Intermittent fasting may help fight type 2 diabetes

Published Saturday 14 October 2018

By Chiara Townley

Fact checked by Jasmin Collier

Lifestyle changes are key in the management of type 2 diabetes. Scientists believe that intermittent fasting could play an essential role.

Lately, intermittent fasting has become incredibly popular.

Type 2 diabetes is the most common type. The condition affects the body's ability to produce insulin, which regulates blood sugar levels.

Diabetes is widespread in both Canada and the United States, and in the U.S., it is one of the leading causes of death.

The American Diabetes Association report that the total estimated cost of treating diabetes is now over $200 billion per year.

Lifestyle changes are crucial to managing the disease, and eating habits play a key role. Doctors normally recommend that people with diabetes follow specific diets.

The effects of a specific diet may differ from person to person, but in general, those with diabetes should avoid processed foods, artificial sweeteners, and refined carbohydrates.

Intermittent fasting could be a way to manage diabetes through diet.

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Low-calorie shakes and soup diets 'recommended for obese'

Diet replacement programmes made up of low-calorie soups, shakes and regular counselling should be a recommended NHS treatment for obesity, a BMJ study says.

People on the diets lost three times more weight than those given standard dietary advice by their GP, University of Oxford researchers found.

And their risk of developing heart disease and type-2 diabetes reduced.

But experts said it would work only if eating habits were changed for good.

Prof Paul Aveyard, study author, GP and professor of behavioural medicine at the University of Oxford, said losing weight and keeping it off was hard.

"It's boring being on a normal diet and people struggle to stick to it for a year," he said.

"But these programmes get you when your mental strength is at its highest.

"You have to concentrate effort into 12 weeks and because they eat so little, they lose a lot of weight quickly."

Total diet replacement programmes are designed for people who are obese or seriously obese, with a body mass index (BMI) of more than 30, who have been unable to lose weight despite changes to diet and lifestyle.

They are currently only available privately - although NHS England has said it is considering the diets as part of a long-term plan for the NHS.

• BMI and obesity: Where are you on the UK fat scale?

The programmes reduce daily calorie intake by replacing food with specially formulated drinks, soups and snacks. Milk, water and fibre supplements are also taken.

A typical daily intake might include:

• a chocolate-flavour skimmed milk and soya protein shake mix (145kcal)
• chicken-and-mushroom-flavour skimmed milk and soya protein soup mix (138kcal)
• skimmed milk and multi-wholegrain porridge mix (149kcal)
• lemon-flavour soya and milk protein bar covered in yoghurt-flavour coating (150kcal)

Stick to the diet

In this study, of 278 people from 10 GP practices in Oxfordshire, half followed the Cambridge Weight Plan programme for eight weeks - limiting intake to 810kcal per day - then re-introduced other food gradually over the next four weeks.

They also saw a trained counsellor every week, for 24 weeks in total, to help them stick to the diet and keep the weight off.

The other half of participants were given the usual weight management advice and support from their GP practice.

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Intermittent Fasting Benefits + Results, Diet, Schedule

Dieting can be a difficult and frustrating way to lose weight. Intermittent fasting is a simple and effective strategy for getting lean while maintaining muscle mass.

Introduction

Intermittent fasting is a technique primarily used for losing weight that comes with many health benefits. It involves changing your eating pattern without having to change your diet or exercise level.

There are many different ways to fast. Common practices include:

• Alternate day eating – one day on and one day off
• Time restricted eating – typically involves skipping breakfast (but I don’t approve)
• 5:2 fasting protocol – restrict calories to 500-700 per day for two days a week

Intermittent fasting is effective because it allows the body to enter its highest fat-burning state, which occurs about 8-12 hours after eating a meal. This helps eliminate body fat without sacrificing muscle mass. A typical eating schedule does not normally allow the body to reach this point.

1) Intermittent Fasting Helps You Lose Weight

Studies have found that the 5:2 fasting protocol has been the most effective for losing weight (R).

