NOTE: An attentive viewer pointed out that the macronutrient breakdown of the shakes shown at 1:30 must be incorrect. The numbers shown on screen are what's described on the study but the authors must have incorrectly reported them because they add up to 80%, not 100%. So the composition of the replacement meals must be somewhat different
I looked at the paper; the macronutrient breakdown is in a supplement to the paper (supplement 2, eTable 3). The reported %'s are not percent of calories, but appear to be % of daily recommended values. The actual caloric breakdown is: Protein: 14.6% Fat: 36.4% Carbs: 49% Given 4kcal/g for protein, 9kcal/g for fat, 4kcal/g carbs.
@@darthrainbows update: we deleted those 5 seconds of the video where the macros are spelled out since it wasn't critical for the conclusion of the study and it was likely incorrect
After 25 years having diabetes in November 2021 , I drastically changed my diet by cutting lots of carbs and eat much lesser. My A1C dropped under 5.8 and according to my CGM data my average blood sugar is around 120 all the time. Lost 50 lbs and discounted lots of meds. I am 58 now and my father died at same age with same disease. As you see I am not lucky on gene pool. But I did not allow it dictate its role. Thanks for amazing videos.
I’ve been there… Fasting sucks (for me anyway). I opted for a daily mild calorie deficit, with a focus on protein and whole foods (limited UPF). I paired that with “energy control,” or using the energy i get from food before it is stored as fat (i.e. not being a lazy ass). It took a year+, but i lost 115 lbs, and put the big D into remission. And, no side effects from drugs! Thanks for helping me through, and helping me to understand.
Try keto, avoid all sugar and fake sugar, and eat sardines or some other fatty tasty fish. With a blood ketone and glucose monitor, easy to see impacts of changing diet and fasting.
After being serious about this for a few years it really just boils down to not being lazy and denying yourself. This works in health, education, career, and interests. Eat food that takes energy and time to prepare, don't eat to much of it, and don't prepare it in a way that satisfies your limbic urges. Congratulations, your healthy.
My most recent blood work on 19th July 2024, my HbA1C is now at 5.4%. Which is great as I am no longer pre-diabetic. With an exercise routine of 3 times a week (total burnt, 1K calories a week) , fasting and a little dieting help tremendously. At 5 feet 7, my initial weight 3 years ago was over 260 lbs. Now maintaining around 189 lbs to 191 lbs. I initially started as OMAD. 24 hour fasting for 2 years, initially strict 1 hour eating window, but slowly open it up to 2 hours maximum so I can meet my caloric needs. However ever since I dropped to 200 lbs, I have being on 18/6 / 16/8 and everything is good. The good thing about 18/6 / 16/8 is that I have some resemblance of normal eating on social settings. But OMAD has taught me subconsciously of how I should eat. So yes, I firmly believe fasting did help me significantly and assisted on my metabolic issues. But I won't encourage the 5/2 approach as 2 days on 600 calories is REALLY rough. The hunger pangs must be terrible. I still think it will be much easier to eat 1500 to 1700 calories a day imo (10k cal to 12K cal a week) and maintain it. And the numbers will be similar, since 2000 x 5 = 10K cals and another 1.2K on meal replacements.
@@danclearwater4486thanks and I know. His videos inspired me to do it after I gained a bit of weight after an injury and it worked for me. That dude was one of my few heros. I hate how he died. He was the GOAT.
I agree but for possibly a different reason. A 5% risk of becoming hypoglycaemic can kill you if exercising especially if it's strenuous like in high heat. So this behaviour can kill you if you aren't careful.
I’ve incorporated 24 to 72 hour dry fasts into my low carb lifestyle. All measurements of metabolic health are now in the optimal range. Reduced prescription drugs from up to 8 per day down to zero prescription drugs. Low carb and/or fasting has had miraculous effects on my health!
All this study shows is that losing weight is helpful for diabetes and the more weight the better. You just need to lose weight by any means possible, fasting is one way to do this.
Eh, maybe not by any means possible; the safest way would be to have a decent caloric deficit while eating lots of protein and working out at least sometimes to avoid muscle loss.
@ddaazahh8064 Both of you are correct. It does seem that any weight loss, regardless of method used to lose the weight, helps A1C. There is certainly a spectrum of safety and health concerning weight loss.
