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*The Intermittent Fasting Diet: An effective strategy for promoting health

Digestion, Diabetes, Heart, Weight loss | October 30, 2014 | Author: The Super Pharmacist

heart, diabetes, weight loss

*The Intermittent Fasting Diet: An effective strategy for promoting health

Both the developed and developing world are currently in the midst of an obesity epidemic with its prevalence almost doubling in the last twenty five years. Individuals who are overweight or obese have an excess of body fat and are at increased risk for serious medical problems including coronary artery disease, high blood pressure, stroke, and type 2 diabetes mellitus. 

The World Health Organisation defines "overweight" as a body mass index (BMI) of 25 or above, and obesity as a BMI greater than or equal to 30. BMI is a simple index of weight-for-height that is commonly used to classify overweight and obese individuals. In men and women between the ages of 18 and 65 years, a healthy BMI score lies between 20 and 25.

How Can Weight Loss Be Sustained Long-Term?

The most common approach to weight loss involves daily dietary restriction of caloric intake (by 15–60% of usual caloric intake). Well-known examples of low-calorie diets are the Nutrisystems and the Weight Watchers diets. Other weight loss diets include low-carbohydrate diets which restrict caloric intake by reducing the consumption of carbohydrates to 20 to 60 g per day (typically less than 20 percent of the daily caloric intake). The consumption of protein and fat is increased to compensate for part of the calories that formerly came from carbohydrates. The Atkins Diet is the prototypical low-carbohydrate diet. Other diets restrict fat (eg, Ornish diet), and others modulate macronutrient balance and glycemic load (Zone diet).

Although weightcontrol is beneficial, the problem of poor compliance in weight loss programs is well known. Only 20% of dieters are thought to be able to successfully sustain a ≥10% weight-loss for more than 12 months.

intermittent fastingTo address this problem, one possible approach may be "intermittent energy restriction" (IER), with short spells of severe calorie or energy restriction between longer periods of habitual energy intake.

For some subjects, this approach may be easier to follow than a daily or continuous energyrestriction (CER) diet.

Intermittent Energy Restriction

Intermittent energy restriction is commonly referred to as "intermittent fasting diet." The physiologic benefits of intermittent fasting have been recognised since the 1940's. A study published in the Journal of Nutrition in 1946 found that intermittent fasting at a frequency of one in every three days increased the lifespan of male rats by 20% and female rats by 15%. Extensive evidence suggests that imposing fasting periods upon experimental laboratory animals increases longevity, improves health and reduces disease, including such diverse morbidities as cancer, neurological disorders and disorders of circadian rhythm.

Intermittent fasting can be undertaken in several ways but the basic format alternates days of 'normal' calorie consumption with days when calorie consumption is severely restricted. This can either be done on an alternating day basis, or more recently, a 5:2 strategy has been developed, where 2 days each week are classed as 'fasting days' (with <600 calories consumed for men, <500 for women). On non-fasting days, subjects can eat normally to their total daily energy expenditure calorie level (approximately 2500 for men and 2000 for women).

Benefits of Intermittent Fasting

Intermittent fasting has been shown to be equally or even more effective than continuous modest calorie restriction with regard to weight loss, improved insulin sensitivity and other health biomarkers. These periods of fasting can limit inflammation, improve circulating glucose and lipid levels and reduce blood pressure. The majority of studies show positive effects on markers of metabolic health and body composition, in part due to the demonstrated effects that intermittent fasting has on metabolic tissues. In addition, intermittent fasting studies both in animals and humans have suggested that fuel selection is altered resulting in more efficient metabolism and reduction of oxidative stress.

Is Intermittent Fasting Effective in Obesity?

Intermittent fasting is known to be useful in the treatment of intractable obesity and morbid obesity. Original treatment regimens were based upon intermittent starving as opposed to calorie restriction, a harsh regime that must have challenged adherence.

Despite the seemingly strict nature of the fasting days, intermittent fasting has a generally good adherence record and can cause significant reductions in body weight in individuals with obesity.

Is Intermittent Fasting Effective in Type 2 Diabetes?

Intermittent fasting can reduce the incidence of diabetes in experimental animals, and there is evidence that this type of fasting may also slow the progression of type 2 diabetes in obese individuals.

A recent study confirmed earlier reports of a reversal of type 2 diabetes through daily calorie restriction, with improvement of pancreatic function and a reduction of occult triglyceride deposition. The particular diet employed a maximum of 600 calories every day, which may prove too severe for many type 2 diabetes patients, but an intermittent fasting strategy may be more acceptable and still improve metabolic parameters, insulin levels and insulin sensitivity, and prevent the development of diabetic complications. Indeed, intermittent fasting might achieve much of the benefit seen with bariatric surgery, but without the cost and risks associated with surgery.

Does Intermittent Fasting Reduce Cardiovascular Risk?

Up to 80% of obese type 2 diabetes patients die from cardiovascular complications and the benefits of weight loss are well recognised. Nevertheless, individuals with type 2 diabetes have difficulty losing weight. Intermittent fasting represents a potential therapy for those patients at high cardiovascular risk.

Intermittent fasting in animal models reproduces some of the same cardiovascular benefits associated with exercise (eg, lowered blood pressure and heart rate). Studies have shown improvements in circulating cholesterol, triglycerides, blood pressure, and carotid intima-media thickness. Intermittent fasting also appears to be cardioprotective, providing experimental animals with resistance to myocardial ischaemic injury.

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