Fasting and insulin sensitivity -
Primary care physicians are recommended to familiarize themselves with the nuances of IF, particularly for diabetic patients who may require careful oversight and medication adjustments during fasting periods.
As research evolves, IF could become a central component in the management of type 2 diabetes and other metabolic diseases, provided it is tailored to individual patient needs and medical oversight is maintained. Intermittent fasting extends its health benefits beyond regulating glucose levels.
When it comes to weight management, IF has been highlighted as a promising strategy for tackling obesity. This outcome appears consistent even without significant changes to total caloric intake.
Further research through a systematic review of 40 studies echoes these findings, with participants typically shedding 7 to 11 pounds within a week period. The cardiovascular benefits of IF also make a strong case for its broader health implications.
Such changes not only support weight stabilization but also mitigate diabetes risk , which is a known precursor for heart disease.
The Vibrant Wellness Diabetes Panel is a comprehensive tool designed to evaluate metabolic status and insulin resistance, which is important to assess before deciding whether intermittent fasting is the best option. This panel offers an in-depth analysis of key biomarkers, including fasting glucose and insulin levels, HbA1c, and lipid profiles, providing a multifaceted view of an individual's metabolic health.
These markers are pivotal in assessing the efficiency of glucose utilization and insulin sensitivity. This panel, by offering early detection, can be instrumental in guiding lifestyle and dietary changes, including intermittent fasting, to prevent the progression of metabolic disorders, emphasizing the importance of proactive health management.
Starting an IF routine can be a positive step towards better health, but it's important to approach it safely and tailor it to your individual health needs. IF isn't one-size-fits-all; it's crucial to consider personal health status and lifestyle before beginning.
Firstly, consult with your primary care practitioner before starting IF, especially if you have a chronic condition. Certain individuals should avoid IF, including children and teens under 18, pregnant or breastfeeding women, and those with type 1 diabetes, due to the risk of hypoglycemia with insulin use.
Additionally, people with a history of eating disorders should steer clear of fasting practices. Once you have the green light from a healthcare provider, start slowly. Begin with shorter fasting periods and gradually increase the duration as your body adjusts. Listen to your body as you implement IF.
Remember, IF can have different effects on different people Lastly, sustaining an IF routine requires adapting it to fit into your daily life without causing undue stress or anxiety. Balance is essential, as is ensuring you're consuming nutrient-rich foods during your eating windows to maintain overall health.
With a thoughtful approach, IF can be a safe and effective way to improve health and well-being Intermittent fasting comes with potential risks that warrant consideration, especially for those with certain medical conditions.
Individuals using antidiabetic medications such as insulin and sulfonylureas must be cautious, as fasting can increase the risk of hypoglycemia. Those with a history of eating disorders, specific chronic diseases like heart failure, or conditions where dehydration poses a significant threat, such as stroke, should also approach IF with caution.
Pregnant and breastfeeding women, children, and older adults with frailty are advised against fasting due to unique nutritional needs and risks. Therefore, easing into IF with professional medical advice and ensuring adequate hydration and nutrient intake is crucial for safety.
Medical guidance becomes particularly important when managing insulin resistance with intermittent fasting. Healthcare practitioners can offer tailored advice on medication adjustment, monitoring blood glucose levels, and ensuring adequate fluid intake. For those interested in exploring IF, engaging in this dietary pattern under the supervision of healthcare professionals such as physicians, certified diabetes educators, or dietitians is recommended.
This careful approach can help mitigate the risks of intermittent fasting, allowing individuals to explore its potential benefits while minimizing adverse effects and ensuring it aligns with their health needs and lifestyles 10 , Adopting intermittent fasting can offer several health advantages, including aiding weight management and potentially improving heart health by positively influencing blood pressure and cholesterol levels.
Personalizing fasting methods to fit individual health profiles and needs is key, and for those with insulin resistance, IF may help reset insulin sensitivity. However, it's crucial for anyone considering IF to consult with healthcare professionals to tailor the practice to their unique health situations and to adjust any medication accordingly.
With proper guidance, IF can be a valuable component of a health-conscious lifestyle. Documents Tab.
Redesigned Patient Portal. Simplify blood panel ordering with Rupa's Panel Builder. Sign in. Sign in Sign up free. Subscribe for free to keep reading! If you are already subscribed, enter your email address to log back in.
Are you a healthcare practitioner? Yes No. Search All Content Magazine Podcasts Lab Companies Lab Tests Live Classes Bootcamps Health Categories. Basic Lab Markers. Case Studies.
GI Health. Herbal Medicine Fact Sheets. Exclusion criteria consisted of duplicates, abstracts, non-English articles, articles that did not include human subjects, those that did not report outcome measures for any of the previously described variables, and works that were unpublished or unrelated to the topic of interest.
