Doctors Heart Series Chapter 7: The Role of Fasting in Reversal of Diabetes and Other Metabolic Diseases

Maximizing wellness and reversing Metabolic disease with Healthy Optimization of Nutrition for everyday Living (HONEY Diet Plan)

Jun 08, 2022

Caution : long read!

Waterfalls in Shenandoah Mountains, Virginia.

Blue zones…

Sardinia, Okinawa, Ikaria, Loma Linda, and the Nicoya Peninsula places have something in common. They are different parts of the Globe and are considered Blue Zones. According to the survey, they found most people live to become Centenarians. So what makes these groups of people in these peculiar places live this long. The survey showed nine qualities that propel them to live longer, and one of the classic ones is eating less and caloric restriction(no kidding!). They have caloric restrictions, but they also consume nutritious foods. Foods include rich in Nuts, Legumes, Vegetables, Whole Grains, and Seafood(discussed in chapter4). It has become so popular now we call them Blue Zone diets. The importance of longevity is the number of quality years. I believe Intermittent Fasting or Caloric Restriction would help achieve that.

"When Creating a Healthy Lifestyle, Make Choice Easy. "

Food is an integral part of health. The quality of food is essential when we discuss fasting; we are talking about changing a Healthy lifestyle for good. We need to be interested in what we put in our mouths and when. We have to figure out how a substantial amount of food should be unprocessed in our everyday diets. I mean primarily in their original form; I mean not frozen or adulterated. Also, this must be something we have to ingrain in our DNA for the better. The Tsunami of Metabolic Disease(Diabetes, Cholesterol Etc.), which I alluded to in the earlier chapters, is coming. To mitigate the risk, our bodies need proper nourishment with unprocessed, wholesome foods.

Processed Food Vs. Unprocessed food…

Per the Department of Agriculture, processed food is any raw agricultural commodities that have been washed, cleaned, milled, cut, chopped, heated, pasteurized, blanched, cooked, canned, frozen, dried, dehydrated, mixed, or packaged — anything is done to them that alters their natural state. This may include adding preservatives, flavors, nutrients, and other food additives or substances approved in food products, such as salt, sugars, and fats.

I mentioned processed foods many times. What is it? And why do I care? When the food is taken from its natural state to the altered state, adding extra sugar, refined dough, or other chemicals. We are essentially changing food's structure and molecule (the future topic of discussion). When eaten, a variety of changes happen at the cellular level. The altered food loaded with simplified refined carbohydrates (Candy, Donut, French fries, Milkshake, Cola Etc.) causes the elevation of a hormone called Insulin. The primary culprit here is Insulin and the metabolic derangements that it brings. Insulin is an essential hormone, and it's doing its job tirelessly. Always vouching for us in survival and planning to keep us plenty of stored (Abdominal fat) energy for future use for famine(famine, really ?). Fortunately, this famine is not coming to most parts of the World anymore. Instead, the World is getting filled with artificial food.

This is precisely what's happening; the logic of poor people needing food and are dying of hunger in Africa and Asia has now been replaced with abundant unhealthy processed foods, and are dying of Heart disease, Diabetes, Cancer, etc. Fresh foods have become scarce and cheaper adulterated foods abundant. Food desserts (limited to absent grocery stores) are cropping up everywhere. People in these communities are loaded with fast food joints and make them eat the fake burger and sugar water, leading to a long-term plethora of metabolic diseases. Obesity has taken over significant morbidity and costs a tremendous amount of money in tax-paying Dollars.

Food was tradition, food was religion, and food was everything the family was about for a very long time. However, Globalization over the turn of the century changed how we look at food. The food rapidly evolved to be eaten with a quick bite due to lack of time.

