What Is Intermittent Fastinganswers By Shamera Robinson Mph Rd
Even if you havent heard about intermittent fasting, the idea of fastinggoing without food, or both food and drink, for a period of timeprobably sounds familiar. People fast for reasons ranging from upcoming medical tests and procedures to religious and spiritual practice. However, the conversation around fasting as a strategy for weight loss is becoming more popular among health professionals.
This article was originally published in Diabetes Forecast.
To Skip Or Not To Skip: Does Intermittent Fasting Help People With Diabetes
Weve reviewed the latest research to weigh the benefits and drawbacks of intermittent fasting and time-restricted feeding for people with diabetes.
Living with diabetes means carefully making sure you are eating foods that will keep your blood sugar and insulin levels in balance. However, a recent trend in the diabetes community focuses on when to eat. You may have heard friends, family, and healthcare professionals use words like intermittent fasting and time-restricted feeding to describe this trend. We are going to take a closer look at what these eating strategies entail, how they might affect people with diabetes, and the risks and benefits to consider if you choose to skip a meal.
Intermittent fasting refers to a style of eating in which you alternate through a pattern of consuming little to no calories for a while and a normal eating schedule. Popular IF schedules include alternate day fasting, where one day you consume very little food and the next day you eat like you normally would this regimen is usually repeated every other day, though some people make exceptions to this depending on what works best for their lifestyle. Another method is periodic fasting , where you reduce your food consumption on certain days of the week but then eat regularly on the other days. These patterns aim to reduce the number of calories you are consuming.
How Does Fasting Affect My Metabolism
Sugars and fats serve as our bodys main sources of energy. After a meal, sugars are used for energy first. They are broken down and delivered to the bloodstream, while fats are stored for energy later. When we restrict eating, our bodies run out of carbohydrates to use for energy and instead breakdown stored fats, converting them into ketones.
Ketones are our body’s alternative to using glucose for energy, and fasting or carbohydrate restriction can make this alternative available for energy use. The change from using sugars to using ketones is known as metabolic switching, a process that scientists believe produces many of the health benefits attributed to IF beyond weight loss. Intermittent fasting and time-restricted feeding allow us to control this process and cause metabolic switching in our own bodies.
However, the excess production of ketones can lead to a dangerous condition known as diabetic ketoacidosis or DKA, especially if you have type 1 diabetes. Because of this risk, you should talk to your healthcare team before starting a diet that includes fasting so that your health can be monitored effectively and your medication doses can be adjusted. If you have type 1 diabetes, you will have to regularly test your ketone levels to avoid the risk of DKA. This risk is especially high if insulin doses are reduced excessively to avoid hypoglycemia while fasting.
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How To Selectthe Intermittent Fasting For Diabetics
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Nonetheless, choosing the intermittent fasting for diabetics might prove to be a hassle for a newbie. Even for early users, it can pose a challenge to select the best product.
Below are some factors to take into account when selecting the intermittent fasting for diabetics on Amazon:
Prescribing Intermittent Fasting In Practice: Recommendations
While alternate day fasting and periodic fasting have demonstrated efficacy in improving metabolic risk factors, it may be difficult to convince patients to give up or severely restrict calories for an entire 24h period. In America, we often eat 3 meals per day in addition to frequent snacking. Furthermore, in American culture most social engagements involve food. Asking patients to eliminate these experiences from their day to day lives may become burdensome, and thus hinder patient compliance. Finally, patients switching to an intermittent fasting regimen may initially experience symptoms such as hunger and irritability, although these symptoms often dissipate within the first 30days . Therefore, it would be more appropriate to gradually introduce intermittent fasting in the form of time restricted feeding. For example, clinicians may first recommend that patients restrict their intake to a daily 12h period, typically an overnight fast . As patients become more comfortable with this pattern of eating, the feeding window can be restricted further . This allows the patient some daily flexibility in choosing when to consume calories, thus increasing the likelihood of compliance. Lastly, patients who have become adapted to time restricted feeding may choose to switch to alternate day or periodic fasting with the supervision and guidance of a registered dietician. See Fig. for a detailed example of an intermittent fasting prescription.
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How Sensible Intermittent Fasting Can Keep You Healthy
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Studies suggest that intermittent fasting typically, eating only during an eight-hour period or eating only every other day could have many potential benefits, including improvements in glucose and cholesterol levels, blood pressure and weight.
The benefits are thought to result from a process called metabolic switching, which is when the body goes into a fasting state and begins using body fat instead of glucose to meet its energy needs. Intermittent fasting helps preserve the bodys normal interplay between the hormone insulin and blood glucose, preventing insulin resistance . Metabolic switching also signals the body to activate maintenance and repair systems, which aid in disease prevention.
