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Stress caused by Covid-19 can lead to diabetes: Top doctors

Healthcare experts and doctors discuss the impact of novel coronavirus on diabetic patients.

Shalini Bhardwaj

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What is the impact of Covid-19 on diabetic patients? Dr Nikhil Tondon, HoD and endocrinologist at AIMS, Dr Pankaj Agarwal, senior endocrinologist, and Dr Ashok Jhingan, chairman of Delhi Diabetic Research Centre, share their views on this and more. Excerpts:

Q. What is the commonest form of diabetes?

Dr Tondon: The commonest form of diabetes is non-insulin-dependent diabetes or type 2 diabetes. 85% or more of all people with diabetes have this particular type, which in earlier years used to be starting at the 30s, 40s, and 50s and was invariably associated with being overweight and responded to oral medication. The part about responding to oral medication remains intact but unfortunately, the age at which it is starting to appear in our population has progressively reduced with time so much so that even people in their late teens have now started developing this particular problem.

Q. Why are Indians prone to diabetes?

Dr Tondon: To understand that we need a little bit of historical context. There is a study or an editorial which is the Journal called Lancet. Lots of paper came out in 1907, about 115 years ago, which is around the time of the aristocracy of Britain. Diabetes is to the aristocracy of India, suggesting that this is a diabetes of the affluent, the disease of the rich who ate and put on weight. Over time that has changed with which improvement developed indices or disease which seemed to have been restricted to the extreme right of social-economic growth has now spread across. We possibly have all genetic trait predispositions. We were not exposed to the role of environment, eating habits, or lack of exercise before, now we possibly have the same genetic exposure. The disease is becoming progressively adverse with environmental exposure. By putting on weight, eating the wrong food, and exercising very little, people who are prexposed are getting this disease.

Q. What are the common symptoms of diabetes?

Dr Jhingan: The common symptoms are excessive thirst, frequent urination, and increased appetite, or loss of weight at times. These were quite common earlier. But now so many people are experiencing other symptoms like fatigue, excessive tiredness, weakness, lethargy and sometimes itching all over the body and many times that’s why we always say it’s a silent disease as people say they’re not having any symptoms. They are going for some executive health checkup or going abroad and then they get examined. A routine examination is required but a large number of hypertensive people are overweight and obese. As Doctor Nikhil has said, they all are prone to developing diabetes and these symptoms are quite common many times in the males and females itching around the genitals. That’s one of the important manifestations because of which the person goes for an investigation and then it is found that he/she has diabetes. Many times when young married girls are not getting pregnant or have frequent abortions and after an investigation, they get to know that they have diabetes. 

Q. What are the common types of diabetes?

Dr Jhingan: I think as Dr Nikhil has said very clearly about 85% of patients have type 2 diabetes, while 10% of patients have type 1 diabetes. There are gestational diabetes and diabetes mellitus which is caused by pancreatic exocrine disease. There are other types of diabetes besides these as well. 

Q. India has around 77 million diabetic people which makes it the second most affected in the world after China. What is the reason behind it?

Dr Agarwal: Yes, this is a big issue for Indians. At one time we used to top the list in the world, now China is heading. The reason is that we are genetically predisposed, which has been mentioned by Dr Nikhil. But we were genetically predisposed for a pretty long period. What happened in recent years that it has manifested in terms of diabetes is because of our change in lifestyle from an active lifestyle to so much mental stress, superseded by this covid era, all this led to having a sedentary lifestyle. All these things are bringing this problem earlier in our lives and increasing its incidents as Dr Ashok has said. The commonest symptom of diabetes is having no symptoms. So, most of the Covid cases are asymptomatic. Lots of patients we were having initially as well were undiagnosed. Now with improved diagnostic techniques and more awareness about the disease, we are detecting quite a good number of those patients. So, genetic predisposition, our lifestyle changes superseded by mental stress and if at all there is any physical distress in terms of infections and other things, then that has led to the increased privilege of diabetes in India, especially in recent days.

Q. Can Covid-19 cause diabetes?

Dr Tondon: No, Covid-19 can’t cause diabetes by itself. It is with any stress, physical or mental in terms of any injury, infection like pregnancies is the stress on the body so it predisposes the likelihood of diabetes. Similar is the case with Covid-19, it may precipitate diabetes in predisposed individuals who already have increased chances of having diabetes. Also, a more precipitous or severe form of infection in some individuals imposes a severe chance of getting diabetes. We use some agents like glucocorticoids to prevent certain complications of this infection. For many individuals, the use of those also increases the likelihood of having diabetes. The stress caused by Covid infection and the use of some medicines to prevent its complications can lead to diabetes.