1980s…

In the early 1980s, during my elementary school years in India, a relatively recent Independent Democratic Country. India primarily was an agrarian society; as a country, India struggled with food cultivation and storage. I remember there were hardly any Overweight or Obese people in India during this time. In just 30 - 40 years, Fast forward to the current state, India, like many other emerging nations worldwide, have surplus food and better trade with the rest of the World. Imports and exports have increased. India has made leaps and bounds with the opening up of the IT Corridor during the 90s. Which has catapulted the advancement of the country economically. Multiple fast food joints started to flood the markets in the last decade in South Asia. Due to the abundance of refined carbohydrates, rice, desserts, bread, and inactive lifestyles in the recent decades in South Asia, especially in the Middle class. South Asia has the highest cardiac morbidity and mortality rate than any other region, likely secondary to rampant metabolic disease.

Understanding the Basic Science of food is essential…

The Diet Industry is the Multi-Billion Dollar Industry in the US. Sometimes, as a physician, I cannot wrap my head around understanding various diets Atkins diet, South Beach diet, Keto diet, Low Carb Diet, and many others that flood the internet every day. The problem with any diet is sticking with it. Unfortunately, many people who start one diet will stop to move to the other one instantly. Also, many diets claim you to lose weight only to gain it later. Some diets have been well studied, including the Mediterranean diet. The Mediterranean diet(another topic of discussion) has unprocessed, wholesome foods as discussed.

One such study was Mediterranean diet and heart disease prevention in Predimed study. In this study, 7,447 individuals with a high risk of heart disease followed either a Mediterranean diet with added Olive oil, a Mediterranean diet with added nuts, or a low fat control group. The study lasted for 4.8 years. Results showed the risk of combined heart attack, stroke, and death from heart disease was lower by 31% in the Med + Olive Oil group and 28% in the Med + Nuts group compared to low fat control group.

In my opinion, if we understand the science behind nutrition and fasting, we have a chance of succeeding in healthier lifestyles. For Science of Fasting, please refer to Chapter 6. Once the reasons become crystallized and understood, the basis of healthy eating becomes more effortless.

What is unprocessed foods?

Unprocessed foods include the natural edible food parts of plants and animals. Minimally processed foods have been slightly altered for the main purpose of preservation but which does not substantially change the nutritional content of the food.

Unprocessed foods provide nourishment to the body and can give essential Macro and Micronutrients. I counsel my patients about the quality of food and the nutritional quality. The idea is to consume less processed and more unprocessed foods. When we eat good quality foods, we don't have to restrict ourselves(Mediterranean diets). It gives sufficient fiber in the diet and helps gut health in check; in return can help keep sugar absorption down (when blood sugars are down, the Insulin is down, when Insulin is down, body repair starts).

In this Day and Age, It’s Humanly Impossible to stay away from the processed food and simple sugars, but identifying them and Understanding in eating less of these foods are the key.

As we discussed earlier, most grains have become significantly fiber-free in the food. We are ripping out any fiber on the grain, whether rice, wheat, or other grains. In addition, having a fiber-free diet has a significant impact on blood glucose levels. As blood glucose levels increase, inflammation and oxidative stress also increase. Fiber consumption slows the absorption of sugars, lowers blood glucose levels and insulin resistance, and decreases the risk of diabetes. Now that we have discussed the food quality, let's jump right in to discuss HONEY Diet Plan without further delay.

Healthy Optimization of Nutrition for EverydaY Living (HONEY) Diet…

I believe Nutrition has paramount importance in health and wellbeing. Therefore, I have created HONEY as in Healthy Optimization of Nutrition for EverydaY Living for anyone interested in maximizing their wellness and minimizing illness. As seen in Parts #5 and #6, I have discussed fasting to show various benefits.

Fasting is Ancient Medicine Re-Inventing itself to the modern times. Fasting is the only current weapon against the Metabolic Disease in this overabundance food World.

I have attached 5 different plans anyone can participate to increase insulin sensitivity, improve lipid profile, decrease insulin resistance, decrease inflammation, and Reverse Metabolic disease, including Pre Diabetes and Early Diabetes (yes, reverse it!). It's a simple plan. Anyone can participate by picking one of five regimens.

Prior to making any changes in the dietary regimen and fasting regimen please consult your provider.

