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Intermittent Fasting:
Evidence-Based Approaches to Optimized Health and Disease Resistance

Written by Robert Iafelice, MS, RD, LDN
Edited by Mary Ann Cockram, MS, RD and Wolf J. Rinke, PhD, RDN

T357
17 CPEUs
HARD COPY
$152.95
T357E
17 CPEUs
ELECTRONIC
$142.95

Manual with 1 reporting form (111 pgs)
A growing body of research supports the practice of intermittent fasting (IF) as an effective strategy to improve health, reduce the risk of many chronic diseases, and increase longevity. IF is associated with weight loss and reduced body fat, as well as improvements in many indicators of cardiometabolic health, including greater insulin sensitivity, lower heart rate and blood pressure, and reduced inflammation. IF enhances cognitive function and holds promise in the treatment and prevention of Alzheimer’s and Parkinson’s disease, and may be valuable in the prevention and treatment of cancer. Due to IF’s growing popularity, RDNs and NDTRs need to take a leading role in providing proper guidance and advice to clients who wish to try IF. This in-depth CPE program, will enable you to:

  • Formulate fasting schedules for clients to accommodate individual preferences and needs.
  • Integrate fasting strategies into weight management and other diet plans for clients.
  • Discuss the underlying mechanisms and rationale for the multiple health-enhancing and disease-preventing effects of IF.
  • Discover how IF activates the major longevity pathways.
  • Apprise patients/clients of the potential adverse effects of IF and how to avoid or minimize them, plus much, much more.

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T357F 17 CPEUs
REPORTING FORM
$50.00

Intermittent Fasting:
Evidence-Based Approaches to Optimized Health and Disease Resistance

Written by Robert Iafelice, MS, RD, LDN
Edited by Mary Ann Cockram, MS, RD and Wolf J. Rinke, PhD, RDN

Copyright 2021 Wolf Rinke Associates, Inc.

CUSTOMER COMMENTS

OVERVIEW AND INSTRUCTIONS

Though fasting has been practiced for religious or medical reasons for millennia, regular periods of involuntary food scarcity are deeply rooted in human evolution. Remarkably, humans respond to the periodic shortage of food via mechanisms that increase cellular protection and resistance to injury and disease.
A growing body of fascinating and robust evidence from animal studies, along with several human intervention trials, supports the practice of intermittent fasting (IF) during adult life as a simple, effective strategy to improve health, reduce the risk of many chronic diseases, and increase longevity. Intermittent fasting is associated with weight loss and reduced body fat, as well as improvements in many indicators of cardiometabolic health, including greater insulin sensitivity, lower heart rate and blood pressure, and reduced inflammation. Intermittent fasting also enhances cognitive function and holds promise in the treatment and prevention of neurological diseases such as Alzheimer’s and Parkinson’s disease. Finally, encouraging results from clinical trials indicate that IF may be valuable in the prevention and treatment of cancer.
Intermittent fasting has several different versions, including alternate day fasting (alternating fasting days with eating days), time-restricted feeding (e.g., fasting for 16 hours with an 8-hour eating window), and periodic fasting (lasting several days or longer). However, it is not known which IF version is most effective, whether different variations of IF result in different outcomes, who would benefit the most from IF, and whether the health benefits of IF are sustained long-term. Also, IF may have some potential contraindications and adverse effects. Therefore, despite compelling preclinical research, large-scale randomized clinical trials are needed to resolve these questions before healthcare professionals can recommend IF as part of standard practice.
Nevertheless, IF is growing in popularity as evidenced by numerous fasting-related books and websites. As interest in IF spreads, people will be looking for direction, particularly concerning the potential benefits of IF in weight management. RDNs and NDTRs need to take a leading role in providing proper guidance and advice to clients that wish to try IF. They must stay be up-to-date on the latest intriguing developments in IF research.
This CPE program is a level 2 Continuing Professional Education (CPE) program approved for 17 continuing professional education units (CPEUs). That means that the reader has general knowledge of literature and professional practice in the area covered. The focus of the program is to enhance knowledge and application.
To get the most benefit from this program, we suggest you adhere to the following four steps:
Step 1: Review the objectives for the CPE program.
Step 2: Study each chapter. As you read, think of patients from your own practice who fit the situation described.
Step 3: Assess what you have learned by completing the self-assessment instrument at the end of this CPE program.
Step 4: Compare your answers to the answer key that has been provided. If you score at least 80% (40 questions) correct, you are ready to transfer your answers to the CONTINUING PROFESSIONAL EDUCATION REPORTING FORM. If you scored less than 80% correct, re-read the appropriate sections of the book and re-test yourself until you score at least 80% (40 questions) correct.

After you have completed the program, fill out the CPE REPORTING FORM and the MANDATORY Critical Thinking Evaluation Tool (CTT) that must be completed by all credentialed practitioners per CDR and:
Submit them online at www.easyCPEcredits.com,
Or fax them to (410) 531-9282,
Or mail them to Wolf Rinke Associates, Inc., 13621 Gilbride Lane, Clarksville, MD 21029.
Upon receipt of your CPE Reporting Form and the CTT, we will email you a Certificate of Completion within 3-5 business days.