One addition I hope all consider, is that on both fasting and non-fasting days the consumption of sugar is limited. Yes limiting it is a means of cutting carbs and calories, but maybe more importantly the fructose in sugar (sodas, fruit juices or processed foods with high fructose content (low fiber)) directly impacts brain chemistry that increase food craving. Having increased craving won't help not cheating during a fast.
I doubt there is really anything special with 5:2 beyond calorie reduction. It's all about compliance to a reduced calorie regimen, and providing the shakes will be a good way of getting more compliance. I would bet you could get the exact same result eating breakfast, and doing the shake regimen for the rest of the day, again providing the actual shakes to improve compliance. Just today, "Nutrition Facts" dropped another Metformin Video, where lifestyle group did something like 50% better, and this was with mixed compliance. When the checked those with strong compliance, 100% didn't progress from Pre-Diabetes to actual diabetes, which was Massively better than Metformin.
@@peterscott2662 is there anyone who said it was about anything more than calorie reduction. I think one other factor is the sustainability because you aren't doing it every day but still get relatively quick benefits. More research is showing that people get more motivated if they see benefits quickly. I suspect 5:2 results in a relatively manageable trade off between pain and gain.
Yes it's all about calorie reduction, but the 5:2 works for some people where they find restriction for 7 days a week difficult. It allows them to think "well it's only for today and then tomorrow I can eat again". This increases adherence in people that have an issue with food and struggle with calorie restricted diets. Not for everyone, just a tool to try where needed.
I know how impressive it could be. I am a type 2 diabetic. Mounjaro was prescribed. But I had to stop. The incidences of pancreatitis as a side effect is significantly low for those who have not had pancreatitis. Me? I had one incident of pancreatitis, perhaps six years ago and because of that I was instructed to not take any of the weight loss medication‘s. That really sucks.
I find that it's much easier to NOT eat, than to QUIT eating. The first bite is always an "appetizer" that my brain can't turn off. Does anyone have a recommendation for the powder shake ? I find that fasting makes my brain better.
While we can't tell exactly the formulation used, such meal replacements generally are not the same as protein powder. Protein powders also vary immensely in quality, often containing ingredients best avoided. Before buying protein powders, I strongly recommend researching these issues.
Thank you! I just started doing protein shakes (made by me) for breakfast and lunch. Now I will do for two days per week. Helps to know that non-consecutive days works. I had wondered about that. Not diabetic here, but looking to lose fat and retain if not gain muscle, which it turns out, not so easy. Have upped my protein, upped weight-lifting (which is still pretty meager). “Progress, not perfection.”
So the shakes were 29%, 32%, 19% of calories being protein, fat, carbs, respectively, that only adds up to 80%. What macro comprised the remaining 20%?
Awesome video with truly remarkable results and I love how you break everything down. Is there any way you could do some videos on Crohns/Ulcerative colitis? There's so much talk of gut dysbiosis and how the microbiome might be linked to IBD. I've had some doctors tell me that diet has nothing to do with IBD, and have read research suggesting people on a vegan diet had much lower rates of relapse. I don't really know what to think and I'm certainly not qualified to do my own literature review. There are so many of us with IBD that feel helpless and like its just a matter of time before the biologics fail and we have to get surgery. There are some people like Dr. Chanu Dasari and his MGI-clinic that are proposing a specific diet for IBD. I just want to understand where we are with the literature on diet and IBD. Thanks!
The elephant in the room? GLP-1's, (I don't take them). Not that they are the end all-be all but it would be very hard to compete against them, using the average person, in the timeline of most studies. I like diet and with discipline, I feel it is the healthiest approach long term.
I can attest to the effectiveness of the 5:2 diet/fasting for losing weight. Worked for me. However, it was not very sustainable ... long term ... for me. I am doing time-restricted eating/fasting now. My A1c is now in the "normal" range. It's a good thing to analyze what and how you eat.
Hope they recorded the fasting insulin of the participants - both before and after the trial. May have provided interesting additional data. The HOMA-IR may not have been improved as I think it takes time for the HDL count to go up. This will likely happen after they are really healthy and utilizing stored fat for energy.
