Intermittent fasting had a strong anti inflammatory effect beside the many other benefits. Intermittent fasting is an eating pattern and Interventional strategy where in individuals are subjected to varying periods of fasting. It doesn’t specify which foods you should eat but rather when you should eat them. Intermittent fasting (IF) is an eating pattern that cycles between periods of fasting and eating. It’s currently very popular in the health and fitness community. Recently attracted attention because: 1- Its Evidence-Based Health Benefits 2- Its potential for correcting metabolic Abnormalities 3- Better adherence than other methods

1. Intermittent
Fasting - 2
Dr. Fathi Neana, MD
Chief of Orthopaedics
Dr. Fakhry & Dr. A. Al-Garzaie Hospital
June, 28 - 2020

3. َ‫ه‬‫و‬ُ‫ص‬ْ‫ح‬ُ‫ت‬ َ‫َل‬ ِ ‫ه‬‫اَّلل‬ َ‫ة‬َ‫م‬ْ‫ع‬ِ‫ن‬ ‫ُّوا‬‫د‬ُ‫ع‬َ‫ت‬ ‫ن‬ِ‫إ‬َ‫و‬ِ‫ح‬‫ه‬‫ر‬ ٌ‫ور‬ُ‫ف‬َ‫غ‬َ‫ل‬ َ ‫ه‬‫اَّلل‬ ‫ه‬‫ن‬ِ‫إ‬ ۗ ‫ا‬ٌ‫م‬‫ي‬
(18)‫النحل‬ ‫سورة‬
And if you should count the favors of Allah, you could not
enumerate them. Indeed, Allah is Forgiving and Merciful.
Who can take all my wealth and let me walk on
my own feet again

4. How fasting reduces inflammation
Inflammation is a normal process that is part of
host defence and tissue healing.
However, excessive or unresolved inflammation
can lead to uncontrolled tissue damage, pathology
and disease
Chronic Inflammation :
1- Root causes
Oxidative stress – obesity – sugar & omega 6
processed diet – pollutants - etc
2- Risk factor
Pro inflammatory mediators - Cytokine storm
caused by Macrophage (phagocytosis +
release of Pro inflammatory mediators)
3- Manifestations
Chronic diseases – cancer - aging

5. 1- SIRS systemic inflammatory response syndrome ->> MOD –MOF
2- CARS compensatory anti inflammatory response syndrome ->> Recovery – healing
3- MARS Mixed Antagonist Response Syndrome Persistent Inflammation, Immunosuppression and Catabolism Syndrome
(PICS). surges of hyperactivity (SIRS) and immunosuppression (CARS) which can become increasingly destructive and if
severe enough leads to MODS, MOFS, septic shock or a state of anergy.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling and complex illness.
People with ME/CFS are often not able to do their usual activities. At times, ME/CFS may confine them to bed. People
with ME/CFS have overwhelming fatigue that is not improved by rest.
Inflammatory VS. Anti inflammatory response

6. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling and complex
illness. People with ME/CFS are often not able to do their usual activities. At
times, ME/CFS may confine them to bed. People with ME/CFS have overwhelming fatigue
that is not improved by rest.

7. 1- Oxidative stress
2- High glucose levels - High carbohydrate and
sugar foods
3- Obesity - Excessive abdominal fat
4- Excessive chronic stress
5- Environmental chemicals
6- Infections, allergies (food and environmental)
7- Unhealthy unnatural processed food.
8- High Omega 6/3 ratio
9- Too little or too much physical activity
(everything in life needs to be in balance in
order to achieve and maintain wellness)
The question still perplexing scientists is, which
came first, the fat or the inflammation?
Origin of Inflammation – Root causes
There are many unknowns in medicine but what causes Inflammation we do know
is: Sugar, Omega 6, Lack of exercise

8. How fasting reduces inflammation – (Free radicals)

10. Role of free radicals in human inflammatory diseases
Silpak Biswas, Rintu Das, Ena Ray Banerjee ,
Immunobiology and Regernative Medicine Research laboratory, Department of Zoology, University of Calcutta, West Bengal, India
Received: 31 August 2017:detpeccA ,17 October 2017:dehsilbuP ,25 October 2017
The role of free radicals can be found in the inflammatory process which is a complex
process resulting many human diseases. Inflammations are mainly divided into acute
and chronic inflammation depending on various inflammatory processes and cellular
mechanisms. In recent years, there has been a great deal of attention to the field of free
radical chemistry. Free radicals such as reactive oxygen species (ROS) and reactive
nitrogen species (RNS) are generated by our body by various endogenous systems,
exposure to different physiochemical conditions or pathological states. The purpose of
the present review is to mention the role of free radical formation in the most common
inflammatory processes in animals. Continued oxidative stress can lead to chronic
inflammation, which in turn could mediate the most chronic diseases including cancer,
diabetes, cardiovascular, neurological, and pulmonary diseases. ROS and RNS are well
recognized for playing role as deleterious species. ROS and RNS are normally generated
by tightly regulated enzymes, such as NO synthase (NOS) and NAD(P)H oxidase
isoforms, respectively. The detrimental effect of free radicals causing health damages is
termed oxidative stress and nitrosative stress. Overproduction of ROS results in
oxidative stress, a deleterious process that can damage cell structures, including lipids,
proteins, and DNA.

11. Obesity
Free fatty acids (NEFA)
Triglycerides
Hyperglycemia
Hyperinsulinemia
Systemic Insulin
resistance
Systemic Insulin
resistance
Kidney
Musculoskeletal
Vessels
DM 2
Metabolic disorders
Metabolic syndrome
Triggering adipose
tissue inflammation
Local insulin
resistance
Adipose tissue
Macrophages Liver
Local insulin
resistance
Lipogenesis
Diabetes & Inflammation—the Vicious Cycle
Anatomy of the Vicious Cycle Dr. Richard K. Bernstein
Chronic low-grade inflammation plays a role in all major diseases including musculoskeletal manifestations
Phagocytosis +
Pro inflammatory mediators
Adipokines
1- Leptin (pro-inflammatory)
2- Adiponectin (anti-inflammatory).
fating
How fasting reduces inflammation – (Obesity)