Q. How has it affected Covid-19 patients?

Dr Tondon: If I tend to diabetes or pre-diabetes, infections will then unmask of that value. That’s one thing and the other equally important thing is, suppose a person with diabetes develops Covid-19, what do we need to do? We need to be worried that a person with diabetes is more likely to have a serious disease, require hospitalisation, intensive care and unfortunately that person is also more likely to die as a result of the infection. Firstly, as opposed to the appearance, he does not have that. Secondly, a person who has diabetes on exposure to certain drugs which are now an essential part of the Covid-19 treatment will also worsen their sugar and thus will need much more aggressive management. Thirdly, there are not two categories, one where people do have diabetes and developed Covid and another where they didn’t know about diabetes and develop Covid. The first category of people can take appropriate metrics. Also, your likelihood of catching infection becomes less and your doctor will be able to treat you much better. But what about the second category? During the treatment, coming to know that they have diabetes is even more dangerous. The message for doctors is that anybody who comes across a Covid patient measures the blood sugar, even if they don’t have diabetes as he might be unaware that he has diabetes. So that the doctors can aggressively manage them. 

Q. What are the latest treatments for diabetes? 

Dr Jhingan: With diabetes, there has been much more improvement but lifestyle change is the basic requirement. So these genetic backgrounds get precipitated with the environmental factors like change in food habits and exercise. The disease can get aggravated because of physical and mental stress. A balanced diet and exercise are a crucial part of the treatment strategy. Do 50 minutes of regular exercise. Then comes the role of oral medications. There had been a paradigm shift in the management part. There’s been a different type of class of drugs. Now very good drugs are there which have good control over sugar but there is again a limitation on the part of each group. So now we have plenty of drugs looking after the various pathways by which diabetes happened and these drugs are quite effective. And once these drugs also with all these things, if we are not able to get our target levels of Hba 1C to 7% that means we have to now try insulin and again in the insulin category, we have all those latest analogues. There is very good insulin which helps to control diabetes. Different types of regimes are there by which today we are in a position to keep the blood sugar levels around 7% Hba1C. This is there as higher HB1C increases the chance of complications of diabetes. With the latest available medications and insulins, we can keep the blood sugar under control.

Q. How gene therapy can be useful for diabetes. Are we doing it in India?

Dr Agarwal: This isn’t still in the investigational phase so the therapy is very promising. No doubt the problem lies with type 2 diabetes. There is no single gene that is leading to the development of type 2 diabetes which is happening in around 85% of cases. For type 2 diabetes, there is no single cause that can lead to diabetes. There is no single gene causing diabetes, so by intervening with one gene only, we cannot cure it. But for type 1 diabetics, there are certain promising things. Not exactly in terms of gene therapy but otherwise, the damage is being inflicted in the same target areas in type 1 diabetes. Those can be prevented to a large extent by some information. By interfering with the immune mechanism of the body, it can be changed by pancreatic beta-cell transplantation or distant cell therapy. 

Q. If diabetes is not treated timely, how chronic can it be?

Dr Jhingan: Yes, the problem and significance of diabetes lie in the complications which are produced because of it. If somebody is having diabetes without symptoms, it doesn’t mean he is fine. It will create more impact on the body and will affect many of the systems and it will be a problem forever and once anything happens, once the target organ, nothing can be done. Every organ is unique and once damaged it can’t be repaired. So we have to maintain the glucose level at its normal limit throughout life to protect those organs and the symptoms or the features associated with organ involvement are unique with their setup. Like for eyes, it will be blurred vision and blindness. With kidneys, it will reduce your urine formation, swelling and then later on kidney failure. With nerves, the feeling of burning sensation of cold, not feeling anything, pricking sensation and later on developing frequent ulcerations. And gangrene leading to the importation of limb with heart, pain, breathlessness, and heart attack. With brain stroke, paralysis and all these things may happen. All this can happen due to continuously raised glucose status which needs to be tackled in its early stages. Once it affects our organ of the body, nothing will change, there can be no cure. It won’t be too clear what the problem is but even if you lower down, even if you normalise global levels thereafter, once destroyed it will be destroyed forever, so we must treat diabetes, control diabetes to prevent the target organ from getting damaged which may happen in future.

