What You Eat Still Matters
As is true with any diet, the best results are obtained by combining early time-restricted feeding with healthy food choices.
You have to eat well. You wont lose weight if you are eating poorly, says Patton. A plant-based or Mediterranean-style diet is ideal. Such diets emphasize fruits, vegetables, lentils, whole grains and healthy fats and restrict the intake of refined grains and sugars, she explains.
If you stay active, follow a healthy diet and avoid mindless snacking, restricting the hours you eat will improve your health, and you will likely lose weight, too.
This article originally appeared in Cleveland Clinic Heart Advisor.
Reverse Insulin Resistance: Use These 8 Simple Steps
Do you want to make yourself immune to chronic disease?
If so, you need to prevent and reverse insulin resistance.
Good news and bad news. Which first? Okay bad news
Insulin resistance is related to almost every chronic disease:
It may not cause them all. But at the very least, persistently high insulin levels exacerbates them.
Good news: you can reverse insulin resistance. And reversing it is one of the most important things you can do for your health.
Learn more below about why insulin resistance is bad and the 8 simple steps to reversing it.
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Intermittent Fasting: The Best Insulin Resistance Diet
The best way to increase your insulin sensitivity is through fasting. In an episode of the Bulletproof Radio podcast . Dr. Jason Fung explains how intermittent fasting drops your insulin levels, which alters your bodys demand for insulin in a good way.
If you become very insulin resistant, then your insulin levels are up all the time, your body is always trying to shove the energy into the fat cells, and then you feel cold and tired and lousy. Thats the real problem. Resistance really depends on two things. Its not simply the high levels, but its the persistence of those levels. What people have realized is that the insulin resistance, because it depends on those two things, a period of time where you can get your insulin levels very low is going to break that resistance because it breaks that persistence. Not simply the levels, but the persistence of those levels.
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Intermittent fasting is the easiest, smartest, most consistent way to fast. In short, intermittent fasting means you eat all of the food youll eat in a day in a short window of time. People will fast anywhere from 12-20 hours per day, depending on goals. More on how to do it here.
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Is Intermittent Fasting Safe For People With Diabetes
The popular diet may help people with diabetes lose weight and lower their blood sugar levels, but before you try it, know that the plan comes with certain risks.
When the now 46-year-old Mary Roberts from Lockhart, Texas, was diagnosed with type 2 diabetes in 2008, her doctor immediately put her on Metformin , a drug to help stabilize blood sugar. When I got the diagnosis, I guess I wasnt surprised, says Roberts, explaining that not only was she overweight but her mom had been on insulin for type 2 diabetes.
Not wanting to be on medication herself for her entire life, Roberts set out on a path to control the diabetes through diet, but a few years of nutrition classes proved unsuccessful in lowering her blood sugar level. It was after her doctor suggested insulin on top of the high dose of Metformin that Roberts switched gears. I really wanted to find a way to get healthy, she says.
She found the solution in changing her approach to eating just not the way she expected. Intermittent fasting combined with the popular ketogenic diet, which emphasizes dramatically reducing carbohydrate intake, helped her lose weight and lower her A1C. I feel amazing, Roberts says.
Ways To Use This Information For Better Health
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I Tried Intermittent Fasting For Diabetes And This Is What Happened
My experience reinforced that there is no one-size-fits-all approach to diabetes management.
If youve ever tried to lose weight, especially for health reasons, you have probably come across articles and blog posts touting the benefits of intermittent fasting.
Its also known as intermittent energy restriction in dietitian, nutritionist, and health coach circles. Regardless of which term you use, intermittent fasting is a method of voluntarily cycling between fasting and nonfasting time periods.
I started reading about it a few years ago, because I heard it was helpful for those with type 2 diabetes.
Reported benefits include weight loss and a lower risk of future diabetes complications, such as organ damage. The thought process around this is that if you reduce your time periods of high blood sugar, then you reduce the potential for damage caused by long-term unmanaged type 2 diabetes.
In one 2013 study in the British Journal of Nutrition, women with overweight who tried intermittent fasting not only lost weight but improved insulin sensitivity after 3 months.
What really caught my eye was people who claimed to reverse their diabetes after following strict programs of intermittent fasting. Many said they had lost weight and were able to stop taking diabetes medication.
Implementing The Intermittent Fasting Study
In all, 15 participants experienced low blood sugar events, for a total of 53 such incidents. The rates of low blood sugar were no differences between the consecutive and non-consecutive groups, but the chance of having low blood sugar was doubled on fasting days than on non-fasting.
Both groups lost weight. At the study start, the group that fasted on non-consecutive days weighed, on average, 242 pounds. By the end of the 12-week study, they had lost on average of 8 pounds. Those in the consecutive fasting group weighed, on average, 239 pounds at the study start, and by the end, they had lost nearly 7 pounds on average, which isnt statistically significant meaning both groups had similar results.