12. NF-kB is a short name of Nuclear Factor kappa-light-chain-enhancer of activated B cells
NLRP3 inflammasome expression is driven by NF-κB
Inflammatory VS. Anti inflammatory response – (NF-kB)
How fasting reduces inflammation – (BHB)
NLRP3
Statins
Fasting – KD
– Exercise ->
BHB (ketone)
(NF-kB)
Nuclear Factor kappa-light-
chain-enhancer of activated B
cells
NF-κB drive the expression of
(NLRP3)
(NLRP3)
part of a complex set of
proteins called the
inflammasome
(BHB)
β-hydroxybutyrate (ketone
bodies) directly inhibits NLRP3

13. BHB

14. Anti-inflammatory mechanism of dieting and fasting revealed
β-hydroxybutyrate (BHB) directly inhibits NLRP3, which is part of a complex set of proteins called the
inflammasome.
By Karen N. Peart, february 16, 2015
The inflammasome drives the inflammatory response in several disorders including autoimmune diseases,
type 2 diabetes, Alzheimer’s disease, atherosclerosis, and autoinflammatory disorders.
endogenous metabolites like BHB that block the NLRP3 inflammasome could be relevant against many
inflammatory diseases, including those where there are mutations in the NLRP3 genes,”
BHB is a metabolite produced by the body in response to fasting, high-intensity exercise, caloric
restriction, or consumption of the low-carbohydrate ketogenic diet.
it is well known that fasting and calorie restriction reduces inflammation in the body, but it was unclear
how immune cells adapt to reduced availability of glucose and if they can respond to metabolites
produced from fat oxidation.
a compound produced by the body when dieting or fasting can block
a part of the immune system involved in several inflammatory
disorders such as type 2 diabetes, atherosclerosis, and Alzheimer’s
disease.
β-hydroxybutyrate (BHB) directly inhibits NLRP3, which
is part of a complex set of proteins called the
inflammasome.

15. Working with mice and human immune cells, Dixit and
colleagues focused on how macrophages — specialized
immune cells that produce inflammation — respond
when exposed to ketone bodies and whether that
impacts the inflammasone complex.
The team introduced BHB to mouse models of inflammatory
diseases caused by NLP3.
They found that this reduced inflammation, and that
inflammation was also reduced when the mice were given a
ketogenic diet, which elevates the levels of BHB in the
bloodstream.
Anti-inflammatory mechanism of dieting and fasting revealed
β-hydroxybutyrate (BHB) directly inhibits NLRP3, which is part of a complex set of proteins called the
inflammasome.
By Karen N. Peart, february 16, 2015
Our results suggest that
the endogenous metabolites like BHB that are produced during low-carb
dieting, fasting, or high-intensity exercise can lower the NLRP3 inflammasome

16. How fasting reduces inflammation –
(Dysbiosis & SIBO)
Curr Biol. 2018 Jun 4; 28(11): 1714–1724.e4.
doi: 10.1016/j.cub.2018.04.015
PMCID: PMC5988561
PMID: 29779873
Short-Term, Intermittent Fasting Induces Long-Lasting Gut Health and TOR-
Independent Lifespan Extension
James H. Catterson,1 Mobina Khericha,1 Miranda C. Dyson,1 Alec J. Vincent,1 Rebecca
Callard,1 Steven M. Haveron,1 Arjunan Rajasingam,1 Mumtaz Ahmad,1 and Linda Partridge1,2,3,∗
Author information Article notes Copyright and License information Disclaimer
Front Microbiol. 2018; 9: 432.
Published online 2018 Mar 12. doi: 10.3389/fmicb.2018.00432
PMCID: PMC5857604
PMID: 29593681
Intestinal Microbiota Influences Non-intestinal Related Autoimmune Diseases
Maria C. Opazo,1,2 Elizabeth M. Ortega-Rocha,3 Irenice Coronado-Arrázola,4 Laura C.
Bonifaz,5 Helene Boudin,6 Michel Neunlist,6 Susan M. Bueno,4 Alexis M.
Kalergis,4,7 and Claudia A. Riedel1,2,*

17. Fasting to reduce inflammation
Intermittent fasting inhibits the development of atherosclerotic plaque
by reducing the concentration of inflammatory markers, such as IL-6,
homocysteine, and CRP.
The IF diet results in an increase in plasma concentrations of adiponectin (anti-
inflammatory). and a decrease in leptin and resistin (inflammatory).
concentrations.
Nutrients. 2019 Mar; 11(3): 673.
Published online 2019 Mar 20. doi: 10.3390/nu11030673
PMCID: PMC6471315
PMID: 30897855
Intermittent Fasting in Cardiovascular Disorders—An Overview
Bartosz Malinowski,1,* Klaudia Zalewska,1 Anna Węsierska,1 Maya M. Sokołowska,1 Maciej
Socha,2 Grzegorz Liczner,1 Katarzyna Pawlak-Osińska,3 and Michał Wiciński1
Author information Article notes Copyright and License information Disclaimer
How fasting reduces inflammation
(Reduce (IL-6, homocysteine, and CRP) – increase (adiponectin) & decrease (leptin))

18. Fasting is
a Common
Factor

19. What is intermittent fasting
Interventional strategy where in individuals are subjected to varying
periods of fasting.
Not a diet in the conventional sense but more
accurately described as an eating pattern that
cycles between periods of fasting and eating.
It doesn’t specify which foods you should eat but
rather when you should eat them.
It’s currently very popular in the health and fitness
community.
Recently attracted attention Because:
1- Its Evidence-Based Health Benefits
2- Its potential for correcting metabolic Abnormalities
3- Better adherence than other methods

20. Fasting has been a practice throughout human
evolution. Ancient hunter-gatherers didn't have
supermarkets, refrigerators or food available year-round.
Sometimes they couldn't find anything to eat. As a result,
humans evolved to be able to function without food
for extended periods of time.
In fact, fasting from time to time is more natural than
always eating 3–4 (or more) meals per day.
Fasting is also often done for religious or spiritual
reasons, including in Islam, Christianity, Judaism and
Buddhism.
What is intermittent fasting (IF)?

