In 1916, Dr. Lewis Webb Hill and dietitian Rena Eckman issued seminal guidelines for the medical community on how to use starvation in the treatment of diabetes. The prescription would be more accurately described today as fasting or severe calorie restriction. It was for a short period of time until a patient had little to no "sugar" in his urine. Although nutritional advice for diabetics has evolved tremendously since then, their writings echo those of Hippocrates, the father of medicine, who wrote, "Disease which results from over-eating is cured by fasting." More recent research reinforces the idea that reducing your caloric intake produces significant improvements in the hallmarks of diabetes.
Eating With Diabetes
Eating with type 2 diabetes is about managing the condition, reducing your risk of complications and avoiding heart disease. A diet that is healthy for just about everyone is also healthy for a diabetic. Diabetics need whole grains, fruits and vegetables, legumes and beans, lean meat, and nutrients such as fiber, calcium, potassium and vitamin D. Your main restriction in the diabetic diet is to avoid foods---mostly carbohydrates---that spike your blood sugar. However, most diabetics are also overweight. Losing weight helps resolve the features of diabetes, so it's better that you consume fewer calories and eat less fat in general if you are diabetic.
Starvation of Diabetes
In the early 20th century Hill and Eckman program, a diabetic came to the hospital and ate normally for two days, then was starved for 12 hours a day, given only coffee with a shot of whiskey or a bouillon tablet. "The disappearance of the sugar is rapid," they write, usually gone within three days, but sometimes obstinate cases could take a few days longer. In research published a quarter-century later, researchers from the University of Pittsburgh School of Medicine concluded that a seven-day period of calorie restriction significantly improves your liver's production of blood sugar, your sensitivity to insulin and your pancreas's ability to produce insulin. They note this short fast was equivalent to about half the result you'd get if you lost a substantial amount of weight---which undoubtedly takes longer. Science now knows that calorie restriction in and of itself makes a valuable contribution to the treatment of diabetes.
Starvation Mechanics
"Science Daily" reports that when you restrict calories for a few days, you cause changes in your liver and muscle metabolism. For example, you rapidly decrease your triglycerides and increase insulin sensitivity. These changes are heightened when the calories you eat come from a diet with relatively little carbohydrate content.
Short-Term Calorie Restriction Improves Weight Loss
Short-term calorie restriction and weight loss work together to improve diabetes. Two studies in the "American Journal of Clinical Nutrition" provide evidence that fasting helps both obese and healthy-weight people lose weight and burn fat. Fasting is difficult to maintain, however, so some research has looked into alternate-day fasting for weight loss to help sensitize people to the process. The benefits were clear, however. Overweight diabetics and healthy-weight individual experienced a 2 to 4 percent decrease in body weight, better insulin sensitivity, fewer free radicals circulating and---important to diabetics---lower cholesterol and lower blood pressure.
Caution
Calorie restriction is not a journey to take alone. You need the advice and consent of your physician and the counsel of your dietitian. If your diabetes is controlled by medication or if you are pregnant, then severe calorie restriction is probably not for you. In addition, extreme caution is warranted if you have high blood pressure or other diabetic complications.
References
- "Hippocratic Writings"; Hippocrates; 1950
- "The Starvation Treatment of Diabetes"; Lewis Webb Hill and Rena Eckman; 1916
- Foods and Food Policy: History of Diabetes Nutrition Therapy
- "American Journal of Clinical Nutrition": Alternate-Day Fasting in Non-obese Subjects--Effects on Body Weight
- "American Journal of Clinical Nutrition": Short-Term Modified Alternate-Day Fasting
- "Journal of Clinical Endocrinology and Metabolism": Relative Effects of Calorie Restriction and Weight Loss in NIDDM
