Non-pharmaceutical approach to lowering hemoglobin A1c using time-restricted eating | Ruth Patterson
Get the full length version of this episode as a podcast.
This episode will make a great companion for a long drive.
The BDNF Protocol Guide
An essential checklist for cognitive longevity — filled with specific exercise, heat stress, and omega-3 protocols for boosting BDNF. Enter your email, and we'll deliver it straight to your inbox.
Pharmaceutical drugs such as metformin are used to bring blood sugar into normal levels. While these drugs can be effective, they often have unwanted side effects. An altered eating pattern that involves fasting in the evening can also reduce Hemoglobin A1C – a measure of blood sugar over the past three months. Women who attempted this method of eating found it a feasible and acceptable way to eat. In this clip, Dr. Patterson explains how a lifestyle approach – an altered eating window – can be an effective way to reduce blood sugar levels.
Rhonda: A couple of points that you mentioned, I just want to circle back to the glycated hemoglobin you mentioned, that basically fasting in the evening had a pretty robust effect in reducing that.
Ruth: Yeah.
Rhonda: And that's a marker obviously, it's a marker of your long-term, you know, blood glucose levels.
Ruth: Absolutely, they use that to approve diabetes drugs. You know, if a diabetes drug reduces hemoglobin A1C, that's how it gets approved. So it's a pretty powerful marker of risk.
Rhonda: So we're talking about, for example, metformin...
Ruth: Yes.
Rhonda: which is a very...
Ruth: Any diabetes drugs has to move hemoglobin A1C down a certain amount before it can be approved. So if we can do this with a non-pharmacologic approach, just changing when you stop eating and the fasting interval, I mean, that's pretty exciting.
Rhonda: It's in the brain.
Ruth: Yeah.
Rhonda: Yeah.
Ruth: It's really exciting because the truth is all these drugs have side effects, they're not that pleasant to take. A lot of people simply discontinue them on their own. You know, so pills aren't necessarily always the answer, and this offers people a lifestyle choice.
Rhonda: And you mentioned that you're...there were women that were involved that you had basically...they made changes, they started fasting in the evening and they also reduced their A1C.
Ruth: In our pilot studies, we were really focused on the feasibility and acceptability of it. So we didn't have any biomarkers, we were testing, could they do it and how hard was it for people to do.
Rhonda: Okay.
Ruth: So that was really a test of...because there's no point in recommending something if people can't do it.
Rhonda: Right.
Ruth: And that...so that's what we really focused on there, in our personal pilot work, is just could they do it. And truthfully, the vast...they almost all did it and they also all said they would recommend it as an eating pattern to their friends, so they would recommend the study, you know, which told us, okay, this is feasible and this is acceptable. And, you know, that's what we're interested in, is not, you know, if it works but it's like impossible to do, then it's not a valuable public health intervention.
Rhonda: Yeah. I was wondering, what I was trying to get at is how quick or how soon do you think it could change those levels...
Ruth: We don't have data on that.
Rhonda: ...be very interesting to see...
Ruth: Yeah.
Rhonda: ...if some of that can be moved pretty quickly or, you know, if it takes longer. I don't know how quick these other...like metformin works.
Ruth: Oh, yeah, most of them...the thing about hemoglobin A1C is since it reflects average blood sugar over the past three months, it takes about three months to move it.
Rhonda: Okay.
Ruth: Even with a really effective intervention, it just...since it reflects the whole vast three months of cycling through, you have to go whole three months to see it.
Rhonda: Red blood cells to turn over. Yeah.
Ruth:Yeah.
Rhonda: Right, that makes sense.
Ruth: Other markers may be faster, but the...you know, because we already know that if you want to measure these markers, you want people to be fasting. So we know just even one fast, one night's fast makes a difference, right?
Rhonda: Right.
Ruth: If you do one night's fast, a lot of these markers will be flatter in the morning than if somebody eats breakfast, right, before they come in. You know, so you're really...what you're doing is you're extending the period of time where you have very low basal levels of a lot of these markers.
A measurable substance in an organism that is indicative of some phenomenon such as disease, infection, or environmental exposure.
A blood test that measures the amount of glycated hemoglobin in a person’s red blood cells. The hemoglobin A1c test is often used to assess long-term blood glucose control in people with diabetes. Glycation is a chemical process in which a sugar molecule bonds to a lipid or protein molecule, such as hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, neuropathy, and retinopathy. Also known as HbA1c.
A drug commonly used for the treatment of type 2 diabetes. Metformin is in a class of antihyperglycemic drugs called biguanides. It works by decreasing gluconeogenesis in the liver, reducing the amount of sugar absorbed in the gut, and increasing insulin sensitivity. A growing body of evidence indicates that metformin modulates the aging processes to improve healthspan and extend lifespan. Furthermore, metformin may prevent genomic instability by scavenging reactive oxygen species, increasing the activities of antioxidant enzymes, inhibiting macrophage recruitment and inflammatory responses, and stimulating DNA damage responses and DNA repair.[1]
[1] Najafi, Masoud, et al. "Metformin: Prevention of genomic instability and cancer: A review." Mutation Research/Genetic Toxicology and Environmental Mutagenesis 827 (2018): 1-8.
Restricting the timing of food intake to certain hours of the day (typically within an 8- to 12-hour time window that begins with the first food or non-water drink) without an overt attempt to reduce caloric intake. TRE is a type of intermittent fasting. It may trigger some beneficial health effects, such as reduced fat mass, increased lean muscle mass, reduced inflammation, improved heart function with age, increased mitochondrial volume, ketone body production, improved repair processes, and aerobic endurance improvements. Some of these effects still need to be replicated in human trials.
Member only extras:
Learn more about the advantages of a premium membership by clicking below.
Attend Monthly Q&As with Rhonda
Support our work
The FoundMyFitness Q&A happens monthly for premium members. Attend live or listen in our exclusive member-only podcast The Aliquot.
Breast cancer News
- Risk of death from breast cancer was 49 percent lower among women with higher running activity.
- A fasting-mimicking diet improved effectiveness and reduced toxicity of neoadjuvant chemotherapy in breast cancer patients.
- A woman with late-stage breast cancer which had metastasized throughout her body is in complete remission after a new immunotherapy treatment.
- Asparagine bioavailability governs metastasis in a model of breast cancer
- A common type of chemotherapy cancer treatment may cause breast cancer to spread and trigger more aggressive tumors.