21. Fasting is often associated with the season
of Lent for Christians or the season of
Ramadan for Muslims
However, many other cultures and religions
around the world fast throughout the year.
While the duration, practice, and specific
reasons differ, all fasts have the similar
goals of showing sacrifice and cleansing
oneself.
Religions and philosophies that practice
fasting include: Buddhism, Christianity,
Islam, Judaism, Taoism, Jainism, and
Hinduism.
fasting in various religions
ُ‫م‬‫ا‬َ‫ي‬ِّ ِ‫الص‬ ُ‫م‬ُ‫ك‬ْ‫ي‬َ‫ل‬َ‫ع‬ َ‫ب‬ِ‫ت‬ُ‫ك‬ ‫وا‬ُ‫ن‬َ‫م‬َ‫آ‬ َ‫ِين‬‫ذ‬‫ه‬‫ل‬‫ا‬ ‫ا‬َ‫ه‬ُّ‫ي‬َ‫أ‬ ‫ا‬َ‫ي‬َ‫ل‬َ‫ع‬ َ‫ب‬ِ‫ت‬ُ‫ك‬ ‫ا‬َ‫م‬َ‫ك‬ْ‫م‬ُ‫ك‬ِ‫ل‬ْ‫ب‬َ‫ق‬ ْ‫ن‬ِ‫م‬ َ‫ِين‬‫ذ‬‫ه‬‫ل‬‫ا‬ ‫ى‬.(‫سورةالبقرة‬:183-184)

22. Timeline of Tissue Breakdown
Fasting Period
(8 h glucose & glycogen) ------ fat ----- (36 - 48 hours protein)
36-48 hours before significant amounts of protein start being broken down

23. How does intermittent fasting work?

24. Simplified View of Insulin Action
Graphic originally published at http://weightology.net/weightologyweekly/?page_id=319
How does intermittent fasting work?

25. How does intermittent
fasting work?

26. 1- Fat burning as KD
More energy – less Reactive oxygen ROS.
2- Calorie restriction (+ increase metabolic rate)
Less ROS with fasting
Increase your antioxidants (not exhausted)
Avoid eating several hours before going to sleep
3- Autophagy
Remove damaged cells and mitochondria known as
mitophagy
4- Triggering the Immune System for Cancer Patients
5- Reducing Cancer Recurrence and Mortality Rates
Interventional strategy
where in individuals are subjected to
varying periods of fasting.
Sources
•https://news.usc.edu/103972/fasting-like-diet-turns-the-immune-system-against-cancer/
•https://www.osher.ucsf.edu/patient-care/self-care-resources/cancer-and-nutrition/frequently-asked-questions/cancer-
and-fasting-calorie-restriction/
•https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680567/
•https://health.clevelandclinic.org/2015/10/interested-fasting-health-get-facts-first/
How does intermittent fasting work?

27. How does intermittent fasting work?
How It Affects The Cells and Hormones
•Human Growth Hormone (HGH):
The levels of growth hormone skyrocket, increasing as much as 5-fold. This has benefits for fat
loss and muscle gain, to name a few (4, 5, 6, 7).
•Insulin:
Insulin sensitivity improves and levels of insulin drop dramatically. Lower insulin levels make
stored body fat more accessible (8).
•Cellular repair:
When fasted, your cells initiate cellular repair processes. This includes autophagy, where cells
digest and remove old and dysfunctional proteins that build up inside cells (9, 10)
•Gene expression:
There are changes in the function of genes related to longevity and protection against
disease (11, 12).
These changes in hormone levels, cell function and gene expression are responsible for
the health benefits of intermittent fasting.

28. How does intermittent fasting work?
A Very Powerful Weight Loss Tool
Weight loss is the most common reason for people to try intermittent fasting (13).
Intermittent fasting can lead to:
1- An automatic reduction in calorie intake.
2- Changes hormone levels to facilitate weight loss.
3- Lowering insulin and increasing growth hormone levels,
4- It increases the release of the fat burning hormone norepinephrine (noradrenaline).
5- May increase your metabolic rate by 3.6–14% (14, 15).
6- Intermittent fasting causes weight loss by changing both sides of the calorie equation. Less intake
& more burning
Studies show that intermittent fasting can be a very powerful weight loss tool.
A 2014 review study found that this eating pattern can cause 3–8% weight loss over 3–24 weeks, which is a
significant amount, compared to most weight loss studies (1).
According to the same study, people also lost 4–7% of their waist circumference, indicating a significant loss
of harmful belly fat that builds up around your organs and causes disease (1).
Another study showed that intermittent fasting causes less muscle loss than the more standard method of
continuous calorie restriction (16).
However, keep in mind that the main reason for its success is that intermittent fasting helps you eat fewer
calories overall. If you binge and eat massive amounts during your eating periods, you may not lose any
weight at all.
SUMMARY:
Intermittent fasting may slightly boost metabolism while helping you eat fewer calories. It’s a very
effective way to lose weight and belly fat.

29. How does intermittent fasting work?
Leptin, Ghrelin, and weight loss
• Cortisol
– Stress hormone
• Leptin
– controls satiety
• Ghrelin
– Sparks hunger
• Thyroid
– Controls metabolic rate
Intermittent Fasting eliminates hunger &
cravings
IT improve insulin & leptin sensitivity
IT reduces or normalizes Ghrelin effect (the
hunger hormone) -> less appetite
EAT PROTEIN BEFORE CARBS (reduce the high glycemic
effect – induce satiety)
We know the amount of certain nutrients
But the order in which you eat them matters too
Blood sugar levels were about 29 percent lower after 30 minutes, 37
percent lower after 60 minutes, and 17 percent lower after 120
minutes after starting their meal
High Sugar (esp fructose) turning off the body's appetite-control system (insulin and leptin signaling)
-> huger -> more eating -> gaining weight

30. Intermittent fasting (IF)
Better adherence with all varieties than other methods
1- ‘Alternate day fasting’ (ADF)
Alternate Day Fasting – 75% restriction on day 1; 25% surplus on day 2.
2- Every other day (EOD) fasting
eat only Every Other Day. 36 hour fasts – from dinner on day 1 until
breakfast on day 3.
3- 16/8 ‘Fasting two non-consecutive days per week’
Skip breakfast.
4- ‘Modified fasting regimes’
(allow water - coffee or tea. limiting caloric intake < 20% - > 500
calories)
5- The Warrior diet (1 large meal per day)
Skip breakfast & lunch
6- Variations
(different combinations of EOD and the Warrior diet)
‘Normal eating’ resumed on non-fasting days

