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Heart Talk – August 2021

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Surprising benefits of intermittent fasting for heart and brain health

Heart-Healthy and Stroke-Free Living with Eric A. Goulder, MD, FACC

MMost people think of intermittent fasting (IF) as a weight loss plan because it helps your body burn fat. This is the case with many of our overweight patients, most of whom have tried numerous diets without success before we suggested they try IF. Some of them have lost 30 pounds or more and report feeling healthier than they have in years.

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However, intermittent fasting is not just a way to shed the pounds. Even if you don’t lose weight with this eating plan, studies show that it’s still the best anti-inflammatory diet and can also help reduce or reverse insulin resistance, the cause of 70 percent of heart attacks, many strokes, and almost all cases of type 2 diabetes. IF may also help you prevent Alzheimer’s disease, which is so common in people with insulin resistance that it’s been dubbed “type 3 diabetes.” Here’s a closer look at IF and its wonderful health benefits:

What is intermittent fasting?

Many diets focus on what you eat, but intermittent fasting is all about when you eat. There are a few variations on this popular eating plan, with the most common being the 16/8 approach, which involves fasting for about 16 hours each day and limiting your daily food intake to about 8 hours. Within this window of time, you can have three small meals or two slightly larger ones, such as lunch and dinner.

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Following this plan can be as simple as not eating after dinner and skipping breakfast the next morning. It’s important to choose healthy foods in moderate portions, however, since you’ll reap no health benefits from loading up on high-fat or processed foods, sweet treats, and oversized portions during the eating window.

Another popular IF regimen is the 5:2 plan, where you eat normally five days a week and limit yourself to 500-600 calories a day the other two days. The fasting days can be chosen freely, provided that there is at least one non-fasting day between them. Again, “eating normally” means eating a healthy diet with moderate portions and avoiding junk food and sweets.

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How does the 16/8 plan work work?

Here’s an example of the 16/8 plan in action: if you finish your dinner at 8 p.m., you would wait until noon the next day to eat again, thus ending a 16-hour fast. During the fasting window, it’s important to stay hydrated by drinking plenty of water, which helps quell hunger pangs.

It’s also okay to drink coffee or tea during the fasting window, as long as those drinks are unsweetened and don’t contain anything with calories like milk or cream. Before you start intermittent fasting, be sure to check with your doctor. This eating method isn’t for everyone and can be harmful to people with certain medical conditions, especially those taking certain diabetes medications.

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What are the latest study results on the effects of intermittent fasting?

Numerous studies have shown impressive health benefits. One of the most recent is a 2021 randomized clinical trial (RCT) in which participants who practiced IF for eight weeks had significant decreases in body fat, oxidative stress and inflammatory markers. The group that followed this eating plan also had significant improvements in blood vessel function, nutrient metabolism, and gut health compared to a control group of participants who ate their usual normal diet without fasting.

A number of other studies came to similar conclusions. For example, in a 2018 RCT, people who practiced calorie restriction through IF for two years lost nearly 20 pounds and dramatically reduced levels of F2-isoprostanes, a biomarker of oxidative stress (an imbalance between free radical formation and protective antioxidant) . defense). F2 isoprostanes, measured with a urine test, show how quickly the body oxidizes or breaks down.

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A 2019 study found that the benefits of intermittent fasting outweigh those of simple calorie saving. The study, published in the New England Journal of Medicine, found that IF improved obesity, waist circumference (regardless of weight loss), insulin resistance, high cholesterol, high blood pressure and chronic inflammation. Researchers also reported the following physical and cognitive health benefits:

  • Maintain muscle mass while losing fat during resistance training

  • Better performance in endurance sports

  • Reduced belly fat

  • Improved verbal and working memory in older adults

  • Improved memory in people with mild cognitive impairment

What is the link between oxidative stress and chronic disease risk?

Your body creates energy by burning fuel (nutrients from digested food) with oxygen. A byproduct of normal metabolism—like smoking and other unhealthy habits—is the formation of free radicals, highly unstable atoms or molecules that are missing one of their electrons. To achieve stability, they steal an electron from nearby molecules, leading to a chain reaction in which the attacked molecules become free radicals and then rob their neighbors.

When a free radical chain rips through cells like a firestorm, it can cause significant damage to important components. When DNA, the cell’s blueprint, becomes damaged, mutations can arise that can lead to cancer, while damage to proteins, the cell’s workhorses, can render cells dysfunctional and more susceptible to disease.

However, the body also has antioxidant defenses to protect against free radical damage, including physical barriers to quell free radicals, enzymes to neutralize dangerously reactive forms of oxygen, and antioxidants in our diet (found in fruits and vegetables, among others)—all of which Donate electrons and defuse chain reactions of free radicals. Therefore, the key to slowing aging and protecting your cardiovascular health is to achieve a balance between destructive oxidation and antioxidant defenses.

How does intermittent fasting affect insulin levels?

Many studies have shown that IF can significantly improve insulin resistance (IR), the precursor to type 2 diabetes. Unlike people with type 1 diabetes — an autoimmune disease involving antibodies that attack and destroy the insulin-producing beta cells in the pancreas, irrevocably stopping insulin production — people with type 2 diabetes make insulin but their bodies don’t use it properly. Normally, this hormone helps cells in the body use glucose (blood sugar) for energy.

When people develop IR, their cells become desensitized to insulin, forcing the pancreas to produce ever-increasing amounts to keep up with demand. Very often, people with IR have both high levels of insulin and glucose circulating in their bodies. Think of this scenario as similar to a factory where workers are forced to work longer and longer hours on the assembly line to meet higher and higher production quotas. Eventually the workers will be so exhausted that they will either collapse or go on strike, bringing the assembly line to a standstill.

Similarly, as insulin resistance progresses, beta cells eventually tire and blood sugar spikes. By the time someone crosses the line to type 2 diabetes, the arterial damage has usually been there for at least 10 years, and in some cases for 20 years or more. This explains why people with diabetes have a greatly increased risk of cardiovascular events.

Although the beta cells of the pancreas produce small amounts of insulin throughout the day, insulin levels rise after eating. On average, most people eat six or seven times a day, including meals and snacks, which puts a heavy workload on the beta cells. By reducing food intake, IF reduces insulin spikes, beta cell demands, and the body’s total insulin levels. In fact, this eating plan helps reprogram our metabolism by reversing our body’s response to insulin, which in turn improves insulin resistance and helps us use this hormone more efficiently.

Does Intermittent Fasting Have Anti-Aging Benefits?

IF helps keep your cells young and healthy by enhancing “autophagy,” the process cells use to get rid of debris (such as without this housekeeping process, which literally means “self-consumption,” the cells would be overloaded with garbage and Die off Reduced autophagy has been linked to a number of diseases and is also believed to play an important role in aging.

As a recent study by BaleDoneen shows reported, enhancing autophagy is a critical step in maintaining arterial health by supporting cells’ ability to isolate harmful substances, such as environmental toxins and infectious agents, and break them down into harmless biological components. When autophagy is impaired, inflammation develops, increasing the risk of both developing arterial plaque (disease) and suffering cardiovascular events if you already have them. Therefore, improving autophagy is crucial to live long and maintain fit arteries.

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