Intermittent Fasting: Effects on Body Weight and Blood Sugar Regulation

[@myrayap1978]

I am a primary care provider nurse practitioner. l will start recommending this channel to my patients.

[@nourishedbyscience]

Thank you. And thank you for your work!

[@chewiewins]

Love my IF. Even those not wanting to skip meals, just stop eating calories after evening meal till breakfast and a natural 12-14h fast can happen naturally

[@tomcaron9113]

Been watching diabetes related videos for a long time as a type 2 person. Like most people who watch these, I am very interested in managing my own condition but still following my doctor’s advice, to a point. Really enjoy your no none sense approach to this!

[@garrettsorensen631]

I always love your videos. you explain everything so well!

[@1959Berre]

This is the best channel about health and weight management. Totally evidence based and very well explained. So much better than those 'insulin guru's' who have no clue about physiology.

[@nourishedbyscience]

Some of them have some clues about physiology; it's just, in my opinion, to often too singularly focused on insulin. Insulin is important, and insulin resistance is a key risk factor for many chronic diseases, but our bodies are complex, and insulin is not to blame for everything.

[@scfan7231]

Great videos, I think these are the best so far. Thank you very much for your effort.

[@sandramorton5510]

Appreciate your work, your teaching is easy to understand. I have work to do, I am watching your videos in succession.

[@marysepaquet7329]

I have an history of gestational diabetes, reactive hypoglycemia and, now, metabolic syndrome. Because I have also a PhD, after reading published articles, I started alternated 24h fasting during weekdays for two weeks, TRE for 8 h for two weeks since the beginning of September 2024. I also implemented a high-fat low-carb diet and daily exercise. I lost a stable 10 lbs and I will know at the end if this months (3 monts endpoint) if the biomarkers are down. Your video supports what I am doing and it will help you to continue. I would like to thank you for your great work.

[@nourishedbyscience]

Congratulations and kudos to you for taking action. If you had gestational diabetes, this suggests you may have 'weak' pancreatic beta-cells, i.e, a limited ability to make more insulin if necessary. Therefore, for you it is particularly important to remain insulin sensitive, and you are taking the right steps to address that IF your main problem is indeed excess visceral and ectopic fat. If you haven't yet, I would encourage you to watch the video linked below about the main causes of insulin resistance. There may be other factors that contribute to your insulin resistance, and it may be beneficial to identify and address these as well. kzbin.info/www/bejne/forXn5-IeNZradUsi=TvxpqbN1ICGgEZlf Best wishes, Mario

[@tobywebb6452]

Great stuff, thank you

[@TorBoy9]

Excellent content. I've used time restricted eating TRE 18-6, low carb (keto), high protein, strength training lifestyle and have lost 18 lbs. This combination works for me, and it can work for you as well. Consider the shift to a different way of eating and exercising.

[@nourishedbyscience]

That's a great approach. And once your glucose tolerance and insulin sensitivity have improved (if you ever were glucose intolerant or insulin resistant), you could probably increase your carb intake again as long as you maintain the other strategies. Particularly the combination of high protein, TRE, and strength training is great, because it lowers fat mass selectively without risking too much muscle loss.

[@randomgal]

Hi Mario! I have been reading up more and more about the gut microbiome. Not sure if it's just a trendy topic or if it really is as impactful to our health as many sources are claiming. Supposedly it's a booming research field. Would love to know your thoughts. Vielen Dank und tolle Arbeit wie immer ☺️

[@suphesizdogru]

Another great video. Thank you.

[@larabraver]

Big Thanks Mario, from a primary care doc.

[@SheLoves2Learn111]

Great content and very well explained. Thanks!

[@TheWkn12]

Wonderful video

[@Lalec122]

Thank you again for a very informative video. I really appreciate your delivery and just sharing the information without all the hype. There are some Dr podcast that almost appear manic, in their videos... "getting high on their own supply" so to speak. Not to be judgmental but wrapping things and a shiny happy package is kind of how we got to this point in society...

[@Lalec122]

I have been on OMAD for 7 months, following, one full year of just quitting sugar and processed foods... just that move , I lost 135 pounds, without even trying, no calorie restriction just no sugar and no processed food... to keep the weight loss moving and to get to my goal weight, I had to adjust my intermittent fasting, and now the "one meal a day", once fat addapted, I am completely and fully satiated, with less than 20 net carbs a day, and losing about 1.2 pounds a week... Just had my six month labs, better than they have been in 20 years, including fasting insulin and advanced lipid profile, (cholesterol levels increased dramatically, however my HDL is very high.... not a new finding on a keto diet or a low-carb diet. I have completely reversed insulin resistance, fatty liver and pre-diabetes... and I have four autoimmune disease diseases, which is a battle to stay well every day , you can do it! I am 64 yo, I hope this helps someone ✌🏼