31. Intermittent fasting (IF)
The most popular methods
•The 16/8 method: Also called the Leangains protocol, it involves skipping breakfast and
restricting your daily eating period to 8 hours, such as 1–9 p.m. Then you fast for 16 hours in
between.
•Eat-Stop-Eat (worrier) : skipping breakfast & lunch T his involves fasting for 24 hours, once
or twice a week, for example by not eating from dinner one day until dinner the next day.
•The 5:2 diet: With this methods, you consume only 500–600 calories on two non-
consecutive days of the week, but eat normally the other 5 days.
Many people find the 16/8 method to be the simplest, most sustainable and easiest to
stick to. It’s also the most popular.
SUMMARY There are several different ways to do intermittent fasting. All of them split the day
or week into eating and fasting periods.
All ways of which involve splitting the day or week into eating and fasting periods.
During the fasting periods, you eat either very little or nothing at all.
don't compensate by eating much more during the eating periods.
By reducing calorie intake, all of these methods should cause weight loss

33. ADF (75% restriction on day 1, 25% surplus on day 2) (Klempel et al., 2013)
They tested this with low fat and high fat versions (all food was provided and both diets worked, with a modest advantage of HF over
LF): Fat mass declined slightly more on HF, and muscle actually increased in both groups, slightly more on HF. The
changes in muscle mass are surprising, as there was no exercise intervention and protein was held at 15% in both groups (but varied
between 19 & 94 grams/d).
Weight loss with fasting

34. ‫البخاري‬ ‫روى‬(2457)‫ومسلم‬(4603)‫ْن‬‫ب‬ َ‫ان‬َ‫ر‬ْ‫م‬ِ‫ع‬ ‫عن‬
‫ه‬‫ل‬َ‫ص‬ ِ ‫ه‬‫اَّلل‬ َ‫ل‬‫و‬ُ‫س‬َ‫ر‬ ‫ه‬‫ن‬َ‫أ‬ ‫عنه‬ ‫هللا‬ ‫رضي‬ ٍ‫ْن‬‫ي‬َ‫ص‬ُ‫ح‬َ‫ق‬ َ‫م‬‫ه‬‫ل‬َ‫س‬َ‫و‬ ِ‫ه‬ْ‫ي‬َ‫ل‬َ‫ع‬ ُ ‫ه‬‫اَّلل‬ ‫ى‬َ‫ل‬‫ا‬:
(َ‫ن‬‫و‬ُ‫ل‬َ‫ي‬ َ‫ِين‬‫ذ‬‫ه‬‫ل‬‫ا‬ ‫ه‬‫م‬ُ‫ث‬ ، ‫ي‬ِ‫ن‬ْ‫ر‬َ‫ق‬ ْ‫م‬ُ‫ك‬َ‫ْر‬‫ي‬َ‫خ‬ ‫ه‬‫ن‬ِ‫إ‬ُ‫ث‬ ، ْ‫م‬ُ‫ه‬َ‫ن‬‫و‬ُ‫ل‬َ‫ي‬ َ‫ِين‬‫ذ‬‫ه‬‫ل‬‫ا‬ ‫ه‬‫م‬ُ‫ث‬ ، ْ‫م‬ُ‫ه‬‫ه‬‫م‬
ْ‫م‬ُ‫ه‬َ‫ن‬‫و‬ُ‫ل‬َ‫ي‬ َ‫ِين‬‫ذ‬‫ه‬‫ل‬‫ا‬.ُ‫ان‬َ‫ر‬ْ‫م‬ِ‫ع‬ َ‫ل‬‫ا‬َ‫ق‬:ِ‫ْر‬‫د‬َ‫أ‬ َ‫َل‬َ‫ف‬‫ا‬ ‫ى‬‫ه‬‫ل‬َ‫ص‬ ِ ‫ه‬‫اَّلل‬ ُ‫ل‬‫و‬ُ‫س‬َ‫ر‬ َ‫ل‬‫ا‬َ‫ق‬َ‫أ‬ ‫ي‬ُ ‫ه‬‫َّلل‬
َ‫أ‬ ِ‫ْن‬‫ي‬َ‫ت‬‫ه‬‫ر‬َ‫م‬ ِ‫ه‬ِ‫ن‬ْ‫ر‬َ‫ق‬ َ‫د‬ْ‫ع‬َ‫ب‬ َ‫م‬‫ه‬‫ل‬َ‫س‬َ‫و‬ ِ‫ه‬ْ‫ي‬َ‫ل‬َ‫ع‬ً‫ة‬َ‫ث‬ َ‫َل‬َ‫ث‬ ْ‫و‬.
َ‫َل‬َ‫و‬ َ‫ُون‬‫د‬َ‫ه‬ْ‫ش‬َ‫ي‬ ٌ‫م‬ ْ‫و‬َ‫ق‬ ْ‫م‬ُ‫ه‬َ‫د‬ْ‫ع‬َ‫ب‬ ُ‫ُون‬‫ك‬َ‫ي‬ ‫ه‬‫م‬ُ‫ث‬َ‫و‬ َ‫ون‬ُ‫ن‬‫و‬ُ‫خ‬َ‫ي‬َ‫و‬ ، َ‫ُون‬‫د‬َ‫ه‬ْ‫ش‬َ‫ت‬ْ‫س‬ُ‫ي‬َ‫َل‬
، َ‫ون‬ُ‫ف‬‫و‬ُ‫ي‬ َ‫َل‬َ‫و‬ َ‫ون‬ُ‫ِر‬‫ذ‬ْ‫ن‬َ‫ي‬َ‫و‬ ، َ‫ون‬ُ‫ن‬َ‫م‬َ‫ت‬ْ‫ؤ‬ُ‫ي‬َ‫ي‬َ‫و‬ُ‫ن‬َ‫م‬ِِّ‫س‬‫ال‬ ْ‫م‬ِ‫يه‬ِ‫ف‬ ُ‫ر‬َ‫ه‬ْ‫ْظ‬).
‫على‬ ‫دَللة‬ ‫الرجل‬ ‫في‬ ‫وهي‬ ،‫الساعة‬ ‫عَلمات‬ ‫من‬ ‫فالسمنة‬
‫للبدن‬ ‫إعمال‬ ‫وعدم‬ ‫والتنعم‬ ‫الترفه‬.

