Its no secret that intermittent fasting is the weight-loss method du jour. Instagram is packed with people who swear intermittent fasting (IF) helped them lose weight, feel more energized, and have better overall health.
But with all of the info out there about intermittent fasting, its easy to gloss over the fact that IF has actually been a used as a medical intervention for years. Its helped people with a range of health conditions, including diabetes.
In fact, the American Diabetes Association (ADA), which is considered the leading educational organization for diabetes in the country, published this in its journal Diabetes in 2018: In both experimental and clinical studies, intermittent fasting has been shown to improve insulin sensitivity and glucose control along with modest decreases in body weight.
And last year, the ADA released a nutrition consensus report that also addressed intermittent fasting. In it, the ADA wrote that somebut not allsmall studies have shown that intermittent fasting reduced A1C in people with diabetes. (A1C is a measure of your average blood sugar over time.) Still, there isnt a mainstream, blanket recommendation for diabetes patients when it comes to intermittent fasting for better health, but there does seem to be some link here.
So whats the deal with intermittent fasting and diabetes, and should you try the eating pattern if you have the condition? Doctors weigh in.
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 BMJ found 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 Metabolism that 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 Metabolism found that intermittent fasting had the same results on a persons insulin resistance and A1C as eating a diet with limited calories.
Basically, there is no evidence that intermittent or any other type of fasting is better than caloric restriction in losing weight, says Mark H. Schutta, MD, medical director of the Penn Rodebaugh Diabetes Center. And, he points out, weight loss can help reduce a patients insulin resistant and A1C levels, regardless of how it was achieved.
The research on the impact of intermittent fasting and diabetes isnt perfect, says Lissette Cspedes, MD, assistant professor of medicine in the Division of Endocrinology at Rutgers Robert Wood Johnson Medical School. In clinical studies, the study sizes have generally been small and the follow up period is short, she says. Studies also vary by which method of fasting is employed. As such, long-term benefit and generalizability cannot be determined.
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.
While some people swear that intermittent fasting will completely change your life, those claims are a little overblown. Still, theres some research to suggest that IF has perks. Those include:
A lot if it comes down to personal preference. Patients need to work with their physician to find a plan that works best for them [that] poses the fewest risks, and that they can sustain over a long period of time, Dr. Cspedes says.
That said, a 16:8 schedule may be easiest to follow and the most beneficial for maintaining good blood glucose controland several studies have found this eating pattern to be beneficial. I often tell my patients that the most impactful change they can make is to eat less at dinner, go to bed with a normal or close to normal glucose, and then wake up with the same, Dr. Schutta says.
But, again, There truly is no one-size fits all approach to selecting a regimen for patients with diabetes who want to improve their insulin resistance and glucose metabolism, Dr. Cspedes says.
Intermittent fasting isnt perfect, and there are some side effects to consider.
If youre interested in trying intermittent fasting to better manage your diabetes, its important to talk to your doctor first, Dr. Cspedes says. They may have some concerns you havent thought of, and may even need to adjust your medication.
Its also important to think about what youre eating during a feeding window. In general, we recommend that patients eat a healthy diet, which will improve their cardiometabolic risks, Dr. Cspedes says. This includes increasing intake of fresh foods, such as fruits and vegetables, and complex carbohydrates and minimizing highly processed foods or simple carbohydrates.
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The quality of your calories matters too, Dr. Cspedes says. A person with diabetes should also take into consideration the amount of carbohydrates being consumed in the diet, she says. Generally, eating fewer than about 150 grams of carbohydrates in a day will improve blood glucose levels, insulin resistance, and help with weight loss.
Complex carbohydrates with a higher fiber content, like using cauliflower instead of white rice, are better options since these are absorbed more slowly and lead to less glucose excursions, Dr. Cspedes says. Given that youll probably be ready to eat as soon as your feeding window starts, its important to plan ahead to make sure you have quality food ready to go once your fasting period is over.
Finally, youll want to create eating and fasting windows that work best for your diabetes management. Breakfast is truly the most important meal of the day for people with diabetes, Dr. Schutta says (your body is better able to process glucose when youre up and moving). But youll want to make sure youre actually hungry in the morning and not still full from a huge dinner you ate. "Patients have to figure out a way to restrict food after dinner and make sure that they eat breakfast every day, Dr. Schutta says.
The bottom line: If youre interested in trying out intermittent fasting to help manage your diabetes, talk to your doctor first. They should be able to offer up personalized advice to help steer you in the right direction.
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Intermittent Fasting And Diabetes - Is It Safe, How Do You Do It? - Women's Health
