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How fasting compares to ketogenic low carb diets for diabetes and weight loss

Find out who should avoid sugar.
Find out who should avoid sugar.
Photo by Astrid Stawiarz/Getty Images

Both intermittent fasting and high fat low carb ketogenic diets have become increasingly popular weight loss plans. Now a new study is indicating that fasting can also help with diabetes and heart health, reported Medical Research News on Thursday.

The fasting clinical trial consisted of a 24-hour period with only water. Participants were pre-diabetics with metabolic syndrome, said Dr. Benjamin D. Horne, director of cardiovascular and genetic epidemiology at Intermountain Heart Institute in Utah.

"The participants were asked to fast once per week for 6 weeks. This is the first interventional trial of fasting in people with pre-diabetes or diabetes," noted Dr. Horne.

Metabolic syndrome afflicts those with multiple risk factors for heart disease, diabetes, stroke and related conditions. Typically associated with obesity, the factors evaluated prior to diagnosing someone with metabolic syndrome include waistline size (especially fat in the stomach area, which increases heart disease risk), cholesterol levels, blood pressure and blood sugar.

The fasting experiment indicated that participants lost weight and improved their cholesterol levels. "These findings indicate that fasting may directly reduce cardiac and metabolic risk factors and, thus, have a long-term impact on coronary disease and diabetes if fasting is engaged in repeatedly over a period of years," said Dr. Horne.

Variations on intermittent fasting include the 5:2 diet, which allows dieters to feast five days a week and then do a restricted-calorie fast on the other two days. Documented in "The FastDiet: Lose Weight, Stay Healthy, and Live Longer with the Simple Secret of Intermittent Fasting," this weight loss plan is backed by scientific trials that showed it also "can improve health,” said Dr. Mark Mattson, Professor of Neuroscience at Johns Hopkins University.

But not everyone is convinced that a diet plan that allows you to eat what you want on non-fast days is the permanent answer. Eating grains, sugar and other refined carbohydrates can increase your risk of conditions such as Alzheimer's disease, warned Dr. David Perlmutter in a Friday interview with WRVO News.

Author of "Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar--Your Brain's Silent Killers," Dr. Perlmutter advocates a high fat low carb diet for preventing neurological problems as well as weight loss. By following a Paleo-style diet that eliminates grains and sugar, dieters can dramatically reduce inflammation.

"Everybody’s [talking about] low fat, no fat, this and that, and that’s the worst thing for your body. Your brain is 60 percent fat; it’s built from the fats that you consume in your diet, and fat can reduce inflammation," Dr. Perlmutter explained.

In a study examining the use of low-carbohydrate high fat ketogenic diets to treat type 2 diabetes, a team of physicians including Dr. Eric Westman evaluated overweight individuals for 16 weeks. Dr. Westman has co-authored an upcoming book about such diets: "Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet."

At the end of the 16-week period, all participants in the trial had lost weight. Moreover, "improved glycemic control in patients with type 2 diabetes such that diabetes medications were discontinued or reduced in most participants," concluded the researchers.

In an exclusive interview, Emily Maguire, who has a master's degree in obesity science specializing in low carb diets and type 2 diabetes, told us that her research highlighted the benefits of ketogenic diets for those with diabetes.

"From my research, I found that all participants not only lost a greater amount of weight that following low fat, but they had significant improvements in all diabetic markers," she said. In addition, her research confirmed Dr. Westman's findings that diabetics on medication benefit.

Based on her studies, diabetics were "able to reduce or completely eliminate their medication, which is consistent with most of the data out there," Emily said. However, she emphasizes that "anyone looking to take this dietary approach should seek help from professionals who know how to work with this."

What if you don't have diabetes but want to lose weight? Emily feels that all of us can benefit from removing sugar from our diet as well as starches.

Instead, she says, the focus should be on "getting our carbohydrate sources from fruits and vegetables." For protein, she recommends variety, from eggs to poultry to fish to red meat. In addition, low-carb dieters need to remember to lose their fear of fats and include foods such as "butter, coconut oil, avocados and nut butters."

A frequently asked question with regard to ketogenic diets: What about cholesterol? The question illustrates the myths that exist when it comes to saturated fat.

It is a myth that Dr. Robert Atkins battled for much of his professional life. Dr. Westman, who co-authored "New Atkins for a New You: The Ultimate Diet for Shedding Weight and Feeling Great," also took up the saturated fat swords in defending the benefits of a high fat low carb diet.

The newest participant in the on-going war of weight loss and healthy diets: Investigative journalist Nina Teicholz and her book "The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet." Asked to defend her notes on how her own cholesterol and health markers improved while her weight dropped on a high fat diet, Nina posted her cholesterol lab tests online.

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