I recently read an article that was
published earlier this year in which I found my mouth ajar intermittently as I read.
The article discusses the positive health effects of food deprivation. All of
my life I was under the assumption that when we deprive our bodies of food, it
stores the energy we do consume so as to keep it long-term rather than using it
up immediately, thus causing weight gain rather than weight loss. This article,
however, countered everything I thought I knew.
The article describes the current
literature about the profound effects of fasting. One effect that has been
found is weight loss. In one study, subjects who were on time-restricted diet lost
four percent of their body weight and reported better sleep and an increase in
energy. Another effect of fasting that has been observed is protection from
metabolic diseases such as diabetes, cardiovascular disease, high cholesterol,
and fatty liver disease. In addition, periodic fasting was found to promote the
repair of damaged pancreatic cells in mouse models of type 1 and 2 diabetes by
reducing PKA and mTOR activity. In the brain, brain-derived neurotrophic factor
(BDNF) was identified as a key mediator of neurological and fasting responses,
causing an increase in the number of mitochondria in hippocampal neurons,
resulting in enhanced learning and memory. Additionally, periodic fasting
calmed inflammation and rescued cognitive function by reducing the quanitity of
proinflammatory cytokines, increasing BDNF levels and activating the
transcription factor responsible for stress responses. Longer periods of
fasting have been found to enhance the immune system and cause alterations to
stem cells. Experiements showed that periods of fasting caused a decrease in
autoimmune T cells by replacing them with immune cells that were not programmed
to attack the neural tissue. In addition, oligodendrocyte precursor cells regenerated
and remyelinated axons, resulting in a decrease in severity of autoimmune
disorders. Fasting diets have shown improvement in or protection against
symptoms of Alzheimer’s, MS, cardiovascular disease, diabetes, and other
metabolic disorders. Cancer is the new area of focus when it comes to research
on fasting. In mouse models with breast cancer and melanoma that were exposed
to periodic fasting conditions combined with chemotherapy, tumor progression
was reduced. It was found that the cancer cells were sensitized to the
chemotherapy, while the normal cells were protected from the toxins due to
increases in levels of lymphoid progenitor cells and tumor-killing lymphocytes.
There is also evidence that periodic fasting can enhance stroke recovery.
Research on fasting raises many ethical
questions for me. Is this going to promote fasting that is not closely mediated
and monitored by doctors? If so, what will the effects be on the development of
eating disorders and, subsequently, mental health disorders? There is little
data regarding the long-term effects of this fasting regimen and until we know
what they are, I believe it is unethical to implement in humans. I believe that
as the research stands right now, the potential harm of intermittent fasting
exceeds the potential benefits. Thus, doctors should practice non-maleficence
by not introducing fasting to patients.
Reference:
Grant, B. (2017). Running on Empty. The Scientist, 31(6).
Taylor,
ReplyDeleteWith a slew of diet fad trends that are circulating the country, the one you present here seems to be backed up with quite a bit of empirical evidence. While intermittent fasting as a diet regimen (or dieting routine?) might seem like a tricky topic to discuss and, perhaps, suggest to patients given the high prevalence of eating disorders in the United States, it may be an acceptable route to take for many people seeking to lose weight, as long as some guidelines are established by the provider and visits are made by the patient to ensure compliance.
Consider the review by Golbidi, et al. (2017) that further highlights the benefits of intermittent fasting and caloric restriction as a means of preventing obesity. Along with controlling diabetes (as you previously mentioned), fasting has a significant effect on modifying apoptosis and upregulating autophagy, the process by which degrades worn-out cells and recycles its essential nutrients (current pop-science discussions suggest that this may be the key to "slowing the aging process"). After highlighting its benefits, however, the authors do mention that behavioral modifications related to regulated fasting are essential in order to achieve desired favorable outcomes. It would appear that they share the same concerns as you do in regards to regulating a fasting regimen.
Golbidi, S. Daiber, A., Korac, B., Li, H., Essop, M.F., Laher, I. (2017). Health benefits of fasting and caloric restriction, Current Diabetes Reports, 17(12):123. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29063418