I tried 5-2 for over a year. It was hard, because you never get into a routine. Switching from eat anything days to 600 cals twice a week. And I never felt any real benefits. I find the 16 hour a day fast so much easier. I have always been fit and healthy but, at age 73, my blood pressure crept up to Stage 1 (blaming 'mthrfr' gene). I averaged normal BP for July. Still creeps up into the elevated range occasionally, but trending down still. After 8 months of fasting, less saturated fat, and resistance exercises. Whole lot of other benefits as well. Less stiffness after running. And getting by with less sleep. Fasting plus other
Interestingly, this 5:2 protocol *on non-consecutive* days) got similar results as the protocol in your previous video where the 2 days were *mostly consecutive*. So it doesn’t seem to matter that you do the fast for 2 days in a row. I bet that 2 non-consecutive days is easier to comply with, since you don’t carry-forward the calorie deficit (hunger) from the previous day.
Thanks for the link to the study! Good numbers, dominated by males. Used BMI which is defined slightly differently in China + other Asian populations for good statistical reasons, e.g. BMI 24 is "overweight". 11/21 meals were "replacement meals" (RM) which I'd guess is hard to maintain. Worth thinking about.
Super Interesting! Many thanks for sharing Dr Carvalho. I know that this was not the goal of the study, but I would have been curious to see more detailed body composition differences berween the three groups in terms of not just weight loss but how much of the weight loss was lean muscle mass, skeletal muscle, visceral, subcutaneous, and overall body fat%. If lean mass or muscle mass was greatest in one group over another, you could be robbing Peter to Pay Paul. Long term, especially if not combined with some form of resistance training, long term especially as you hedge towards sarcopenia, it may prove detrimental in other ways as it relates to grip strength, functional strength, not to mention other potential benefits to achieving a healthy life span.
“When only looking at the completers…” Does limiting analysis to those who finish the program introduce a self-selection bias? IE motivated people more likely to have other healthy habits stick to more challenging regimens?
How can eating breakfast, lunch, and dinner be considered fasting? Shouldn't there be a period of time where eating is restricted for it to qualify as fasting? Am I missing something?
I will stick with 16:8 75gram of carbs minimum per day preferably less checking fasting insulin to make sure it stays in the 4-6 range , 2 meals a day plenty protein and fats. Easy and sustainable never have to count anything or portion size.
You should do a video on AI. I recently learned you can use tools like ScholarGPT and command it to find only meta analyses of RCTs and give you a consensus of them or give you links or explanations etc based only on those studies
I like how another similar study is published just weeks after a similar prior study. I love studies comparing meds (synthetic drugs mostly) with lifestyle changes. They are super interesting, especially considering that more often than not the lifestyle change prices to be equal or better than the drug. But generally people are lazy and underinformed.
How can the percentage of calories due to each macro add up to only 80%? What was the other 20% of the calories that was not protein, fat, or carbohydrate?
As always for any of these studies, I'm curious, is there anything "magical" about having days of very low calories, or, if they just simply ate the same amount of total lower calories spread across all days instead of having "fasting" days would it have the same effect.
Meal replacements are probably the worst kept secret in metabolic medicine. Here’s a passage from the paper in question lMeal replacement is a prepackaged food or beverage that is substituted for 1 or more meals and provides energy.9 The Look AHEAD study has demonstrated that, as part of a comprehensive lifestyle intervention, at 1 year MR effectively reduced hemoglobin A1c (HbA1c) levels by 0.7% (to convert to proportion of total hemoglobin, multiply by 0.01) and achieved initial weight loss of 8.6% to 9.0% among patients with overweight or obesity and type 2 diabetes.10,11 A systematic review including 23 studies and 7884 adults found that MR was associated with more weight loss (mean, −1.4 kg [95% CI −2.5 to −0.4 kg]) compared with other diets.12 Important randomized clinical trials in White European indviduals (DiRECT),13 Middle Eastern indviduals (DIADEM-I)14 and South Asian individuals (STANDby)15 have proved that MR can alleviate diabetes by lowering body weight.
I have Reactive hypoglycemia, that is the issue for a1c and fasting glucose. Both show normal but throw me on a glucose monitor all day and the endocrinologist goes what the hell.