Q. What are the five tips to manage diabetes?

Dr Jhingan: Do regular exercise for 50 minutes and to control the stress, do meditation and yoga. Also, have a balanced diet; have regular intake of medicine; regular monitoring; and regular treatment for sugar to be under control. After all, prevention of a complication is most important. Expenses for the treatment are high but once the complications develop it will be very expensive. The person who knows about his diabetes and keeps it under control can live the longest. Awareness and education are the cornerstone of the treatment of diabetes 

Q. Would you like to give any message?

Dr Tondon: The statement made by Dr Pankaj that the most common symptom of diabetes is a lack of symptoms is the message. People should periodically get tested for diabetes or blood pressure so that they are identified early and treatment starts. Awareness is needed, if your parents have diabetes or some uncle or aunt has diabetes, it means that there is a problem in the family. So they should get themselves checked even more frequently as they are more likely to have diabetes. Earlier women who got pregnant, it was mandatory to get checked for gestational diabetes but it’s not done very often now. They should get tested. Screening is required; one must incorporate a healthy lifestyle right from childhood. It’s very difficult if people over 40 often have fried food, they should change their diet and eating habits. Regular exercise will help from the beginning so that you don’t encounter it. Also, you are much more likely to have diabetes if your periods postpone. You will be able to handle diabetes well with a balanced diet and healthy living and regular physical activity. These things should be a part of our lives from the start and not only after we develop diabetes.

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COMMON ANTIDEPRESSANT SHOULD NO LONGER BE USED TO TREAT DEMENTIA

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A drug used to treat agitation in people with dementia is no more effec-tive than a placebo, and might even increase mortality, according to a new study.

The research, led by the University of Plymouth and published in the journal The Lancet, has shown that antidepressant mirtazapine offered no improvement in agitation for people with dementia – and was possibly more likely to be associated with mortality than no intervention at all. Agi-tation is a common symptom of dementia, characterised by inappropriate verbal, vocal, or motor activity, and often involves physical and verbal aggression. Non-drug patient-centered care is the first intervention that should be offered but, when this doesn’t work, clinicians may move to a drug-based alternative.

Antipsychotics have proven to increase death rates in those with demen-tia, along with other poor outcomes, and so mirtazapine has been rou-tinely prescribed. This study was designed to add to the evidence base around its effectiveness.

Funded by the National Institute for Health Research (NIHR), the study recruited 204 people with probable or possible Alzheimer’s disease from 20 sites around the UK, allocating half to mirtazapine and half to placebo. The trial was double-blind; meaning that neither the researcher nor the study participants knew what they were taking.

The results showed that there was no less agitation after 12 weeks in the mirtazapine group than in the control group. There were also more deaths in the mirtazapine group (seven) by week 16 than in the control group (only one), with analysis suggesting this was of marginal statistical significance.

Lead researcher Professor Sube Banerjee, Executive Dean of the Faculty of Health and Professor in Dementia at the University of Plymouth, ex-plained why the results were so surprising but important.

“Dementia affects 46 million people worldwide – a figure set to double over the next 20 years. Poor life quality is driven by problems like agita-tion and we need to find ways to help those affected,” he said.

This study shows that a common way of managing symptoms is not help-ful – and could even be detrimental. It’s really important that these results are taken into account and mirtazapine is no longer used to treat agita-tion in people with dementia.

“This study has added important information to the evidence base, and we look forward to investigating further treatments that may help to im-prove people’s quality of life,” Banerjee added.

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Know these benefits of wine’s red grape pulp

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Better not to keep the mashed, leftover pulp from red grapes in the early process of making wine aside, as according to a new Cornell University-led food science study, viticultural leftovers have numerous nutritional benefits.

The group showed that two stilbenes, beneficial molecular compounds found in plants, can affect the human intestines and the stomach’s microbiome in a healthy way. While this still needs further research, the finding may play a role in reducing the risks from cardiovascular disease and diabetes, according to their work published in the journal Nutrients. “This byproduct of making wine has important potential. If we can use the pomace to either extract key compounds or use them as a dietary ingredient to fold into food, then grape pomace can be a very sustainable source of nutritional compounds with demonstrated health benefits,” Elad Tako, associate professor of food science in the College of Agriculture and Life Sciences, said.

