Intermittent Fasting Diet
Literature Review
Studies indicate that insulin resistance, which features in type 2 diabetes improves as one restricts calories (Grajower & Horne, 2019). When an individual goes through a period of fasting, sensitivity towards insulin increases while the levels of insulin in the body decline. As this happens, an individual experiences improved fasting. The postprandial glucose levels also improve in the body. Additionally, when insulin induces the growth of adipose tissue, the propensity to gain weight declines with prospects for weight loss.
Intermittent Fasting and Weight Loss
Frequent intermittent fasting influences weight loss, especially when there is high frequency. An early study concerning the health effects of fasting hypothesizes that fasting can ameliorate some major effects resulting from weight loss diets adopted by individuals. Studies by Harris et al. (2018) and Carter et al. (2018) show that intermittent fasting is as effective as daily calorie restriction in ensuring that an individual can experience weight loss. Therefore, when done with the frequency required, studies by Carter et al. (2018) and Trepanowski et al. (2017) show that fasting ensures healthy weight loss in an individual, though evidence shows that fasting does not produce superior results.
Intermittent fasting and calorie restriction have been explored because of their ability to improve the pathways to metabolism and inflammation. Some of the processes included are increment in shock protein, promotion of cellular autophagy, reduced end products from glycation, increased adiponectin, while the cytokines inflammation decreases (Golbidi et al., 2017). The effects of this kind are responsible for the decline in vascular dysfunction and may improve the risk of mortality. However, sustaining the significance of fasting changes remains to be proved.
Caloric restriction and weight loss, therefore, emerge as important factors that help in remitting type 2 diabetes (Furmli, Elmasry, Ramos, & Fung, 2018). An open-label Diabetes Remission Clinical Trial (DiRECT) shows that remission and maintenance of diabetes can be done through caloric restriction of 840 calories daily; this remission and maintenance works for a non-insulin-dependent population with diabetic individuals (Lean, 2018). However, there are very few documentations that indicate the effect of fasting as a cure for type 2 diabetes such that it replaces the use of insulin.
Overcoming Barriers
Overcoming some of the barriers that diabetic patients face may require the exploration of dietary interventions as alternative options. Intermittent fasting emerges as an alternative dietary solution that diabetic patients can explore. Intermittent fasting has many variations, though the main one is the restriction of caloric intake to the specified time. One of the methods explored for intermittent fasting is to restrict the intake of calories for 18 to 20 hours per day (Arnason, Bowen, & Mansell, 2017). The remaining hours can feature eating ad libidum. The period when an individual can eat is between midday and early evening. During this period, an individual can explore increased intake of proteins that can be recommended or discouraged depending on the need to maintain satiety. People can consume water, tea, or coffee when fasting. Intermittent fasting of this kind exhibits caloric intake during diurnal peak or diurnal peak in cortisol levels as a person fasts. This may, in theory, benefit the control of glucose. Such protocols yield benefits for individuals belonging to the non-diabetic populations. According to previous studies, the exploration of intermittent fasting where all daily calorie consumption occurs in the four-to-six hour window can result in participants feeling that they are full with loss of weight even when recommended to consume calories.
Obesity Epidemic
Obesity continues to be an epidemic in the United States. According to estimates, close to 34% of the adults in the United States and (15-20%) of children are considered obese (Mitchell, Catenacci, Wyatt, & Hill, 2011). The obesity curve has flattened in subpopulations of the United States, though it is too soon to conclude that the epidemic is at its maximum level (Mitchell, Catenacci, Wyatt, & Hill, 2011). Evidence shows that diabetes continues to increase in the rest of the world. Much of research is directed towards better understanding the treatment dynamics of obesity and efforts to reduce the rates of obesity in the United States and the rest of the world (Mitchell, Catenacci, Wyatt, & Hill, 2011). The epidemic of obesity has been complemented by the increase in cases of chronic conditions.Despite the growing recognition of the problem, the obesity epidemic continues in the U.S., and obesity rates are increasing around the world. The latest estimates are that approximately 34% of adults and 15–20% of children and adolescents in the U.S. are obese. Obesity affects every segment of the U.S. population. Obesity increases the risk of many chronic diseases in children and adults. The epidemic of obesity arose gradually over time, apparently from a small, consistent degree of positive energy balance. Substantial public health efforts are being directed toward addressing obesity, but there is not yet clear evidence of success. Because of the complexity of obesity, it is likely to be one of the most difficult public health issues our society has faced.