35. Insulin dosage &
glycosylated haemoglobin
with fasting)
Re adjust the dosage of
anti diabetic drugs with
Bariatric surgery and
Fasting

36. •Improved mental clarity and concentration
•Weight and body fat loss
•Reduction of inflammation
•Lowered blood insulin and sugar levels
•Reversal of type 2 diabetes
•Increased energy
•Improved fat burning
•Increased growth hormone
•Lowered blood cholesterol
•Prevention of Alzheimer’s disease (potential)
•Longer life (potential)
•Activation of cellular cleansing (potential) by stimulating autophagy
(a discovery that was awarded the 2016 Nobel Prize in medicine)
Some of the purported physical benefits of
fasting include
Dr. Yoshinori Ohsumi
Dr. Jason Fung

37. Changes The Function of Cells, Genes and Hormones
When you fast, insulin levels drop and human growth hormone increases. Your cells also
initiate important
cellular repair processes and change which genes they express.
Help You Lose Weight and Belly Fat
Intermittent fasting helps you eat fewer calories, while boosting metabolism slightly. It is a
very effective tool to lose weight and belly fat.
.1Reduce Insulin Resistance, Lowering Your Risk of Type 2 Diabetes
Intermittent fasting can reduce insulin resistance and lower blood sugar levels, at least in
men.
Reduce Oxidative Stress and Inflammation in The Body
Studies show that intermittent fasting can reduce oxidative damage and inflammation in the
body. This should have benefits against aging and development of numerous diseases.
May be Beneficial For Heart Health
Studies show that intermittent fasting can improve numerous risk factors for heart disease
such as blood pressure, cholesterol levels, triglycerides and inflammatory markers.
10 Evidence-Based Health Benefits of Intermittent Fasting
Written by Kris Gunnars, BSc on August 16, 2016

38. 10 Evidence-Based Health Benefits of Intermittent Fasting
Written by Kris Gunnars, BSc on August 16, 2016
Induces Various Cellular Repair Processes
Fasting triggers a metabolic pathway called autophagy, which removes waste material from
cells.
May Help Prevent Cancer
Intermittent fasting has been shown to help prevent cancer in animal studies. One paper in
humans showed that it can reduce side effects caused by chemotherapy.
Good For Your Brain
Intermittent fasting may have important benefits for brain health. It may increase growth of
new neurons
and protect the brain from damage
May Help Prevent Alzheimer's Disease
Studies in animals suggest that intermittent fasting may be protective against
neurodegenerative diseases
like Alzheimer's disease
May Extend Your Lifespan, Helping You Live Longer
Given the known benefits for metabolism and all sorts of health markers, it makes sense that
intermittent fasting could help you live a longer and healthier life.

39. Effect of intermittent fasting and refeeding on insulin action in healthy men
Nils Halberg, Morten Henriksen, Nathalie Söderhamn, Bente Stallknecht, Thorkil Ploug, Peter Schjerling, Flemming Dela
Journal of Applied Physiology Published 1 December 2005 Vol. 99 no. 6, 2128-2136 DOI: 10.1152/japplphysiol.00683.2005
Intermittent fasting 20h every second day for 15
days. :
1- Increased the insulin sensitivity 7 folds (2)
2- Decreased the incidence of diabetes (32).
3- Decrease in circulating leptin after 8–20 h of
fasting
We mimicked the fluctuations in eight healthy young men [25.0 ± 0.1 yr (mean ± SE); body
mass index: 25.7 ± 0.4 kg/m2] by subjecting them to intermittent fasting every second day
for 20 h for 15 days.
This study was undertaken to test the hypothesis that 14 days of intermittent fasting and
refeeding improves insulin-stimulated glucose disposal.

40. Intermittent
fasting Safety
and Limitations

41. A 2014 review have shown
fasting improves indicators of health
Blood pressure
Insulin sensitivity
Inflammation
Cellular responses to stress
Reduce the risk of chronic diseases
cancer
Limitations
Intermittent fasting not studied
in children
the elderly
the underweight
and could be harmful in this population
fast for periods of time greater than 24
hours
should be monitored by a physician, as
changes to the gastrointestinal system
or circadian rhythm can occur
Safety and Contraindications
Underweight
Pregnant
Breastfeeding
Have an eating disorder
Intermittent fasting Safety and Limitations
Fasting is unlikely to have much effect on
conditions other than obesity, such as aging
or other chronic condition
unless combined with moderate calorie
restriction and plant-based diet such as the
Mediterranean diet.[7]

42. Who Should Be Careful Or Avoid It?
Intermittent fasting is certainly not for everyone.
If you’re underweight or have a history of eating disorders, you should not fast without
consulting with a health professional first.
In these cases, it can be downright harmful.
Should Women Fast?
There is some evidence that intermittent fasting may not be as beneficial for women as it is for
men.
For example, one study showed that it improved insulin sensitivity in men, but worsened blood
sugar control in women (33).
Though human studies on this topic are unavailable, studies in rats have found that
intermittent fasting can make female rats emaciated, masculinized, infertile and cause them to
miss cycles (34, 35).
There are a number of anecdotal reports of women whose menstrual period stopped when
they started doing IF and went back to normal when they resumed their previous eating
pattern.
For these reasons, women should be careful with intermittent fasting.
They should follow separate guidelines, like easing into the practice and stopping immediately if
they have any problems like amenorrhea (absence of menstruation).
If you have issues with fertility and/or are trying to conceive, consider holding off on intermittent
fasting for now. This eating pattern is likely also a bad idea if you’re pregnant or breast
feeding.

