Intermittent Fasting – Part 5

By: Kelly Gilthorpe Burkenstock, M.D.

Religions have long maintained that fasting is good for the soul, but its health benefits were not widely recognized until doctors began using various fasting diets to treat many issues such as diabetes, obesity and epilepsy. Interestingly, fasting as a treatment for epilepsy dates back to the Roman Era where people with epilepsy were caged and starved to rid them of their demons.

Whether an individual practices fasting for spiritual, health or medical reasons, most people will fast at some point in life.

Intermittent Fasting is a regimen that cycles between periods of fasting, with either no food or significant calorie reduction, followed by periods of unrestricted eating. It changes the body’s composition through loss of fat and weight, while also improving many health parameters associated with disease such as: blood pressure, cholesterol, inflammation, obesity, brain health, heart health, aging, andropause and menopause and possibly cancer. Intermittent Fasting drains the body of one’s glucose (sugar) reserves – the main energy source from the foods we eat. Without this glucose reserve, an individual’s body switches to burning fat as fuel – known as ketosis. There are many different versions of Intermittent Fasting; some notable examples include:

5:2 Fast, consisting of eating normally for five days every week and fasting for two days. On the two fasting days the client restricts their calorie intake to 500-600 calories per day. The other five days the client eats normally and unrestricted.

16:8 Fast, clients eat normally and unrestricted for eight hours and fast for the remaining 16 hours- drinking only water and calorie free drinks.

18:6 Fast, clients eat normally and unrestricted for six hours and fast for the remaining 18 hours – drinking only water and calorie-free drinks.

2:5 Juice Cleanse Fast, a quality juice cleanse is used for 48-72 hours, (two or three days), and then clients eats nutritious meals after the cleanse is complete. A low sugar, low salt, all natural juice cleanse, enriched with vitamins, minerals, fiber and PREBIOTICS is best. Clients eat normally (but nutritiously) for four or five days, then fast with a quality juice cleanse for two to three days.

When an individual switches to an Intermittent Fasting diet plan, they upgrade their body’s performance in a number of ways. Their body initiates a number of important hormonal changes which make fat more accessible to burn. There are diverse and powerful benefits thought to occur due to intermittent fasting such as: weight loss, disease prevention, improved memory, brain restoration, heart health, mood improvement, decrease in insulin resistance, increase in lifespan (Anti-Aging), enhancement in stress tolerance and an upgrade to the immune system. Several trials have shown significant weight loss, without an overall increase in appetite. Though these benefits are proven in animal trials, we await final confirmation from ongoing human trials.

Part 5 Insulin Resistance, Blood Sugar and Type 2 Diabetes with Intermittent Fasting

The gut functions best on a 12 to 18 hour fasting cycle benefiting the gut’s microorganisms and the body’s immune system. In doing this practice, the body is benefited in many ways. Metabolism becomes less stressful, and the body is much more receptive to insulin due to it not being subjected to wide swings in blood sugar, known as insulin resistance. In addition, when an individual consumes a heavy dinner or late-night snack, the following may occur: the food is digested less efficiently, sleep is impaired, and gut motility slows down hampering the bowel movement process.

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During intermittent fasting, blood levels of insulin drop significantly which increases fat burning. With the lower insulin levels, we see higher growth hormone levels and increased amounts of norepinephrine, which all increase the break down of body fat; this fat is used for energy. Intermittent fasting has shown to reduce fasting blood sugar from three to six percent, congruently fasting insulin is reduced by 20 – 30 %. One study in diabetic rats showed that intermittent fasting protected against kidney damage, one of the most severe complications of diabetes. Intermittent fasting appears to tame the majority of diabetes complications.
As noted in the publication BMJ October, 2018, planned intermittent fasting may help to reverse type 2 diabetes, suggest doctors after three patients in their care, who did this, were able to cut out the need for insulin treatment altogether. Further research may prove an exciting new treatment plan for diabetes type 2. (Note: This does not apply to type 1 diabetes, juvenile, insuln dependent.)

