How safe is intermittent fasting beyond 12 hours?

[LiSwati]

Your initial question regarding fasting, is something I frequently use everyday.
Usually, I don't eat after 7pm for logical reasons that I need to know where my BG levels will be.
I don't eat till mid afternoon. This is what I do. Small meals of probably meat and salad, eggs and such.
however because I can, I have and will fast for a few days, my longest is five days.
I wasn't hungry I did drink, but I needed some nutrition afterwards.
but it isn't something I would advise for that long, firstly because some people just can't do it. Some for medical reasons, others just can't. Some could do a day or two. But it is so forced into our psyche to eat too much from young. And we do. Never mind the number of meals but actual portion size and amount through the day.

Start with missing one meal, then half a day while awake, then intermittent, then if you can a whole day.
if not, smaller plate size, less snacking, less starch and carbs, sugars.

For a T2, it is the spikes of higher than normal BG levels you need to avoid as much as possible, especially going into double figures mmols.
And the longer your BG levels are in or around normal BG levels (4-6) your health will improve.

Finally, a tailored dietary regime to your own tastes etc. Is what I would recommend.
No fad diet will do anything. And from my experience fresh food only will help so much to control your T2.

My best wishes.

Wow Lamont, that sounds extreme. 5-days without food would kill me for sure. Maybe not from starvation but certainly from going mental.

But I like the progressive approach, which I will indeed consider. Thanks.

PS: What did all this fasting do to your gut-health? Does it cause constipation?

 

[LiSwati]

That's good advice. Which I didn't realise till I was diagnosed.

I'm wearing a CGM at the moment. Most of the day I'm around 4.5 mmol/L and occasionally just below 4.0. And I'm still alive.

Thanks IanBish. You certainly brought a smile to my face.

 

[LiSwati]

I sometimes go 36 hours, but not very often. There's no feeling of hunger, just that it's time to eat something.

And it's not that I don't eat much quantity. I eat lots of meat, in particular. The "all you can eat" barbecue places are perfect.

I just don't eat very much of anything that has carb in it.

Best of luck. There's no single right way to do this - you need to find what works for you.

Thanks KennyA. I’m not sure how you guys don’t get hunger pains. I just had my last meal at 7 pm and skipped my usual fruit at 08:30, and now I feeling hungry as hell. But I will just drink water and go to bed. Thanks again.

PS: I wouldn’t mind going to an ‘all you can eat’ barbecue joint, right now.

 

[Lupf]

Hi @LiSwati, welcome to the forum. As you ask about intermittent fasting (IF), let me add my story.
Five years ago I lost 10 kg with IF, basically by doing Michael Mosley's 5+2 diet.
On the two fast days each week I only ate 600 calories and basically very little carbs, i.e. a small breakfast, e.g. an egg or nature yoghurt with half an apple, during the day I drank only water and coffee. For dinner it was lots of vegetables, e.g. curries, soup and salads, maybe a bit of chicken of fish. On the other five days I ate normally, i.e breakfast, a small lunch and dinner, but no snacking. Rather quickly the pounds started melting away and my belt needed tightening. The amazing thing was that I never really felt hungry when fasting. You can eat lots of soup, vegetables and salad for 600 calories. This allowed me to get off Metformin and get my HbA1c into the 40s. I still do IF, it has allowed me to sustain my weight for four years so far.

Reading Jason Fung "The Diabetes Code" has been very informative. Basically a low calorie diet is not sustainable, as your base metabolic rate BMR will reduce and you will need fewer calories to maintain your weight. You will stop losing weight, feel increasingly miserable and give up eventually. You might try again later, but this circle of yo-yo dieting is only successful for weight loss companies, and is the source of lots of human misery.

I now understand that our bodies are not like combustion engines, but hormonal engines and the effects of calories from carbs differ from those from fat and from protein. Fatty food is much more satiating than carbs, e.g. compare eating an omelette with ham and cheese with having cornflakes with milk for breakfast. The former will last you through the day, if needed, while the latter will make you hungry after 2 hours. People here have lost lots of weight without trying by simply increasing the amount of fat in their diet, i.e switching to a low carb high fat diet.

