DEAR DR. ROACH: I am a 50-year-old overweight woman (5 feet, 6 inches tall at 240 pounds). So far, I am not diabetic, but my A1C has been creeping upward. In an effort to control my weight and reap the benefits of fasting, I have been engaging in 36-hour fasts.

Although I have lost about 1 pound per week since embarking on this endeavor, I am also aiming to enhance my cellular repair and metabolic response, as well as decrease inflammation.

I have been frustrated that the urine strips I have used at the end of my fast have been negative for ketones. Should I believe the strips? Am I getting any of the benefits of fasting if I never reach ketosis? — J.H.

ANSWER: Intermittent fasting has become increasingly used as a strategy for weight loss and also has been shown to improve markers of

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