A Short Fast for the Holidays

Holidays are known for overeating. All the family get-togethers, all the treats can really make glucose control or weight control a challenge. But here’s a possible way out: Take one day off from eating!

A little fasting might help people with prediabetes avoid developing diabetes. A recent study from Utah found that “periodic fasting” may reduce insulin resistance. The research is being done at Intermountain Medical Center and was reported in Medical News Today.

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According to Benjamin Horne, PhD, Intermountain’s Director of Cardiovascular and Genetic Epidemiology, 10–12 hours (or more) without food causes the body to use fat for energy. This leads to a temporary rise in cholesterol level. Sounds bad, but after the cholesterol is used up, levels may be reduced for weeks.

Lower cholesterol levels and reduced fat volume may lower insulin resistance, according to Dr. Horne. Periodic fasting (usually one day at a time, once or twice a week) has become a popular weight-loss strategy. It had not been studied extensively for effects on diabetes before.

We still don’t have enough evidence to know that fasting will help with diabetes. It makes sense, though. Researchers at Newcastle University in the United Kingdom have published several papers on people reversing diabetes on a very-low-calorie diet (600 calories a day), which is pretty close to a fast.

A recent book called The Fast Diet, by Dr. Michael Mosley and Mimi Spencer, recommends 500 calories a day for women and 600 for men, and calls that a fast. They say you should do that twice a week to lose weight.

The Newcastle subjects ate 600 calories every day for eight weeks, so one or two days a week should be manageable. Note, though, that their 600 calories were a medically approved nutritional drink, not just any old calories.

To me, it seems like the holidays are a perfect time to fast. Taking a break from big meals is one good thing. Fasting can also be a spiritual practice of its own. You might take time to focus on the meaning of the holidays, of family, or of your life, for example. You might remember the people who don’t have enough to eat. A combined physical/spiritual benefit! Then you’ll be set up to really appreciate the next feast.

Fast safely
Amy Campbell RD, CDE, warns that if you are taking insulin or a sulfonylurea drug, you will probably have to consult your medical team about making dosage adjustments and be very careful about lows.

Everyday Health posted an article called “Fasting Safely with Diabetes.” They stressed the importance of working with your health-care provider to make sure you stay safe.

They were writing about fasts for religious reasons, such as the Muslim holiday Ramadan or the Jewish holiday Yom Kippur, or fasting to prepare for a medical test. They didn’t mention fasting for health benefits, but the same safety measures should apply.

They caution about the risk of diabetic ketoacidosis (DKA). DKA can be brought on by fasting, as sometimes happens when sickness prevents a person with Type 1 from eating. Ketoacidosis can develop from the waste products (ketones) created when the body uses fat for fuel during a fast.

An important way to prevent ketones from building up is to drink lots of water. It’s also possible to become dehydrated while fasting, especially on holidays such as Ramadan where no water is allowed either. I would advise you to keep drinking water even during a fast if you have diabetes.

If you are on insulin or a sulfonylurea, consult with your doctor or diabetes educator to make a plan for your medicines during a fast. You might also want to check your blood sugar more often than usual while fasting, and be sure to keep glucose tablets or gels handy at all times.

Quoted on Everyday Health, diabetes educator Constance Brown-Riggs, RD, advises “Stop the fast immediately if blood glucose levels exceed 300 mg/dl or drop lower than 70 mg/dl.”

If you’re careful, there’s no reason fasting should hurt you. Whether it helps or not is not proven, but it looks like it could. And it seems like it might fit right into your holidays. Everyone needs a day off.