I have consequently banned all low fat products from my fridge. I never liked them anyway. These usually have lots of added sugar as removing fat removes taste, are ultra-processed and the sugar is addictive. I avoid plant based oils and margarine and use olive oil and butter instead, eat significantly more cheese and despite eating lots of eggs - fried, scrambled, soft and hard-boiled or in omelettes - and fry ups with bacon my cholesterol has come down as well. Eating in this way also makes it easier not to snack.

Of course all our bodies are different and your own mileage may vary, but If you want to do IF I can only encourage it. To me IF is the only diet tested by evolution. if our ancestors were unsuccessful in hunting they had a lot less to eat, only what they could forage. In more recent times fasting is practised in many cultures and religions and is considered healthy.

 

[AloeSvea]

Wow Lamont, that sounds extreme. 5-days without food would kill me for sure. Maybe not from starvation but certainly from going mental.

But I like the progressive approach, which I will indeed consider. Thanks.

PS: What did all this fasting do to your gut-health? Does it cause constipation?

Hi @LiSwati. This would be a great thread in the Fasting sub-forum! But great to see it generating lots of discussion about intermittent fasting (IF), and fasting (F) proper for T2D treatment. A great tool in the dealing-with-T2-tool box imho.

Re gut-health, I'm interested in that subject independently of my interest in and fasting practices. Re the gut biome - that would be the food you eat when you do eat? Quite simply, I would say. IF and F has great, and interesting effects for the person with diabetes. But I am sure there must be some info out there about what happens to the gut biome during fasting - is there someone out there in ouyr Forum who can answer that detail?

The constipation question is easier to answer from a personal standpoint. What happens to you in early hours or days of fasting with your digestion and pooping must be closely related to your movements when eating? i would say. ie if you are regular, and not suffering straining, there is no constipation issue when adapting your window of eating to a new regime. If you have constipation issues, then that will cross over into your toileting exprerience early on in your new IF regime? (And LCHF way of eating I would imagine.) If you go some time when not eating, then the pooping does stop, but it isn't a problem. When you re-start eating, pooping restarts, and no straining. I must have been told very strongly as a kid not to talk about one's own pooping, as I find it very hard to actually write 'in my own experience' , but yes. Gee. In my own experience.

 

[AloeSvea]

Thanks KennyA. I’m not sure how you guys don’t get hunger pains. I just had my last meal at 7 pm and skipped my usual fruit at 08:30, and now I feeling hungry as hell. But I will just drink water and go to bed. Thanks again.

PS: I wouldn’t mind going to an ‘all you can eat’ barbecue joint, right now.

I totally agree on the all you can eat BBQ - yum yum big time!

But back to the details of fasting. I contribute the same thing on the subject of hunger and not eating for any length of time as I always do - we as a species would not be here today if we did not experience hunger, even keenly, especially keenly? and definitely thirst , when not eating, and defintely when not drinking/water. We have a normally fine-tuned hormonal system in order to keep us leaping off the sofa and getting to the garden/game environs/slaughter-shed or the supermarket, and certainly to the water tap/well/stream - and again that busy supermarket.

So, in my own experience at least, as someone who feels hunger keenly, it's about that awful 'discipline' thing, at least until you can habituate your body (is that a thing?) to your new window of eating regime, or, deal with not eating for a longer period of time. (If memory serves, my longest fast was 10-11 days, but that was a bone-broth and cream in coffee assisted fast, not a water only one. The longest water only fast I have done was three to four days.) I have read medical professionals-educators who swear hunger goes away, and of course in here, but I have not experienced this. Lucky those who can do such a terrific treatment without suffering hunger! But I would say - prepare yourself for dealing with hunger, at least for longer periods of fasting, then it won't come as a shock. (I don't like shocks.)

So yeah - deal with the hunger with any self-disciplinary technique/motivation/distraction that works for you.