[@nourishedbyscience]

That's impressive. Thanks for sharing. Just a note about your lipids: if your apo B/LDL-chol is high, we no longer think that elevated HDL-chol protects against the negative consequences of that. Sure, your overall CVD risk almost certainly was reduced by your weight loss and improvements in insulin sensitivity and glycemic control; however, I would still discuss the apo B with a good preventive cardiologist. Here is some more information: Blood Lipids and CVD Risk: Everything You Need to Know kzbin.info/www/bejne/rpuzdXRmeMifa5Isi=ljG4wpEVBoj4CrQu Cheers Mario

[@Lalec122]

@ thank you, I do in fact have the genetic cholesterol issue... however, I'm still focused on losing the last 30 pounds, and will continue omad keto, until i accomplish that... it has been drastic changes to my lifestyle, just the fact that I'm not putting sugar or processed foods in my body has been unbelievable... and anyone can do that.

[@roygoen6139]

Great information. Thanks! I alw ays enjoy your videos.

[@turimetok4709]

If I buy a super thanks, do the proceeds go to you? Thank you for all the informative science back knowledge and for your integrity.

[@nourishedbyscience]

Thank you for your kind consideration. Yes, creators on KZbin receive 70% of the Super Thanks. If you use one of the donations links in the video description, I receive >95%. Appreciate you! Cheers Mario

[@markgingerich2242]

Thank you Mario for this great information. It agrees with Jason Fungs studies. I have a question though. I have a bmi of 22 and don't need to lose weight and yet have type 2 diabetes. Wouldn't fasting cause me to lose even more weight and muscle mass?

[@nourishedbyscience]

If you have T2DM at a BMI of 22, there are a few possibilities to explain this: 1.) Your primary problem may not be insulin resistance. In fact, you may be very insulin sensitive, and your problem may be a defect in the function of your pancreatic beta-cells. Has anyone ever measured beta-cell autoantibodies? There are mixed cases of diabetes, such as LADA in which the clinical picture looks like T2DM, but where there is an autoimmune process driving the slow destruction of the beta-cells, similar to T1DM, just more slowly. Even if that's not the issue, it is possible that you may have bet-cell dysfunction, which most often is genetic in nature in lean people. To fully understand glucose homeostasis, I recommend this video here: Regulation of Blood Sugar: kzbin.info/www/bejne/j5iccoZoqMuMb7ssi=_0eoEnwxEJ1ZBttj 2.) You could still be insulin resistant. I suggest the following steps to figure this out: The first step is to figure out whether we are insulin resistant: Measuring Insulin Resistance: kzbin.info/www/bejne/hYvXqaKaprR1mNksi=C681vsKNjXqWJSMq If we are insulin resistant, then the next step would be to think through the most common causes of insulin resistance to identify potential reasons for OUR insulin resistance: Causes of Insulin Resistance: The Personal Fat Threshold: kzbin.info/www/bejne/mYGYaKKDbdF1l7csi=eK6OeDRpGNpPzOqW -> Note that there are RARE cases where people have a low BMI and still store most of their body fat in their visceral and ectopic fat depots. These are called lipodystrophy, characterized by an inability of the body to store fat in the subcutaneous fat tissue. However, there are also numerous other causes of insulin resistance: Insulin Resistance: Top Causes & Contributing Factors: kzbin.info/www/bejne/forXn5-IeNZradUsi=kfHudBNBlFN1NlzU To understand why insulin resistance is damaging to long-term health: Insulin Resistance Syndrome: A Neglected Risk Factor for Chronic Disease: kzbin.info/www/bejne/fJiWn2Csnpenabssi=Cob6H4vwk6yCz12F Wearing a CGM can also be useful to identify early signs of glucose intolerance and insulin resistance: The Complete Guide to Understanding Your CGM Data: kzbin.info/www/bejne/eoexdWxmq7Zjrqssi=vpLTb-bAIvenYWjB And once you have identified potential causes or contributing factors to your glucose intolerance and/or insulin resistance, you can address these specifically. It’s important to be clear that while excess visceral and ectopic fat is a common cause of insulin resistance and glucose intolerance, it’s not the same for all people. Others are insulin resistant because of low muscle mass, chronic stress, chronic sleep deprivation, or micronutrient deficiencies. In your particular case, I would not engage in IF or try to lose weight at this point, before you know what the causes of your glucose intolerance are. Try to figure out WHY you have T2DM, and then address this specific cause or causes. Hope this helps.

[@markgingerich2242]

Thank you so much Mario!! This is so very helpful. I did have an antibody test done for LADA. It came back negative. I have a CGM which is very helpful. I will pursue the other areas that you have mentioned. God bless!

[@Marc_de_Car]

Thank you.