Subcutaneous fat is protective, but when the cells are full it loses this effect. Just made it protective again, but we know 96% will get fat again and will go back out of remission and become diabetic again. Muscle is also protective, probably more. Would be more practical to gain 10kg of muscle than losing 10kg of fat. Of course if you do both, there is more of a buffer if shit goes wrong for a period. Fasting is ok, but it is not good for fat loss, that is done other ways, you know fat loss is dangerous
It doesn’t cause it, it can have good effects if it helps you lose weight, but the body doesn’t necessarily learn to cope with carbs. Reducing calories on a whole food plant based diet may help in the long run. You don’t reduce carbs, but generally speaking, you do reduce weight and the body learns to deal with carbs.
@@CaroAbebe Several family members who swear by very low carb were surprised when I showed them studies showing that people who ate low carb and high fat had a greater risk of developing diabetes. I found numerous articles online about this, but haven't dug into the studies to see if they are any good. It was surprising to me to see how many places claim this to be true.
@@Hanover-ek4jy I don't think it's starvation. Have you tried it? I've done this level of restriction using one meal instead of three and I only get hangry during the last two hours before eating(I had my meal at 8 p m.). It's not that hard. Granted I'm not very big, and it would be harder for a larger person, but the participants ate normally on other days. I think it couldn't hurt to supplement for nutrition on the restricted days but I wouldn't call this starvation, especially because it is only two days a week. P.s. for me having lots of fiber/veg with the meal was essential. It helped to fill me up so I went to bed feeling satisfied.
Also only eat once a day not 3 times a day. If you do heavy labour work you can eat twice a day, switch your fasting days to monday and thursday, not tuesday and thursday. Watch out for sugars and other chemicals in foods & drink. Get sugar from fruits that hold fibers for slow absorption
How is this study relevant when semaglutide and the even better tirzepatide were not included? Fasting is no match for these 2 meds. If you are going to compare fasting against meds, use state of the art FDA approved meds, not old school meds which don't even have weightloss indications.
NOTE: An attentive viewer pointed out that the macronutrient breakdown of the shakes shown at 1:30 must be incorrect. The numbers shown on screen are what's described on the study but the authors must have incorrectly reported them because they add up to 80%, not 100%. So the composition of the replacement meals must be somewhat different
Just add water to 100% ?
Perhaps it was really ketogenic, but don't tell the People. :)
@@to4522 that would make a powder based dough instead of a shake. Maybe the rest was inedibles mostly fibers.
20% is probably the water in the powder
I looked at the paper; the macronutrient breakdown is in a supplement to the paper (supplement 2, eTable 3). The reported %'s are not percent of calories, but appear to be % of daily recommended values.
The actual caloric breakdown is:
Protein: 14.6%
Fat: 36.4%
Carbs: 49%
Given 4kcal/g for protein, 9kcal/g for fat, 4kcal/g carbs.
@@darthrainbows update: we deleted those 5 seconds of the video where the macros are spelled out since it wasn't critical for the conclusion of the study and it was likely incorrect
After 25 years having diabetes in November 2021 , I drastically changed my diet by cutting lots of carbs and eat much lesser. My A1C dropped under 5.8 and according to my CGM data my average blood sugar is around 120 all the time. Lost 50 lbs and discounted lots of meds. I am 58 now and my father died at same age with same disease. As you see I am not lucky on gene pool. But I did not allow it dictate its role. Thanks for amazing videos.
Who would've thought that overeating caused so many issues? Oh wait, only every Dr/Trainer/Dietician for like many decades 😂
I’ve been there… Fasting sucks (for me anyway). I opted for a daily mild calorie deficit, with a focus on protein and whole foods (limited UPF). I paired that with “energy control,” or using the energy i get from food before it is stored as fat (i.e. not being a lazy ass). It took a year+, but i lost 115 lbs, and put the big D into remission. And, no side effects from drugs!
Thanks for helping me through, and helping me to understand.
Try keto, avoid all sugar and fake sugar, and eat sardines or some other fatty tasty fish. With a blood ketone and glucose monitor, easy to see impacts of changing diet and fasting.
5:2 with 500 calories a day on the 2 days really seems to work well for type 2 folks. Good news!
I'm glad it works to help people with diabetes, but 500 calories on any day is NOT fasting.
Calories still matter but fasting certainly helps enhance caloric reduction. Another good review, thanks
❤❤❤❤ hi dr. Gil. You are more than great!! ❤❤❤❤ thank you so much! At least your videos are so clear!