 

[Outlier]

With the caveat that we are all different - I suffered terrible hunger over a lifetime of calorie control, then when I changed to very low carb/keto, I found I was only hungry once or twice a day. I listen to that hunger, and accordingly eat mostly once a day but have something small e.g. a bowl of home-made soup, some plain Greek yoghurt, a few slices of meat, a couple of boiled eggs, that sort of thing IF I am hungry before the evening meal. We need to listen to our bodies and respond to actual hunger, not boredom, any kind of emotion where we need comfort, or because others are going to eat etc. We each deal with such situations in our own way, all of us here have our tips and wrinkles for managing, and I have learned a lot from others here. It's so easy that many of us wonder why we didn't find out earlier! There is no need to suffer hunger pangs. Not all of us do, but they certainly still exist for me. However, while I have no intention of suffering, and deal with genuine hunger when it manifests, for me the change in what I eat has resulted in an unexpected change in when I eat. You have nothing to lose by giving it a try - we are each our own experiment.

 

[Lamont D]

Wow Lamont, that sounds extreme. 5-days without food would kill me for sure. Maybe not from starvation but certainly from going mental.

But I like the progressive approach, which I will indeed consider. Thanks.

PS: What did all this fasting do to your gut-health? Does it cause constipation?

My gut health was very poor before diagnosis.
And fasting.
I was following medical dietary advice, the usual eat well plate etc.
Anyway, I was diagnosed with helicobactor pylori after a endoscopy.
I was having issues with stomach pains.
I had the antibiotics, and it was better.
stopping the metformin and going keto, improved my stomach issues much more.
Don't have them now.
don't have constipation.
And when fasting, it can be irregular but that is okay.
Hope that helps.

 

[LiSwati]

Hi @LiSwati, welcome to the forum. As you ask about intermittent fasting (IF), let me add my story.
Five years ago I lost 10 kg with IF, basically by doing Michael Mosley's 5+2 diet.
On the two fast days each week I only ate 600 calories and basically very little carbs, i.e. a small breakfast, e.g. an egg or nature yoghurt with half an apple, during the day I drank only water and coffee. For dinner it was lots of vegetables, e.g. curries, soup and salads, maybe a bit of chicken of fish. On the other five days I ate normally, i.e breakfast, a small lunch and dinner, but no snacking. Rather quickly the pounds started melting away and my belt needed tightening. The amazing thing was that I never really felt hungry when fasting. You can eat lots of soup, vegetables and salad for 600 calories. This allowed me to get off Metformin and get my HbA1c into the 40s. I still do IF, it has allowed me to sustain my weight for four years so far.

Reading Jason Fung "The Diabetes Code" has been very informative. Basically a low calorie diet is not sustainable, as your base metabolic rate BMR will reduce and you will need fewer calories to maintain your weight. You will stop losing weight, feel increasingly miserable and give up eventually. You might try again later, but this circle of yo-yo dieting is only successful for weight loss companies, and is the source of lots of human misery.

I now understand that our bodies are not like combustion engines, but hormonal engines and the effects of calories from carbs differ from those from fat and from protein. Fatty food is much more satiating than carbs, e.g. compare eating an omelette with ham and cheese with having cornflakes with milk for breakfast. The former will last you through the day, if needed, while the latter will make you hungry after 2 hours. People here have lost lots of weight without trying by simply increasing the amount of fat in their diet, i.e switching to a low carb high fat diet.

I have consequently banned all low fat products from my fridge. I never liked them anyway. These usually have lots of added sugar as removing fat removes taste, are ultra-processed and the sugar is addictive. I avoid plant based oils and margarine and use olive oil and butter instead, eat significantly more cheese and despite eating lots of eggs - fried, scrambled, soft and hard-boiled or in omelettes - and fry ups with bacon my cholesterol has come down as well. Eating in this way also makes it easier not to snack.

Of course all our bodies are different and your own mileage may vary, but If you want to do IF I can only encourage it. To me IF is the only diet tested by evolution. if our ancestors were unsuccessful in hunting they had a lot less to eat, only what they could forage. In more recent times fasting is practised in many cultures and religions and is considered healthy.

