For women with a history of gestational diabetes, intermittent fasting may be just as effective for weight loss as the more traditional method of calorie restriction, according to a new study published in the American Journal of Clinical Nutrition.
Gestational diabetes develops during pregnancy, and is distinct from both type 1 and type 2 diabetes. While it tends to resolve following a pregnancy, women with a history of gestational diabetes are at greater risk for type 2 diabetes — a risk that many of them appear to underestimate. Gestational diabetes affects as many as one in 10 pregnant women, and many medical organizations recommend screening for it in all pregnancies. Risk factors for gestational diabetes include being older than 25, being overweight or obese, not getting enough physical activity, a family history of type 2 diabetes, and having gestational diabetes during a previous pregnancy. There is some evidence that following a healthy diet, such as a Mediterranean diet, may reduce the risk for gestational diabetes. While dietary and lifestyle changes are often enough to treat gestational diabetes, in some cases medications are necessary — with insulin being the most widely recommended treatment, although there is evidence that the oral drug metformin offers certain advantages over insulin.
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For the latest study, researchers at the University of South Australia compared different dietary strategies for weight loss in women with a history of gestational diabetes. For women with excess body weight who previously had gestational diabetes, losing weight is widely recognized as a key strategy to reduce the risk for type 2 diabetes. A group of 121 women were randomly assigned to follow one of two strategies — intermittently fasting or traditional (continuous) caloric restriction. The intermittent fasting group ate normally on five days each week, but restricted their caloric intake to 500 calories on two days each week. The traditional caloric restriction group ate 1,500 calories each day of the week. Both groups ended up restricting their total caloric intake by about 25% each week, and followed their assigned strategy for 12 months.
Among the 62 participants who completed the study — with an median age of 40, and a median duration of 2.9 years since experiencing gestational diabetes — members of both study groups experience significant weight loss over the 12 months. The average weight loss in the intermittent fasting group was 4.8 kilograms (10.6 pounds), while in the traditional caloric restriction group it was 3.2 kilograms (7.1 pounds). This result demonstrated that at the very least, intermittent fasting was not inferior to traditional caloric restriction when it comes to inducing weight loss. There were no significant differences between the two groups in A1C (a measure of long-term blood glucose control), fasting blood glucose, or fasting insulin levels, or in the result of an oral glucose tolerance test (OGTT) after 12 months.
“Our research shows that [intermittent fasting] is just as effective at achieving weight loss as a continuous energy-restricted diet in women who have had gestational diabetes, which is great, because it provides women with greater choice and control,” said study author Kristy Gray, PhD, in a press release. “Of course, women should seek advice from a health professional before commencing this type of diet, to make sure that it is suitable for them.”