Intermittent fasting

Intermittent fasting

An effective strategy for losing weight and treating diabetes

Since January 1, 2023, intermittent fasting has officially been part of the standards of care for the management of diabetes, published and updated annually by the American Diabetes Association.

This decision is based on the extensive preclinical and clinical research published on the subject over the past two decades. These studies have demonstrated the effectiveness of this practice in facilitating weight loss and treating diabetes, in particular thanks to its action on the key mechanisms of these diseases (chronic hyperinsulinism, insulin resistance, etc.).

What is intermittent fasting?

Intermittent fasting is an umbrella term that includes three main forms of food restriction: alternate day fasting (energy restriction of 500-600 calories on alternate days), 5:2 diet (energy restriction of 500-600 calories on consecutive days or non-consecutive days with usual intake the other five) and time-restricted eating (alternating fasting periods with feeding periods where the fasting periods must last longer than the feeding period, typically 16 hours of fasting and eight hours of feeding).

Time-restricted eating is the easiest form of intermittent fasting to set up (no need to count calories ingested) and maintain over time.

Intermittent fasting

The practice of intermittent fasting has multiple health benefits, such as reducing chronic hyperinsulinism from which obese or diabetic patients suffer, but also those reducing triglycerides and cholesterol, improving intestinal health and prolonging life expectancy, to name a few.

Chronic hyperinsulinism, obesity and diabetes

Chronic hyperinsulinism is defined as chronically elevated blood insulin levels in response to high blood glucose levels (hyperglycemia). Insulin is a hormone secreted by the pancreas, which lowers blood glucose levels by storing it in the liver, muscles and adipose tissue. Insulin is, therefore, the storage hormone.

Any excess food that will not be used immediately by our body to produce energy will, therefore, be stored in the form of glycogen in the muscles and liver, and adipose tissue to be used later, especially during our periods of fasting (for example at night).

Unfortunately, our current diet is based on diets rich in refined carbohydrates (e.g., white bread, pasta, etc.), sugar (cakes, cookies, soda, yoghurts, ice cream, etc.) and low in fibre (fruits, vegetables, legumes, whole grains, etc.). The consequence of this diet is a strong and rapid rise in our blood glucose and, therefore, insulin levels, generating hyperinsulinism.

In addition, living in a society where food is accessible everywhere and at any time of the day contributes to the fact that we eat five to six times a day, producing a constant rise in our insulin during the day, and thus generating chronic hyperinsulinism.

However, having chronic hyperinsulinism leads us, on the one hand, to gain weight because our body is continually “in storage mode” and, on the other hand, to develop resistance to insulin, which is the initial stage in the development of diabetes.

Intermittent fasting

Intermittent fasting and hyperinsulinism

Time-restricted eating reduces the number of hours per day we eat (to e.g., eight hours per day) and increases the time we fast per day (to e.g., 16 hours per day), which makes it possible to reduce a continuously high level of insulin, and in this way to reduce hyperinsulinism and restore our body’s insulin sensitivity.

In obese people, intermittent fasting will, therefore, be very effective in putting the body into “fat destocking mode”, thereby optimising fat and weight loss (3% to 8% compared to the starting weight over a short period duration: 8-12 weeks depending on the studies).

As for diabetic patients, the improvement of insulin sensitivity and the reduction of hyperinsulinism will allow better control of their glycemia, reduce the dose of their drugs against diabetes and even, according to recent studies, experience a lasting remission of their diabetes.

Finally, it is important to emphasize that intermittent fasting is not a diet but a way of eating, which humans has carried out for thousands of years. The first step is, therefore, to rebalance your diet (in particular by reducing foods with a high glycemic index) before embarking on intermittent fasting, which must be supervised by a health professional.

By Dr Aurélien Núñez

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Aurélien Nuñez is a Functional and micronutritional Medical Doctor, graduated from the Favaloro University of Buenos Aires, Argentina. Specialised in Micronutrition, Food, Prevention and Health (MAPS) from the Paris Descartes University. He is working at Hotel Capela Das Artes in a project named Smart Treatments, where with his colleague, Silvestre Gonzalez, an Ayurveda-oriented Medical Doctor, and a team of therapists, are offering consultations, body therapies, retreats, yoga, meditation classes and workshops.
Instagram: @smart_treatments