[@mathewjohn3385]

I am a dedicated follower of your videos because they clarify my health concerns. I started practicing time-restricted eating (18/6) for the past month, and after a recent lipid checkup, I found that my triglycerides have decreased and my HDL has slightly increased. However, my total cholesterol and LDL levels are high. What is the reason for the paradox in cholesterol levels?

[@nourishedbyscience]

Your body is probably in ketosis in the morning hours after your extended fast overnight. With 18:6, you may have been fasting 14 or more hours, depending on when you usually have your last meal of the day. And in ketosis, the body burns more fat and increases transport of fat throughout the body. In some people, LDL-cholesterol can rise while in ketosis, in some people substantially, particularly if you are also doing a low-carb diet. I would suggest discussing this with your doctor. If you and he/she are concerned about your total and LDL-cholesterol, I would consider shortening the fasting window by trying 16:8 or 14:10 TRE, and - if you are doing low-carb - to include a bit more carbs in all of your meals. Another possibility could be that you have increased your consumption of saturated fatty acids and cholesterol, and/or decreased your consumption of fiber. All of these changes could also explain an increase in LDL-cholesterol. Cheers Mario

[@mathewjohn3385]

Thank you, Dr. Mario, for your quick response. My last meal was at 8:00 PM, and the blood was drawn at 7:00 AM. I follow a low-carb diet during my eating window. I hope that the increase in total cholesterol and LDL will not be a major issue, especially since my triglycerides have decreased and my HbA1c is at 5.3.

[@nourishedbyscience]

@@mathewjohn3385ok, i would give some consideration to a slightly higher carb intake, and maybe switching to 16:8 TRE. If you have a history of blood sugar issues and high triglycerides, just experiment with a slightly higher carb intake, roughly equal at each meal, and always paired with some fiber-rich vegetables or fruit/berries and some protein. The goal should be to make progress on all of your risk factors, not exchange one problem area for another.

[@mathewjohn3385]

Thank you Doctor... I will do so...

[@dcnike820]

You videos are amazingly helpful. My one gripe, as a long term type 2 diabetic, is that you use the incorrect term, root cause, for visceral and ectopic fat. The root cause is hyperinsulinemia (which starts up to 20 years before one becomes diabetic) and/or fructose induced NAFLD. It is a little strange how you ignore the main driver for both weight gain and T2DM.

[@nourishedbyscience]

Well, I don't agree with the low-carb narrative in this regard because this is a channel based on the cumulative evidence, and in my opinion, one has to be willing to ignore a large number of data points to insist that insulin is the root cause of weight gain/loss. To first address the claim that fructose causes fatty liver, yes, fructose consumed chronically in liquid form where it also triggers a caloric surplus probably causes fat accumulation in the liver. I talk about this here: kzbin.info/www/bejne/mWW6dpiElJt0passi=b6c2Wz1SadBiXtUK However, the cumulative evidence does not support the idea that fructose in solid form, for example in the form of fruit or berries, triggers a similar increase in liver fat content. So I am not sure why people keep insisting that it's 'the fructose'. An increase in liver fat can be seen when three conditions meet: high fructose, excessive calories, and fructose in the form of a liquid. Maybe we don't need the last condition, but all the evidence that I have seen suggests that we need the first two. Now to the topic of insulin driving both weight gain and loss. It's a very common narrative among the low-carb community that calories don't matter, and that only insulin matters for weight loss/gain. That is a narrative I do not share, because it is not consistent with all of the evidence. In my opinion, we are making the old nutrition science mistake of trying to explain a complex chronic disease by blaming only one factor. To me, the cumulative evidence suggests that the situation is a lot more complex, with many more factors affecting whether we gain or lose weight. If you question this, here is an experiment you may want to do: buy yourself some dextrose (pure glucose), and eat about 50g of that 5 times per day. And nothing else. Eating this much pure dextrose will give you a substantial blood glucose and insulin response, particularly if you start out insulin resistant. But it's only 1,000 kcal, probably less than your energy expenditure. So if the lore of 'only insulin matters' were true, the high diurnal insulin levels would prevent you from losing any weight. Do you believe that? In other words, could we simply distribute a few sugar cubes a few times per day and prevent people from starving? Of course calorie intake matters here, because the starving tissues would gobble up our glucose very rapidly, and our blood glucose and insulin levels would drop even on this highly glycemic and insulinemic 'diet'. In fact, several studies have put the hypothesis that only insulin matters to the test. And if you do put overweight, insulin resistant people on a high-carb (=highly insulinemic) diet that is calorie reduced, what happens? They lose weight, and about as much as if you had switched them to a low-carb diet. And even if you put them on an ad libitum high-carb diet that is high in fiber, with a low energy density and low in ultra-processed and hyperpalatable foods, they will lose weight, even if they can eat as much as they want. And that is even though, at least initially, obese, insulin resistant people are bound to be pretty hyperinsulinemic when you first switch them to a high-carb diet. To me, the much better explanation is that is because many other factors also matter for our energy balance. There is another line of evidence that makes me question the carbohydrate-insulin-model of obesity. If we look at people who are obese or even morbidly obese, there will always be a few who are perfectly insulin sensitive. Based on my model, this is because they manage to store all of their excess body fat in their subcutaneous adipose tissue, which does not trigger insulin resistance until we reach our own personal fat threshold: Causes of Insulin Resistance: The Personal Fat Threshold: kzbin.info/www/bejne/mYGYaKKDbdF1l7csi=Knbg3l3W06kteOfG Now, this is relevant because if the low-carb narrative were true that carbs trigger hyperinsulinemia and hyperinsulinemia triggers both insulin resistance and weight gain, how did these people become obese or even morbidly obese if they are still insulin sensitivity even AFTER they became obese? For example, look at Figure 1 in this paper here: [](pubmed.ncbi.nlm.nih.gov/20570822/)Kloeting N et al.; Insulin-sensitive obesity. PMID: 20570822. This figures shows that some people with obesity are very insulin sensitive, based on the gold-standard clamp measurement. How did they become obese? They probably never in their life suffered from more hyperinsulinemia than most lean people. On the other hand, you are also correct that calories are not the only thing that matters. Of course, our hormonal environment, including insulin, matters, and it matters a lot. Partly because it affects our fat storage, but also because it affects our glucose metabolism and our energy homeostatic mechanisms directly. But what people need to understand is that reducing calorie intake, for example by fasting intermittently, is also a good way to lower insulin levels. All of the research shows this: if you lose enough of your excess visceral and ectopic fat, then your insulin sensitivity will improve and your diurnal insulin levels will come down. In other words, calories matter. Many aspects of our diet matters, as I explain in my playlist 'Keys to a Healthy Body Weight'. And hormones, including insulin, matter. To me, the best model at this point that considers all of the data suggests that insulin is one of many factors involved in regulating energy homeostasis, including weight gain and loss. Cheer Mario