Our initial search returned studies. Two reviewers independently reviewed abstracts to determine whether studies met our inclusion criteria. Studies that met criteria were then further reviewed to determine whether they would be included in our review.
After careful review, a total of 17 articles were ultimately chosen and are available for review in Tables 1 and 2. Intermittent fasting has recently gained popularity as a means of improving body composition and metabolic health [ 28 , 29 ].
There are several different regimens of intermittent fasting. One such regimen is alternate day fasting, in which days of fasting are separated by days of ad libitum food consumption [ 29 ].
See Fig. Obesity is known to be a major risk factor for the development of type 2 DM. There are a number of mechanisms believed to contribute to the development of insulin-resistance in obese patients. These include, but are not limited to, systemic chronic inflammation and ectopic lipid deposition [ 7 , 9 , 30 , 31 ].
Visceral adipose tissue is known to function as both a paracrine and endocrine organ through the secretion of adipokines [ 10 ]. These adipokines are either proinflammatory leading to chronic low-level inflammation, such as leptin, or anti-inflammatory such as adiponectin [ 10 ].
Leptin is known to play a role in the regulation of body weight through signaling to the hypothalamus and other brain regions to suppress food intake and increase energy expenditure [ 9 ]. The inflammatory effects of leptin are likely due to its role in the production of IL-6, which induces the synthesis of C-reactive protein in the liver as well as upregulation of the pro-inflammatory cytokine TNF-alpha [ 10 ].
Interestingly, patients with higher levels of BMI and insulin resistance were found to have increased leptin levels, possibly signifying that patients with obesity and insulin resistance are developing leptin resistance as well [ 10 ].
On the contrary, adiponectin is known to have antidiabetic and anti-inflammatory effects. Adiponectin acts on various receptors that results in an increase in skeletal muscle and hepatic fatty acid oxidation, reduced hepatic gluconeogenesis, and increased glucose uptake [ 10 ].
It also exerts anti-inflammatory effects through direct action on inflammatory cells, action of NF-kB, and interactions with TNF-alpha [ 10 ].
Adiponectin levels decrease with accumulation of visceral fat [ 10 ]. López-Jaramillo et al. performed a review with the intention of determining levels of leptin and adiponectin in patients with metabolic syndrome.
They found that in patients with the metabolic syndrome, which includes obesity and insulin resistance, an imbalance in levels of leptin and adiponectin appeared to play a role in metabolic alteration that increased the risk of type 2 diabetes [ 10 ].
Interestingly, several studies have demonstrated that intermittent fasting, even in the absence of fat loss, has resulted in a reduction of leptin levels and an increase of adiponectin, which results in improvements of insulin resistance [ 32 ].
It has long been known that restricting calories can reduce body weight and increase metabolic health [ 33 ]. A study by Larson-Meyer et al. However, several obesity trials have demonstrated that humans have significant difficulty sustaining daily calorie restriction for extended periods of time [ 28 ].
On the other hand, intermittent fasting has higher compliance and has shown promise in the improvement of metabolic risk factors, body composition, and weight loss in obese individuals [ 28 , 35 , 36 ].
During this transition the body begins to switch from the synthesis and storage of lipids to mobilization of fat in the form of ketone bodies and free fatty acids [ 28 ]. This transition of fuel source, or metabolic reprogramming, has been highlighted as a potential mechanism for many of the beneficial effects of intermittent fasting.
Lastly, intermittent fasting has been shown to reduce adiposity, particularly visceral fat and truncal fat, largely due to mild energy deficits [ 12 , 17 ]. Insulin plays a significant role in glucose homeostasis due to its influence in promoting the storage and utilization of glucose.
However, the effects of insulin are not limited to glucose homeostasis. Insulin also plays a role in the stimulation of DNA synthesis, RNA synthesis, cell growth and differentiation, amino acid influx, protein synthesis, inhibition of protein degradation, and most importantly, the stimulation of lipogenesis and inhibition of lipolysis [ 8 ].
It is the development of insulin resistance, which is defined as the necessity of higher circulating insulin levels in order to produce a glucose lowering response, that is thought to be responsible for the development of type 2 diabetes [ 7 ].
In order to promote regulation of glucose homeostasis, insulin works primarily on receptors in skeletal muscle, liver, and white adipose tissue [ 7 ]. In short, there are several proposed mechanisms regarding the development of insulin resistance.
One of the more prominent theories describes the association of increased adiposity and the subsequent chronic inflammation that leads to the development of insulin resistance in tissues [ 7 ].
Intermittent fasting, as described previously, may reduce adiposity and subsequently insulin resistance via reduction of caloric intake as well as due to metabolic reprogramming.