But intermittent fasting isnt for everyone. Going for long periods without food may be too extreme for some older adults, people with diabetes, and those who must take certain medications at designated hours, among others, says Dorothy Sears, a professor of nutrition at Arizona State University College of Health Solutions in Phoenix.
How To Do Intermittent Fasting With Type 1 Diabetes
As a person with type 1 diabetes, you might even notice that you feela little free, because you arent worrying about whether youre going to be high or low after your breakfast.
The awesome part of this for people with type 1 diabetes is this: your blood sugar is steady, steady, steady all morning long until you end your fast by eating at 11 a.m. or 2 p.m. or dinnertimedepending on which fasting schedule you follow.
Ive also found that if I do a 24-hour fast before a carb-heavy meal like pizza, Ive found that fasting actually cuts down significantly on the insulin I need for that meal.
If you stick to your fasting program consistently, youll find you lose weight and you gain insulin sensitivity, which means: youll need to decrease your background/basal insulin rates! This is a good thing! This is part of weight-loss with diabetes, but if you arent expecting it, youll be annoyed and frustrated with the low blood sugars.
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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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What Foods Should I Avoid
On an intermittent fasting diet, foods that you should avoid foods are:
- Refined carbohydrates: This means any carbohydrates that have been highly processed and contains little of the original grain. These foods will cause a rapid spike in your blood glucose levels and include white flour, white bread, white rice, white pasta and many breakfast cereals.
- Sugar: This includes simple sugars such as honey, table sugar and maple syrup but also any foods that contain added sugar such as sugary drinks, sweets, chocolates, ice cream, biscuits etc.
- Animal fats: Foods that contain animal fats such as butter, cheese, cream, dripping and lard should be avoided on a low-fat diet as they are high in saturated fat.
- Red & Processed meat: Processed meats such as bacon and sausages contain a lot of saturated fat. Stick to lean meats any cut any visible fats off meat.
- Processed foods: Processed foods are defined as any food that has been altered in some way during preparation. These include cakes, pastries, biscuits, fast food, pies, crisps and convenience foods. They are generally high in calories due to the amount of saturated fat and added sugar.
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Benefits Of Intermittent Fasting
A few small human studies have shown evidence that intermittent fasting can have health benefits for those with diabetes. These include:
- Weight loss
- Lowering insulin requirements
A long-term study, published in the New England Journal of Medicine, revealed that a fasting state can support several benefits including:
- Lessening inflammation
- Dehydration
- Sleepiness during the day
- Low energy levels
- A significantly increased risk of low blood sugar
- High blood sugar resulting from a surge of stored glucose from the liver when low blood sugar levels result from fasting
Its important to note that more research is needed to definitively back up the claims of side effects from intermittent fasting and to confirm the severity of such untoward reactions.
Because of the likeliness of side effects from fasting when a person has diabetes, its important to consult with your healthcare provider before deciding to start any type of fasting diet.
What Are The Downfalls Of Intermittent Fasting For Diabetes
Many clinicians, myself included, have found that intermittent fasting can exacerbate disordered eating patterns in vulnerable individuals. Waiting too long to eat can alter hunger hormones and increase cravings and appetite. For many people this can lead to overeating and sometimes binge eating.
As far as the research goes, some studies have found that IF may increase binge eating in women with bulimia. Others have found that IF may actually help in overweight and obese individuals.
So, the existing data tells us that IF has the potential to be harmful to normal-weight individuals and those with preexisting disordered eating behaviors and diagnosed eating disorders. Women may also be at an increased risk for negative outcomes associated with intermittent fasting.
A few studies have found that long-term intermittent fasting in overweight and obese women resulted in a longer than average menstrual cycle and altered reproductive hormone levels in normal-weight women. More research needs to be done to understand the full impact of IF on women’s menstrual cycles, but this is definitely something to look out for if you’re thinking of trying IF.
Additionally, one study looked at the effects of three weeks of IF in overweight men and women. Results found that men had improved measures of glucose control, but women actually had impaired glucose control.
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Does Intermittent Fasting Help Diabetes
Intermittent fasting is a diet plan in which you do not eat for a specific period of 16-24 hours. For example, you can eat within 8 hours and fast for 16 hours. You can also fast on certain days of the week.A popular alternate-day fasting plan is the 5:2 plan, which allows you to eat normally for 5 days and limit your diet to 500-600 calories 2 days a week. Johns Hopkins Medicine.