[@dcnike820]

@@nourishedbyscience Thank you for taking my comment seriously and for the long answer with references. Clearly your response is practiced (and cut and paste) likely because I am not the only one that questioned your choices. That also likely means you did not read my comment carefully enough because I never said calories do not matter (I agree with you, the topic is too complex for simple answers). Anyway, much smarter people than me have looked at the science and have elevated the role of hormones over that of calories and question the directionality of the correlations so I will not try to engage. As I noted earlier, I love your videos and I hope you keep putting them out, even though I do not agree 100% with every choice you make; I STILL LEARN A LOT FROM YOUR POSTS AND LOVE THEM. I do have a PhD in health statistics and because I am a type 2 diabetic (for over 16 years), I have read every paper published on the subject (having given up on my doctors' advice) and have used that to reverse my T2DM for 5 years now, and at the heart of it was managing insulin through IR, TRE, and Low carb high fat diet which ended up eventually dropping my weight considerably.

[@nourishedbyscience]

Yes, indeed, it was partly copied. I get so many questions about this that it doesn't make sense to type the same thing every time. I really need to make a video about it that I can share. Given that you are a colleague, though, what do you say about the arguments I made? If we have a model and then test it, we need to discard or change it if the data we generate does not fit the model. To me, it's clear that the currently proposed central role of insulin in weight gain and loss is irreconcilable with some of the data points we have. All the best to you, Mario

[@dcnike820]

@@nourishedbyscience It is really kind of you to respond a second time and to take my comments seriously, truly appreciated. My own dive into the research have focused only on T2DM and not obesity science so I cannot engage on that topic beyond my n=1 experiment that has changed my life for the better for the last 5 years. The two people I respect the most on metabolic health are Benjamin Bikman and Jason Fung, both of whom did amazing narrative reviews of the literature and produced 3 books with extensive bibliographies which have helped me a lot in my own research (Bikman's Why we Get Sick, and Fung's Diabetes Code and Obesity Code). Both of them are on the hormone side of the story of metabolic health and have issues with the way the energy balance model is applied (closed versus open system). I tend to trust their conclusions and have lived it out in my own n=1. Of course, they could be wrong, and so could the other side. Nutrition science is not always based on high quality research and that is the main reason I love your posts, you look at high quality research.

[@CoreofShane]

@@nourishedbyscienceAwesome response! Learned something

[@justin333eb]

Anything the Government say to eat i just do the opposite. I recommend reading “Health and Beauty Mastery” by Julian Bannett that book is a real eye opener about shocking stuff health industry is doing! I completely changed my habits

[@AnnaLorris]

totally agree

[@marynlyn]

Nothing by that author is published on Amazon.

