by Dr. Will Cole, IFMCP, DNM , DC

Going without food for a long period of time may seem like the last thing that would get you closer to your health goals. However, intermittent fasting does exactly that. By restricting your eating to specific windows of time it has been shown to unlock a variety of next-level health benefits.

In fact, intermittent fasting has been so transformative for my patients in my telehealth functional medicine clinic that I set out to write my new book Intuitive Fasting all about how to determine the best way to fast for your body and how it can help you become more metabolically flexible.

But out of all of the ways to intermittent fast, one of my favorites is OMAD. Well, almost. Read on to learn more about the benefits of this particular fasting protocol and the very important tweak I make to really elevate its effectiveness.

What is OMAD?

OMAD simply stands for “One Meal A Day”. This 23:1 fasting-to-eating window allows for 23 hours straight of fasting with one hour to eat all of your food for the day. Whether that is waiting until dinner to break your fast or only eating breakfast, your one meal can be at any time of the day as long as it is just one meal during one hour of a 24-hour period.

The Pros of OMAD

Intermittent fasting has been shown to provide a wide-range of important health benefits including:

• Increased human growth hormone (HGH) levels: Fasting increases levels of this hormone that helps build muscle and burn fat.
• Lowered inflammation levels: Fasting is known for its ability to reduce inflammation. When you aren’t eating, your body can divert its energy towards repair.
• Decreased disease risks: Fasting is also associated with stabilized blood sugar and metabolic health, along with reduced cancer risk.
• Increased autophagy: Fasting increases cellular renewal to clear out old, dead cells and make room for new, healthy cells.

And as we lean into these longer fasts, we lean into deeper benefits. Studies have shown that longer fasts encourage a shift into nutritional ketosis more than shorter fasting windows which have their own fat-burning, anti-inflammatory, and autophagy enhancing benefits. Therefore, as the longest form of fasting (other than a full 24 hour fast), OMAD allows for some of the deepest benefits all around.

The Cons of OMAD

While the pros are significant, the cons can also be pretty significant if OMAD isn’t done correctly, especially when it comes to digestion.

Getting all the nutrition you need all at once in a short period of time can be hard on your digestion, and studies have shown that it can increase something called the PKR pathway, which can spike meta-inflammation, or systemic inflammation. Which is not good, especially if your main reason for intermittent fasting is to decrease inflammation or soothe digestive distress by giving your gut a break from the process of digestion.

What To Do Instead

All of this to say, instead of advocating for strict OMAD I lean more towards an Almost-OMAD approach. By spreading out your eating window to 2 to 4 hours versus the more traditional 24:1 fasting-to-eating OMAD approach allows time for you to eat your food in a more gentle, sustainable way for your body while still taking advantage of deeper fasting benefits.

In order to do this, you’ll fast for between 20 and 22 hours within a 24 hour period. Then you’ll break your fast with one smaller transition meal - what I call a Break-a-Fast meal - then an hour later you’ll eat your one full meal. This smaller meal will help you transition into eating by prepping your digestion with a smaller amount of gentle, gut-friendly foods.

Some Break-a-Fast meal ideas include:

• Bone broth
• Soups
• Smoothies
• Hard boiled eggs
• Cooked greens

My favorite options are straight bone broth or bone broth-based soups as these will help support your gut’s mucosal lining and your intestinal villi, which will help your body prepare to digest and absorb the food you eat. Ultimately, your Break-a-Fast meal should be smaller, lower in fat, lower in carbs, and have a moderate amount of protein. You should eat it slowly, making sure to chew your food completely before swallowing it. Remember, your gut has been resting and repairing on your fast. Your goal with this meal should be to make it as simple and digestible as possible.

The only real question you need to answer is what time of the day you’ll break your fast and how you’ll fit a single day's worth of calories and nutrients into your Almost-OMAD meals. To do this, you’ll have to incorporate how many calories and nutrients you need for your age, weight, and activity level, then make sure your Break-a-Fast and main meal meet these requirements.

While Almost-OMAD still might not be the best option for your particular health case - especially if you are new to fasting in general - remember that there are many other ways to intermittent fasting that can still help you achieve the associated health benefits. I encourage you to check out my book Intuitive Fasting that will help you identify the fasting routine that works best for you. When you preorder the book you will receive access to my private online fasting group, a shopping guide for the meal plan in the book and a sneak peek of the book right now.