The level of A1cs declined from 8.2 to 7.5 in the non-consecutive group and from 8.4 to 7.8 in the consecutive fasting days group also not significantly different.
The final answer on the worth of this approach is still up for debate, the researchers write, “Our study protocol could be adopted for the longer-term studies that will be required to assess the tolerability and sustained efficacy of an intermittent fast.1 Unfortunately, they didnt respond to our questions about how the groups differed and whether any of the participants were willing to stay with the diet long-term.
Intermittent Restricted Calorie Dieting Not Encouraged
“My guess is, people who try this long-term are going to end up gaining weight,” Dr. Apovian says. ”They need something more consistent.”
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How Does Insulin Resistance Happen
The obesity or weight-related spectrum of conditions has varied labels.
- Insulin Resistance.
Insulin Resistance isnt just for some people. It holds no prejudice. It develops in every body.
So then, how does insulin resistance happen?
The body, over time, grows resistant to insulin to some degree because insulin has been signaling your cells throughout your entire lifetime every time you eat and every time you experience an emotional rise or feel stressed. Insulin becomes especially overly present in a body that has been over-fueled, burdened, or over-loaded with glucose. Glucose is the sugar that foods break down into during digestion.
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Early Eating Works Best
Several intermittent fasting patterns have been studied. Not all were shown to be equally effective.
Alternate-day fasting did not produce greater weight loss or offer any heart healthy benefits above and beyond those obtained from eating a low-calorie diet.
Studies of time-restricted feeding have shown the early eating pattern to be more effective than a 12/12 pattern in helping to lower insulin levels and normalize blood pressure in men with prediabetes and prehypertension.
Study participants who followed the 8/16 pattern also found they were not hungry in the evening, which made the eating pattern sustainable over the long term.
Not everyone in these studies lost weight, but none gained weight. There is some flexibility in the schedule. You can eat from 7 a.m. to 2 p.m. or from 9 a.m. to 5 p.m., depending on when you go to sleep and when you rise. The point is that you eat early in the day, and never before bed, says Patton.
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Does Research Suggest That If Improves Markers Of Health In Humans
The majority of IF research has involved animals rather than human participants. The evidence to support health improvements in people is promising, but many of the clinical studies to date have been relatively short-term interventions over a period of months.
A 2018 review article showed that nearly all IF studies resulted in some degree of weight loss, ranging from , and associated fat mass loss. However, there is little research to prove that IF is superior to other diets and eating patterns in promoting weight loss.
The use of an IF diet may also have a beneficial effect on blood pressure. In one , researchers observed 1,422 people for 1 year while they followed a fasting program. The participants experienced a reduction in both systolic and diastolic blood pressure.
In another study , which involved adult males, researchers found that IF provided metabolic and cardiovascular benefits, such as a decrease in total cholesterol and low-density lipoprotein cholesterol.
Scientists know that insulin resistance improves with calorie restriction. After a period of fasting, insulin sensitivity increases, and insulin levels decrease. These changes result in improved blood sugar levels both during fasting and shortly after eating.
IF can have various health benefits for people with diabetes. These include:
- promoting weight loss
- improving insulin sensitivity, leading to lower insulin requirements
- normalizing fasting blood glucose levels
- reducing hemoglobin A1c levels
Intermittent Fasting Does Come With Potential Side Effects That Anyone With Diabetes Should Know About
Intermittent fasting isnt perfect, and there are some side effects to consider.
- It can mess up your hunger cues. That can cause you to overeat when youre in a feeding window. Thats a problem for anyone, but especially for someone with diabetes, Dr. Schutta says, noting that this can lead to elevated glucose levels. Regularly having elevated, uncontrolled glucose levels can lead to complications like nerve damage, eye issues, kidney disease, and stroke, per the ADA.
- Low blood sugar. On the flip side, people with diabetes risk having low blood sugar during fasting periods, Dr. Céspedes says. That can lead to symptoms like headaches, dizziness, trouble concentrating, nervousness, irritability, and uncoordinated movements.
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What Happens To Your Body During Fasting
The changes that occur in the body during fasting depend on the length of the continuous fast. Usually your body enters into a fasting state eight or so hours after the last meal. Your body will initially use stored sources of glucose and then later in the fast it will break down body fat to use as the next source of energy. Using your bodys fat stores as an energy source can, in the long run, lead to weight loss. Losing weight, particularly if you are overweight, can also lead to better control of blood glucose, blood pressure and cholesterol levels. However, fasting should not be used as a way of losing weight in the long term.