Intermittent fasting triggers a «metabolic switch» that helps the body and brain in many ways, including improving memory, heart health, and physical function . This approach also helps prevent obesity, which is a risk factor for diabetes, especially type 2 diabetes.Obesity causes inflammation in the body, which affects the way the body produces insulin, according to alive. If intermittent fasting can potentially prevent obesity, does it help diabetes?
Intermittent Fasting Can Help Weight Loss
IF makes intuitive sense. The food we eat is broken down by enzymes in our gut and eventually ends up as molecules in our bloodstream. Carbohydrates, particularly sugars and refined grains , are quickly broken down into sugar, which our cells use for energy. If our cells dont use it all, we store it in our fat cells as, well, fat. But sugar can only enter our cells with insulin, a hormone made in the pancreas. Insulin brings sugar into the fat cells and keeps it there.
Between meals, as long as we dont snack, our insulin levels will go down and our fat cells can then release their stored sugar, to be used as energy. We lose weight if we let our insulin levels go down. The entire idea of IF is to allow the insulin levels to go down far enough and for long enough that we burn off our fat.
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Before You Try Fasting
Talk to your doctor first. If you have type 1 diabetes, other health problems due to diabetes, or have had hypoglycemia, your doctor may recommend you not fast.
If your doctor says itâs OK to try, ask if you need to check your blood sugar more often or adjust your diabetes medication during and after fasting.
Watch for signs of low blood sugar. If you start to feel shaky, sweaty, or confused, your blood sugar may be too low. Stop fasting right away and do what you normally would to treat hypoglycemia. For example, eat a glucose gel or have a sugary drink followed by a small, balanced meal when your blood sugar level is back to normal.
Be careful about what you eat after fasting. Eating too many carbohydrates after fasting can cause your blood sugar levels to become too high. Choose healthy, balanced meals and snacks.
Use caution. Donât do tough workouts while youâre fasting. Hard exercise can make your blood sugar levels dip, which can lead to hypoglycemia. Ask your doctor what activities are OK to do, or just take a break.
Stay hydrated. Having diabetes puts you at risk of dehydration, which can make your blood sugar harder to manage. Drink lots of water and calorie-free beverages when you fast.
Kathryn A. Boling, MD, Mercy Medical Center.
CMAJ: âIntermittent fasting: the next big weight loss fad.â
Annual Review of Nutrition: âMetabolic Effects of Intermittent Fasting.”
The Ohio State University Wexner Medical Center: âDoes Intermittent Fasting Work?â
How Intermittent Fasting Works
The primary goal of intermittent fasting for weight loss is to get the insulin levels to decrease to a level where the body will begin to burn stored fat for energy.
Here is how it works. When the food we eat is metabolized , it ends up as molecules in the blood stream. One such molecule is glucose . Normally, when there is more circulating blood glucose than the body can use for energy, the excess is stored as fat for future use. But, for glucose to be utilized by the cells, it requires insulin. Between meals the body doesnt require insulin so insulin levels decline. When insulin levels are low, the fat cells release some of the stored glucose, resulting in weight loss.
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Fasting And The Risks
As well as the abstinence from food , fasting is also usually a time of prayer, reflection and purification. If you treat your diabetes with certain medications such as insulin, there is also the danger of the blood sugar levels after fasting becoming too low. This can lead to a hypo, or having your blood sugar levels too high which can lead to diabetic ketoacidosis , which would require hospital treatment. The symptoms of DKA include feeling very thirsty and passing a lot of urine.
If someone is fasting and does not take in fluids to reduce their thirst, this will accelerate dehydration and they will require urgent admission to hospital.
You should always check with your GP or diabetes team if you are thinking about fasting, particularly if you’re not sure of what to do with your diabetes medications. If you can’t get hold of them, it would be advisable not to fast. And if you require urgent medical help you can use the NHS 111 online service.
How Fasting Reverses Type 2 Diabetes
While many consider type 2 diabetes irreversible, fasting has been long known to reverse diabetes. In a previous post, we considered bariatric surgery. While extreme, these surgeries have proven the point that the metabolic abnormalities that underlie T2D can be fully reversible even after a few short weeks.
Many early studies were done with the heavy-duty Roux-en-Y surgery, which is the heavyweight champions of surgeries. The best weight loss. The most complications.
But even milder forms of bariatric surgery show the same reversibility of T2D. A gastric band is essentially a belt implanted around your stomach. The surgeon keeps tightening the belt so that you cant eat.
The results of gastric banding versus medical treatment showed a significant and pretty good drop in their fasting blood sugars. In other words, their T2D was reversing in a b-i-g way. Those given medicines alone basically stayed the same. They were no better than before.
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