43. Safety and Side Effects
Hunger is the main side effect of intermittent fasting.
You may also feel weak and your brain may not perform as well as you're used to.
This may only be temporary, as it can take some time for your body to adapt to the new meal
schedule.
If you have a medical condition, you should consult with your doctor before trying
intermittent fasting.
•Have diabetes.
•Have problems with blood sugar regulation.
•Have low blood pressure.
•Take medications.
•Are underweight.
•Have a history of eating disorders.
•Are a woman who is trying to conceive.
•Are a woman with a history of amenorrhea.
•Are pregnant or breast feeding.
SUMMARY:
1- Intermittent fasting has an outstanding safety profile. There is nothing dangerous about not
eating for a while if you’re healthy and well-nourished overall.
2- The most common side effect of intermittent fasting is hunger. People with certain medical
conditions should not fast without consulting with a doctor first

44. Fasting safety and Limitations was answered >1400 y
Limitations
Intermittent fasting not studied
in children
the elderly
the underweight
and could be harmful in this
population
fast for periods of time greater than
24 hours
should be monitored by a physician,
as changes to the gastrointestinal
system or circadian rhythm can occur
Safety and Contraindications
Underweight
Pregnant
Breastfeeding
Have an eating disorder

46. Fasting safety and Limitations was answered
>1400 y
‫الصوم‬ ‫وصال‬ ‫وكراهة‬ ‫عن‬ ‫النهي‬
‫قال‬ ‫وسلم‬ ‫عليه‬ ‫هللا‬ ‫صلى‬ ‫النبي‬ ‫أن‬ ‫هريرة‬ ‫أبي‬ ‫عن‬" :‫والوصال‬ ‫إياكم‬"-‫ثَلث‬ ‫قالها‬
‫مرات‬-‫قالوا‬:‫قال‬ ‫هللا؟‬ ‫رسول‬ ‫يا‬ ‫تواصل‬ ‫فإنك‬:"‫أبيت‬ ‫إني‬ ،‫مثلي‬ ‫ذلك‬ ‫في‬ ‫لستم‬ ‫إنكم‬
‫يطعمني‬(2)،‫ويسقيني‬ ‫ربي‬‫تطيقون‬ ‫ما‬ ‫اَلعمال‬ ‫من‬ ‫فاكلفوا‬"‫ومسلم‬ ‫البخاري‬ ‫رواه‬.
‫وسلم‬ ‫عليه‬ ‫هللا‬ ‫صلى‬ ‫قوله‬:(َ‫د‬َ‫ب‬َ ْ‫اْل‬ َ‫م‬‫ا‬َ‫ص‬ ْ‫ن‬َ‫م‬ َ‫م‬‫ا‬َ‫ص‬ َ‫َل‬)‫البخاري‬ ‫رواه‬(1977)‫ومسلم‬
(1159)
‫وسلم‬ ‫عليه‬ ‫هللا‬ ‫صلى‬ ‫هللا‬ ‫رسول‬ ‫سأل‬ ‫أنه‬ ‫عنه‬ ‫هللا‬ ‫رضي‬ ‫الخطاب‬ ‫بن‬ ‫عمر‬ ‫وعن‬( :
َ‫ل‬‫ا‬َ‫ق‬ ‫؟‬ ُ‫ه‬‫ه‬‫ل‬ُ‫ك‬ َ‫ر‬ْ‫ه‬‫ه‬‫د‬‫ال‬ ُ‫م‬‫و‬ُ‫ص‬َ‫ي‬ ْ‫ن‬َ‫م‬ِ‫ب‬ َ‫ْف‬‫ي‬َ‫ك‬:ْ‫ف‬َ‫أ‬ َ‫َل‬َ‫و‬ َ‫م‬‫ا‬َ‫ص‬ َ‫َل‬َ‫ر‬َ‫ط‬)‫مسلم‬ ‫رواه‬(1162)
ِ‫ه‬‫َّللا‬ َ‫ول‬ ُ‫س‬َ‫ر‬ ‫ه‬‫َن‬‫أ‬ ‫ا‬َ‫هم‬ْ‫ن‬َ‫ع‬ ‫هم‬‫ه‬‫ل‬‫ال‬ ‫ي‬ ِ‫ض‬َ‫ر‬ ‫و‬ٍ‫ر‬ْ‫م‬َ‫ع‬ ِ‫ن‬ْ‫ب‬ ِ‫ه‬‫َّللا‬ ِ‫د‬ْ‫ب‬َ‫ع‬ ْ‫ن‬َ‫ع‬َ‫ال‬َ‫ق‬ َ‫م‬‫ه‬‫ل‬ َ‫س‬َ‫و‬ ِ‫ه‬ْ‫ي‬َ‫ل‬َ‫ع‬ ‫هم‬‫ه‬‫ل‬‫ال‬ ‫ى‬‫ه‬‫ل‬ َ‫ص‬
ُ‫ه‬َ‫ل‬:
:‫إني‬ ‫قلت‬ ‫السَلم‬ ‫عليه‬ ‫داود‬ ‫صيام‬ ‫وهو‬ ‫الصيام‬ ‫أعدل‬ ‫وهو‬ ‫يوما‬ ‫وأفطر‬ ‫يوما‬ ‫صم‬
‫وسلم‬ ‫عليه‬ ‫هللا‬ ‫صلى‬ ‫هللا‬ ‫رسول‬ ‫فقال‬ ‫ذلك‬ ‫من‬ ‫أفضل‬ ‫أطيق‬:‫ذلك‬ ‫من‬ ‫أفضل‬ ‫َل‬
(‫داود‬ ‫وأبي‬) ( ‫مسلم‬ ‫)صحيح‬

47. 1- Compliance is poor with multiday water
fasting
2- Catabolism (breakdown) vs. Anabolism
(regeneration)
•Many of the benefits of fasting occur when you
refeed, and this is why cycling in and out of
fasting and feasting is so valuable. Half of the
process occurs in the absence of food, while the
other half occurs when food is reintroduced
How to Make Fasting Easier, Safer and
More Effective
Analysis by Dr. Joseph Mercola Fact Checked - April 30,
2019
‫تطيقون‬ ‫ما‬ ‫اَلعمال‬ ‫من‬ ‫فاكلفوا‬”
‫ومسلم‬ ‫البخاري‬ ‫رواه‬

48. 3- Fat soluble Toxins
in the 21st century we have increased toxic
exposure that makes it potentially dangerous
to do extended water fasts.
The reason for my change in view is because
our toxic exposures have dramatically
increased, which makes fasting riskier now
than it ever was historically.
The body's seven cleansing systems are the liver, lungs, lymphatic system; the
blood, the skin, colon and the kidneys. Each has it own unique purpose and way of
assisting the human body to detoxify. The liver is one of the largest and most
important organs in your body.
Phase II detoxification involves conjugation, which means that a protective
compound becomes bound to the toxin. Besides glutathione conjugation there are
essentially five other processes: amino acid conjugation, methylation, sulfation,
sulfoxidation, acetylation and glucuronidation.
How to Make Fasting Easier, Safer and More Effective
Analysis by Dr. Joseph Mercola Fact Checked - April 30, 2019

49. Intermittent fasting is not something that anyone needs to do.
It’s simply one of many lifestyle strategies that can improve your health.
Still the most important factors to focus on.
1- Eating real food,
2- Exercising
3- taking care of your sleep
The best diet for you is the one you can stick to in the long run.
Intermittent fasting is great for some people, not others. The only way to
find out which group you belong to is to try it out.
If you feel good when fasting and find it to be a sustainable way of eating,
it can be a very powerful tool to lose weight and improve health.
Should You Try It ?