Hello Lupf. Thank you for this amazing guidance. Your personal experience has been most helpful. A lot of what you’ve said gave me ideas on how I can change my lifestyle.

I am proud to say that today I did a 19-hour fast and I’m still alive. I hadn’t planned on going that long but I attended a function and we only got to eat at 2 pm. I only had a coffee and lots of water, but I managed with ease. I only experienced blurred version and by the time I ate, I could hardly see what was on my plate.

But I took everyone’s advice and ate veg and meat only. I also had a small slice of cake, but later took a 2-3 km walk to burn off the cake (yes, it was a walk of shame).

After my walk I tested (it was around 5:40 pm). To my surprise, my reading was 4.7 mmol/L, the lowest it’s been this year. Unfortunately, I didn’t take my tester with me to the function, but next time I fast, I will do so, as I need to know how low I get when the symptoms kick in.

Thanks again Lupf and thanks to everyone who responded to my need for advice. All the advice has truly changed the way I am now looking at managing my diabetes. Siyabonga (thank you).

Hi @LiSwati. This would be a great thread in the Fasting sub-forum! But great to see it generating lots of discussion about intermittent fasting (IF), and fasting (F) proper for T2D treatment. A great tool in the dealing-with-T2-tool box imho.

Re gut-health, I'm interested in that subject independently of my interest in and fasting practices. Re the gut biome - that would be the food you eat when you do eat? Quite simply, I would say. IF and F has great, and interesting effects for the person with diabetes. But I am sure there must be some info out there about what happens to the gut biome during fasting - is there someone out there in ouyr Forum who can answer that detail?

The constipation question is easier to answer from a personal standpoint. What happens to you in early hours or days of fasting with your digestion and pooping must be closely related to your movements when eating? i would say. ie if you are regular, and not suffering straining, there is no constipation issue when adapting your window of eating to a new regime. If you have constipation issues, then that will cross over into your toileting exprerience early on in your new IF regime? (And LCHF way of eating I would imagine.) If you go some time when not eating, then the pooping does stop, but it isn't a problem. When you re-start eating, pooping restarts, and no straining. I must have been told very strongly as a kid not to talk about one's own pooping, as I find it very hard to actually write 'in my own experience' , but yes. Gee. In my own experience.

@AloeSvea , thanks. Yes, the impact fasting has on gut health, could certainly be an interesting thread.

Not too long ago, I had gut issues from insufficient fibre in my diet, and from what was being said about cutting out starches as much as possible, got me concerned about cutting out All Bran cereal, which had been my source of added fibre and kept me regular; thus the reason I posed the question.

But I later realized that an increase in vegetables to my diet, would serve to replace the fibre I was getting from All Bran cereal.

It would still be interesting to know how fasting has impacted the gut health of our group. Thanks for highlighting this.

 

[LiSwati]

I totally agree on the all you can eat BBQ - yum yum big time!

But back to the details of fasting. I contribute the same thing on the subject of hunger and not eating for any length of time as I always do - we as a species would not be here today if we did not experience hunger, even keenly, especially keenly? and definitely thirst , when not eating, and defintely when not drinking/water. We have a normally fine-tuned hormonal system in order to keep us leaping off the sofa and getting to the garden/game environs/slaughter-shed or the supermarket, and certainly to the water tap/well/stream - and again that busy supermarket.

So, in my own experience at least, as someone who feels hunger keenly, it's about that awful 'discipline' thing, at least until you can habituate your body (is that a thing?) to your new window of eating regime, or, deal with not eating for a longer period of time. (If memory serves, my longest fast was 10-11 days, but that was a bone-broth and cream in coffee assisted fast, not a water only one. The longest water only fast I have done was three to four days.) I have read medical professionals-educators who swear hunger goes away, and of course in here, but I have not experienced this. Lucky those who can do such a terrific treatment without suffering hunger! But I would say - prepare yourself for dealing with hunger, at least for longer periods of fasting, then it won't come as a shock. (I don't like shocks.)