[@nourishedbyscience]

Hm, haven't heard of that book. Will look into it. Regarding governmental dietary advice, I am also critical of our history of the dietary guidelines, and I am certainly critical of the impact of the ultra-processed food industry, but 'doing the opposite' of what the government recommends would not be my position ... I do think one can find a healthy diet and still follow the dietary guidelines.

[@TasteOfButterflies]

Do the opposite of what the government says you should: eat under 5 fruits and vegetables per day, exercise as little as possible, get most of your grain intake from refined grains, and avoid brushing your teeth.

[@danasamu5404]

Hi Mario. I am confused by your comment at 7:58 when you say we that can reduce the degree of lean mass loss by "making sure we keep our protein intake high both ON FAST DAYS [emphasis added] and on feast days", while earlier in the video you define fasting as "not eating or drinking anything with calories for a defined period of time". Perhaps you explain this apparent contradiction later in the video, in which case I'll delete my comment, but if it's still here, it means I'd be very grateful for your clarification :)

[@nourishedbyscience]

Fast days can consist of either no calorie intake, or - more commonly - a substantially reduced calorie intake of most often 500-800 kcal/day. Even if one consumed food on fast days, it usually still leads to longer fasting times. For example, if only one meal is eaten around lunchtime, that will usually lead to a fasting period of around 16 hour before and 16 hours afterwards. And my recommendation is that if a meal is consumed on the fast days to make it rich in protein; that'll slow down loss of muscle mass, and it will also make that meal more satiating per calorie, making it easier to stick to the low calorie intake on fast days. Sorry this wasn't clear. Cheers Mario

[@danasamu5404]

@@nourishedbyscience Thank you for the speedy and thorough reply, Mario! I just finished watching the video, and I understand now that it is a semantic issue. The fault for that does not lie with you personally, but rather with the inconsistent or imprecise use of the term in the literature in general. Fasting (to me) is, you know, fasting. Ideally the scientific community should settle on a term for low calorie consumption to differentiate it.

[@mikeprendergast6866]

Is it possible or meaningful to add any content regarding topic relationship to controlling type 1 diabetes

[@nourishedbyscience]

Yes, planned for the future. It's a lot easier to prevent or reverse type 2 diabetes, however, and the number of type 2 diabetes patients is around 30-times larger, so I am focusing on T2DM first.

[@peterbedford2610]

I eat low carb ( 20% of calories) and a 16:8 daily eating schedule. My BMI is 20. HIIT 3 times per week and resistance as well. But, my fasting glucose is always around 110.

[@nourishedbyscience]

There could be any number of reasons for it. For example: - Your primary issue may not be insulin resistance, but beta-cell dysfunction, i.e., a relative inability of your beta-cells to produce insulin - Even if it's insulin resistance, the cause is not always excess body fat. In the playlist linked below, there is a video entitled 'Insulin Resistance: Top Causes & Contributing Factors'. Maybe go through that list and consider which of these you may be expose to. - There are also some rare conditions such as lipodystrophy in which the overall BMI is low, but most fat is stored in ectopic depots such as the liver. This is unlikely, but something you could discuss with a doctor. That could drive fasting glucose up to due insulin resistance in the liver associated with elevated liver fat. The primary defect here is basically a very limited ability to store fat in subcutaneous depots. There are two videos in the playlist linked below that I recommend watching for this: "The Personal Fat Threshold" to understand the importance of storing fat in subcutaneous fat depots, and "Insulin Resistance Syndrome" to understand the role of liver fat in the development of insulin resistance and its sequelae, and how to use blood-based tests to get an estimate of whether we may have an elevated fat content in the liver (fasting TGs and HOMA-IR). These blood-based tests are not conclusive, but a good first step before requesting further imaging. If both fasting TGs and HOMA-iR are in the green portion of the graph I discuss in the video, a fatty liver is unlikely. Cheers Mario Here is the playlist "Diet, Blood Sugar Regulation, and Diabetes": kzbin.info/aero/PLIMWy92HkBVbyyjkxJky7WYFEOhMs45Ts&si=ZAZwJFxinBLZh83Q

[@peterbedford2610]

Thank you. I will watch these to see which may apply most closely to me.

[@nourishedbyscience]

@@peterbedford2610 And let me know if you have any questions. It's good to get to the bottom of something like that before it gets worse. Best wishes, Mario

[@BartBVanBockstaele]

Lovely presentation. I tried this myself, years ago but couldn't do it. The uncontrollable hunger, pain, nausea and vomiting it caused were unbearable. Nevertheless, I consider it more than worth a try and Mario's dispassionate and objective presentation style make this a pleasure to watch.