After being serious about this for a few years it really just boils down to not being lazy and denying yourself. This works in health, education, career, and interests.
Eat food that takes energy and time to prepare, don't eat to much of it, and don't prepare it in a way that satisfies your limbic urges. Congratulations, your healthy.
My most recent blood work on 19th July 2024, my HbA1C is now at 5.4%. Which is great as I am no longer pre-diabetic. With an exercise routine of 3 times a week (total burnt, 1K calories a week) , fasting and a little dieting help tremendously.
At 5 feet 7, my initial weight 3 years ago was over 260 lbs. Now maintaining around 189 lbs to 191 lbs.
I initially started as OMAD. 24 hour fasting for 2 years, initially strict 1 hour eating window, but slowly open it up to 2 hours maximum so I can meet my caloric needs. However ever since I dropped to 200 lbs, I have being on 18/6 / 16/8 and everything is good.
The good thing about 18/6 / 16/8 is that I have some resemblance of normal eating on social settings. But OMAD has taught me subconsciously of how I should eat.
So yes, I firmly believe fasting did help me significantly and assisted on my metabolic issues.
But I won't encourage the 5/2 approach as 2 days on 600 calories is REALLY rough. The hunger pangs must be terrible.
I still think it will be much easier to eat 1500 to 1700 calories a day imo (10k cal to 12K cal a week) and maintain it. And the numbers will be similar, since 2000 x 5 = 10K cals and another 1.2K on meal replacements.
It's a shame Michael Mosley didn't live to see this trial.
@@darkpatches Michael Mosley forever. I loved him.
@@hystrionic He was on the 5/2 diet. Watch his documentary and he got great results from it..
@@danclearwater4486thanks and I know. His videos inspired me to do it after I gained a bit of weight after an injury and it worked for me. That dude was one of my few heros. I hate how he died. He was the GOAT.
I agree but for possibly a different reason. A 5% risk of becoming hypoglycaemic can kill you if exercising especially if it's strenuous like in high heat. So this behaviour can kill you if you aren't careful.
I’ve incorporated 24 to 72 hour dry fasts into my low carb lifestyle. All measurements of metabolic health are now in the optimal range. Reduced prescription drugs from up to 8 per day down to zero prescription drugs. Low carb and/or fasting has had miraculous effects on my health!
Why dryfast? What benefits you get by torturing yourself? I mean the water part, i also do extended fasting, but i drink water.
All this study shows is that losing weight is helpful for diabetes and the more weight the better. You just need to lose weight by any means possible, fasting is one way to do this.
"All this study shows is that.."
And the evidence for this is..?
Eh, maybe not by any means possible; the safest way would be to have a decent caloric deficit while eating lots of protein and working out at least sometimes to avoid muscle loss.
Nope, you can eat crap and still lose weight but you won't be healthy.
Critical thinking is not your strong suit.
@ddaazahh8064 Both of you are correct. It does seem that any weight loss, regardless of method used to lose the weight, helps A1C. There is certainly a spectrum of safety and health concerning weight loss.
One addition I hope all consider, is that on both fasting and non-fasting days the consumption of sugar is limited. Yes limiting it is a means of cutting carbs and calories, but maybe more importantly the fructose in sugar (sodas, fruit juices or processed foods with high fructose content (low fiber)) directly impacts brain chemistry that increase food craving. Having increased craving won't help not cheating during a fast.
I doubt there is really anything special with 5:2 beyond calorie reduction. It's all about compliance to a reduced calorie regimen, and providing the shakes will be a good way of getting more compliance. I would bet you could get the exact same result eating breakfast, and doing the shake regimen for the rest of the day, again providing the actual shakes to improve compliance.
Just today, "Nutrition Facts" dropped another Metformin Video, where lifestyle group did something like 50% better, and this was with mixed compliance. When the checked those with strong compliance, 100% didn't progress from Pre-Diabetes to actual diabetes, which was Massively better than Metformin.
@@peterscott2662 is there anyone who said it was about anything more than calorie reduction. I think one other factor is the sustainability because you aren't doing it every day but still get relatively quick benefits. More research is showing that people get more motivated if they see benefits quickly. I suspect 5:2 results in a relatively manageable trade off between pain and gain.