A 2013 study found that people who steadily reduced their daily calorie intake became more insulin sensitive and lost more weight compared to people who followed a regular eating pattern (R).

Intermittent fasting has been effective in preventing obesity (R).

Efficiency of metabolism is improved as a result of intermittent fasting (R).

2) Intermittent Fasting Can Prolong Your Life

Intermittent fasting can increase a person’s lifespan by up to 30% according to some researchers (if animal studies are an indicator) (R).

Intermittent fasting boosts the body’s stress resistance, which increases longevity in humans (R).

It helps protect and treat the body from disease, which can delay aging (R).

Intermittent fasting can prolong the health-span of the nervous system by impacting biological pathways that regulate the lifespan (R).

3) Intermittent Fasting May Reduce the Likelihood of You Getting Sick

In a study done on mice that were infected with salmonella, intermittent fasting lowered intestinal and systemic bacteria by boosting their intestinal immune system (R).

4) Intermittent Fasting Promotes Cardiovascular Health

Intermittent fasting:

• Decreases cardiovascular disease risk (R).
• Increases HDL cholesterol and lowers triglyceride levels and LDL cholesterol (R).
• Decreases resting heart rate and blood pressure (R).
• Improves circulation of triglycerides and cholesterol (R).
• Increases resistance to ischemic injuries (R).
• Reduces the risk of coronary heart disease (R).

5) Intermittent Fasting Decreases Cancer Risk

Intermittent fasting lowers blood glucose and IGF-1 levels, which reduces the risk of cancer (R).

Studies have found that reducing energy intake and fasting for longer intervals during the night can reduce the risk of breast cancer (R).

6) Intermittent Fasting Can Forestall Cognitive Decline

Intermittent fasting protects neurons from genetic and environmental stress factors during aging (R).

Intermittent fasting increases insulin sensitivity, which benefits neurons that stimulate the production of enzymes that help cells cope with stress and fight against disease (R).

Fasting can reduce issues with brain function and neurodegenerative disorders caused by inflammation (R).

7) Intermittent Fasting Can Prevent Chronic Degenerative Diseases

Fasting reduces inflammation and boosts cellular protection (R).

Intermittent fasting helps protect against obesity, diabetes, rheumatoid arthritis, hypertension, and asthma in humans (R).

Intermittent fasting protects against damage caused by an ischemic stroke (R).

Calorie restriction increase sirtuins and AMPK signaling, which help the body maintain internal stability (R).

8) Intermittent Fasting Heals Your Gut

Motilin and Ghrelin, which regulate the digestive tract, are released during fasting (R).

Ghrelin readies the body for the incoming nutrients by stimulating gastrointestinal motility and gastric acid secretions (R).

Studies show that there may be a therapeutic use for ghrelin in gastrointestinal inflammatory diseases like colitis and ischemia (R).

Fasting therapy has improved abdominal pain, diarrhea, nausea, and anxiety in patients with irritable bowel syndrome (R).

9) Intermittent Fasting Boosts Mood and Motivation

Studies show that fasting and calorie restriction improves anger, tension, confusion, and overall mood in aging males (R).

High levels of ghrelin are associated with anti-depressant effects (R).

10) Intermittent Fasting Is A Cognitive Enhancer

IF affect energy and oxygen radical metabolism, and cellular stress response systems, in ways that protect neurons against genetic and environmental factors to which they would otherwise succumb during aging (R).

Fasting increases the presence of drebrin, a protein that regulates neuronal development (R).

The loss of drebrin results in cognitive impairment that causes neurological disorders (R).

Intermittent fasting is associated with growth of the hippocampus, which is responsible for emotion and memory (R).

11) Fasting Reduces Inflammation

Fasting produces ghrelin in the body, which suppresses inflammation (R).

Intermittent fasting reduces pro-inflammatory cytokines and immune cells in the body (R).