Tako said the research provides an understanding of how stilbenes work at the human gut level. Additionally, in the study, the Tako research group screened red grape varieties typically found in the Finger Lakes Region of New York, where a robust winery economy exists.

The team used Vitis vinifera (wine grapes), Vitis labruscana (Concord grapes) and an interspecific hybrid, to associate the findings with practical dietary health benefits of grape and grape product consumption.

“I’ve been working with polyphenols (plant-based nutritional compounds), and I was intrigued by previous research that suggested that bioactive compounds – such as resveratrol in red wine – has cardiovascular and other health benefits. The mechanism of how these compounds work in the body was not clear, so I used my in vivo model to find the answer,” Tako added.

By using a chicken (Gallus gallus) as in vivo model, the scientists were able to determine the nutritional benefits of the stilbenes, resveratrol and pterostilbene.

The embryonic phase (the fertile egg) of Gallus gallus lasts for 21 days, which is when the embryo is surrounded by amniotic fluid (egg whites), naturally and orally consumed by the embryo prior to hatch on day 21.

In the experiment, the stilbenes extract was injected into the eggs’ amniotic fluid, consisting mostly of water and peptides, on day 17 of embryonic development. The amniotic fluid and the added nutritional solution were then consumed by the embryo by day 19 of incubation – a method developed by Tako called “intra amniotic administration.”

In this way, the group learned how resveratrol and pterostilbene affect the gastrointestinal tract, as well as other physiological systems and tissues, Tako said. The group confirmed positive, nutritional effects on the intestinal microbiome and small intestine.

This research has led to a patent, and the manuscript is part of a Nutrients special issue, “Dietary Polyphenols and Flavonoids, Mineral Bioavailability, Gut Functionality, Morphology and Microbiome.”

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EXTRA BRAIN PROCESSING DURING SLEEP ENHANCES LEARNING OF NEW MOTOR SKILLS

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WASHINGTON : Practice makes perfect, but sleep helps, too. Learning and executing a new motor skill can be enhanced if you can get additional memory pro-cessing during sleep, according to a recent study led by researchers at Northwestern University.

The study was published in the journal JNeurosci. Researchers com-pared how well participants performed a challenging motor task with and without the extra processing during sleep.

The participants played a computer game using a myoelectric computer interface, which enabled them to move a cursor by activating specific arm muscles. Each command to move the cursor in a particular direction was paired with a unique sound; after practicing, the participants played the game blindfolded and moved the cursor based on the sound cue alone.After completing a test round, the participants took a 90-minute nap.

The researchers played half of the sound cues during the nap, reactivat-ing the motor memories associated with each cue. After the nap, the participants performed the motions cued during sleep better than the uncued ones: it took less time to move the cursor, the cursor traveled a more direct route, and fewer superfluous muscles were activated. These results show we can improve the performance of new motor skills by reactivating memories during sleep.

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New depression screeners measure symptoms, track treatment progress: Study

Measurement-based care is important to track a patient’s progress in order to make adjustments to care when needed. This study found that the PROMIS scales are an accurate measure of depression to aid in diagnosis and treatment.

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Research from Regenstrief Institute and Indiana University School of Medicine has shown that the Patient-Reported Outcomes Measurement Information Systems (PROMIS) scale for depression developed by the National Institutes of Health can accurately measure depression symptoms and its severity.

The findings of the study were published in the ‘Journal of Psychosomatic Research’.

“Depression is treatable, that’s why routine screening is strongly recommended,” said study lead author Dr Kurt Kroenke, M.D., Regenstrief research scientist and IU School of Medicine professor of medicine.

“Measurement-based care is important to track a patient’s progress in order to make adjustments to care when needed. This study found that the PROMIS scales are an accurate measure of depression to aid in diagnosis and treatment,” added Dr Kroenke.

The research team analyzed data from three randomized clinical trials involving about 650 patients. It compared the results of the PROMIS scale, which is a survey where patients report their symptoms, to the results of a structured psychiatric interview.

They also compared the diagnostic performance of the PROMIS scale and Patient Health Questionnaire nine-item depression scale (PHQ-9), which has been validated and widely adopted around the world, to benchmark the PROMIS measures. The PHQ-9 was developed by Dr Kroenke.