5 different eating regimens :

Time-restricted feeding daily - 16 hr fast (Ideally dinner by 6 PM to 10 AM next day) followed by 8 hours of feeding. Try to stick with unprocessed foods and or wholesome foods during the feeding. There is no restriction on calories, which lessens the processed diet. Do not consume more than 150 grams of carbs daily.
6:1 Plan- 6 days of standard eating and one day of caloric restriction with a Fasting simulating diet as attached below. Start with this plan as it is much easier to do. (Start at 6PM, possibly after dinner continue to the next day at 6PM)
5:2 Plan - 5 days of regular foods and 2 days of decreased calorie intake. My Favorite*, I do most Mondays and Tuesdays(workdays). Start last meal on Sunday at 6 PM. Continue with the fasting simulation until Tuesday at 6PM, then meal.
4:3 Plan - 4 days of regular food and 3 days of diet discussed here. Start last meal on Sunday 6pm continue with Fasting simulation nutrition until Wednesday 6pm. Slightly hard thing to do, But once able to do 5:2, it becomes much more manageable(Try once a month).
3- day water-only fast once a Quarter ( try this after successfully undergoing the above time-restricted / fasting simulating diets ). The plan with the most benefits is also the toughest.

Fasting Simulation Diet…

Water unlimited ( Minimal 2.5 to 3 Lit / day or 35 ml/kg/day)
Bone Broth, Fresh Lemon Juice, Green Tea, Black coffee, Vegetable Broth.
Non Starchy Vegetables : Spinach, Lettuce, Asparagus, Avocado, Olives, Tomatoes, Eggplant, Cabbage, Cauliflower, Broccoli, Bell peppers, Kale, Green beans, Bean Sprouts and Baby corn.
Below Ground Vegetables: Carrots, Beet Roots, Onions, Radish
Low Carb Fruits Raspberry, Blackberry, Strawberry, Plums, Clementine, Grape Fruit, Oranges, Kiwi, Cherry, Blueberries, Cantaloupe.
Raw Nuts (15 pieces/day) : Walnuts, Pecans, Almonds, Peanuts
Egg whites (extremely low calorie and can be eaten as veggie omelet)
Probiotics (1 tab/ day)
Magnesium (especially water only fasts) 1 tab / day
Omega 3 (DHA and EPA)Supplements (1 tab/day)
Multivitamin with Minerals (1 tab/day)

Avoid (during fasting days)

Milk and Milk products /Alcohol /Juices /Alcohol/Sodas /Pizza/Anything to do with Potato / Starch (fries) /Burgers/Rice/ Wheat Bread/ Sugar or Sugar Substitutes

Myths of Fasting…

Myth #1-Fasting Will Slow My Metabolism : Fasting actually Increases the release of adrenaline, which revs up the metabolism.

Myth #2-Fasting Will Break Down Muscle : Our bodies are designed to preserve muscle in times of fasting, it triggers growth hormone and breaking down the muscle is the last resort.

Myth #3-Fasting Triggers Hunger and Overeating: Eating triggers hunger and overeating, not fasting. Eating today’s standard diet one is victim to the glucose and insulin rising and falling sharply causing hunger and binge. You are not in control of your food. Your food is in control of you.

Myth #4- My Blood Glucose Might Drop Too Low : Like the mechanism of fasting described as above. Your body is a glucose-storing and glucose-making machine. Glucose levels typically stabilize and over time we see tremendous improvements and even reversal of insulin resistant conditions like diabetes with strategic intermittent fasts.

Myth #5- Fasting is too Hard: Fasting is completely natural and is encoded into our DNA. Modern life has made fasting seem impossible for many reasons. Start with the time restricted feeding.

SIDE EFFECTS of FASTING…

Fasting Side Effects: New Study Reveals - DrJockers.com — Courtesy Dr. Jockers.com

The side effect of fasting can be overcome by breaking the fast. Most symptoms are very transient if sticking with the Fasting Simulating Diet and short term fasting. They eventually fade away mostly after a month of doing intermittent fasting.