Yes it's all about calorie reduction, but the 5:2 works for some people where they find restriction for 7 days a week difficult. It allows them to think "well it's only for today and then tomorrow I can eat again". This increases adherence in people that have an issue with food and struggle with calorie restricted diets. Not for everyone, just a tool to try where needed.
Good lifestyle requires effort, focus, will..
That's a lot of energy.
Taking the pill is way easier.
No matter the side-effects.
I know how impressive it could be. I am a type 2 diabetic. Mounjaro was prescribed. But I had to stop. The incidences of pancreatitis as a side effect is significantly low for those who have not had pancreatitis. Me? I had one incident of pancreatitis, perhaps six years ago and because of that I was instructed to not take any of the weight loss medication‘s. That really sucks.
I find that it's much easier to NOT eat, than to QUIT eating. The first bite is always an "appetizer" that my brain can't turn off. Does anyone have a recommendation for the powder shake ? I find that fasting makes my brain better.
Same here.
I think any protein powder is good enough.
@@siposz Okay. I'm looking online at " ORGANIC All In ONE".
While we can't tell exactly the formulation used, such meal replacements generally are not the same as protein powder. Protein powders also vary immensely in quality, often containing ingredients best avoided. Before buying protein powders, I strongly recommend researching these issues.
@@Starchface Thanks. I'm considering an "Organic All-in-one" meal replacement shake powder.
Thank you! I just started doing protein shakes (made by me) for breakfast and lunch. Now I will do for two days per week. Helps to know that non-consecutive days works. I had wondered about that. Not diabetic here, but looking to lose fat and retain if not gain muscle, which it turns out, not so easy. Have upped my protein, upped weight-lifting (which is still pretty meager). “Progress, not perfection.”
Thank you, is there a pamphlet/standardized advice that we as clinicians can give to patients to suggest this?
Fascinating, makes me want to try 5:2 again
Another great video to pin Thanks for this channel.
Why do you call this fasting? The definition of fasting is abstaining from food. It seems that the food shakes replaced meals.
So the shakes were 29%, 32%, 19% of calories being protein, fat, carbs, respectively, that only adds up to 80%. What macro comprised the remaining 20%?
20% fibre would be a little too much, I guess 🤔
Fiber is zero calorie. Doesn't count!@@CaroAbebe
Alcohol? Does protein powder dissolve in vodka?
@@juliebrown8375 alcohol is a carbohydrate and would be included in the 32% for carb calories.
when can we expect the full interview with Esselstyn?
ASAP. was on the road last couple weeks so everything got held up but it will come out in Aug
Awesome video with truly remarkable results and I love how you break everything down. Is there any way you could do some videos on Crohns/Ulcerative colitis? There's so much talk of gut dysbiosis and how the microbiome might be linked to IBD.
I've had some doctors tell me that diet has nothing to do with IBD, and have read research suggesting people on a vegan diet had much lower rates of relapse. I don't really know what to think and I'm certainly not qualified to do my own literature review. There are so many of us with IBD that feel helpless and like its just a matter of time before the biologics fail and we have to get surgery. There are some people like Dr. Chanu Dasari and his MGI-clinic that are proposing a specific diet for IBD. I just want to understand where we are with the literature on diet and IBD. Thanks!
Thank you thank you!! God bless you
many diets do reduce A1C and FPG but the problem is the maintenance. the 5:2 IF might be easier to sustain. Thanks Gil
The elephant in the room? GLP-1's, (I don't take them). Not that they are the end all-be all but it would be very hard to compete against them, using the average person, in the timeline of most studies. I like diet and with discipline, I feel it is the healthiest approach long term.
nice review thanks - i shared this on my FB page
I can attest to the effectiveness of the 5:2 diet/fasting for losing weight. Worked for me. However, it was not very sustainable ... long term ... for me. I am doing time-restricted eating/fasting now. My A1c is now in the "normal" range. It's a good thing to analyze what and how you eat.
Hope they recorded the fasting insulin of the participants - both before and after the trial. May have provided interesting additional data. The HOMA-IR may not have been improved as I think it takes time for the HDL count to go up. This will likely happen after they are really healthy and utilizing stored fat for energy.