So yeah - deal with the hunger with any self-disciplinary technique/motivation/distraction that works for you.

10-11 days? Were you on a hunger strike? And you did this willingly? Wow .

Yes, the devil is always in the details (“discipline”). I agree, self-discipline is everything in life and fasting just takes a little more.

I found that water worked well to ease the hunger. I drunk more water than usual today and it worked. Together with the cup of creamed coffee, it helped and I did suffer from hunger.

 

[LiSwati]

My gut health was very poor before diagnosis.
And fasting.
I was following medical dietary advice, the usual eat well plate etc.
Anyway, I was diagnosed with helicobactor pylori after a endoscopy.
I was having issues with stomach pains.
I had the antibiotics, and it was better.
stopping the metformin and going keto, improved my stomach issues much more.
Don't have them now.
don't have constipation.
And when fasting, it can be irregular but that is okay.
Hope that helps.

Thank you Lamont. I too had H-Pylori a year before I was diagnosed T2. It healed after treatment and therefore, I followed a high fibre diet to maintain a good gut. Thanks for sharing.

 

[AloeSvea]

10-11 days? Were you on a hunger strike? And you did this willingly? Wow .

Yes, the devil is always in the details (“discipline”). I agree, self-discipline is everything in life and fasting just takes a little more.

I found that water worked well to ease the hunger. I drunk more water than usual today and it worked. Together with the cup of creamed coffee, it helped and I did suffer from hunger.

Lol - just trying to beat the ol diabetes thing. Didn't work. But I don't regret the experimentation.

I'm totally with you on the drinking as a good way of dealing with hunger. I have quite a selection of herb teas, and I like the routine around tea-making and serving too. Fills a gap where food prepration and serving sits too, I imagine.

 

[LiSwati]

Greetings one and all. It’s been one month since I started this thread and I thought it be proper to give you feedback on all the great advice you gave me, for which I am very grateful.

I started the 16/8 intermittent fasting soon after and found that it worked wonders for me. I lost 6 kg and I am on track to losing an additional 10 kg. My target weight is 82 kg, and soon, I’ll be needing a new wardrobe to cater for my new me. The last time I was 82 kg was in 1989. Thanks to your advice, my weight target is a stone-throw away.

My BG has also been excellent, ranging around 5.5-6.2 mmol/L every morning. I no longer experience low BG symptoms, as my body has adjusted to the new normal. So in all, I am doing very well, with continuous monitoring of all my vitals. Should my BG go too low, I will reduce my metforim to 1 a day (I am currently on 2 x 500g / day). My doctor is happy, too.

Thanks to you all, my life is back on track, and with exercise, I should find that 6-pack I lost, oh so many years ago.

 

[Chris24Main]

Fantastic news, and ell done. Reading this first thing in the morning makes for an excellent start to the day..!

 

[Lamont D]

Greetings one and all. It’s been one month since I started this thread and I thought it be proper to give you feedback on all the great advice you gave me, for which I am very grateful.

I started the 16/8 intermittent fasting soon after and found that it worked wonders for me. I lost 6 kg and I am on track to losing an additional 10 kg. My target weight is 82 kg, and soon, I’ll be needing a new wardrobe to cater for my new me. The last time I was 82 kg was in 1989. Thanks to your advice, my weight target is a stone-throw away.

My BG has also been excellent, ranging around 5.5-6.2 mmol/L every morning. I no longer experience low BG symptoms, as my body has adjusted to the new normal. So in all, I am doing very well, with continuous monitoring of all my vitals. Should my BG go too low, I will reduce my metforim to 1 a day (I am currently on 2 x 500g / day). My doctor is happy, too.

Thanks to you all, my life is back on track, and with exercise, I should find that 6-pack I lost, oh so many years ago.

Excellent!

 

[KennyA]

Fantastic news, and ell done. Reading this first thing in the morning makes for an excellent start to the day..!

Well done!

 

[Lupf]

Congratulations, this is excellent to hear. Keep us updated how it goes, please.

 

[Outlier]

Tremendous - you rock!