned from time-restricted IF --- which I've been doing pretty painlessly for ~2 years now --- is that I generally won't feel hungry until I eat for the first time every day. I started by skipping breakfast and waiting until 2PM for lunch, but over the last 6 months I've pushed 2PM forward to 6PM and eat just one meal a day.

I have friends who have noticed the same thing, and others who haven't. I'm sure it depends on your metabolism. For anyone not training who hasn't tried time-restriction, it's worth it: if your metabolism works like mine, not having to think at all about food except for ~4 hours of the day is super convenient.

>not having to think at all about food except for ~4 hours of the day is super convenient.

Interesting. Much earlier (teens), I had read a book - I think it was a story about Robin Hood - in which they said that he and his men ate only once or twice a day. I remember wondering at the time how it was possible, how they did not feel hungry, more so since they had active physical lives.

> maybe it's placebo but I recognize a stronger ability to focus when I'm in the midst of a fasting period

I vaguely recall a recent study that covered this. I believe the theory is that when we're hungry our brains become more focused to aide in our ability to find food. After we've eaten there's not much need to think.

To the greater arguments regarding intermittent fasting: I hate to call on the historical human argument, because it's often abused (e.g. for the raw food diet, paleo diet, etc), but in this case I think it applies because until very, very recently the vast majority of humans spent most of their lives hungry. Hell, we still have parts of our world today where people starve to death (not because of lack of food production, by the way; it's a political issue). It's no surprise, then, that not only can we go without food just fine, but a significant portion of our behaviors and adaptations are built around intermittent fasting.

That isn't to say that intermittent fasting is maximally optimal. It may just be more optimal then how most Americans eat (large meals 3+ times a day, occasional snacks and a sugary beverage throughout the day).

I think the biggest issue we face today is our food culture, particularly in Western societies. Food is the center of every occasion. In Latin derived families you see the habit of constantly forcing food on guests, and both Latin and Southern European cultures are big on forcing their children to eat until their plate is empty.

This made a lot of sense when food and calories wasn't abundant, and there has likely been a lot of selective pressures on those cultures over our recent history. But food is plentiful now. Whereas in the past when forcing children to eat every last speck meant them barely getting enough to eat; today forcing children to eat, eat, eat means making them fat.

Unfortunately I don't think the same selective pressures will work. Being overweight isn't going to stop you from raising a family. So our only two real solutions are to either forcefully change our cultures so that dieting, whatever the diet may be, is the cultural norm, or we apply science to develop foods with lower caloric densities. The latter is, unfortunately, demonized for some godforsaken reason (e.g. artificial sweeteners).

I saw this video called "Fasting vs. Eating Less: What's the Difference? (Science of Fasting)" just yesterday, and it's good to hear many of the points it raised validated by your experience:

https://www.youtube.com/watch?v=APZCfmgzoS0

> hunger comes in waves, you'll get to a point where you feel super hungry, it'll usually pass after some time

Matches what the video above talks about "Ghrelin" from 5:03 onwards.

I recently fasted for 5 days, and it was much easier than I expected. When I started, I didn't think I'd last 1 day, never mind 5 - but actually I could easily have gone longer!

I agree about hunger coming in waves; I'd go 12 hours without even thinking about food, then it's all I could think about for an hour. Probably didn't help that I was still cooking for the family!

Err, I don't think that not eating for five days straight is any kind of healthy, though.

What is this conjecture based on?

There is a lot of evidence to suggest that fasting, and even intermittent fasting, is a good thing (actually, I seem to recall some papers/articles have ended up on HN). Fasting has also been shown to regenerate the immune system[1]

Besides, I have enough body fat to supply calories for a good bit longer than 5 days :)

[1] https://news.usc.edu/63669/fasting-triggers-stem-cell-regene...

Depends who you ask. I did a 12 day fast once, nothing but water. I intended to do a 10 day fast, but I felt so wonderful, so healthy, so clear, that I decided to add 2 extra days.

For those interested, most of the benefits (for me) happened after the 5th day. Thats when the hunger and caffeine withdrawal ended.

I don't know all of the science behind it, but I can honestly say that I never felt better/healthier in my life.

3 days and your immune system "reboots." Not sure if anything after that helps but an extra day or two hardly sounds troubling.

Depends on the person. Angus Barbieri completed a 382 day medically supervised fast in 1966. Depending on body composition and physiology, one might reap a lot of benefit from simple intermittent fasting while another person might continue fasting for longer stretches to help reset their body to more normalized hormone levels.

As is often the case, it depends on the context. For someone obese and/or diabetic, extended fasts of 3-7 days as recommended by Dr. Fung can be very beneficial.

Why do you think that?

Can you describe your regimen, starting/ending weight, exercise habits, and general health status? I've considered not eating one day a week for general health reasons, but I am very thin, and it is hard for me to maintain weight even with 3 meals per day on a healthy diet.

5-6 days a week I eat twice a day. 1-2 days I fast. I normally don't eat breakfast. I go to the gym at least once a week, but normally not more than 2 times. I don't do cardio, I only lift weights. Blood tests etc are all in the normal ranges, no major (or minor) health problems. I don't have any good advice for maintaining weight since I'm on the opposite side of the spectrum. :( I lost a little more than 10% of my weight over 6 months; for my height my weight is average.

Are there any particular foods you avoid or ones that you eat more? Fruits for example, are you eating more or less of those? How many times a day do you eat and which meal do you skip? I'd like to hear more usable info about this if you don't mind me asking.

I generally try to avoid sugar and refined carbohydrates. I find if I eat too much of them my appetite spikes later in the day or the next day. So my "normal" diet low-carb, hight fat. I eat a lot of protein and vegetables but I'm not religious about it. If my family / friends want to go out for pizza or whatever, I'll have it, and dessert. :) But most days, except for those when I'm fasting, I usually eat chicken or fish and vegetables. I only eat breakfast once or twice a week (on the weekends with my family) and then it's just eggs and bacon, maybe a slice of toast. I fast a day or two a week. The meal plan for those days is simple: water and black coffee.