I tried 5-2 for over a year. It was hard, because you never get into a routine. Switching from eat anything days to 600 cals twice a week. And I never felt any real benefits. I find the 16 hour a day fast so much easier. I have always been fit and healthy but, at age 73, my blood pressure crept up to Stage 1 (blaming 'mthrfr' gene). I averaged normal BP for July. Still creeps up into the elevated range occasionally, but trending down still. After 8 months of fasting, less saturated fat, and resistance exercises. Whole lot of other benefits as well. Less stiffness after running. And getting by with less sleep.
Fasting plus other
On the 2 part of the diet 29%+32%+19% adds up to 80%. What was the other 20% of the 500-600 calories?
Interestingly, this 5:2 protocol *on non-consecutive* days) got similar results as the protocol in your previous video where the 2 days were *mostly consecutive*. So it doesn’t seem to matter that you do the fast for 2 days in a row. I bet that 2 non-consecutive days is easier to comply with, since you don’t carry-forward the calorie deficit (hunger) from the previous day.
Muito bom. Obrigada !
On the 5:2 what shake did they drink?
Thanks for the link to the study! Good numbers, dominated by males. Used BMI which is defined slightly differently in China + other Asian populations for good statistical reasons, e.g. BMI 24 is "overweight". 11/21 meals were "replacement meals" (RM) which I'd guess is hard to maintain. Worth thinking about.
Would have been nice to see them use the jardiance dose for T2DM (25mg) as opposed to the CKD dose (10mg)
OMAD worked best for me.
Lost 39 lbs / 18 kgs.
I hope you find what works for you.
I am inclined to believe a person will get the most benefit by combining drugs and lifestyle modifications.
Super Interesting! Many thanks for sharing Dr Carvalho. I know that this was not the goal of the study, but I would have been curious to see more detailed body composition differences berween the three groups in terms of not just weight loss but how much of the weight loss was lean muscle mass, skeletal muscle, visceral, subcutaneous, and overall body fat%. If lean mass or muscle mass was greatest in one group over another, you could be robbing Peter to Pay Paul. Long term, especially if not combined with some form of resistance training, long term especially as you hedge towards sarcopenia, it may prove detrimental in other ways as it relates to grip strength, functional strength, not to mention other potential benefits to achieving a healthy life span.
Hi Doctor Gil, what if you are a healthy person, will 5:2 induce muscle loss?
“When only looking at the completers…” Does limiting analysis to those who finish the program introduce a self-selection bias? IE motivated people more likely to have other healthy habits stick to more challenging regimens?
Great information! Thank you.
How do we know that the individuals on IF did not reduce their calorie intake during the 5 days of not fasting?
Cool!
Doing 16:8 now because I don’t want to go on weight loss drugs or Metformin.
How can eating breakfast, lunch, and dinner be considered fasting? Shouldn't there be a period of time where eating is restricted for it to qualify as fasting? Am I missing something?
yes, 5:2 is normally referred to as a type of fasting but the way it is often done it's more like "caloric reduction"
So basically out of 21 meals a week, 11 were shake+fruit and veg meal replacements.
I will stick with 16:8 75gram of carbs minimum per day preferably less checking fasting insulin to make sure it stays in the 4-6 range , 2 meals a day plenty protein and fats.
Easy and sustainable never have to count anything or portion size.
You should do a video on AI. I recently learned you can use tools like ScholarGPT and command it to find only meta analyses of RCTs and give you a consensus of them or give you links or explanations etc based only on those studies
Is there a study that compares the effectiveness of 5:2 fasting vs proportional calorie restriction (eating less).
I like how another similar study is published just weeks after a similar prior study.
I love studies comparing meds (synthetic drugs mostly) with lifestyle changes.
They are super interesting, especially considering that more often than not the lifestyle change prices to be equal or better than the drug.
But generally people are lazy and underinformed.
How can the percentage of calories due to each macro add up to only 80%? What was the other 20% of the calories that was not protein, fat, or carbohydrate?
yes, see pinned comment, there must be an error in the manuscript
What about daily 16:8 or 18:6 fasting?
So is this just down to losing weight?
As always for any of these studies, I'm curious, is there anything "magical" about having days of very low calories, or, if they just simply ate the same amount of total lower calories spread across all days instead of having "fasting" days would it have the same effect.
