Diabetic and former Diabetes genetic researcher here.
To paraphrase an old mentor, curing diabetes in mice is kind of the sport of the field. It's been done a number of times. Mice have some abilities to regrow tissue we don't. It's unclear how well various mouse models for diabetes mimic the human phenotypes.
I am very hopefully for this line of research in general but I expect any cure in humans will be more complex and perhaps also deal with somehow suppressing the immune response that destroys the Beta cells in type 1's like myself. For a type 1 the best I'd expect something like this to be able to achieve is a temporary return to the "honeymoon" period where the pancreas still produces enough insulin to make small adjustments but supplemental insulin is required.
On a personal level i have found that diet can have massive effects on my diabetes management. I may try a diet like this (with the advice of a doctor in adjusting insulin to handle it well etc and with the realization i may need to break the diet to treat low blood sugars etc). Edit: I also use a continuous glucose monitor which helps greatly with avoiding low bloodsugars while changing diet/activity levels and recommend one to any other diabetics.
'dangerous' for people who make major life changes based on headlines alone? I pray to Xenu they don't exist but if they do it seems like Darwinism at work.
It's dangerous if you read "fasting can cure your diabetes", when the article is about mice.
For the record, I have friends that are fasting, and family members with diabetes.
If you have diabetes you can't fast without correcting the dosage of insulin that you're taking. If, for example, you take a normal dosage of insulin, but fail to consume the corresponding amount of sugars, your blood glucose level will start decreasing. Soon you will faint, and your level will still go down. Next step is coma, and finally death. So yes, I consider this dangerous.
The article also says "People are advised not to try this without medical advice.", to reiterate that it is dangerous.
As the article pointed out it should not be tried without medical supervision, and the root of the comment thread also pointed out that s/he is using a continuous glucose monitor to prevent low blood sugar levels when changing or adjusting diets. For diabetics, diets, esp. radical diets can very easily lead to life-threatening situations.
In addition to the risk of low blood sugars (hypoglycemia which can lead to coma) in diabetics there is also a risk that someone might try something like this and then forgo other treatment (say insulin or metformin) without properly monitoring to see if they still need.
For what it's worth, I'm a T1D that has been in honeymoon for three years since diagnosis (with no external insulin) by going on a ketogenic diet. (Disclaimer - no one try this without consulting your endocrinologist...)
A close friend is T1D and says going keto/LCHF over the last year changed his life. Still on external insulin but often reporting at non-diabetic levels. I can say for myself intermittent fasting has kept me in some of the best shape of my life.
"Diabetic and former Diabetes genetic researcher here."
Thank you for commenting here. As you are a diabetic who was also a diabetes researcher, I think it would be helpful to have you describe your exercise regimens (both cardio and resistance training) as well as your own experience with fasting and/or intermittent fasting ?
To be clear I work in genetics and data analysis. I have no special expertise in treatment.
I haven't experimented with fasting yet, I'm thinking of doing some sort of test of my insulin needs before and after if i do.
I climb, ski tour, mountain bike and trail run but am not particularly structured in my routine. Happy to talk about exercising with diabetes off line though.
Since this is now one of the top comments, I should have been clearer. If I try something like this I'll do so as part of the proud tradition of self experimentation with a hearty skepticism of it actually producing any lasting effect.
I have gone through this thread and given a downvote to every post that's giving dangerously-incorrect medical advice. Which seems to be most of them.
I don't expect anyone who's actually diabetic to fall for this; every T1 diabetic is in practice forced to become an expert. But, for the sake of confused bystanders: for a diabetic using insulin, fasting is dangerous. That's not an abundance of caution thing; we diabetics micromanage a key part of our metabolism using insulin, and if we leave the range of metabolic states we're familiar with we'll get insulin dosages wrong. The most likely outcome of trying to fast for a day would be being forced to abort the fast by hypoglycemia.
As a person with type 1 diabetes I would like to add that, just as one has to learn what amounts of insulin to inject when one first starts using insulin with his/her given diet, one would need to learn what amounts of insulin are appropriate for the days one is on this diet.