NOTE: Per CDR we are NOT able to send you a Certificate of Completion unless we receive your completed CTT.

When you submit your CPE Reporting Form and the CTT to us via www.easyCPEcredits.com, fax, or mail, be sure to write your correct email address in the space provided on the CPE Reporting Form. If writing by hand, be sure to print your email address.

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OBJECTIVES

Upon completion of this CPE program you will be better able to:

  • Compare and contrast all the distinct variations of intermittent fasting (IF).
  • Assess which clients inquiring about IF may benefit from fasting and suggest a suitable IF version should they decide to proceed.
  • Formulate fasting schedules for clients to accommodate individual preferences and needs.
  • Integrate simple fasting strategies into weight management and other diet plans for your clients.
  • Evaluate risk factors for potential contraindications of IF and recommend medical supervision when appropriate.
  • Discuss the underlying mechanisms and rationale for the multiple health-enhancing and disease-preventive effects of IF, and why the simple practice of eating less often is an invaluable addition to lifestyle intervention strategies.
  • Compare intermittent fasting with continuous calorie restriction with respect to metabolic improvements, weight loss, tolerability, and compliance.
  • Discover the major longevity pathways and how IF activates them.
  • Explain how, remarkably, IF is potentially beneficial as an adjunct therapy for cancer patients undergoing chemotherapy.
  • Apprise patients/clients of the potential adverse effects of IF and how to avoid or minimize them.

TABLE OF CONTENTS

CHAPTER 1 Background
EVOLUTIONARY PERSPECTIVE OF INTERMITTENT FASTING (IF)
CULTURAL AND HISTORICAL CONSIDERATIONS
Meal Frequency
Religious Fasting
Ramadan Fasting
The Mormons
Greek Orthodox Christians
The Daniel Fast
Therapeutic Fasting
CHAPTER 2 Types of Intermittent Fasting Methods
ALTERNATE DAY FASTING (ADF)
ALTERNATE DAY MODIFIED FASTING (ADMF)
TIME-RESTRICTED FEEDING (TRF)
PERIODIC FASTING (PF)
FASTING-MIMICKING DIET (FMD)
Case Study 1
Case Study 2
CHAPTER 3 Mechanisms for Health Promoting Effects of Intermittent Fasting
ADAPTIVE CELLULAR STRESS RESPONSES (HORMESIS)
Oxidative Stress
Reactive Oxygen Species (ROS) and Antioxidant Defenses
Intermittent Fasting Reduces Oxidative Stress
Mitohormesis (Mitochondrial Hormesis)
Summing-up
Inflammation
NLRP3 Inflammasome
Mitochondrial Energy Metabolism
Mobilization of Fatty Acids and Ketones for Energy
Mitochondrial Biogenesis
Repair and Removal of Damaged Molecules and Organelles
Autophagy and Mitophagy
DNA Repair
IMPROVED CIRCADIAN RHYTHMS
Master Clock
Peripheral Clocks
MODULATION OF GUT MICROBIOTA
STEM CELL ACTIVATION AND REGENERATION
CHAPTER 4 Clinical Applications of Intermittent Fasting in Age-Related Diseases
EFFECTS OF INTERMITTENT FASTING IN CARDIOMETABOLIC DISEASE
Intermittent Fasting and Insulin Resistance
Mechanism of Action of IR
Metabolic Inflexibility and IF
Intermittent Fasting and Overweight/Obesity
The Thrifty Gene
Weight Maintenance
Intermittent Fasting and Type 2 Diabetes
Prevention
Treatment
Risks
Clinical Guidelines
Summing-up
Intermittent Fasting and Cardiovascular Disease (CVD)
CVD and Insulin Resistance/Hyperinsulinemia
Cardioprotective Effects
Traditional and Emerging CVD Risk Factors
Blood Pressure and Heart Rate
Summing-up
EFFECTS OF INTERMITTENT FASTING IN CANCER
Prevention
Mechanisms
Treatment
Mechanisms
Summing-up
EFFECTS OF INTERMITTENT FASTING IN NEURODEGENERATIVE DISORDERS
Neurodegenerative Disorders
Alzheimer’s disease
Parkinson’s disease
Stroke
Epilepsy
Evidence for Intermittent Fasting in Neurodegeneration
Mechanisms for the Effects of Intermittent Fasting in Neurodegeneration
Neuron Energy Metabolism
Synaptic Plasticity and Neurogenesis
Neuron Resilience
Summing-up
EFFECTS OF INTERMITTENT FASTING IN AUTOIMMUNE DISEASES
Multiple Sclerosis
Inflammatory Bowel Disease
Systemic Lupus Erythematosus
CHAPTER 5 Anti-Aging Effects of Intermittent Fasting
NUTRIENT SIGNALING PATHWAYS OF STRESS RESPONSES
Insulin/IGF-1 Signaling Pathway
Sirtuins
mTOR/AMPK Pathway
EFFECTS OF INTERMITTENT FASTING IN IMMUNOSENESCENCE
CHAPTER 6 Potential Contraindications and Adverse Effects of Intermittent Fasting
POTENTIAL CONTRAINDICATIONS
COMMON ADVERSE EFFECTS
RARE ADVERSE EFFECTS
CHAPTER 7 Summary and Conclusion
REFERENCES
FOR YOUR CONTINUING EDUCATION
LIST OF ABBREVIATIONS
GLOSSARY
RESOURCES
SELF-ASSESSMENT QUESTIONS
ANSWER KEY
EXPLANATION FOR ANSWERS
ABOUT THE AUTHOR
ABOUT THE EDITORS