[@nourishedbyscience]

Thank you for your kind words. Sorry to hear of your negative experience. If you don't carry excess visceral and ectopic fat, you can probably just ignore this. If you do carry some excess body fat, here are a few ideas: either try a very relaxed form of intermittent fasting, say 6:1 with one day of ~1,000 kcal in the form of two medium-sized meals. Or a mild form of TRE, such as 10-h-TRE. Weight loss will obviously be slow with this approach, but may be meaningful over an extended period of time, particularly if you combine it with other suggestions from my 'Keys to a healthy body weight'-playlist such as raising protein and fiber intake, lowering energy density, avoiding UPF and liquid calories etc. Cheers Mario

[@BartBVanBockstaele]

@@nourishedbyscience Thank you so much for your kind and thoughtful response! That is almost exactly what I'm doing, except for the fasting/TRE. I am constantly hungry, so what I do, is attempting to make it tolerable, which seems to be the best I can hope for. It works. I lost over 50% of my body weight, from 127 kg to 57.5 kg. Due to an ad libitum experiment with fruit I gained about 5-6 kg back but am in the process of losing them again. No one I know wants to do what I do, but I rather love it. Essentially just vegetables, beans and grains with an odd exception here or there as I am not a saint ^_^. I tried to make my diet as boring and bland as possible in order to reduce the probability of taste-induced overeating. Unfortunately, that doesn't work. Foods I once found boring are now ridiculously delicious, so portion-control and time-control remain essential. One big advantage is that my diet is all but effort-free. The microwave is my best friend. There is one thing people almost never talk about with respect to fibre: it clogs the toilet ^_^ I remember that Denis Burkitt and David Jenkins joked about that as well.

[@sharkair2839]

i achieved weight loss by increasing my fat intake, moderate protein and heavily reducing carbohydrate. usually i don"t eat until noon, sometimes later. if i eat late enough then it would be just one meal a day.

[@shootitamboo7553]

I think its not about calories but more of fat loss due to drop in the insulin levels which is a fat storage hormone? That's what I've heard

[@nourishedbyscience]

It's a very common narrative among the low-carb community that calories don't matter, and that only insulin matters for weight loss/gain. That is a narrative I do not share, because it is not consistent with all of the evidence. If you question this, here is an experiment you may want to do: buy yourself some dextrose (pure glucose), and eat about 50g of that 5 times per day. And nothing else. Eating this much pure dextrose will give you a substantial blood glucose and insulin response, particularly if you start out insulin resistance. So if the lore of 'only insulin matters' were true, the high diurnal insulin levels would prevent you from losing any weight. Do you believe that? In other words, could we simply distribute a few sugar cubes a few times per day and prevent people from starving? In fact, several studies have put the hypothesis that only insulin matters to the test. And if you do switch overweight, insulin resistant on a high-carb (=highly insulinemic) diet that is calorie reduced, what happens: they lose weight, and about as much as if you had switched them to a low-carb diet. And even if you put them on an ad libitum high-carb diet that is high in fiber, with a low energy density and low in ultra-processed and hyperpalatable foods, they will lose weight, even if they can eat as much as they want. On the other hand, you are also correct that calories are not the only thing that matters. Of course, our hormonal environment, including insulin, matters, and it matters a lot. Partly because it affects our fat storage, but also because it affects our glucose metabolism and our energy homeostatic mechanisms directly. But what peope need to understand is that reducing calorie intake, for example by fasting intermittently, is also a good way to lower insulin levels. All of the research shows this: if you lose enough of your excess visceral and ectopic fat, then your insulin sensitivity will improve and your diurnal insulin levels will come down. In other words, calories matter. The quality of our diet matters. And hormones, including insulin, matter. In this video, I simply decided to focus on what I consider is most important to implement intermittent fasting.

[@nexuslockhart]

When you are the subject of an experiment, many results become unreliable because the testers know they are research subjects, so they can resist the urge to eat because every time they eat, their weight changes are recorded. This is the flaw of this type of research.

[@Education-yk5ug]

I've been practicing 60hr fasting (0 Cal) for the last 5 weeks, so its like 4.5+2.5. During the fast I lose 3-4lb, but once I go back to eating I gain it within 2-3 days. I've been observing it each time. Not sure how to stop this yo-yo.

[@Spectral_Nights]

Starvation is not a solution, in this type of IF, the body starts to store more fat because our body has an emergency mechanism that says our body that we need more fat stores to use in future emergency situation.

[@nourishedbyscience]

I agree with the other commenter here. I suggest you try one of the other types of IF mentioned in this video; if you can maintain a 60-hour fast, something like alternate-day fasting or the 5:2 diet may be easy for you to do.

[@peterbedford2610]

Have you seen the VIRTA story? It doesn't sound like a keto diet can help more than about 25% of the people with type 2 diabetes. Your thoughts?