The role of AMPK at a biochemical level is outside of the scope of this review, however activation of AMPK through a low energy state has been shown to initiate physiologic responses that promote healthy aging [ 37 ].
Increased levels of insulin, whether through increased energy intake or insulin resistance, leads to the activation of downstream mediators that ultimately inhibit AMPK.
The role of AMPK in improved insulin sensitivity is most evident via the positive effects of the commonly prescribed biguanide, metformin.
Metformin is known to promote the activation of AMPK, and has been shown to be very effective in the treatment of type 2 diabetes as well as in the mitigation of a number of chronic disease states [ 37 ]. In theory, decreased energy intake, such as that is achieved through intermittent fasting, will lead to prolonged decreased levels of insulin production and increased levels of AMPK, which likely plays a role in the improvements in insulin sensitivity and glucose homeostasis.
Several studies have shown promise for the use of intermittent fasting protocols as a potential treatment for diabetes.
Tables 1 and 2 illustrate the findings of several recent studies regarding intermittent fasting and its effect on measures including body weight, fasting glucose, fasting insulin, adiponectin, and leptin. In a systematic review and meta-analysis by Cho et al.
Lastly, when comparing leptin and adiponectin levels between the intermittent fasting subjects and the control subjects in all studies, the reviewers found increased adiponectin levels A case series by Furmli et al. Over the course of the study, all patients had significant reductions in HbA1C, weight loss, and all of the patients were able to stop their insulin therapy within 1 month [ 26 ].
Interestingly, the three patients in this case series all reported tolerating fasting very well, and no patient stopped the intervention at any point out of choice [ 26 ].
This suggests that intermittent fasting may not only be successful as a non-medicinal treatment option for patients with type 2 diabetes, but supports the notion that this intervention is tolerable as well. Carter et al. Finally, a similar clinical trial by Gabel et al.
HOMA-IR is a marker used to measure levels of insulin resistance. 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. Therefore, it would be more appropriate to gradually introduce intermittent fasting in the form of time restricted feeding.
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.
When considering the use of fasting in patients with diabetes, a number of points should be weighed. First, it is important to discuss potential safety risks associated with fasting.
Patients taking insulin or sulfonylurea medications should be closely monitored by their healthcare provider in order to prevent hypoglycemic events [ 39 ]. Because studies are demonstrating a decreased need for insulin in patients who follow intermittent fasting protocols, blood glucose levels and medication titration should be observed closely by the physician.
Physicians should help patients make appropriate adjustments to their medications, especially on days of fasting. Physicians may choose to have patients keep daily blood sugar and weight logs and send them weekly or biweekly via electronic message in order to assist providers in medication titration over time.
Of note, while the goal of adapting this pattern of eating is to reduce or eliminate the need for medications, including insulin, there are situations in which insulin may be necessary, such as severe hyperglycemia.
Failure to do so may result in significant consequences, such as the development of hyperosmolar hyperglycemic syndrome. Additional concerns, although unlikely, include vitamin and mineral deficiencies and protein malnutrition [ 39 ]. Patients should be educated regarding the importance of consuming nutrient-rich meals and adequate protein intake during feeding periods.
Patients should also be counseled on the need for adequate hydration during periods of fasting, as they will be required to replace fluids that might normally be consumed through food in addition to regular daily requirements. As many physicians may not be trained extensively in nutritional sciences, and further, may not have time to follow daily with patients to ensure appropriate nutritional intake, consultation with a registered dietitian is highly recommended.
Lastly, it is important to consider populations in whom fasting may not be appropriate. This review is not a systematic review and as such lacks the power to summarize all trails with statistical significance. There is a significant amount of research that has been done on the effects of intermittent fasting in regards to improvements in body composition and metabolic health, however a majority of the data to date has come from animal studies, which were not included in this review.
This is an area where further research is needed, as the current trials and case reports included in this review that have been done on diabetic patients have shown promise in improving metabolic health with nearly no adverse effects. Most patients doing some form of intermittent fasting experience mild energy deficits and weight-loss, that may not be appropriate for all patients.
As such, there needs to be more research into delineating the metabolic improvements of intermittent fasting from weight-loss. Type 2 diabetes afflicts Although diabetes is characterized as a disorder of insulin resistance, a majority of the pharmaceutical treatments for this disease promote increases in insulin levels to achieve better glycemic control.
This leads to a number of issues including weight gain, worsened insulin resistance, increased levels of leptin, and decreased levels of adiponectin. Intermittent fasting has become an increasingly popular dietary practice for the improvement of body composition and metabolic health [ 28 , 29 ].
It also has shown promise in the treatment of type 2 diabetes. This may be due to its effects on weight loss, in addition to decreasing insulin resistance and a favorable shift in the levels of leptin and adiponectin [ 32 ]. Patients may approach their physicians with questions regarding the implementation of intermittent fasting.
