This is the most restrictive phase of the diet, but it lasts only two weeks. Two weeks isn’t very long—especially when the restriction is limited to every other day, which means a total of only seven days!
During this time you will be restricting your down-day calorie intake to no more than 20 percent of what you would normally eat. To simplify matters for you, I’ve rounded this off to 500 calories, which is about 20 percent of the total calories eaten daily by the average overweight woman. I arrived at that number based on a couple of criteria. First, if you consume 20 percent of your normal calories on alternate days, you will be reducing your total calorie consumption by 40 percent a day (a total reduction of 80 percent—on the down day—spread over a two-day period), which means that, on average, you’ll be eating 60 percent of what you would eat normally, which is the figure that has been shown by various studies to be maximally effective in prolonging the lifespan of a number of species. And second, I thought—and later proved through the Asthma Study as well as my own experience and that of others who have tried it—that eating 20 percent of what they normally would every other day is tolerable for most people.
USE A MEAL-REPLACEMENT SHAKE TO CONTROL DOWN-DAY CALORIES
For the first two weeks, you will be getting your 500 down-day calories specifically from meal-replacement shakes such as Slim Fast, Ensure, Atkins, and Zone, to name the most popular and widely available. In fact, if you don’t use the shakes in place of regular food on your first two weeks of down days, you will probably not be successful. This statement is based not only on my own experience and that of my patients but also on the many studies of meal-replacement shakes that confirm their usefulness in helping people adhere to their intended intake.
There are several reasons for this.
• Accuracy: The meal-replacement shake makes it easy to determine how many calories you are actually consuming.
Eating regular food on a down day is likely to allow denial and rationalization to creep in. Studies have shown most people are not capable of accurately judging how much they eat because the powerful survival instinct to eat overwhelms our conscious intentions. One of the main reasons people fail at diets is the rationalization that unconsciously allows us to lie to ourselves about how much we are consuming.
• You won’t have to think about what you’re going to eat next, which means that you won’t be thinking about food all the time. Soon you will notice that you have far fewer thoughts about food on your down days.
• Because these drinks, while certainly palatable, are not generally “taste treats,” you won’t be tempted to have more than you should just because it tastes good, so you’ll be much more likely to eat (or drink) only when you’re actually hungry, which will also give you a better sense of what hunger actually feels like.
• Shakes are portable and easy to carry with you throughout the day so that you can have a sip when you feel overwhelmed by hunger.
Canned shakes vary in protein, fat, and carbohydrate content. Those that are lowest in carbohydrates and sugar are preferable because a higher sugar content will stimulate insulin, which turns off SIRT1. But the amount of sugar in the shake is less important than the total calories you consume, so find the one that is most palatable for you.
Making the Most of Your Shake
Rather than consuming your entire shake all at once, you’ll be drinking small amounts (1 to 5 ounces at a time) throughout the day and evening. This will minimize not only your feelings of hunger but also your body’s reaction to the calories, and thus will help to intensify the SIRT1 gene-activating mechanism.
WHAT TO EXPECT ON THE DOWN DAYS
Your first down day will certainly be the hardest. At first you may think that it will be impossible for you to get through the day on just 20 percent of what you’ve been eating. Then, after you have 100 or 200 calories in the form of a shake for breakfast and again for lunch, you’ll realize that although you may not be full, you are not starving, and you actually feel good. This will undoubtedly come as a delightful surprise.
The real temptation invariably comes between 11 a.m. and 2:30 p.m., when you feel you have to eat in order to perform optimally. But, as you’ll discover after just a few days, you really don’t need to eat.
By late afternoon you’ll undoubtedly be assaulted by both hunger and fatigue. When this happens, you can restore yourself with a few minutes’ rest and/or meditation, drinking water to rehydrate yourself, and another 100 calories from your shake.
Dinnertime can also be a challenge because sharing a meal is so much a part of the social ritual. You can, however, participate in the social interaction even if you’re only drinking the shake.
The hours between dinner and bedtime may be the most challenging of all, because you won’t be distracted by work or other daily activities. It’s important to have a procedure to follow when the pressure to eat seems to be too great: Sit down, close your eyes, take four deep breaths, inhale/exhale slowly, visualize your thin body enjoying yourself, remind yourself why you are doing this, and recite the Alternate-Day mantras (“I’ll eat tomorrow,” “Don’t blow it,” “Get busy,” “It’s worth it.”). Get outside yourself by engaging someone else (help your children with their homework, etc.), call a supportive friend or relative, or engage yourself in some simple, repetitive task.
Save 100 or 200 calories for bedtime to help you fall asleep, and go to bed early. Most of us are sleep-deprived anyway.
After just three or four days, you’ll notice that you don’t feel as hungry, your down days will become easier—in fact, you’ll actually begin to look forward to how you feel, because you’ll be experiencing an improvement in energy and mood. Alternate-Day dieters often describe this as feeling “wired,” “euphoric,” “like being in love,” or “like the Energizer Bunny.”
Additionally, the alternate-day eating pattern appears to create an unconscious habit that suppresses thoughts of hunger and food. The universal experience of those on the diet is that they are much less aware of hunger or thoughts about food, so, in effect, their perceived hunger is greatly reduced. In other words, just as practice builds muscle memory when you’re learning to play a sport, our minds learn to not think about what we have made a decision not to think about.
DOWN-DAY STRATEGIES TO STAVE OFF HUNGER
I’m not saying that you won’t ever be hungry on your down days. But your down days are only 24 hours long, and, it is hoped, for about 8 of those hours you’ll be sleeping. There are, however, some simple strategies you can use to stay strong when you think you’re going to blow it.