And if you had to abort the fast a few times before you home in on your insulin needs during the fast, that is not a life or death situation.
I feel you are being too cautious. Please chime in if you feel I'm being cavalier. Thanks!
It is worth noting that while there is evidence that murine beta cells can regenerate even late into life, there is very little indication that human beta cells can do the same. Many beta cell regeneration studies die in between mouse and human studies. Some more on the questions around regeneration here: http://diabetes.diabetesjournals.org/content/59/10/2340 with discussion of human versus rodent toward the end.
I don't understand why it's potentially so dangerous to try it out on your own. Fasting is kinda natural. Assuming you go back to the roots and live in the forest. You are not going to eat every day... so why is it suddenly so dangerous?
Some explanation on the risks would have been helpful.
I understand health advice sometimes has obnoxiously overcautious disclaimers, but the warning seems valid in this case. It's referring to people who already have a serious condition - diabetes - reminding them not to suddenly make a major intervention in their eating routine.
This was my thought. To add on, any dietary change that has major impacts on a diabetic's blood sugar levels, specifically if they are taking insulin, can be life threatening. Taking the wrong insulin dose with low blood sugar can and does kill people.
Also and probably more to the front of the lawyers mind who reviewed this paper prior to publication. Cause of death may be difficult to determine and if you engaged in this fasting and then happened to die even if fasting was not the cause of your death it would be likely your family would have grounds to sue. Even if the publisher won the lawsuit he would be out legal fees, thus a notice like this is prudent on almost any actionable medical information.
I agree. I've been water-only fasting five consecutive days every two weeks for over a year now (largely but not entirely as a result of Longo's work).
I assume that telling people they need medical guidance before doing so is a means of avoiding liability should someone do something stupid.
The only plausible risk I've seen mentioned, by Longo himself, is in women where the risk of gallstones might be increased. To quote him "Water-only fasting should only be done in a specialized clinic. Also, certain types of very low calorie diets, and particularly those with high protein content, can increase the incidence of gallstones in women at risk." [0]
The idea that water-only fasting should only be done "in a specialized clinic" seems daft to me, but in a litigious society I can understand why he says that.
Other researchers worth following in this area are Mark Mattson and Luigi Fontana.
What are your results like? What did you hope to accomplish when you started, and what actually happened? Can you name some of the biggest benefits and some of the biggest pitfalls?
I'm just trying not to die quite as soon as I otherwise might. I was and am fit an healthy (to the best of my knowledge).
In terms of results, my heart rate and BP have decreased (they weren't elevated previously). My weight remained the same as ever (around 10st, 65kg), which was my plan.
I've been fasting in other configurations for about 4.5 years now. I have a suspicion that I've been ill less (in the sense of colds etc) than pre-fasting, and that I recover more quickly, but I wouldn't take that as any kind of evidence. As soon as I can find some kind of cheap aging biomarker test, I'll start recording it regularly.
Also seconding the recommendations to talk to a doctor before you do anything. I know that usually goes without saying, but it deserves emphasis given the article is about diabetes. As the current top comment points out, fasting can be very dangerous for diabetics.
Oddly enough I an a doctor of sorts - qualified in medicine 25 years ago, but left immediately to do other things. Thanks for the link. I'm pretty sure I'm not hypocaloric. I make sure I eat enough during the 9 out of 14 days on which I eat, and I haven't lost weight. And yes, none of my comments refer to diabetes.
Based on the parent's fasting regimen, and assuming they fast Monday to Friday, that would mean 9 days of normal eating between fasts. If you eat a normal healthy diet during those 9 days, you will be fine. Malnutrition takes more than 5 days to develop.
Can you point to any instructions on how to do water only fasts? It has been surprisingly difficult to google. Most articles talk about intermittent fasting or some variation of fasting, where people drink a lot of juice!
In particular I would like to know is it really necessary to use laxatives? Or other supplements? Or do you just stop eating and then start slowly again 5 days later.
I have just done a 3 day water fast to give it a try. With mixed results.
Hmm. Not really. I say water, btw, but I also drink black tea and occasional diet cokes. The point is no calories, or virtually none.