Fasting for long intervals at night can reduce systemic inflammation (R).

Intermittent fasting reduces the risk for degenerative diseases connected to inflammatory response in the central nervous system (R).

12) Increased Ghrelin Levels May Slow the Onset of Parkinson’s Disease

Ghrelin increases the concentration of dopamine in an area of the brain where the decline of dopamine cells leads to Parkinson’s Disease (R).

13) Intermittent Fasting Improves Learning and Memory

A study demonstrated that mice on intermittent fasting had better learning and memory than mice with a regular eating schedule (R).

Studies suggest that learning may be best when the stomach is empty during the day because ghrelin levels are high (R).

14) Intermittent Fasting Protects Against Diabetes Risk

Intermittent fasting is associated with a reduced risk of diabetes (R).

15) Fasting Protects Against Autoimmune Disease

Fasting every three days has been effective in reducing autoimmunity and promoting regeneration (R).

Studies have shown that periods of fasting reversed symptoms of multiple sclerosis in animals (R).

Fasting prevents and improves systemic lupus erythematosus (R).

16) Intermittent Fasting Improves Sleep

Periods of fasting can lead to decreases in arousal during sleep (R).

Intermittent fasting has proven to benefit daytime performance and quality of sleep in non-obese individuals (R).

17) Intermittent Fasting Helps Protect Against Infections

Periods of food deprivation increases resistance to salmonella typhimurium infection because the body produces more IgA, which is critical in immune function (R).

Intermittent fasting promotes responses in the brain that suppress inflammation and maintain cognitive function during systemic bacterial infection (R).

Neutrophils have a preference to engulf refined carbohydrate (glucose, fructose, sucrose, honey and orange juice) over bacteria (R).

The neutrophil phagocytic capacity to engulf bacteria is affected when simple sugars are digested. And fasting strengthens the neutrophils phagocytic capacity to engulf bacteria (R).

However, the digestion of normal starches has no effect. The researchers concluded that the scientific data found that the function, and not the number of phagocytes in engulfing bacteria was altered by the ingestion ofsugars (R).

Even among sugars, neutrophils can again be picky and engulf preferred sugars (R, R2, R3).

18) Intermittent Fasting Allows You to Maintain Your Performance

Intermittent fasting has no effect on daily functioning and sports performance (R).

Intermittent fasting does not promote drowsiness or lack of vigilance (R).

This method of fasting preserves lean body mass (R).

The cellular effects of intermittent fasting are similar to the effects of physical exercise (R).

19) Intermittent Fasting Heals Your Skin

There is evidence that intermittent fasting may aid in skin wound healing (R).

Fasting has been effective in alleviating contact dermatitis and chronic urticaria (R).

The effects of intermittent fasting can assist with fighting acne (R).

20) Intermittent Fasting Helps Ease Chronic Pain

Intermittent fasting enhances neuroplasticity and learning in adults, which can aid in healing chronic pain (R).

My Recommendation On How To Do It (The Diet / Schedule)

For most readers of this blog, I will recommend doing a restricted eating window from 8am to 6PM – that means eating only from 8am to 6PM.

You can also do the 5:2 protocol while you’re at it, which means to do a 24 hour fast two days a week (separated by at least one day).

Eat your normal diet five days a week. Pick any two days of the week to restrict your intake of food to fewer than 700 calories.

You will get the best results if your “normal diet” is a healthful one, but you do not need to try to restrict calories on your non-fast days.

For people with inflammatory issues

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STUDY CLAIMS, EATING AN EARLY BREAKFAST AND A LATE DINNER DOUBLES FAT LOSS

Changing the time you eat your meals could be key to reducing body fat, a new report claims.

According to a 10-week study into “time-restricted feeding” led by the University of Surrey, meal times can have a significant impact on body composition.

Unlike other studies into this particular type of intermittent fasting, participants were not required to follow a particular diet and could eat whatever they wanted, so long as it was within a specific window.

