Approximately 11% of the American population suffered from diabetes in 2021, with type 2 diabetes accounting for 90% to 95% of these cases.
An alternating fasting and dietary fasting is effective in alleviating symptoms of type 2 diabetes and is easier to follow than reducing daily calorie intake over the long term.
A new study conducted using real-world evidence shows that type 2 diabetic patients following fasting diets with five consecutive days of energy intake per month exhibit reduced blood glucose (sugar) levels, weight loss, and dependence on diabetic medications.
This fasting program is patented by nutrition technology company L-Nutra. One of the research authors, William HSU, MD, endocrinologist and chief medical officer at L-Nutra, told Medical News today:
“This study, when combined with physician surveillance and registered dietitian (RD) coaching, shows a fasting-mimicking diet (FMD) that can be safely and effectively implemented in a real-world clinical setting to manage type 2 diabetes.”
Treatment of type 2 diabetes usually involves a combination of lifestyle modifications and medication. Lifestyle modifications, including dietary changes and increased physical activity, can help lower blood sugar levels and promote weight loss.
Medications such as metformin and GLP-1 agonists promote the management of diabetes symptoms, but only lifestyle changes such as dietary modifications can lead to disease remission.
Studies have shown that limiting daily calorie intake is effective in managing blood sugar levels and losing weight in patients with type 2 diabetes. However, adherence to such diets is difficult in the long term.
Additionally, the body adapts to long-term calorie restriction, slowing metabolism and making sustained weight loss more difficult.
Instead, it has been suggested that different forms of fasting, which involve alternating fasting and unlimited food intake, are more likely to adhere to the symptoms of diabetes, while alleviating them.
Fasting promotes healthy aging by causing stress responses between the cells and the body, promoting metabolism while reducing inflammation and oxidative damage.
Fasting diets include limiting your calorie intake on a specific time of the day called intermittent fasting, or on a specific day of a week or month called regular fasting.
A diet that mimics fasting is a type of regular fasting that includes a limited calorie intake of 4-7 days per month.
Researchers developed a fasting mimic diet to simulate the beneficial health effects of water-only fasting, including only water intake during a period of 24-72 hours. In contrast to water-only fasting, diets that mimic fasting are difficult to adhere to due to limited calorie intake during the fasting period.
The authors of the current study developed a patented, low-calorie, plant-based diet that is low in sugar and protein, but rich in healthy unsaturated fats and fiber.
Previous studies have demonstrated that diet mimicking a 5-day fasting leads to a decrease in blood glucose and insulin levels, while increasing ketone levels.
Furthermore, a recent randomized controlled trial has demonstrated that a 5-day fasting diet combined with a drug is more effective than medication alone in improving glycemic control and reducing drug dependence.
These results were observed under highly controlled conditions in clinical trials, including strict criteria for patient inclusion and exclusion. This makes it essential to assess the real-world effectiveness of this intervention.
In this study, the researchers evaluated the real-world benefits of integrating diets that mimic fasting into regular care for type 2 diabetes patients.
The study included data from patients enrolled in a diabetes management program with a diet that mimics a five-day month fasting under the supervision of a physician and registered dietitian.
Patients were enrolled in the study on a rolling basis, and data were collected from patients who completed at least three or six months of the program.
At the end of three and six months, a fasting mimetic diet was effective in promoting weight loss and lowering glycated hemoglobin levels, a marker of blood glucose levels. Meals that mimic fasting also helped a greater proportion of participants achieve glycemic control at these points than at the time of enrollment.
A diet that mimics fasting also reduces dependence on glycemic control medications, resulting in increased program involvement.
“Most participants can integrate fasting imitation diets into their daily lives without significant disruption. As it is a five-day monthly intervention rather than a daily regimen, many feel that work and family duties can be completed with RD support to coordinate practical strategies, especially adherence and personal belongings.”
Diets that mimic fasting can be safely performed by most individuals with type 2 diabetes, but patients should consult with their doctor before starting such a diet.
Michel Lutenstein, MS, RD, CDCES, CDN, fully-fed preventive cardiology nutritionists and heart health experts who were not involved in this study, expressed some caution about the findings.
“Positive effects on weight and HBA1C of FMD programs [a marker of blood sugar] It is important to note that in a considerable number of participants during the 5-day fasting period, the intervention is associated with common signs of energy deficiency, such as fatigue, headache, dizziness, and nausea.
“Though these symptoms have been resolved between cycles, they can pose risks to certain individuals, especially those who are coexisting with health and frailty,” she noted.
HSU also warns: “The programme caters to most people with type 2 diabetes or metabolic syndrome, but certain conditions are excluded, including recent cardiovascular events, terminal diabetes complications, vulnerability, BMI under the age of 18, or allergies to FMD components.
Finally, Routhenstein advised that “inclusion of lifestyle advice in the option to consult a nutritionist could have impacted some of the findings of the study.”