50. You've already done many intermittent fasts in your life. Simply by skip meals
from time to time when you're not hungry or don't have time to cook
If you skip ‘breakfast , then you've probably already fasted for 16+ hours.
Some people instinctively eat this way. They simply don't feel hungry in the
morning.
- It's recommended to start with the 16/8 method,
- If you find it easy and feel good during the fast, then may be try moving on
to more advanced fasts like 24-hour fasts 1–2 times per week (Eat-Stop-Eat)
- or only eating 500–600 calories 1–2 days per week (5:2 diet).
There is no need to follow a structured intermittent fasting plan to derive at
least some of the benefits.
Experiment with the different approaches and find something that you enjoy,
fits your schedule and works for you.
Getting Started

51. Fasting Tricks and Tips
1. Food choices matter.
2. Be patient. It can take 3-6 weeks to get
comfortable with it
3. Exercise helps
4. Timing is everything, you need to figure out your
optimal fasting length
5. Progress slowly, don’t jump straight into 24-36
hour fasts
6. Don’t overdo it: fasting daily is called an eating
disorder
7. Eat protein
8. It’s still a lifestyle: you can’t do it for a month, then
stop
9. Some shouldn’t do it: if you have a history of
disordered eating. if you have a really fast
metabolism.

52. SUMMARY

53. Metabolic Syndrome reaches an epidemic in MENA
No cure by insulin, drugs, low fat diet
Can be Cured by bariatric surgery, fasting, very low
carb diet
SUMMARY
Our bodies are very well equipped to go without
food for 1-2 days at a time.
There is no significant detriment to our health.
We can survive many weeks without food!
Intermittent Fasting offers
1- Fasting Benefits
2- Health Benefits

54. SUMMARY
Fasting Benefits:
Rules are easy to understand
(not necessarily follow)
Did you eat something? Yes/No
Less emphasis on weighing/measuring
Not as important to consider low Carb vs. low fat
Dramatic calorie cuts (in a single day, followed by regular eating)
may make it tougher for metabolism to down-regulate
Less food prep and eating time
Cheaper than other diets
Removing entire meals as opposed to buying less calorie dense foods

55. SUMMARY
Health Benefits of Intermittent Fasting:
1- fat-burning maintain a healthy body weight
2- Rise of human growth hormone (HGH)
The only other thing that can compete in terms of dramatically boosting HGH levels is high-
intensity interval training
3- Normalizing insulin and leptin sensitivity
which is key for optimal health
4- Normalizing Ghrelin levels
also known as "the hunger hormone
5- Lowering triglyceride levels
6- Improving biomarkers of disease
7- Reducing inflammation and lessening free radical damage
8- Preserving memory functioning and learning

56. SUMMARY
Health Benefits of Intermittent
Fasting:
Reduced
blood lipids
blood pressure
markers of inflammation
oxidative stress
Cancer
Increased
cell turnover and repair
fat burning
growth hormone release
metabolic rate.
Improved
appetite control
blood sugar control
cardiovascular function
neuronal plasticity

57. Intermittent Fasting vs Dieting regime
Instead of trying to create a deficit of 300-500 kcal/day
(dieting regime)
you are making deficits of 1500-2000 kcal
a couple of days a week
Intermittent Fasting vs Bariatric
surgery
Studies show that fasting is actually
superior to surgery in both weight loss
and reduction in blood sugars.
SUMMARY

58. Intermittent fasting Makes Your Healthy
Lifestyle Simpler
Eating healthy is simple, but it can be incredibly
hard to maintain.
One of the main obstacles is all the work
required to plan for and cook healthy meals.
Intermittent fasting can make things easier, as
you don't need to plan, cook or clean up after
as many meals as before.
For this reason, intermittent fasting is very
popular among the life-hacking crowd, as it
improves your health while simplifying your life
at the same time.
SUMMARY: One of the major benefits of
intermittent fasting is that it makes healthy
eating simpler. There are fewer meals you need
to prepare, cook and clean up after.
Fasting offers many important unique advantages
that are not available in typical diets:
Where diets complicate life, fasting simplifies.
Where diets are expensive, fasting is free.
Where diets can take time, fasting saves time.
Where diets are limited, fasting is available
anywhere.
Where diets have variable efficacy, fasting has
unquestioned efficacy.
There is no more powerful method for lowering
insulin and decreasing body weight.