Data analysis showed that PROMIS and PHQ-9 depression scales have similar accuracy when diagnosing depression. “PROMIS scales are already commonly in use, and both PROMIS and PHQ scales are accessible and free in the public domain. This research supports both as viable screening options,” said Kroenke.

“The pandemic has taken a substantial toll on mental health, and there will likely be a lingering effect. Screening has become all the more important because we must be able to diagnose and treat patients who are suffering. Monitoring depression is no different than monitoring blood pressure, so these scales are important tools that are proven to work,” he added.

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TRY NATURAL REMEDIES TO TREAT MIGRAINE

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If you have a throbbing headache, nausea and sensitivity to light and sound, then you aren’t going through those regular headaches. These are actually migraines, which not only makes you completely bed-ridden but also hamper your daily activities.

It’s a common condition, with an estimated global prevalence of 14.7% (that is around 1 in 7 people). When the migraine strikes, you will almost do anything to get rid of the excruciating pain. Medication can help manage the pain, and antidepressants and beta blockers might help prevent recurring episodes. However, all these methods have potential side-effects including nausea, insomnia, hypertension, and heart attacks. Clinical studies have shown that home remedies provide more effective pain relief when compared to usual care.

The best way to deal with it is to understand the root cause behind the trigger. Some of the prevalent triggers are related to dehydration, hypertension, stiff muscles in the neck or shoulder, emotional stress, certain medications, additives or reaction to some food items. Helicobacter pylori, commonly known as H-Pylori bacteria, is found to be one of the active reasons of migraine, ulcers and other gastric issues. Therefore, shifting to natural remedies is a drug-free way to evaluate migraine symptoms. These at-home treatments may help prevent migraines, or at least help reduce their severity and duration

HYDRATION IS THE KEY

The best way to treat migraine without medication is to drink loads of water or an electrolyte beverage. It has been seen that dehydration is the leading cause of headache. Ensure that the electrolyte beverage, which you are opting for, doesn’t have added sugar or colour in it as these can aggravate the headache. Taking a vitamin C drink is also a good option. One needs to check the sugar content of the drink if the individual has diabetes.

PERFORM YOGA REGULARLY

Research has shown that yoga can be effective for controlling headaches. Yoga is an ancient discipline that promotes a holistic approach to pain management through a combination of breathing techniques and postures. These asanas and pranayamas don’t have any side-effects. Practicing them twice every day under the guidance of a certified trainer will reduce the intensity of migraine pain and help prepare for future attacks.

TRY ACUPUNCTURE

Through this alternative medicine technique, pressure points are identified on the body to provide relieve from pain and other such symptoms. Studies have also credited acupuncture as one of the trusted alternative therapy for people suffering from chronic headaches. Even patients going through throbbing migraine pain, who have tried out sessions with acupuncturists, will also advocate acupuncture being one of the safest non drug options for pain relief during migraine.

MINDFUL MEDITATION

Mindful meditation involves focusing one’s attention at the current moment with a non-judgmental set of mind. This in a way helps to reduce the stress, which is one of the most common migraine triggers. Mind-body techniques like meditation and resting for sometime may relieve headaches by alleviating underlying stress.

EXERCISE

Regular exercise helps in reducing the frequency and intensity of migraine attack. But, don’t forget the fact that vigorous exercise can be detrimental to migraine. Exercise actually helps to ward off stress, which is a common migraine trigger. When we exercise we release feel good hormones, which are also considered as the body’s natural painkillers and anti-depressants. Don’t exercise if you are in the middle of a migraine pain as it will worsen your condition.

SELF-MASSAGE

Self-massage around the temples, shoulders and back of the head can help tension headaches. Massage, either self-massage or working with a massage therapist, can resolve chronic neck and shoulder tension that can cause headaches. It’s always advisable to put pressure on pressure point LI-4, also called Hegu, which is located between the base of your thumb and index finger. It will help to relieve pain and headache.

MANAGE GUT HEALTH

There is a strong connection between the gut and the brain. It signifies that if our gut is unhappy, its consequences can be experienced in the form of migraine. This is why GI disorders, such as irritable bowel syndrome and Inflammatory Bowel Disease, and migraine are often experienced together in a person. Unhealthy diet practices and excess consumption of antibiotics has caused a soaring population of H-Pylori bacteria in human body (inside human-gut) suppressing the good and vital bacterial population causing imbalance of intestinal fauna.