• When you think you must eat, wait a few minutes. More often than not, the craving will have passed. Hunger pangs occur in waves every 2 to 3 hours and typically last 15 to 20 minutes. Remind yourself that the hunger will go away if you can distract yourself for that short period of time.
• If you still think you’re hungry, take a sip of your shake. After you’ve had a couple of sips, your hunger will probably be alleviated.
• Drink calorie-free liquids as much as you want on the down day to avoid becoming dehydrated, which can make you feel weak and tired and make you think you’re hungry. Many of us tend to think we’re hungry when we’re really just thirsty. And the water will also fill you up for a while. As a guideline, drink at least 2 liters of calorie-free liquid in addition to the shake. Coffee, diet colas, and the like are okay (in fact, caffeine may raise your blood sugar slightly and reduce feelings of hunger), but it is best not to take in too much caffeine: it may make you feel overstimulated because of the energizing effect of the diet.
• Get involved in an activity you enjoy that occupies your mind and your hands. It’s hard to think about two things at once, and if your hands are busy, you won’t be using them to eat.
• Call somebody. Mutual support helps you to stay with the program.
• Sit down, close your eyes, and tell yourself to relax. Take four deep breaths, exhaling slowly, and rest for 5 minutes.
• Visualize yourself thin, enjoying yourself, and recite the reasons you are following the diet: to enjoy better health, to live longer, to feel happy about the way you look.
• Use the following aphorisms to boost your resolve:
• I will eat tomorrow, or I can always eat tomorrow.
• Put off until tomorrow what you can’t eat today.
• It’s the calories, stupid!
• It’s not the carbs, it’s the calories, sweetie!
• Rx Food: Take only as directed.
• Surgeon general’s warning: Overeating may be injurious to your health.
• If not now, when?
• I’ll be around for my family.
• It’s worth it!
WHAT ABOUT THE UP DAYS?
This is the part you want to hear: On the up days eat anything you want. Particularly when you start the diet, it’s important to feel that you can have anything you want to eat every other day so that you avoid the sense of deprivation that sets in with other diets. Remember, compliance is everything, and most people who tend to be overweight have tried numerous diets, have developed a sense of frustration and failure, and envision the future as an infinite horizon of hunger and deprivation. The up days on this diet are your insurance that no matter what you’re feeling today, you can always eat tomorrow. And if you’re sticking to 20 percent of normal calorie intake on your down days, you’d have to eat a whopping 180 percent on your up days just to come out even. As a practical matter, this just doesn’t happen, at least in the first three months or so.
As time passes, however, people do begin to increase their up-day intake, with a resultant slowing of weight loss. At that point it’s a good idea to begin keeping a record of your up-day intake to become more mindful of what you are eating. You still need to be aware of the hungry crocodile within and remain conscious of when you’re eating for pleasure rather than because you’re hungry.
In our Asthma Study there was some evidence that the subjects were restraining themselves (but to a far less degree) on the up days as well as on the down days. This is a natural consequence of the desire to lose weight and there is no harm in restraining to some degree on the up day. It is critically important, however, that you not feel deprived; otherwise the Alternate-Day Diet would be nothing more than another daily dieting program. The goal is to eat whatever you want until you’re satisfied, but not to overeat.
You can estimate your projected weekly weight loss by assuming that all weight-loss results from a reduction in body fat—although, particularly in the first week or so, you will experience several pounds of water loss, and some of the weight loss that occurs over time may be due to muscle loss. As a rough estimate, however, a pound of fat supplies 3,500 calories, the amount by which you must reduce your intake to lose one pound. So if your estimated daily calorie requirement is 2,000, over 30 days you require 60,000 calories to maintain your weight. If you consume 20 percent, or 400 calories on 15 down days, and 2,000 calories on 15 up days, your calorie intake for the 30 days is 15 x 2,000 + (15 x 400) = 36,000 calories. Therefore, 60,000 – 36,000 (24,000) is your calorie deficit, and 24,000 ÷ 3,500 = 6.9 pounds of fat lost in 30 days.
WHAT TO EXPECT ON THE UP DAYS
When you wake up after your first down day your initial thought will undoubtedly be something like “Wow! I did it!” You’ll be amazed that you were able to limit yourself to only 500 calories, and you’ll be proud of your achievement. You’ll also realize that you aren’t hungry—or at least not any hungrier than you would normally be.
Within just a few days you’ll begin to realize that hunger is not the overwhelming force you imagined it to be. You’ll start to feel proud of your ability to conquer the dragon of hunger. This is the central realization that makes it possible to continue the Alternate-Day Diet feeling hopeful and reborn.
Within a short time you’ll begin to see that your attitude toward food, even on the up days, has changed. You’ll eat to satisfaction, but you won’t overeat as you might have done before you began the diet. You’ll actually want to feel slightly empty rather than too full.
Interestingly, your food preferences will also start to change. You’ll begin to think, “Oh boy, I can eat whatever I want! But what I want is not what I thought I’d want.” The compulsion to eat something “bad” (say a dozen Krispy Kreme doughnuts) that often occurs on the down day simply vanishes on the up day. Over a period of weeks, most people find that they begin to choose healthier foods, especially vegetables. It’s unclear exactly why this shift occurs, but it may be that your body’s perception of a low energy supply triggers a genetic program that tells you to eat a diet high in nutrients, meaning that you find vegetarian sources more appealing than before. Another possible explanation is that because (after the initial two weeks when you reintroduce regular food) you are hungrier on the down days and choose to eat more vegetables in order to reduce caloric intake subsequently, you find them better-tasting because they may be preferable to other “diet” choices. Whatever the cause, I have noticed a trend to greatly increase vegetable consumption on the up days and—after the initial two weeks—on the down days as well.