[@nourishedbyscience]

Yes, I know all of the VIRTA publications. In general, I do think we should give them credit that they aim to reverse a chronic disease that is often just seen as something we should 'manage'. And their remission rates are not bad. In my opinion, they are not higher because (a) long-term compliance issues, and (b) they use one approach for everyone even though even type 2 diabetes can have many different causes. As to point b, a low-carb diet lowers, obviously, the glycemic load of the diet, which is good in anyone who is glucose intolerant. And it can also help with weight loss, which is great IF excess body fat mass is the problem underlying the glucose intolerance. However, if someone has type 2 diabetes because of sarcopenia (lack of muscle mass) or because of a major chronic inflammatory condition, weight loss may not help them normalize their glucose tolerance. I personally would be more in favor of customizing the approach to reversing type 2 diabetes much more, based on (a) the persons long-term dietary preferences so that they can maintain their new diet long-term, and (b) based on a thorough analysis of why someone is glucose intolerant. Cheers Mario

[@peterbedford2610]

Thank you! As usual, your perspective is far more valuable than any other nutrition channel I have watched. And I watch quite a few.

[@4everhdt]

This is some of the highest quality information out there thank you very much! I'm so grateful for all of your videos and I believe I've now watched almost all of them. Just an idea for a future topic. How to raise your metabolic rate, like for example some scientists like Ray Pete and Robert lustig and Richard Johnson have suggested that omega-6 fatty acids and fructose slow down or damage metabolism.

[@nourishedbyscience]

Thank you for your feedback and the suggestion. Always welcome to hear what you guys would like to see. Cheers Mario

[@lindenbrook1320]

@@nourishedbyscience I would be interested in that as well, I've heard that a lower metabolic rate can extend life span, so always wondered why the emphasis on a faster metabolic rate is desired. Where is the sweet spot?

[@felipearbustopotd]

20:54 so overlooked.

[@gsp0819kri]

Thank you for another super informative video! My BMI is now 22.3. I am of South Asian background so I need to aim for a lower BMI. I started my journey in August/September.

[@nourishedbyscience]

At that BMI, I would consider biomarkers such as insulin resistance or the fasting triglycerides to get a sense of whether I indeed have excess visceral and ectopic fat. I talk about this here: kzbin.info/www/bejne/fJiWn2Csnpenabssi=K5F7lAEU95iTXQQb If you feel you would like to lower your body weight more, consider which changes you can make to your diet and lifestyle that you can happily sustain over the long term. That way, you'll have a better chance to keep whatever weight you end up losing off.

[@gsp0819kri]

@nourishedbyscience I will ask for the metabolic bloodwork based on the video you recommended above. My follow up with my PCP is in February, believe it or not. I was diagnosed with prediabetes in August, and I also have super high cholesterol. Apparently, to my PCP, this isn't a health crisis it seems. I had to advocate for myself and if it weren't for you and two or three other KZbinrs that I follow, I'd probably be dead by now. Just kidding! Sorta. I even had to ask my PCP to prescribe a glucometer. (I still haven't gotten that CGM that I've been wanting to get). Thank you so much for your response!

[@nourishedbyscience]

@@gsp0819kri I would agree with him or her that it isn't a health crisis, and you certainly don't need to be in panic mode. However, I do strongly feel that this right now is the right time to figure out why your blood glucose and lipids are moving in the wrong direction, and address these causes. I see it as a wasted opportunity to be diagnosed with an early stage disease, and not act upon that to prevent it from progressing.

[@gsp0819kri]

@nourishedbyscience thank you! You do always know how to set me back on track. Lol. Love it. ❤️ I will add that I think perimenopause may have a role here. Just from what I've been listening to from other KZbinrs (although, I can't tell if these are credible or not; however, the coincidence is there).

[@gsp0819kri]

@@nourishedbyscience so my doctor said she'd be more than happy to order the requested bloodwork that I put in the portal yesterday. Thank you for the suggestion!

[@WeAreNotGoingBackEver]

Why do people always suggest we talk to our doctors first? Most have absolutely no knowledge or training and nutrition which is why the first thing they run to our panels, which is an easy solution.

[@nourishedbyscience]

Well, while fasting may be a good idea for most people, there are risks that may manifest for some people, and I do think that people should talk to their doctor if they are not certain.

[@ianjames8794]

Rather than some form of fasting. What are your thoughts on daily calorie deficit. Say, for instance, maximum calorie intake of 1200 calories every day. Any thoughts would be appreciated.

[@nourishedbyscience]

That works as well, at least theoretically. It's just not easy to do long term. The trick is to find a way of eating that helps you have a lower calorie intake that you can maintain long-term. This is often difficult for many people with a daily calorie restriction. In my opinion, using the strategies I outline in my playlist 'Keys to a Healthy Body Weight' should help make the meals more satiating, which should be helpful to spontaneously eat less, but also to feel more full when on any form of restricted diet. Then combining that with, say, a 5:2 diet, would be my prefered way if I wanted to lose weight. Simply because that is much less tiresome to only count calories on two days of the week, rather than on all seven, and it makes social life a lot easier. For many people, it also helps to go to either a low-carb or very low-fat diet. My suggestion is to experiment with all of these options for some time, to find what you can tolerate enough to maintain long term.

