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The Impact of Fasting on Fasting Blood Sugar (FBS) Levels
Introduction to Fasting and FBS
Fasting, particularly intermittent fasting and energy-restricting diets, has gained significant attention for its potential health benefits, including its effects on fasting blood sugar (FBS) levels. FBS is a critical marker for glucose control and is often used to diagnose and monitor diabetes and other metabolic disorders.
Effects of Fasting on FBS and Insulin Resistance
Systematic Review and Meta-Analysis Findings
A comprehensive systematic review and meta-analysis of randomized controlled trials (RCTs) examined the impact of fasting and energy-restricting diets on FBS, insulin, homeostatic model assessment insulin resistance (HOMA-IR), and hemoglobin A1c (HbA1c) levels. The pooled results from 30 eligible articles demonstrated a significant decrease in FBS (weighted mean difference (WMD): -3.376 mg/dl), insulin (WMD: -1.288 μU/ml), and HOMA-IR (WMD: -0.41 mg/dl) following fasting or energy-restricting diets. However, no significant changes were observed in serum HbA1c levels. The subgroup analysis indicated that overweight or obese individuals with energy-restricting diets and treatment durations longer than eight weeks experienced greater reductions in FBS, insulin, and HOMA-IR levels compared to other subgroups.
Intermittent Fasting and Physiological Ketosis
A study on intermittent fasting evaluated the effects of consuming a Fast Bar™ with coffee or tea in extending physiological ketosis. The study found that there was no postprandial glucose increase after consuming the Fast Bar with either black coffee or tea. The 4-hour ketone and glucose area under the curves (AUCs) of the Fast Bar groups were similar to those of subjects who water-fasted for 19 hours, suggesting that the Fast Bar can support intermittent fasting or time-restricted eating patterns while providing satiety.
Alternate-Day Fasting and Insulin Resistance
Research on alternate-day fasting (ADF) in mice demonstrated that ADF could improve fructose-induced insulin resistance. The study found that the mean FBS levels in the control and ADF100% groups were significantly lower compared to the daily food and fructose (DFF) and ADF50% groups. Additionally, the ADF100% group was more insulin-sensitive than the DFF and ADF50% groups, indicating that ADF can be an effective strategy to combat insulin resistance induced by high fructose intake.
FBS vs. 2-Hour Blood Sugar (2hBS) in Glucose Intolerance Screening
A study comparing the diagnostic effectiveness of FBS and 2-hour blood sugar (2hBS) during an oral glucose tolerance test (OGTT) found that elevated FBS primarily depends on defective insulin secretion, while impaired 2hBS is associated with insulin resistance. The sensitivity of FBS in predicting 2hBS was 19%, with a specificity of 93%. This suggests that FBS and 2hBS measure different abnormalities and are useful in combination for screening glucose intolerance.
Fasting and Non-Alcoholic Fatty Liver Disease (NAFLD)
A randomized controlled trial investigated the effectiveness of modified alternate-day calorie restriction (MACR), a form of intermittent fasting, in controlling NAFLD activity. The study found significant reductions in weight, BMI, and liver enzymes (ALT) in the MACR group compared to the control group. However, no significant reductions in lipid parameters and FBS were observed between the groups. Both liver steatosis and fibrosis scores were significantly reduced in the MACR group, indicating that intermittent fasting can effectively control NAFLD activity with good adherence rates.
Conclusion
Fasting and energy-restricting diets have been shown to significantly reduce FBS, insulin, and HOMA-IR levels, making them effective strategies for improving glucose control and insulin sensitivity. While FBS and 2hBS measure different aspects of glucose intolerance, they are both valuable in combination for comprehensive screening. Additionally, intermittent fasting can support metabolic health and control conditions like NAFLD, highlighting its potential as a therapeutic approach.
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