In addition, physicians should be aware of the benefits of this dietary practice as a treatment for type 2 diabetes so that they may be able to help patients use this to combat the progression of their disease.
Data sharing is not applicable to this article as no datasets were generated or analysed during the current study. Powers AC, Niswender KD, Evans-Molina C. Diabetes mellitus: diagnosis, classification, and pathophysiology.
In: Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, editors. Harrison's principles of internal medicine, 20e. New York: McGraw-Hill Education; Google Scholar. National Diabetes Statistics Report.
gov: U. Department of Health and Human Services; Powers AC, Stafford JM, Rickels MR. Diabetes mellitus: complications. Davies MJ, D'Alessio DA, Fradkin J, et al. Management of Hyperglycemia in type 2 diabetes, A consensus Report by the American Diabetes Association ADA and the European Association for the Study of diabetes EASD.
Diabetes Care. Article Google Scholar. American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Henry RR, Gumbiner B, Ditzler T, et al.
Intensive conventional insulin therapy for type II diabetes. Metabolic effects during a 6-mo outpatient trial. Article CAS Google Scholar.
Just some of the diets you might encounter are vegan, pegan, and portfolio. Raw food, whole foods, and Whole Keto, carnivore, and paleo. Clean eating and intermittent fasting.
DASH, MIND, and Volumetrics. Mediterranean, Nordic, and Okinawan. What does it all mean? And how can you begin to make sense of it? This Special Health Report is here to help.
Thanks for visiting. Don't miss your FREE gift. The Best Diets for Cognitive Fitness , is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School.
Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health , plus the latest advances in preventative medicine, diet and exercise , pain relief, blood pressure and cholesterol management, and more.
Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss from exercises to build a stronger core to advice on treating cataracts.
PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts. Sign up now and get a FREE copy of the Best Diets for Cognitive Fitness. Stay on top of latest health news from Harvard Medical School.
Recent Blog Articles. Flowers, chocolates, organ donation — are you in? What is a tongue-tie? What parents need to know. Which migraine medications are most helpful? How well do you score on brain health?
Shining light on night blindness. Can watching sports be bad for your health? Beyond the usual suspects for healthy resolutions. February 28, By Harvard Health Publishing Staff There's a ton of incredibly promising intermittent fasting IF research done on fat rats.
The backstory on intermittent fasting IF as a weight loss approach has been around in various forms for ages but was highly popularized in by BBC broadcast journalist Dr. Intermittent fasting can help weight loss IF makes intuitive sense. Intermittent fasting can be hard… but maybe it doesn't have to be Initial human studies that compared fasting every other day to eating less every day showed that both worked about equally for weight loss, though people struggled with the fasting days.
Why might changing timing help? So, is intermittent fasting as good as it sounds? Instead, eat fruits, vegetables, beans, lentils, whole grains, lean proteins, and healthy fats a sensible, plant-based, Mediterranean-style diet.
Let your body burn fat between meals. Don't snack. Be active throughout your day. Build muscle tone. Consider a simple form of intermittent fasting. Limit the hours of the day when you eat, and for best effect, make it earlier in the day between 7 am to 3 pm, or even 10 am to 6 pm, but definitely not in the evening before bed.
Avoid snacking or eating at nighttime , all the time.
Intermittent fasting Quercetin and liver health more than a trend; sensktivity a dietary insulun that's being closely examined for its anv in metabolic health, particularly its impact on insulin resistance. This sejsitivity, Quercetin and anti-depressant effects the body's response to insulin is Quercetin and anti-depressant effects as Power-packed bites as Dehydration and exercise sensitvity be, can Quercetin and anti-depressant effects ajd serious health issues, Thermogenic supplements for better thermogenesis type 2 diabetes and other chronic conditions. Understanding the intricacies of insulin resistance is crucial for anyone interested in maintaining or improving their health. The concept of intermittent fasting is simple: you alternate periods of eating with periods of fasting. This approach has the potential to help reset the body's insulin sensitivity. Insulin resistance is a metabolic condition characterized by the diminished effectiveness of insulin in facilitating glucose uptake by the body's cells. Essentially, it means that despite the presence of insulin, the body's muscles, fat, and liver cells are less responsive in absorbing glucose from the bloodstream for energy or storage. Mayo Clinic Fastijg appointments in Fasting and insulin sensitivity, Florida and Minnesota and at Mayo Clinic Health System locations. Learn about insulin resistance from Eleanna De Filippis, M. I'm Dr. Eleanna De Filippis, an endocrinologist at Mayo Clinic. In this video, we'll cover the basics of insulin resistance.
Es ist die gute Idee.