I would suggest starting gradually. Initially I think I did 48hr fasts. After a couple of years I upped to three days. Following Longo's stuff last year I moved to five.
No supplements. Definitely no laxatives ;-)
I don't start eating again particularly slowly. But I don't binge either.
The most amazing thing to me is that I don't get hungry. I haven't eaten since Sunday night, and I feel fine.
Yeah that irritates me somewhat. His research is great but I have my suspicions about the diet he's flogging. In my view the best way to mimic fasting is by not eating anything.
[edit] btw I suggest using google scholar rather than google. intermittent fasting, periodic fasting, prolonged fasting, calorie restriction. Lots of interesting stuff in there.
He (obviously) was an author, not a nutritionist or medial professional. But he was a "fasting practitioner" and has an interesting perspective on this topic.
No. I hope nothing I've said indicates that. And fwiw I concur with the suggestions in many other comments that diabetics should take medical advice before doing anything as drastic as I'm doing.
1) People with diabetics may not surely die when they fast for 3 days, but it isn't something they can discard as a freak event, either.
2) For diabetics, blood sugar is an issue.
3) Many diabetics do quite well understand how diabetics _died_ 100 years ago, let alone 10,000 years ago ('young'. http://www.defeatdiabetes.org/diabetes-history/: "In 1897, the average life expectancy for a 10-year-old child with diabetes is about 1 year. Diagnosis at age 30 carries a life expectancy of about 4 years. A newly diagnosed 50-year-old might live 8 more years.")
You'd be amazed how many people show up for activities like that after having surgery. I had a woman come to a dance class with a knee brace on and ask if it was okay to participate even though she had had knee replacement surgery the week prior.
For someone with diabetes, an unmonitored and poorly planned fasting diet could be a recipe for disaster.
So test your blood sugar levels when you fast? I've started experimenting with intermittent fasting (36 hour fasts) and bought a test kit just to be sure even though I'm not diabetic. If you are, then you should definitely consult a doctor first and you're probably already testing your blood sugar.
Where did you get the testing equipment? I tend to get very cold if I haven't eaten recently, if I'm not active -- always have -- and it would be fascinating to see if there's a connection.
Not sure where you're located, but the Walmart brand Reli-on testers are as accurate as any other brand you'll find on a pharmacy shelf, and have very reasonably priced test strips (glucose meters are like razor blades or printers, most of your cost will come from test strips, not the meter itself). I'm a T2 diabetic, and have a Reli-on Confirm. The device is only around $10 and the strips are ~$20 for a 50 pack or ~$35 for 100. It's a pretty good deal. Test strips the only thing I ever go to Walmart for anymore.
Reli-on Prime user here. When I discovered that I could buy the test strips over-the-counter for less than the deductible on the ones my doctor prescribed, I switched and never went back. $18 for 100.
I bought this for £12 a year ago. I see it's unavailable from that seller but you'll find it elsewhere. In the UK diabetics get these free. https://www.amazon.co.uk/gp/product/B004343VWS
Isn't that just the case if they take too much insulin for their glycemic load? Persumably if they fast they would adjust their insulin levels (which they do for other reasons as well).
"Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific situations. Management concentrates on keeping blood sugar levels as close to normal, without causing low blood sugar. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin, in type 2 diabetes)." (emphases mine)
I did this diet by myself a couple of years back and had great results (slightly modified, I did 1200 calories a day with a daily jog - works out at a net of roughly 800 calories). I found the first 4 days pretty uncomfortable but after that the diet was easy to follow. After a few days I was able to stop taking medication completely and ever since have been able to just use diet/exercise. I now do a top-up week about once every 6 months or so which I find is necessary to maintain the same level of glucose control (HBA1C is now 5.6, down from 8.1 at diagnosis).
I agree that fasting seems natural and as a doctor (though not an endocrinologist) I can tell you that it is generally safe for most people with what I would call "normal" physiology.
However, the discussion here is not about people with "normal" human physiology.