Real Patient Experiences…

Earlier this year, I have started to write medical blogs and decided to spread awareness about disease prevention and longevity. I started spending a reasonable amount of time reading and researching the scientific literature. That has opened me to the latest cutting-edge science. The idea of Fasting in the reversal of metabolic disease has really captivated me. My quest for understanding fasting deepened and bringing into patient care. I would like to discuss 2 patients from my practice, and these are their preliminary results from the Fasting or HONEY Diet Plan.

Patient A…

Patient A in his 40’s South Asian Gentleman, visited me 4 months ago for yearly Physical Exam after 2 years due to COVID, underwent extensive laboratory testing and was found to have new onset Diabetes Metabolic disease. I started Counseling the patient about the lifestyle changes and nutritional plan. Patient A agreed for intermittent fasting. As discussed patient started with 3 day water only fast, then continued with heavily enriched fruits and vegetables that have mentioned here as HONEY Diet Plan. He also did significant reduction in carbohydrates during the non fasting days. He continued with 1-2 day water only or fasting simulating diet and 5 days of regular food but minimal carbohydrate intake. We obtained results after 3 months. His diabetes was almost reversed and also other parameters of lipid profile significantly improved. The excitement palpable and was mutual. I have taken care of thousands of patients, but this was “Eureka movement“ for me. I have not used any medications during the process. I will be closely following him for the next year to see if the results are permanent. He was advised to followup closely and continue at least 5:2 diet for at least one year.

Patient B…

Patient B, 40’s South Asian Gentleman, new to the practice, wanted to complete metabolic health workup. He noted to have early Diabetes Mellitus and abnormal lipid profile. After undergoing studies along with the recent physical lab reports, it was noted that he had the similar results as the Patient A. After counseling patient was placed on HONEY Diet Plan in regards to the nutrition and fasting. Patient B started fasting 5:2 regimen. 2 days of fasting and followed by the diet plan that has been described here. In the 2 months after the discussion we have done the labs noted to have significant changes in the cholesterol and blood glucose. We are awaiting to see the changes in the next blood test. But overall improvement of the numbers especially in the cholesterol and blood sugars has given me more confidence into working towards reversing diabetes and metabolic disease. I am hoping he will be our second practice patient to reverse Diabetes with the HONEY Diet.

The Diabetes management has not changed in more than a century but the disease has skyrocketed to become epidemic in epic proportions not only to Americans for across the Globe. This ain’t going to stop anytime soon. The ability of not only preventing but reversing disease by using food and fasting as medicine is amazing. Again these are preliminary reports. Anecdotally, I really think it works for majority of people. But, I am planning to do small study with 20 subjects and to see if the results extrapolate. I will be able to post those results once I finish later this year.

Conclusion…

Healthy Optimization of Nutrition for everyday living ( HONEY Diet Plan) . The idea of understanding the disease process with fasting can shed some light on the prevention. Metabolic disease is a total lifestyle disease and can be reversed with unprocessed nutrition and fasting. Nature has provided us with abundance of natural foods, however we have become prisoners to the processed food. It’s an absolutely pleasure for me about tackling metabolic disease and to diagnose very early and prevent it. I believe in science and where we have come, unfortunately the fasting will never be mainstream due to the various reasons. Use Non-Starch vegetables in abundance before eating a big course of the meal(even when not fasting). I advise spending more time at cooking and buying fresh food at the groceries and enjoying the experience especially with kids. Always enjoy a good meal. The idea is to be aware of fasting in the natural day-to-day lifestyle. When the excess is eaten, try fasting the next day. Enjoy foods intermittently (We all have our vices, chocolate or desserts, or alcohol).

There is no short cut to good health, but fasting comes close. Life is short, Enjoy and don’t forget to fast intermittently.

Dr. Suman Manchireddy MD FACP FHM, Leesburg, Virginia.

Physician in Internal Medicine (Acute and Chronic disease Specialist) writing Medical blogs to spread awareness about disease prevention and longevity. Ever since I had a Heart Attack, my quest for the latest cutting-edge science research to help us stay healthier. Prevention is better than cure always - as being at the forefront of the medical field, I have managed the sickest of the patients in the Intensive Care Unit, Hospital Medical Floors, and Rehab to the outpatient office patients.

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