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            Why diet choices have              a bigger emotional                    impact on women than              men

Researchers split participants into two groups: a control group who ate their meals as they normally would and another group who were required to eat their breakfast 90 minutes later than normal while also eating their dinner 90 minutes earlier.

Each participant also completed diet diaries throughout the experiment, provided blood samples beforehand and completed a questionnaire afterwards.

The results showed that those who stuck to eating within a specific window lost more than twice as much body fat on average than the control group.

The questionnaire also revealed that 57 per cent of participants in the study group noticed a reduction in their food consumption, either due to decreased appetite or reduced snacking as a result of the restrictive time period in which they were allowed to eat.

Following the study, researchers examined whether this form of intermittent fasting was sustainable in the long term.

However, more than half (57 per cent) of participants in the fasting group said they wouldn’t be able to maintain their restrictive eating window due to it being incompatible with their family and social lives.

On the other hand, 43 per cent said they would consider maintaining the plan if there was more flexibility with regards to eating times.

"Although this study is small, it has provided us with invaluable insight into how slight alterations to our meal times can have benefits to our bodies,” explains lead author Dr Jonathan Johnston, reader in chronobiology and integrative physiology at the University of Surrey.

“Reduction in body fat lessens our chances of developing obesity and related diseases, so is vital in improving our overall health.

"However, as we have seen with these participants, fasting diets are difficult to follow and may not always be compatible with family and social life. We therefore need to make sure they are flexible and conducive to real life, as the potential benefits of such diets are clear to see.

"We are now going to use these preliminary findings to design larger, more comprehensive studies of time-restricted feeding".

It’s not the first time intermittent fasting has been linked to promoting fat loss.

In 2012, the 5:2 Diet surged in popularity, advocating structuring your week around five “normal” days of eating and two “fasted” days when you’re advised to limit your food intake to 500-600 calories.

However, the diet has sparked controversy, with some researchers claiming it could increase the risk of diabetes and does not in fact reduce the risk of heart disease, as a previous study claimed.

The study was based on a sample of 16 healthy people between the ages 

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Intermittent Fasting Controls Blood Glucose Levels, Study Finds

• BY Mark L.Fuerst

Aug 26, 2018Diabetes Type 2

Type 2 diabetes mellitus (T2DM) patients are just as likely to lose weight and control their blood glucose levels with intermittent semifasting for 2 days per week as with an ongoing daily calorie-restricted diet, according to the first long-term clinical trial comparing the different diets in T2DM.

The results suggest that intermittent fasting could be a solution for people with diabetes who find it difficult to stick to a diet 7 days a week. 

“Conventional weight-loss diets with daily energy restrictions are difficult for people to adhere to so we must look for alternative solutions,” said co-author Peter M. Clifton, MD, PhD, professor of nutrition at the University of South Australia in Adelaide, Australia.

The researchers published their results on July 20, 2018, in JAMA Network Open.

A noninferiority trial randomized 137 patients with T2DM to either intermittent energy restriction (70 patients) or continuous energy restriction (67 patients). The intermittent energy restriction diet of 500 to 600 kcal per day was followed for 2 nonconsecutive days per week, and then the patients followed their usual diet for the other 5 days. The continuous energy restriction diet of 1200 to 1500 kcal per day was followed for 7 days per week. The regimens were followed for 12 months.

An intention-to-treat analysis showed similar reductions in mean hemoglobin A1c (A1c) level between the continuous and intermittent energy restriction groups (–0.5% vs –0.3%), which met the criteria for equivalence. Mean weight change was similar between the continuous and intermittent energy restriction groups (–5.0 kg vs –6.8 kg).

The criteria for equivalence in fat mass or fat-free mass were not met.

Results similar across multiple measures

Total weight loss recorded after 12 months was associated with weight change after 2 weeks on the assigned diet. A small number of patients in both groups continued to lose more weight throughout the course of the trial. Similar outcomes were reported for both groups with other clinical markers after 12 months -- improvements in lipid levels, total medication effect score, fasting glucose levels, and total step count.

