Friday Q&A: intermittent fasting; APOE4 testing for Alzheimer’s; Pap test frequency; & at-home menopause tests

Something for everyone this week 🥳

ICYMI 👉

• Do You Get in Your Own Way?

• It’s Okay to Not be Okay

• The Food Group You May Be Missing

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The first question (on intermittent fasting) is free for all subscribers. Questions 2-4 (about APOE4 gene testing for Alzheimer's; abandoning yearly Pap testing; & at-home menopause tests) are for paid subscribers only. If you would like a paid subscription but it’s not in your budget, please message me directly.

Click here to submit your questions (about anything) for future Q&A posts!

Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.

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QUESTION #1: INTERMITTENT FASTING

Do you have any advice or recommendations regarding intermittent fasting?

-Rebecca

Dear Rebecca,

In my experience, some people find that putting a fence around their eating habits helps them stay accountable to their goals—either to lose weight or improve their metabolism. If it works for you, that’s great!

However, I find that most of my patients who try intermittent fasting report feeling irritable, unfocused, or “hangry”—ultimately making this type of routine difficult to adhere to. Additionally, restrictive eating behaviors are never a good idea for people with disordered eating.

Some experts believe that intermittent fasting works by a process called metabolic switching, which basically puts the body into a fasting state, allowing fat cells to be used instead of glucose as energy. In general, we know that loss of excess adipose tissue is associated with a decreased risk of hypertension, diabetes and cardiovascular disease.

However, the data on intermittent fasting is mixed. Its effectiveness seems to depend entirely on the person. (Here is an excellent piece about intermittent fasting by the ever-sensible primary care physician,

Adam Cifu, MD

.)

The upshot? Extreme diets typically don’t work in the end. Whether it’s with weight loss or any other health goal, we pave the way for long-term success when lifestyle changes are realistic and sustainable first.  

Photo by Jay Castor on Unsplash

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QUESTION #2: APOE4 GENE TESTING FOR ALZHEIMER’S

When, if ever, do you recommend a patient find out their APOE status? I am prone to health anxiety, but I also hear there are lifestyle interventions you should take if you carry an APOE4 gene. Thanks!

-Amanda

Dear Amanda,