ABOUT THE AUTHOR

Robert Iafelice, MS, RD, LDN is a freelance medical writer and member of the American Medical Writers Association. He has contributed several chapters to the 6th edition of Disease Prevention and Treatment, a medical reference book of evidence-based protocols to combat the diseases of aging.
Robert received a Bachelor of Arts degree in Chemistry from Miami University in Oxford, Ohio, and a Master of Science degree in Nutrition Science from Case Western Reserve University in Cleveland, Ohio. Most of his experience as a practicing registered dietitian was in the field of integrative/functional medicine with a focus on food allergy. Robert provided medical nutrition therapy at an integrative allergy-immunology clinic in Chicago, where he specialized in conducting double-blind, placebo-controlled food challenges – the gold standard for food allergy diagnosis.
Robert’s diverse background also includes extensive experience in fitness/wellness as a gym owner, university nutrition instructor, health educator in the nutraceuticals industry, and oncology. His favorite writing interests include intermittent fasting, nutritional ketosis, and high-intensity interval training.

ABOUT THE EDITORS

Mary Ann Cockram, MS, RD is retired from Abbott Nutrition where she was a Research Scientist in the Scientific and Medical Affairs group. In this role, she provided clinical nutrition education and brand support internally to Sales and Marketing and externally to clinicians and consumers for Abbott’s critical care and surgical enteral nutrition products. Her area of interest is enteral feeding.
Mary Ann received a Bachelor of Science in Home Economics from Valparaiso University in Valparaiso, Ind., and a Master of Science in Clinical Nutrition from Rush University in Chicago.
Mary Ann served as chair of the Medical Nutrition Practice Group, and as the assistant editor and editor of Medical Nutrition Matters, the newsletter of this practice group. Mary Ann participated as an evidence analyst on the Evidence Analysis Team for Adult Weight Management for the Academy of Nutrition and Dietetics, and she attended the test item writer workshop sponsored by the Commission on Dietetic Registration.

Wolf J. Rinke, PhD, RDN is the president and founder of Wolf Rinke Associates, Inc., a company that has provided high-quality CPE programs to nutrition and dietetics practitioners since 1990.
Dr. Rinke earned a BS at Drexel University, an MS at Iowa State University, a PhD in Continuing and Vocational Education (Adult Ed) at the University of Wisconsin and interned at Walter Reed Army Medical Center. He participated in a test item writer workshop sponsored by the Commission on Dietetic Registration (CDR).
Dr. Rinke is a past Adjunct Associate Professor, Graduate School of Management & Technology at the University of Maryland, and a former Adjunct Faculty Member of the School of Continuing Studies at The Johns Hopkins University.
He has served as past president of the District of Columbia (DC) Dietetic Association and has been honored by the Academy of Nutrition and Dietetics with the Award for Excellence in the Practice of Management, the Outstanding Dietitian of the Year Award, and the Outstanding Service Award, in addition to delivering the Lenna Frances Cooper Lecture.
Dr. Rinke has served in numerous leadership roles at the Academy of Nutrition and Dietetics: Chair of the Scholarship Committee for Dietitians in Business and Communications; Chair of the Communication Committee, Honors Committee, and Licensure Panel and Ethical Practices Task Force for the Commission on Dietetic Registration; Chair of the Area Coordinating Committee and Chair for the Code of Ethics; Member of the Resource for Education Programs Committee; Member of the House of Delegates; and Member of the Board of Directors.
Dr. Rinke is the author of more than 500 articles, numerous CPE self-study programs, and several popular books including Make It a Winning Life: Success Strategies for Life, Love and Business; Winning Management: 6 Fail-Safe Strategies for Building High-Performance Organizations; and Don’t Oil the Squeaky Wheel and 19 Other Contrarian Ways to Improve Your Leadership Effectiveness.

ACKNOWLEDGMENTS

Special thanks to the following individuals for their review.

Patti Welch, MPH, RDN, LDN
Nutrition Advisor, Save the Children
Washington, DC

Barbara Klick, MPH, RDN, CSOWM
Weight Management Consultant
Jericho, VT

Sara A. Wagner, MS, RDN
Director, Undergraduate Program in Nutrition Science and Dietetics
University of Wisconsin Green Bay
Green Bay, WI

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