Complications of Obesity (Diabetes)
Obesity has a negative effect on the body systems of the individuals it affects because of its prevalence and costs through medical problems such as type 2 diabetes, high blood pressure, cancer, and cognitive dysfunction. Type 2 diabetes develops as indicated by risk factors such as an individual’s BMI, fat distribution in the abdomen, and weight gain (Mitchell, Catenacci, Wyatt, & Hill, 2011). Estimations indicate that 90% of the people who have type 2 diabetes also have obesity. Some people with obesity have coronary artery disease, especially when one has abdominal fat distribution. Individuals that have visceral obesity also tend to develop dyslipidemia that is consistent with elevated levels of triglycerides.
The Benefits of Weight Loss in Diabetic Patients
Type 2 diabetes can be delayed or prevented in high-risk individuals when they pursue lifestyle interventions. Such interventions include the modification of diets and weight reduction by increasing physical activity (Wilding, 2014). The evidence of this has been seen to work in clinical trials. Weight loss is beneficial in reducing instances of type 2 diabetes by sustaining lower weight, lowering the plasma glucose levels, and 2-h postprandial plasma glucose levels of the patient with the potential for diabetes.
Types of Weight Loss Methods
There are two main methods to lose weight. They are diet methods and physical activity methods. People can use the diet method by choosing methods like having fewer calories, having low amounts of carbohydrates, and having low amounts of fat (Apovian & Korner, 2012). Exercises also help an individual to lose weight. This approach mainly depends on the frequency of exercises. The higher the frequency, the better one has a chance to lose weight, and in the process, reduce instances of obesity and diabetes.
References
Apovian, C. M., & Korner, J. (2012). Proven Weight Loss Methods. The Journal of Clinical Endocrinology & Metabolism, 97(7), A33–A34. doi:https://doi.org/10.1210/jcem.97.7.zeg33a
Arnason, T. G., Bowen, M. W., & Mansell, K. D. (2017). Effects of intermittent fasting on health markers in those with type 2 diabetes: A pilot study. World Journal of Diabetes, 8(4), 154-164. doi:10.4239/wjd.v8.i4.154
Carter S., Clifton P.M., Keogh J.B. (2018). Effect of intermittent compared with continuous energy restricted diet on glycemic control in patients with type 2 diabetes. JAMA Netw. Open. 1:e180756. doi: 10.1001/jamanetworkopen.2018.0756.
Furmli, S., Elmasry, R., Ramos, M., & Fung, J. (2018). Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin. BMJ Case Reports. doi:10.1136/bcr-2017-221854
Grajower, M. M., & Horne, B. D. (2019). Clinical Management of Intermittent Fasting in Patients with Diabetes Mellitus. Nutrients, 11(4). doi:10.3390/nu11040873
Lean ME, Leslie WS, Barnes AC, et al. (2018). Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet, 391 10.1016/S0140-6736(17)33102-1
Mitchell, N., Catenacci, V., Wyatt, H. R., & Hill, J. O. (2011). Obesity: Overview of an Epidemic. Psychiatric Clinics of North America, 34(4), 717–732. doi:10.1016/j.psc.2011.08.005
Trepanowski J.F., Kroeger C.M., Barnosky A., Klempel M.C., Bhutani S., Hoddy K.K., Gabel K., Freels S., Rigdon J., Rood J., et al. (2017). Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults. JAMA Intern. Med., 177:930–938. doi: 10.1001/jamainternmed.2017.0936.
Wei M., Brandhorst S., Shelehchi M., Mirzaei H., Cheng C.W., Budniak J., Groshen S., Mack W.J., Guen E., Di Biase S., et al. (2017). Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease. Sci. Transl. Med. 9:eaai8700. doi: 10.1126/scitranslmed.aai8700.
Wilding, J. P. (2014). The importance of weight management in type 2 diabetes mellitus.
International Journal of Clinical Practice, 68(6), 682–691. doi:10.1111/ijcp.12384