[@ianjames8794]

Thanks Mario.

[@clemenceabel5494]

Hey, I saw your videos. They're great and informative but your thumbnails are not appealing enough. I think you should hire a Professional Thumbnail Artist for your videos to increase your view count cause every impression matters. I can improve your ctr from 2-3% to 15%. Please acknowledge and share your contact details to get your thumbnail.

[@nourishedbyscience]

Thank you, but I am not interested. My videos are pretty lengthy and deep and don't appeal to a general audience, so my channel would not benefit all that much if I made flashy thumbnails or hyped-up titles. This kind of stuff would only attract the wrong audience that would switch click away from the video within a few seconds. Thanks for the offer though. Cheers Mario

[@sarmedmahdi1942]

If we reduce calories to 500 or 800 calories, the body will reduce the metabolism and the result will be disastrous. The body is an intelligent machine and you cannot cheat it without consequences.💞🙏

[@nourishedbyscience]

Hm, the data would suggest otherwise. You are correct that if you eat a low-calorie diet, your body adjust to slow down the loss of body weight. However, the truth is that the primary issue underlying many common chronic disease such as type 2 diabetes or fatty liver disease is what we often call energy toxicity. This means that we simply have too much energy in our body to handle safely, and this is what leads to insulin resistance, beta-cell dysfunction, glucose intolerance, and type 2 diabetes. If someone is affected by that, it is certainly the opposite of 'disastrous' if intermittent fasting helps them shed some of that excess energy in the form of excess body fat. And the data support this, given that intermittent fasting is able to bring type 2 diabetes into remission in a large percentage of patients. Best, Mario

[@sarmedmahdi1942]

@nourishedbyscience I was on that beach. I had been suffering for years from type 1 diabetes, and over the years I was able to reduce it to type 2. Now I have completely recovered, and I was suffering from fatty liver, blood diseases, high blood pressure, hormonal imbalance, etc., but as I mentioned, there are other consequences. Thank you for your efforts, you are the best.🌼💞🙏💗🌹

[@rodhoutx]

The body is very intelligent and complicated, that's why you can't just look only at calories. I like how Jason Fung explained it... when blood sugar (insulin) is lower, the body can finally access the fat stores that it put there. The rest of the "calories" the body needs on those days can just be pulled from the fat stores, especially if that person is fat adapted. It doesn't have to reduce metabolism because you're still walking around with a ton of calories in storage. It's also just a couple of days here and there, is the body going to just change metabolism that fast? Plus there is activity level to consider -- if someone is just sitting in a chair watching TV all day, it probably needs to reduce metabolism vs the person still being active on those days.

[@nourishedbyscience]

@@rodhoutx It's a very common narrative among the low-carb community that calories don't matter, and that only insulin matters for weight loss/gain. That is a narrative I do not share, because it is not consistent with all of the evidence. If you question this, here is an experiment you may want to do: buy yourself some dextrose (pure glucose), and eat about 50g of that 5 times per day. And nothing else. Eating this much pure dextrose will give you a substantial blood glucose and insulin response, particularly if you start out insulin resistance. So if the lore of 'only insulin matters' were true, the high diurnal insulin levels would prevent you from losing any weight. Do you believe that? In other words, could we simply distribute a few sugar cubes a few times per day and prevent people from starving? In fact, several studies have put the hypothesis that only insulin matters to the test. And if you do switch overweight, insulin resistant on a high-carb (=highly insulinemic) diet that is calorie reduced, what happens: they lose weight, and about as much as if you had switched them to a low-carb diet. And even if you put them on an ad libitum high-carb diet that is high in fiber, with a low energy density and low in ultra-processed and hyperpalatable foods, they will lose weight, even if they can eat as much as they want. On the other hand, you are also correct that calories are not the only thing that matters. Of course, our hormonal environment, including insulin, matters, and it matters a lot. Partly because it affects our fat storage, but also because it affects our glucose metabolism and our energy homeostatic mechanisms directly. But what peope need to understand is that reducing calorie intake, for example by fasting intermittently, is also a good way to lower insulin levels. All of the research shows this: if you lose enough of your excess visceral and ectopic fat, then your insulin sensitivity will improve and your diurnal insulin levels will come down. In other words, calories matter. The quality of our diet matters. And hormones, including insulin, matter. In this video, I simply decided to focus on what I consider is most important to implement intermittent fasting.

[@mikeprendergast6866]

Thanks!

[@nourishedbyscience]

Thank you. Appreciate your support!