NATURAL MIGRAINE RELIEF KIT

After following these steps if still there is no relief, then, try out the Natural migraine relief kits. These kits are available online and provides 100% natural remedy to fight and cure migraines and headaches. These herbal probiotic kits made with indigenous herbs including black cumin, cumin, moon leaf, ginger and peppermint aims to resolve the headaches and pain by allowing intestinal flora to flourish in your gut.

The writer is a Senior Consultant at The Lifekart.in

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FASTING REQUIRED TO SEE FULL BENEFIT OF CALORIE RESTRICTION

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Over the last few decades, scientists have discovered that long-term calorie restriction provides a wealth of benefits in animals: lower weight, better blood sugar control, even longer lifespans.

Researchers have largely assumed that reduced food intake drove these benefits by reprogramming metabolism. But a new study from the University of Wisconsin-Madison researchers finds that reduced calorie intake alone is not enough; fasting is essential for mice to derive full benefit. The team published their findings in the journal Nature Metabolism.

The new findings lend support to preliminary evidence that fasting can boost health in people, as trends like intermittent fasting continue to hold sway. These human and animal studies have added to the growing picture of how health is controlled by when and what we eat, not just how much.

The research further emphasizes the complexity of nutrition and metabolism and provides guidance to researchers trying to untangle the true causes of diet-induced health benefits in animals and humans.

The researchers discovered that combined with eating less, fasting reduces frailty in old age and extends the lifespan of mice. And fasting alone can improve blood sugar and liver metabolism. Surprisingly, mice that ate fewer calories but never fasted died younger than mice that ate as much as they wanted, suggesting that calorie restriction alone may be harmful.

The research was led by UW School of Medicine and Public Health metabolism researcher Dudley Lamming, his graduate student Heidi Pak and their colleagues at UW-Madison and other institutions.

Pak and Lamming were inspired to conduct the study because researchers began to realize that previous studies had unintentionally combined calorie restrictions with long fasts by providing animals with food just once a day. It was difficult, then, to distinguish the effects of one from the other.

“This overlap of treatment — both reducing calories and imposing a fast — was something that everybody saw, but it wasn’t always obvious that it had biological significance,” said Lamming, who has long studied the effect of restricted diets on metabolism. “It’s only been in the past few years that people started getting interested in this issue.”

To untangle these factors, Lamming’s group designed four different diets for mice to follow. One group ate as much as they wanted whenever they wanted. Another group ate a full amount, but in a short period of time — this gave them a long daily fast without reducing calories.

The other two groups were given about 30 per cent fewer calories either once a day or dispersed over the entire day. That meant that some mice had a long daily fast while others ate the same reduced-calorie diet but never fasted, which differed from most previous studies of calorie restriction. It turned out that many of the benefits originally ascribed to calorie restriction alone — better blood sugar control, healthier use of fat for energy, protection from frailty in old age and longer lifespans — all required fasting as well. Mice who ate fewer calories without fasting didn’t see these positive changes.

Fasting on its own, without reducing the amount of food eaten, was just as powerful as calorie restriction with fasting. Fasting alone was enough to improve insulin sensitivity and to reprogram metabolism to focus more on using fats as a source of energy. The livers of fasting mice also showed the hallmarks of a healthier metabolism. The researchers did not study the effect of fasting alone on lifespan or frailty as mice age, but other studies have suggested that fasting can provide these benefits as well.

While the mice that ate fewer calories without ever fasting did show some improved blood sugar control, they also died younger. Compared with mice who both ate less and fasted, these mice that only ate less died about 8 months earlier on average.

“That was quite surprising,” said Lamming, although other studies have also shown some negative effects from restricting calories. The team also measured frailty through metrics like grip strength and coat condition. “In addition to their shorter lifespans, these mice were worse in certain aspects of frailty, but better in others. So, on balance, their frailty didn’t change much, but they didn’t look as healthy.”

The primary studies were done in male mice, but Lamming’s lab also found similar metabolic effects of fasting in female mice. The research reveals how difficult diet studies are, even in a laboratory environment. That difficulty is magnified for human studies, which simply can’t match the level of control possible in animal models. The new study can provide direction to future work trying to answer whether fasting improves human health.

“We need to know whether this fasting is required for people to see benefits. If fasting is the main driver of health, we should be studying drugs or diet interventions that mimic fasting rather than those that mimic fewer calories.” Lamming said.

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