The Science Behind It
When we eat, we take in more energy from food than can immediately be used by the body. Insulin is produced when we eat so it can break down the carbohydrate into glucose and be used by the cells for energy, or it will be stored in the liver or muscle as glycogen. When we need a quick source of energy or the body isnt getting glucose from food, glycogen released from the liver is broken down into glucose and sent into the bloodstream.
However, there is limited storage space for glycogen and once stores are full, the liver will turn excess glucose into fat. Some of this will be stored in the liver, or it will be exported to other fat deposits in the body.
When in a fasted state, insulin levels fall which signals the body to start burning stored energy. Blood glucose levels will fall so the body needs to use the stored glucose for energy, it will use the glycogen in the liver first as that is the most accessible. After this has depleted, the body will start to break down fat to get the energy it needs.
So, the body is in either of two states the fed or fasted state. Either we are increasing our stores of food energy, or we are decreasing the stores by burning through stored energy. If these are balanced, then there should be no change in weight.
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Can Fasting Reverse Insulin Resistance
As research shows, regular intermittent fasting directly improves insulin sensitivity. Therefore it doesnt just reduce high insulin levels.
Furthermore, fasting can reverse insulin resistance, which most diets cant .
Additionally, a fasting detox yields lots of health benefits like the removal of unnecessary or dysfunctional components from cells.
The 2016 Nobel Prize in Physiology or Medicine was awarded to Yoshinori Ohsumi for the discovery of this mechanism known as autophagy .
However, there are many myths about the drawbacks of fasting. For example, a sticky myth ist that it will overwhelm you with hunger.
But Viennese researchers have shown that the hunger hormone ghrelin gradually decreases after the peak on the first day of fasting .
According to research, blood glucose levels also remain stable when switching to burning body fat for energy .
Therefore the intake of carbohydrates is simply not necessary. And isnt it the body fat that generally worries us? Consequently, the breakdown of body fat will not harm us in any way.
In contrary to conventional wisdom, fasting also doesnt cause muscle loss, as you will see when we compare intermittent fasting and calorie restriction.
Circadian Rhythm Fasting: Why Youve Been Fasting All Wrong
Intermittent fasting. Its all the rage these days. But are you doing, right?
I know, I know, there is a plethora of information telling you it must be a done a certain way where you end up eating later in the day sometimes before bed. The trend is to skip eating upon waking and extend that well into the afternoon.
But is that the correct way to fast? More importantly, if youre honest with yourself, does that really for work you?
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Heres What We Know About Whether Intermittent Fasting May Be An Effective Tool For Diabetes Management
Again, this isnt an eating plan thats widely recommended by diabetes specialists, but there is some data to suggest IF could help with diabetes management.
A case report published in BMJfound that intermittent fasting helped treat the insulin resistance in three patients with insulin-dependent type 2 diabetes. It also lowered their A1C levels. And, this is definitely worth paying attention to: After using intermittent fasting for several months, the patients were able to stop using their insulin medication.
Intermittent fasting may even help with prediabetes. A clinical trial published in the journal Cell Metabolismthat had men with prediabetes try intermittent fasting. Some were asked to follow a plan for five weeks where they could eat for six hours a day the others were asked to eat for 12 hours a day. Those who followed the six-hour eating plan ended up having less insulin resistance at the end vs. those who followed the more regular 12-hour eating pattern.
But all of that said, a meta-analysis of research on intermittent fasting published in the journal Cell Metabolismfound that intermittent fasting had the same results on a persons insulin resistance and A1C as eating a diet with limited calories.
All in all, it’s unclear if intermittent fasting is helpful for any other reason than the fact that it may help you cut calories, since you’re eating in a shorter window of time.
Could Any Diet Takeaways From If Be Helpful For People With Type 2 Diabetes
There are a few diet takeaways from the science of IF. Insulin sensitivity changes with a circadian rhythm, decreasing throughout the day and into the night. Therefore, meals that a person consumes at night are associated with higher glucose and insulin levels.
Liming the hours of eating to a time earlier in the day for example, selecting an 8-hour window between 7 a.m. and 3 p.m. or even 10 a.m. and 6 p.m. is effective in boosting metabolism and aiding in weight loss.
People should also try to avoid eating and snacking shortly before going to bed. Not snacking between meals will facilitate the metabolic switch from the use of glucose for energy to the use of fat.
A balanced diet is also important, so people should avoid sugars and processed carbohydrates, focusing instead on eating fruits, vegetables, whole grains, lean meat, and healthy fats.
Perhaps the most important factor, though, is that people choose an eating plan that they can sustain in the long term.
Dr. Kelly N. Wood, M.D., is an internal medicine physician who is board certified in Endocrinology, Diabetes, and Metabolism. She earned her medical degree from The University of the West Indies in Barbados before relocating to the United States in 2006. Dr. Kelly is currently in clinical practice in Atlanta, GA.
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