APNA Foundation



The Andhra Pradesh and Telangana Physicians and Professionals of North America



The Andhra Pradesh and Telangana Physicians and Professionals of North America

Intermittent Fasting

One of the recent trends in medicine is intermittent fasting/Prolong fasting. Prolonged/intermittent fasting good not only for weight control,

 but also for patients with diabetes and high blood pressure. This is not simply a fad but appears to be evidence-based. It is advisable to either omit dinner or breakfast so that fasting would be about 14 hours at a stretch. This makes lunch

the most important meal of the day. This also

 reduces the time spent each day processing food and lengthens the period devoted

to restoring body cells. It is healthy to avoid

 eating late in the evening to let the body burn energy from food rather than storing it, so one needs to finish eating dinner at least three hours before going to bed. This also helps patients with acid reflux disease. I would recommend patients skip dinner

 rather than breakfast. According to older studies, prolonged fasting can increase the risk of gallstones, but by skipping dinner rather than breakfast, that risk will be

lessened along with the added benefit of reducing acid reflux.

There was a study conducted at California Salk Institute

which showed the possible benefits of this

 approach. A group of mice who were fed a high fat diet around the clock for 18 weeks developed fatty livers, pancreatic disease,

and diabetes. Another group was fed the exact same number of calories but all during an eight hour span. Surprisingly, the second group stayed healthier

 and thinner than the other group. When we eat, our body releases insulin. This disrupts the process of self-devouring or autophagy in which cells deconstruct old, damaged components to release energy and build new molecules. 

Not eating can also contribute to brain health and happiness.

 Mark Mattson neurobiologist at the National Institutes of Health demonstrated that fasting, restricting calories, and exercising sparked distinct increase in

best known nerve factor, BDNF. In test animals,

 Dr. Mattson showed fasting significantly lowers the risk of Parkinson’s disease, Multiple Sclerosis, and Alzheimer’s in animal studies. Obviously, this had to be confirmed in large human studies to come to a definite conclusion and to recommend across the

 board. Healthy athletes, fasting for 16 hours benefited from metabolic changes over eight weeks compared to with their peers. Fasting might even be effective in preventing the recurrence of cancer as suggested by researchers at The University of California,

 San Diego. They showed significant reduction of the incidence of recurrence of breast cancer in women that fasted for 13 hours nightly. Cancer cells are less able to survive than normal cells if there is a lack of sugar. Successful fasting increased self-efficacy.

 Fasting enhances physical and mental strength.

A recent study done at The University of Pennsylvania Hospital by Dr. Goel revealed that a daytime eating schedule promoted weight loss and a positive profile

 for fuel oxidation, energy metabolism, and hormonal markers when compared to a night-time eating schedule independent of the calorie intake. This was a small but well-controlled study. 12 healthy adults participated in this crossover randomized control study.

 Participants’ weight was decreased in the daytime versus delayed eating schedule/night-time eating schedule. Resting energy expenditure, respiratory quotient, and trunk fat percentage versus leg fat percentage were decreased for the daytime versus delayed

 eating volunteers. Total cholesterol and insulin were also decreased in the daytime eating group. This supports that  prolonged fasting is beneficial and that it is better to fast at night-time rather than during day-time.

There is a recent study by Dr. Courtney Peterson from the Department of Nutrition Services at UAB. The group has discovered that mealtime strategies like intermittent

 fasting or eating earlier in the daytime appeared to help people lose weight. This approach was also shown to lower appetite rather than burn more calories. This study was published online in the Journal of Obesity. Intermittent fasting where dinner is eaten

 in the afternoon helped to improve patients’ ability to switch between burning carbohydrates for energy to burning fat for energy, an aspect of metabolism known as metabolic flexibility. Although this is also a small study consisting of 11 volunteers with

 excess weight, it still gives useful insight. Overall, prolonged fasting appears to be helpful in many ways.

Adi B. Reddy, MD, FACG, AGAF

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