Similar outcomes were reported for both groups with other clinical markers after 12 months -- improvements in lipid levels, total medication effect score, fasting glucose levels, and total step count.

Hypoglycemic or hyperglycemic events in the first 2 weeks of treatment were similar between the continuous and intermittent energy restriction groups (mean number of events 3.2 vs 4.9), affecting one-third (35%) of the patients using sulfonylureas and/or insulin.

While fasting is safe for people with diet-controlled T2DM, for those using insulin and oral medications likely to cause hypoglycemia, blood glucose levels need to be monitored and medication doses changed accordingly, cautioned the authors.

“Anecdotally, participants in the intermittent energy restriction group reported that although they were not following the protocol consistently after 3 months, they found that they could use it effectively to prevent weight gain because the energy restriction involved only 2 days,” the authors stated.

In conclusion, they stated that “intermittent energy restriction is an effective alternative diet strategy for the reduction of HbA1C level comparable to continuous energy restriction in patients with type 2 diabetes, and it may be superior to continuous energy restriction for weight reduction.”

Source: Carter S, Clifton PM, Keogh JB. Effect of intermittent compared with continuous energy restricted diet on glycemic control in patients with type 2 diabetes: a randomized noninferiority trial. JAMA Network Open. 2018;1(3):e180756. doi:10.1001/jamanetworkopen.2018.0756

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Harvard study uncovers why fasting can lead to a longer and healthier life

New research has found that a cell's mitochondria (represented in green above) can be affected through fasting which results in better health and longevity(Credit: NICHD Flickr CC-BY-2.0)

Intermittent fasting diets are all the rage these days. We are seeing everything from the conservative 5:2 diet to more extreme fasting methods gaining prominence in Silicon Valley circles, but while there has been plenty of observational research pointing out the correlation between fasting and positive health outcomes, we still don't have a good understanding of any underlying biological mechanism at play.

A new study from Harvard researchers has now shown how fasting can increase lifespan, slow aging and improve health by altering the activity of mitochondrial networks inside our cells.

"Although previous work has shown how intermittent fasting can slow aging, we are only beginning to understand the underlying biology," says William Mair, senior author on the study.

Mitochondria are a little like tiny power plants inside our cells. Last year a team of researchers led by Newcastle University successfully showed how mitochondria are fundamental to the aging of cells. The new research from Harvard shows how the changing shapes of mitochondrial networks can affect longevity and lifespan, but more importantly the study illustrates how fasting manipulates those mitochondrial networks to keep them in a "youthful" state.

Inside cells mitochondrial networks generally alternate between two states: fused and fragmented. Using nematode worms, an organism useful for studying longevity as it only lives for two weeks, the study found that restricted diets promotes homeostasis in mitochondrial networks allowing for a healthy plasticity between these fused and fragmented states.

"Our work shows how crucial the plasticity of mitochondria networks is for the benefits of fasting. If we lock mitochondria in one state, we completely block the effects of fasting or dietary restriction on longevity," says Mair.

The study also found that fasting enhances mitochondrial coordination with peroxisomes, a type of organelle that can increase fatty acid oxidation, a fundamental fat metabolism process. In the study's experiments, the lifespan of the worm was increased by simply preserving mitochondrial network homeostasis through dietary intervention. These results help shed light on how fasting can increase longevity and promote healthy aging.

"Low-energy conditions such as dietary restriction and intermittent fasting have previously been shown to promote healthy aging. Understanding why this is the case is a crucial step toward being able to harness the benefits therapeutically," explains Heather Weir, lead author of the study.

"Our findings open up new avenues in the search for therapeutic strategies that will reduce our likelihood of developing age-related diseases as we get older."

The study was published in the journal Cell Metabolism.

Source: Harvard University

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