Is the diet sustainable?
5:2 fasting and Metformin are both anti aging mechanism.
What was the meal replacement drink?
If that's the case why are we told by medical professionals that diabetes is "not curable"?
we weren´t taught this in med school!! :)
Because this study shows "remission" of diabetes, not - technically speaking - a "cure".
Meal replacements are probably the worst kept secret in metabolic medicine. Here’s a passage from the paper in question
lMeal replacement is a prepackaged food or beverage that is substituted for 1 or more meals and provides energy.9 The Look AHEAD study has demonstrated that, as part of a comprehensive lifestyle intervention, at 1 year MR effectively reduced hemoglobin A1c (HbA1c) levels by 0.7% (to convert to proportion of total hemoglobin, multiply by 0.01) and achieved initial weight loss of 8.6% to 9.0% among patients with overweight or obesity and type 2 diabetes.10,11 A systematic review including 23 studies and 7884 adults found that MR was associated with more weight loss (mean, −1.4 kg [95% CI −2.5 to −0.4 kg]) compared with other diets.12 Important randomized clinical trials in White European indviduals (DiRECT),13 Middle Eastern indviduals (DIADEM-I)14 and South Asian individuals (STANDby)15 have proved that MR can alleviate diabetes by lowering body weight.
do you know of any well designed studies that compared metformin and berberine?
I have Reactive hypoglycemia, that is the issue for a1c and fasting glucose. Both show normal but throw me on a glucose monitor all day and the endocrinologist goes what the hell.
What about using metformin and 5:2?
Meanwhile, the ones on empagliflozin had higher rates of declaring bankruptcy.
Not during the trial ;-)
Subcutaneous fat is protective, but when the cells are full it loses this effect. Just made it protective again, but we know 96% will get fat again and will go back out of remission and become diabetic again. Muscle is also protective, probably more. Would be more practical to gain 10kg of muscle than losing 10kg of fat. Of course if you do both, there is more of a buffer if shit goes wrong for a period. Fasting is ok, but it is not good for fat loss, that is done other ways, you know fat loss is dangerous
Does eating low carb cause diabetes, prevent diabetes, or have little effect either way?
It doesn’t cause it, it can have good effects if it helps you lose weight, but the body doesn’t necessarily learn to cope with carbs. Reducing calories on a whole food plant based diet may help in the long run. You don’t reduce carbs, but generally speaking, you do reduce weight and the body learns to deal with carbs.
@@CaroAbebe Several family members who swear by very low carb were surprised when I showed them studies showing that people who ate low carb and high fat had a greater risk of developing diabetes. I found numerous articles online about this, but haven't dug into the studies to see if they are any good. It was surprising to me to see how many places claim this to be true.
2 days of fasting mimicking.
its easier just to take the drug.
The prophet Muhammad recommended, as a regular practice, fasting two days a week 1,450 years ago. Thanks Doctor. I really appreciate your methodology.
I was thinking just the same thing...
How many cals on restriction days?
500-600
@@NutritionMadeSimplebasically starvation?
@@NutritionMadeSimple thanks
@@Hanover-ek4jy I don't think it's starvation. Have you tried it? I've done this level of restriction using one meal instead of three and I only get hangry during the last two hours before eating(I had my meal at 8 p m.). It's not that hard. Granted I'm not very big, and it would be harder for a larger person, but the participants ate normally on other days. I think it couldn't hurt to supplement for nutrition on the restricted days but I wouldn't call this starvation, especially because it is only two days a week.
P.s. for me having lots of fiber/veg with the meal was essential. It helped to fill me up so I went to bed feeling satisfied.
@@NutritionMadeSimplea less severe Dr Roy Taylor protocol
Also only eat once a day not 3 times a day. If you do heavy labour work you can eat twice a day, switch your fasting days to monday and thursday, not tuesday and thursday. Watch out for sugars and other chemicals in foods & drink.
Get sugar from fruits that hold fibers for slow absorption
When I did 5:2 I did
Just imagine if they added 20 mins a day of sunbathing to that.
lmao
How is this study relevant when semaglutide and the even better tirzepatide were not included? Fasting is no match for these 2 meds. If you are going to compare fasting against meds, use state of the art FDA approved meds, not old school meds which don't even have weightloss indications.