Three men, aged between 40 and 67, participated in a planned intermittent fasting to see if it might ease their symptoms. They were taking various prescriptions to control their disease as well as daily units of insulin. In addition to type 2 diabetes, they all had high blood pressure and high cholesterol.

Two of the men fasted on alternate days for a full 24 hours, while the third fasted for three days a week. On fast days they were allowed to drink very low-calorie drinks, such as tea/coffee, water or broth, and to eat one very low calorie meal in the evening.

Before embarking on their fasting regime, they all attended a 6-hour long nutritional training seminar, which included information on how diabetes develops and its impact on the body; insulin resistance; healthy eating; and how to manage diabetes through diet, including therapeutic fasting.

They stuck to the planned intermittent fasting for 10 months after which fasting blood glucose, average blood glucose (HbA1c), weight and waist circumference were re-measured.

All three men were able to stop injecting themselves with insulin within a month of starting their fasting schedule. In one case this took only five days.

Two of the men were able to stop taking all their other diabetic drugs, while the third discontinued three out of the four drugs he was taking. They all lost weight (by 10-18%) as well as reducing their fasting and average blood glucose readings, which may help lower the risk of future complications, say the authors.

Feedback was positive, with all three men managing to stick to their dietary schedule without too much difficulty.

In a separate study, New Zealand researchers found the risk of low blood sugar (hypoglycemia) was increased during the fasting days, as expected, but that the two intermittent fasting plans they tested still managed to produce weight loss and a drop in A1c levels, which is used to assess your risk for diabetes. The study is published in Diabetic Medicine.
In the New Zealand study, men and women were on a variety of medications, including insulin, sulfonylureas, metformin, and oral hypoglycemic agents. The researchers made adjustments to their medications in response to lower blood sugar levels on the fasting days, to avoid worrisome hypoglycemic episodes. The main study aim was to look at low blood sugar events and to monitor the amount of weight loss, A1c levels, and other parameters.

All participants experienced lower blood sugar and all clients lost weight. The level of HgbA1cs improved in the study group.

Angela Fitch, MD, FACP, associate professor at the University of Cincinnati College of Medicine, says that while intermittent fasting can be an option, for type 2 diabetics, patients who choose this approach must work closely with their doctor to figure out how best to lower their hypoglycemic medications on fasting days.

Everyone, but especially those with high blood sugar, insulin resistance or diabetes, should avoid processed foods, artificial sweeteners and refined carbohydrates.While intermittent fasting is a no brainer for insulin resistance and those who struggle with high blood sugar, it may prove to be a way to manage diabetes through diet.

The quality of the carbohydrates we choose is crucial. Choose carbohydrates with higher fiber content cauliflower or quinoa, instead of white rice.

The main dietary sources of refined bad carbohydrates are white flour, white bread, white rice, pastries, sodas, snacks, pasta, sweets, breakfast cereals and added sugars. Bad carbohydrates are also added to all sorts of processed foods and processed grains. Corn syrup, maple syrup, high fructose corn syrup and sugar alcohols are often hidden in the list of food ingredients and are bad as well.

On to better blood sugar and a decrease in insulin resistance via a combination of Intermittent Fasting intertwined with better carbohydrate choices. Better complex carbohydrate choices are: Fresh fruits – blueberries, apples, grapefruit, lemons, oranges, cantaloupes, melons and bananas; Vegetables – squash, cauliflower, broccoli, Brussel sprouts; Legumes – beans, peas, lentils, chick peas, yams and potatoes; Seeds and nuts – almonds, macadamia, pistachio, sunflower, flax and chia; Whole grains – quinoa, oats, couscous, barley, buckwheat. Note: Organic and NON-GMO are the best produce options.

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“The use of a therapeutic fasting regimen for treatment of [type 2 diabetes] was virtually unheard of,” until now. Several studies are ongoing and appear promising!