59. ‫مسلم‬ ‫روى‬(1154)َ‫ع‬ ُ ‫ه‬‫اَّلل‬ َ‫ي‬ ِ‫ض‬َ‫ر‬ َ‫ين‬ِ‫ن‬ِ‫م‬ْ‫ؤ‬ُ‫م‬ْ‫ل‬‫ا‬ ِِّ‫م‬ُ‫أ‬ َ‫َة‬‫ش‬ِ‫ئ‬‫َا‬‫ع‬ ْ‫َن‬‫ع‬ْ‫ت‬َ‫ل‬‫ا‬َ‫ق‬ ‫ا‬َ‫ه‬ْ‫ن‬:ُ‫ل‬‫و‬ُ‫س‬َ‫ر‬ ‫ي‬ِ‫ل‬ َ‫ل‬‫ا‬َ‫ق‬
ٍ‫م‬ ْ‫و‬َ‫ي‬ َ‫ات‬َ‫ذ‬ َ‫م‬‫ه‬‫ل‬َ‫س‬َ‫و‬ ِ‫ه‬ْ‫ي‬َ‫ل‬َ‫ع‬ ُ ‫ه‬‫اَّلل‬ ‫ى‬‫ه‬‫ل‬َ‫ص‬ ِ ‫ه‬‫اَّلل‬:َ‫ش‬ِ‫ئ‬‫َا‬‫ع‬ ‫ا‬َ‫ي‬ْ‫ت‬َ‫ل‬‫ا‬َ‫ق‬ ‫؟‬ ٌ‫ء‬ْ‫ي‬َ‫ش‬ ْ‫م‬ُ‫ك‬َ‫د‬ْ‫ن‬ِ‫ع‬ ْ‫ل‬َ‫ه‬ ، ُ‫ة‬:ْ‫ل‬ُ‫ق‬َ‫ف‬ُ‫ت‬:
َ‫ل‬‫ا‬َ‫ق‬ ، ٌ‫ء‬ْ‫ي‬َ‫ش‬ ‫ا‬َ‫ن‬َ‫د‬ْ‫ن‬ِ‫ع‬ ‫ا‬َ‫م‬ ِ ‫ه‬‫اَّلل‬ َ‫ل‬‫و‬ُ‫س‬َ‫ر‬ ‫ا‬َ‫ي‬:ٌ‫م‬ِ‫ئ‬‫ا‬َ‫ص‬ ‫ي‬ِِّ‫ن‬ِ‫إ‬َ‫ف‬. )
‫النسائي‬ ‫ورواه‬(2330)‫بلفْظ‬:ِ‫ه‬ْ‫ي‬َ‫ل‬َ‫ع‬ ُ ‫ه‬‫اَّلل‬ ‫ى‬‫ه‬‫ل‬َ‫ص‬ ِ ‫ه‬‫اَّلل‬ ُ‫ل‬‫و‬ُ‫س‬َ‫ر‬ َ‫ء‬‫ا‬َ‫ج‬َ‫ل‬‫ا‬َ‫ق‬َ‫ف‬ ‫ا‬ً‫م‬ ْ‫و‬َ‫ي‬ َ‫م‬‫ه‬‫ل‬َ‫س‬َ‫و‬:
(ُ‫ت‬ْ‫ل‬ُ‫ق‬ ‫؟‬ٍ‫ام‬َ‫ع‬َ‫ط‬ ْ‫ن‬ِ‫م‬ ْ‫م‬ُ‫ك‬َ‫د‬ْ‫ن‬ِ‫ع‬ ْ‫ل‬َ‫ه‬:َ‫ل‬‫ا‬َ‫ق‬ ، َ‫َل‬:ُ‫م‬‫و‬ُ‫ص‬َ‫أ‬ ‫ا‬ً‫ذ‬ِ‫إ‬. )
Intermittent fasting Makes Your Healthy
Lifestyle Simpler
The Prophet Mohammad piece be upon him on any
day he do not find food he simply fast that day.

60. Patient compliance and willpower
POP cast
vs.
Patient Education
Intermittent fasting
vs.
Beriatric surgery
VS
Dieting regime
a personalized weight-loss plan that’s tailored to your goals and needs.

61. The Best Intermittent Fasting Books of 2019

63. Other Benefits of Fasting
Fasting is also known to provide many other health benefits, including
Stem cell activation — Stem cells play an important role in health and longevity as they are
instrumental in repairing and rejuvenating your cells and tissues. By upregulating autophagy and
mitophagy (autophagy in your mitochondria) 9 and boosting stem cells you will lower your risk of most
diseases, including cancer10 and neurodegeneration.11
Nutrient composition is important here, and in "KetoFast" I provide details on how to optimize
autophagy and stem cell activation processes by eating certain foods (and avoiding others) at the right
time.
Releasing ketones into your bloodstream, which help preserve brain function and protect against
epileptic seizures, cognitive impairment12 and other neurodegenerative diseases.
Boosting brain-derived neurotrophic factor, which stimulates creation of new brain cells and
triggers brain chemicals that protect against brain changes associated with Alzheimer's and Parkinson's
disease.13,14
Increasing growth hormone by as much as 1,300 percent in women and 2,000 percent in
men,15thereby promoting muscle development and vitality.

64. Other Benefits of Fasting
Fasting is also known to provide many other health benefits, including
Lowering insulin and improving your insulin sensitivity; studies have shown
intermittent fasting can both prevent and reverse Type 2 diabetes, which is rooted in insulin
resistance.16,17,18,19
Increasing levels of the neurotransmitter norepinephrine, which helps your body break down
fat to be used as fuel and benefits your metabolism.20,21,22
Lowering oxidative stress and inflammation.23
Improving circulating glucose24 and lipid levels.
Reducing blood pressure.
Reproducing some of the cardiovascular benefits associated with exercise.
Regenerating the pancreas25 and improve pancreatic function, reversing diabetes.
Improving gut health — While the exact mechanisms are still unclear, I believe fasting helps jump-
start microbiome health by increasing bacterial diversity and repairing leaky gut. Overall, fasting
facilitates healing of your gastrointestinal tract and enhances the integrity of your gut lining.

65. Protecting against cardiovascular disease.
Reducing low-density lipoprotein and total cholesterol.
Improving immune function.26
Synchronizing your body's biological clocks.27
Eliminating sugar cravings as your body adapts to burning fat instead of sugar.
Increasing longevity — There are a number of mechanisms contributing to this effect. Normalizing
insulin sensitivity is a major one, but fasting also inhibits the mTOR pathway, which plays an
important part in driving the aging process.
Other Benefits of Fasting
Fasting is also known to provide many other health benefits, including

66. ْ‫ن‬ُ‫ك‬ ْ‫ن‬ِ‫إ‬ ْ‫م‬ُ‫ك‬َ‫ل‬ ٌ‫ر‬ْ‫ي‬َ‫خ‬ ‫وا‬ُ‫م‬‫و‬ُ‫ص‬َ‫ت‬ ْ‫ن‬َ‫أ‬َ‫و‬َ‫ون‬ُ‫م‬َ‫ل‬ْ‫ع‬َ‫ت‬ ْ‫م‬ُ‫ت‬.
(‫سورةالبقرة‬:183-184)
(You are required to fast) for a prescribed number of days. But if
anyone of you is sick or is on a journey he shall fast (to make up) the
prescribed number in other days. And for those who are able to fast
is an expiation (as thanksgiving) the feeding of a poor person (daily
for the days of fasting). And he who volunteers (extra) good, (will
find that) it is even better for him. And that you observe fasting is
better for you, if you only know.
184 AL-Baqarah