We know that body weight has to do with an algebraic sum between the energy that is incorporated and the energy that is expended. From this obvious point, if more calories are incorporated than are really necessary, the unused ones become reserve energy, which is nothing other than body fat. It is an evolutionary adaptation that allowed us to survive even in the chronic lack of food. Some days there was enough to eat, others not. The history of humanity then it is intermittent fasting survival. Now, in the oversupply of food in the urban population, this adaptation works against us. Intermittent fasting, so fashionable, but at the same time ancient, postulates benefits of weak scientific supportbased mostly on animal models, but frames truths that our grandmothers already knew: if you eat less you lose weight.
But then, why are the weight loss results so frustrating with this method?
Our brain has the so-called “weight memory”. It is a mechanism that activates the appetite and slows down the metabolism to generate energy savings when we do not eat for a long time. In this sense, we know that eating once a day (especially at night) is more obesogenic than if the same amount of food is distributed throughout the day. The yo-yo effect, which we see in those who gain weight after a sudden loss due to a very strict eating plan, is also explained by this phenomenon.
Regarding intermittent fasting and diabetesthere are several reasons to advise against it except very strict medical supervision and the willingness to increase blood glucose self-monitoring:
- Increases the risk of hypoglycemiaespecially in those who use insulin or the so-called sulfonyl ureas such as glucosamine, glibenclamide, glimepiride.
- The dehydration It is also a risk, so you should insist on fluid intake during fasting hours or days. Dehydration can lead to hypotension.
- On fasting days, people may need reduce or stop completely the use of some diabetes medications such as SGLT-2 inhibitors (empagliflocin, canagliflocin or dapagliflocin that are marketed in Argentina) as well as antihypertensives and diuretics, which can eventually lead to dehydration. This with special emphasis on older adults, who are more sensitive to it.
We then insist on the strict professional supervision before starting this eating model.
by *Gabriel Lijteroff- Director of the scientific and international affairs committee and former president of the Argentine Diabetes Federation (FAD).
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