Remember what diabetes is: simplistically, it's the inability to properly regulate the glucose in the blood vs in the cells. Type I diabetes is an autoimmune condition that results in the destruction of the insulin-producing cells of the pancreas. Without insulin, blood glucose levels elevate but the cells of the body continue to starve.
Type I diabetics are basically trying to synthetically replace the activity that their pancreas would be performing through a combination of carefully regimented eating (including very close attention paid to carbohydrate) and blood glucose checks / insulin injections. Suddenly changing over to a fasting diet without careful supervision from a physician could be lethal for a type I diabetic.
We live in a pretty litigious society. Everything has to be caveated to cover the lowest common denominator. On top of that nutrition is a complex subject filled with a lot of mis-information. In this particular case fasting can be risky for those who are obese or have a lot of toxins in their fatty tissue.
From what I understand, pollutants in food (from pesticides and other sources) and in the environment which are not easily broken down are stored by the body in fat.
Fasting or sudden weight loss can cause these toxins to be released more rapidly than would otherwise be the case. This can tax your system pretty heavily if you're obese or have a higher incidence of pollutants in your body.
So you state something as fact yet don't actually have the expertise to understand if that's even true? I'm not a medical doctor, but it seems fairly reasonable to me that people with diabetes shouldn't arbitrarily and radically change their diet because of an article they read on the internet...
If you believe most doctors have expertise in nutrition and fasting you've not been paying attention.
It seems fairly obviously no one should arbitrarily and radically do anything just because someone told them to. There are a lot of special circumstances, but thankful there are useful concepts such as personal responsibility and common sense that have generally been useful in keeping humans alive for quite a while.
It's risky if you shoot up insulin every day, or take other drugs that have an effect on blood sugar. You could wind up in a hypoglycemic coma and die.
I know it shouldn't be a big deal to fast even for a few days, and I don't find hunger to be a problem, but I do find feeling very drunk-dizzy and incredibly tired starting around hours 14-16 to be a problem. That part definitely doesn't feel very healthy, and it's what's keeping me from making 1day+ long fasts part of my regular routine.
I used to have the same problem. Probably low blood sugar if you're accustomed to a more carb rich diet. Switching to eating more healthy fats (olive oil, raw coconut oil, butter) and less sugar helped me with this particular problem.
Yeah, I'm doing salad-with-fats lunches now to hopefully aid the next attempt, and I rarely eat breakfast anyway but when I do it's already mostly fats 90% of the time (full-fat yoghurt with no added sugar + nuts).
Doubt I'd be able to go full-on keto and still eat dinner with my family, and the diet sounds pretty miserable anyway but I'm hoping this plus trying a fast again every week or so will get me past the problem.
Just want it to be known that, if you haven't tried it and don't know how you'll react, even a shortish fast may leave you feeling like you're an hour and a half in to a visit to a beer festival, which might be problematic if you have to actually do stuff that day. Maybe not doctor's-supervision-required, but consider doing the first couple attempts on days when you have no responsibilities (unfortunately much harder, IMO, since it's easier to fast when busy and not at home, but hey.)
I'd like to give another perspective. When someone says people should not start exercising before seeing a doctor and without supervision, they are saying: you can die!
And people can really die if they "go back to the roots" and start running pursuing animals.
So, when someone says: don't this radical change in your nutrition habits, people should listen carefully.
Appeal to Nature is only a fallacy when discussing whether something is good or not, not whether or not it is healthy or safe.
The argument that, say, "walking for six hours a day is unlikely to be dangerous, since early humans did so" may or may not be factually correct, but it's a reasoned argument.
You're not really correct: There are, for instance, poisons and venoms in nature.
Additionally, the example argument you make isn't an appeal to nature; The argument is based upon what early humans did (not nature, or whether something is "natural"), and is a resonable conjecture.
What I had an issue with in the parent comment was "Fasting is kinda natural" - which doesn't say anything about fasting in and of itself.
Because for diabetics your diet and changes to can lead to wild swings of your glucose levels and would require much more diligent monitoring, something individually is very hard to do while asleep. Sleeping is not a good time to have a low sugar even and it can happen quickly and you just don't wake up from it.
purely anecdotal but my mother has seen high levels before going to bed only to wake up dangerous low. Or the fun good level and suddenly in the morning you are at 300+. Ask three doctors at hospital and get three different opinions.
