- Over the course of 16 weeks, people who were asked to practice intermittent fasting lost more weight and had greater improvements in their blood sugar control than those who were given metformin or empagliflozin (two commonly prescribed diabetes medications).
- The research focused on a type of fasting called the 5:2 diet, in which people eat normally five days a week and then fast for two days, consuming only 500 to 600 calories on the fasting days.
- After 16 weeks, the fasting group lost an average of 21 pounds, which was almost double the average 12 pounds lost by people taking metformin. Those who were prescribed empagliflozin lost an average of about 12.8 pounds during the study.
- previous studies They have examined whether intermittent fasting could help people with type 2 diabetes, but they were mostly small and did not compare the diet with medications.
- The study included more than 330 overweight and obese adults who had recently been diagnosed with type 2 diabetes.
courtney petersonAn expert who was not involved in the study said the results were “exciting.”
“Often we assume that medications are more powerful than lifestyle approaches,” said Peterson, an associate professor of nutritional sciences at the University of Alabama at Birmingham. “But here they showed that a lifestyle approach was more effective at lowering blood sugar than giving people medications. That’s a very powerful statement.”
The 5:2 diet was first popularized a decade ago by a BBC documentary and a bestseller book, “Fast DietThe book, written by British physician Michael Mosley and co-authored by Mimi Spencer: Lose weight, get healthier and live longer with the simple secret of intermittent fasting.
The new study of the 5:2 diet took place in China, which has the largest number of people with type 2 diabetes than any other country in the world. At least 141 million adults in China have diabetes and half the population is overweight or obese.
The authors of the new study recruited adults with type 2 diabetes and then divided them into three groups. In the first two groups, participants were asked to take either metformin or empagliflozin. In the third group, participants were taught to follow the 5:2 diet. Women consumed only 500 calories on each of their two weekly fasting days, while men consumed no more than 600 calories – which is equivalent to about a quarter of their usual calorie intake.
On fasting days, participants ate very small amounts of food: one egg at breakfast, two servings of fruit or vegetables at lunch and a light salad at dinner. Each meal was accompanied by a low-calorie meal-replacement drink that contained healthy fats, protein, vitamins, minerals and other nutrients. On fasting days, participants ate normally at breakfast and lunch and then ate a light meal with the meal-replacement drink.
Significant and continuous improvement
In addition to losing weight, the fasting group also saw a 1.9 percent drop in their HbA1c, a long-term measure of their blood sugar levels — significantly more than the groups taking medication. Nearly 80 percent of participants in the fasting group had their HbA1c drop below 6.5 percent, the cutoff for diabetes, compared with 60 percent of participants taking metformin and 55 percent of those taking empagliflozin.
Eight weeks after the study ended, researchers conducted a follow-up study with participants and found that most of those in the fasting group had maintained blood sugar levels below the threshold for diabetes, suggesting that the diet “significantly and durably improved HbA1c levels,” the authors wrote.
Researchers found that the fasting group experienced greater reductions in waist circumference, blood pressure levels and triglycerides (a type of fat that circulates in the blood) than participants who took the medication.
The researchers cautioned that more studies are needed to examine the long-term effectiveness of the 5:2 diet with meal replacements for type 2 diabetes. But they said their findings suggest the diet could be a good initial lifestyle intervention for people with early-stage diabetes.
Meal replacement with fasting
The study was large, rigorous and cleverly designed, Peterson said, because it primarily involved two dietary interventions — intermittent fasting and meal replacements — that have been proven to help people with diabetes.
several studies Diets containing low-calorie meal-replacement shakes, soups, and bars have been found to help people lose weight and lower their blood sugar levels. Multiple studies They also indicate that the 5:2 diet helps people improve their blood sugar control.
Peterson said one downside of the 5:2 diet is that people see impressive results in the first few months, but after about six months to a year on the diet, “they start to taper off.”
“While it appears to have benefits in the short term, over the long term, a year or more, it does not appear to be any better than a standard reduced-calorie diet,” he said.
He also stressed that more long-term research is needed. But in the meantime, he said people recently diagnosed with type 2 diabetes should discuss with their doctor whether it’s worth trying the 5:2 diet with meal replacement shakes like Optifast, Ensure, Soylent or others.
He said that the participants in the study did not experience any adverse effects while fasting, but about 6 percent of the people showed symptoms of low blood sugar during the fast, which can be potentially dangerous.
“People should consult their doctor if they want to try it,” Peterson said. “They shouldn’t try it alone.”
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