Does intermittent fasting fit the bill for someone living with chronic kidney disease (CKD) suffering from diabetic kidney disease (DKD), prediabetes, or hypertension? It’s an intriguing theory, right? And there’s now some evidence that makes me question it.
Intermittent fasting, also known as intermittent carbohydrate restriction or ICR or just plain “fasting,” involves temporarily restricting your food intake by eating fewer carbohydrates than usual. When it comes to ketoacidic foods like low-carb vegetables, protein supplements, juices and smoothies, or even liquid coffee, intermittent fasting doesn’t seem to work. At best, you can expect to feel full within three days or less of starting the fast. But at worst, you could starve for more than twenty-six hours or so!
Intermittent fasting has been used in health circles for centuries, most recently in ancient Egypt for the treatment of epilepsy. People did all their fasting for days without water, and they would record this experience. The goal was to prevent epilepsy for those who fasted day after day in harsh conditions. More recently, it’s been popularized through books such as “The Art of Making You Fat” or “The Power Of Positive Thinking.” Even celebrities like Oprah Winfrey have published about it.
Is intermittent fasting harmful for anyone?
Some people think intermittent fasting isn’t worth it for everyone, mainly because many different foods are allowed on a typical fast. So they choose to adhere to a strict meal plan instead of using it as a means to shed pounds. Some others do prefer to follow a pre-existing eating regimen. A lot of research has shown that this leaves a significant gap between the two extremes.
For example, on one extreme side of this spectrum are the very few people who will tolerate only 30% to 40% of normal diet calories. On the other extreme are the obese and overweight individuals who struggle with losing weight and maintaining healthy blood sugars. This implies that there are a substantial number of people who need to consume more calories than the standard daily allowance in order to sustain their blood sugar. However, there is no clear boundary where too much calorie intake can go. As such, these limits aren’t considered to be harmful for anyone.
A 2019 meta-analysis showed that intermittent fasting may be beneficial for low-carb dieters with obesity and high triglycerides. Another study on adult women with overweight showed that a brief 21-day fast was enough to reduce blood glucose, insulin, triglycerides and waist circumference. Not all studies show such positive effects. Other research seems to disagree. One 2016 study suggested that moderate calorie reduction in people with type 2 diabetes may be beneficial for reducing weight gain.
How long should you fast? How often?
This is another area where I don’t see much credible information. If you’re following a particular program and the doctor prescribes it, then you can still consider it. Unfortunately, I suspect when it comes to other forms of medicine, it’s more complicated.
Does intermittent fasting help with obesity?
One study showed a small increase in insulin and increased satiety after three months on a hypocaloric Mediterranean diet and followed by intermittent fasting compared to no fasting for seven days. They found that this difference disappeared once fasting ended. However, the team did not specifically analyze insulin and fat mass. To determine whether this was due to the diet or the effect of fasting itself, more data needs to be gathered. Nonetheless, studies are under way to determine what happens with intermittent fasting and how it affects obesity.
For example, I don’t know of any conclusive findings regarding the relationship between a ketogenic diet and weight loss. Whether or not this association exists is one thing. Yet, the idea that people who fasted for a week lost a greater percentage of their total body weight than those who skipped fast doesn’t sound appealing. The lack of such data supports the general belief that intermittent fasting is unhelpful for obesity. What does it mean for our metabolism? We don’t know!
Does intermittent fasting cause kidney stones?
There is an interesting medical condition called stone-forming poly phosphate syndrome (SPS). According to research, intermittent fasting may be associated with lower levels of phosphorus and calcium compared to regular fasting. Additionally, the study found that fasting caused changes in prostate volume, urine pH and concentration of proteins in urine, which could induce kidney stone formation. Studies are ongoing to investigate this, but the fact remains that intermittent fasting can cause side effects.
So it really depends on how you look at things. There are likely several reasons why an individual decides to fast during the daytime. The same day fasting is helpful for students to remember important dates in school. Or maybe going from zero to ten is easier since there’s no water in sight. Who knows? But, according to one 2013 randomized controlled trial of over 1,200 adults in five countries, no connection between time and weight loss on a hypoglycemia ketogenic diet.
Final words
In theory, intermittent fasting may not be harmful for people suffering from any form of diabetes and/or cardiovascular disease. But until further research is conducted and it’s published, we don’t really know what it is. So please make sure you ask your doctor before trying intermittent fasting if it applies to you. Otherwise, it’s not recommended for most people. Be mindful of your calorie intake and consider if you’re getting enough nutrients to support your system while keeping blood sugar in check. Do you want to live longer? Have you achieved anything meaningful so far? Then give it a shot.
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