No, don't do it at home and don't do it unless monitored by a health care professional who knows how to respond.
The research has been going on for a decade about metabolic.
I use to fast once a week from dinner to dinner (Prior to midnight day break most of the world's day started at sunset so a day fast was from sunset to sunset). I seriously need to jump back on the fasting bandwagon my self-discipline has gotten lower and lower ever since I hit my mid-thirties and got married.
Not sure what you're trying to tell me. The first link you provide doesn't link to the original research it's talking about. The second is about a mouse study.
Maybe you're trying to reinforce my point that the HN audience likes to quote weak scientific evidence.
Not sure if your just a cynic and distrust everything or your trying to be a skeptic and try and find the truth.
This is what makes medical research. Using mice is a very established way of testing hypothesis. Are you trying to say that we should only trust human studies when humans can't be controlled and limit what is impacting the body?
I also fail to see that research not being reproducible = weak science when you then knock a study that is reproducible but then you knock it for being not human based. The fact that a lot of science isn't reproducible has many honest scientific reasons, while other's are fraud.
I see nothing wrong with the BBC article - it could be more accurate by adding 'in mice' to the subject but that's the only problem I see. Research starts somewhere. If you're genuinely interested in quality, well researched information there's a documentary on the subject of fasting which I can highly recommend. Changed my perspective on the matter:
http://www.dailymotion.com/video/xvdbtt_eat-fast-live-longer...
AFAIK, type 1 diabetes is thought to be an autoimmune disease, where the immune system incorrectly identifies the beta cells as an infection/foreign body and destroys them.
With that in mind, I wonder how effective this actually is. I (I'm a T1 diabetic) grow some new beta cells, my overly aggressive immune system wipes them out again..
EDIT: reading the reddit thread (https://www.reddit.com/r/science/comments/5vufpb/the_pancrea... - thanks austinjp) i'm not the only one to ask this. The general consensus is it's not going to be useful for T1 diabetics, it's just treating the symptoms, not the cause (the immune system), again (like injecting insulin).
I wonder if this might of been a repair mechanism evolved when going some time without access to food was more common. Perhaps there is a biological reason certain organs can't be repaired while the digestive system is running at full capacity.
A friend of mine was on the brink of Type 2 diabetes and reversed the symptoms / indicators after reading about the Newcastle University study. Worked for him.
I had metabolic syndrome x, pretty much the final stage before type 2 diabetes.
I also had an undiagnosed (despite every test the docs could think off).
I went on a 1500 calorie a day diet for 7 months and dropped weight from 245lbs to 185lbs (I'm 6 foot) at the next doc appointment indicators where all in normal range and at the most recent they where all excellent for someone my age.
Diet for this 7 months was cottage cheese, veg, nuts and rolled oat porridge with either chicken or fish and veg.
No fruit, lots of supplements and a protein shake before bed.
First month was grim I felt terrible all the time but every month after was easier.
"The human version of the FMD is a propriety formulation belonging to L-Nutra (http://l-nutra.com/prolon/). It is a plant-based diet designed to attain fasting-like effects on the serum levels of IGF-I, IGFBP1, glucose and ketone bodies while providing both macro- and micronutrients to minimize the burden of fasting and adverse effects (Brandhorst et al., 2015). Day 1 of the FMD supplies ∼4600 kJ (11% protein, 46% fat, 43% carbohydrate), whereas days 2-5 provide ∼3000 kJ (9% protein, 44% fat, 47% carbohydrate) per day. The FMD comprises proprietary formulations of vegetable-based soups, energy bars, energy drinks, chip snacks, tea, and a supplement providing high levels of minerals, vitamins and essential fatty acids (Figure S3). All items to be consumed per day were individually boxed to allow the subjects to choose when to eat while avoiding accidentally consuming components of the following day. For the human subjects, a suggested FMD meal plan was provided that distributes the study foods to be consumed as breakfast, lunch, snacks, and dinner. (See lists below for ingredients and supplements)"
Type 1 diabetic here, I'm sure if you still retain a small amount of basal insulin in combination with regular glucose monitoring I can't see how it would be dangerous? The real danger would be the billion dollar insulin business looking to discredit this research.