While inflammation is a good and normal response to injury or trauma, chronic inflammation can lead to lifelong disease and perforations of the gut lining. Some scientific research has found relationships between chronic inflammation and heart disease, diabetes, obesity and cancer. As noted in nutrition research, people following Ramadan fasting for religious or cultural obligations have decreased inflammation markers during their Ramadan fasting. This concurs with other scientific research that found longer duration nighttime fasting was associated with decreased inflammation and oxidative stress. Lower levels of both chronic inflammation and oxidative stress may prove to improve gut health, fight off many diseases and offer the body Anti-aging, vitality and longevity.

As opposed to Intermittent Fasting, severe long-term fasting results in a reduction in size in most organs, except the brain. The human body goes to great lengths to preserve the most important organ, the brain. Severe long-term fasting is harmful and not recommended. VERY IMPORTANT DIABETICS must NOT initiate a regimen of intermittent fasting without the guidance and supervision of a physician. Diabetic medications would have to be modified as blood sugar will decrease and a true risk of hypoglycemia exists.
Foolproof? Unfortunately, not. The main reason for success with intermittent fasting is that there is less caloric intake overall, so if an individual binges on massive amounts of food, eats before bed or indulges in high fat, junk carbs and/or processed foods or consistently eats against their personal DNA macronutrient profile, they may not lose any weight at all. They may also not experience many of the other health benefits of Intermittent Fasting.

Some animal studies have shown that food is processed differently at different times of the day. This could be due to fluctuations in body temperature, biochemical reactions, hormone levels, physical activity and/or absorption and digestion of food. In addition, a person’s unique DNA macronutrient profile determines what percent of each macronutrient (proteins, fats, and carbohydrates) they are personally built to metabolize most efficiently due to their genetic makeup. This explains why an individual may begin a certain diet plan with a friend (Atkins, Keto-Diet, South Beach Diet, etc.), but the weight lost by each individual may differ.
In essence, I recommend that everyone incorporate a juice cleanse detox into their life with a quality grade juice cleanse product plus raw greens, or one salad per day for several days. This acts as a method of Intermittent Fasting to slow aging and prolong lifespan as an easier alternative to water fasting. Water fasting has a rapidly decreasing effect at removing toxins, as nutrients necessary for the removal also decrease as the water fast progresses. Electrolyte imbalances can also appear.

Juice cleanse fasting with a quality product enables clients to continue to work, and is safer than water fasting. Juice cleanse fasting prevents dehydration, loss of electrolytes and fainting.

A few days of juice cleansing can be a great way to reset an individual’s taste buds, and jump start a new, healthful diet. However, there is no health benefit of trying to use a juice cleanse as a temporary detox. This will inevitably lead the individual to return to their unhealthy diet practices. This Intermittent Fasting magic only works if you stick with a nutritious diet long-term; such as one that is congruent with your DNA macronutrients, and also incorporates some juice cleansing and occasional caloric restriction.

As always, please consult a physician before starting any diet plan if you have any medical conditions, especially if you are a DIABETIC, pregnant or nursing.

Stay tuned to part 6 – Cancer and Intermittent Fasting

– Dr. Burkenstock’s articles can also be found on www.healthfitnessmag.com.

– Dr. Kelly Gilthorpe Burkenstock is an internal medicine physician, and has studied abroad with several of the world’s foremost international luminaries. She has locations in Metairie and Mandeville.
For more information, please call 985-869-8400 or 504-502-7600.

References:
Current Biology 2018
Short-Term, Intermittent Fasting Induces Long-Lasting Gut Health and TOR-Independent Lifespan Extension
Documentary Eat Fast and Live Longer
NCBI/Pubmed 23112824
Dr. Krista Varady, University of Illinois
Dr. Sandrine Thuret, Neuroscientist
Dr. Mark Mattson, National Institute on Aging
University of Pennsylvania School of Medicine’s Center for Weight and Eating Disorders.

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