How to read this thread: "what's right _for me_" not "what's right".
Also, it's impractical to fast when you have work to do and meetings. You risk becoming cranky and grumpy and pissing colleagues off. Better to fast when you have a day off or at night.
> He told the BBC: "It boils down to do not try this at home, this is so much more sophisticated than people realise." He said people could "get into trouble" with their health if it was done without medical guidance.
If T1D is properly managed (frequent testing, insulin injection every meal), fasting actually poses less danger than a typical diet that has carbs in every meal. Carbs set you up for a wild swing.
I would like to have some info on that as when I don't eat for extended periods of time my bloodsucker goes haywire no matter what I do (insulin wise), as well as having nightly hypoglycemia no matter what.
Nobody reacts the same unfortunately...
The liver dumps some glucose in the morning (partly to wake you up). You're also somewhat insulin resistant in the morning. I take 3-4 units just to stay level until lunch, when insulin starts working again.
As the day progresses, I feel like the body becomes saturated with insulin, and everything is more predictable.
I try not to eat after 8-9pm. Pretty similar to the eight hour diet: you eat between noon and 8pm.
Hope that helps.
There was a headline yesterday on HN that most scientific results cannot be peer reviewed. Maybe this too falls in that category and we have to take it with a grain of salt.
Apparently I've been fasting daily pretty much most of my adult life. Last meal between 17-20, I generally never eat breakfast, and then eat lunch between 12-14. Maybe that explains why I'm rarely sick, and haven't been to a doctor since I was fourteen?
There are many form but the general thin is that cells get resistant to massive amounts of insulin, which are caused by high blood sugars, resulting in higher blood sugars and/or higher insulin levels which can cause damage to any tissue. As far as I know (I have T1 diabetes, no doctor though) the Beta cells producing insulin have (like any cells) a sort-of define lifetime/production level and stressing them out doesn't help you in the long run. You can take medication to allow cells to have easier access to insulin, be more susceptible to it or increase the betacell insulin production but these are generally stopgap measures which in the end result in nearing Type 1 insulin levels if no change in lifestyle is taken.
Many old people will get it (Type 2) anyway since the pancreas is simply out of juice, but with relatively simple medication it can be managed. Eating like a fat pig will definitely accelerate the reduction in betacell insulin production capacity and increase the insulin resistance of other cells as described above (nice feedback effect).
High blood sugar damages the pancreas beta cells. If you have poorly controlled high blood sugar for long enough, you will lose the ability to make insulin in addition to being insulin resistant.
That is type 2 diabetes, and is genrerally avoidable with proper diet anyways for most people. (your results may vary). This won't fix any type 1 people otherwise plenty of teenage girls would have been gotten rid of t1 diabetes already.
If you're genetically predisposed, then "proper diet" is pretty strict. I am a T2 diabetic, and control my blood sugar with a low carb diet. I'm pretty familiar.
To paraphrase an old mentor, curing diabetes in mice is kind of the sport of the field. It's been done a number of times. Mice have some abilities to regrow tissue we don't. It's unclear how well various mouse models for diabetes mimic the human phenotypes.
I am very hopefully for this line of research in general but I expect any cure in humans will be more complex and perhaps also deal with somehow suppressing the immune response that destroys the Beta cells in type 1's like myself. For a type 1 the best I'd expect something like this to be able to achieve is a temporary return to the "honeymoon" period where the pancreas still produces enough insulin to make small adjustments but supplemental insulin is required.
On a personal level i have found that diet can have massive effects on my diabetes management. I may try a diet like this (with the advice of a doctor in adjusting insulin to handle it well etc and with the realization i may need to break the diet to treat low blood sugars etc). Edit: I also use a continuous glucose monitor which helps greatly with avoiding low bloodsugars while changing diet/activity levels and recommend one to any other diabetics.