Metabolički
Post: šećer u krvi, inzulin i lipidi
Biljezi se poboljšavaju. Teško je pitanje poboljšavaju li se više nego što bi se poboljšali uz isti gubitak težine postignut na neki drugi način.
Što kažu najkvalitetniji pregledi
Cochraneov pregled o povremenom gladovanju za odrasle s prekomjernom težinom ili pretilošću [1] i sustavni pregled strategija gladovanja u časopisu BMJ [2] dvije su sinteze koje treba pročitati ako čitate samo dvije. Oba pronalaze stvarne učinke na tjelesnu težinu i povezane kardiometaboličke biljege, a oba su oprezna u pogledu veličine i pouzdanosti tih učinaka.
Ponavljajuća napomena: biljezi se poboljšavaju približno proporcionalno izgubljenoj tjelesnoj težini. Ispitivanja koja uspoređuju povremeno gladovanje s kontinuiranim ograničenjem energetskog unosa kod dijabetesa tipa 2 pokazala su usporedive ishode [4], što je i za očekivati ako je mehanizam upravo energetski deficit.
Poboljšanje glikemije
Ispitivanja o dijabetesu
Ispitivanje EARLY klinički je najzanimljivije: dijeta zamjene obroka uz povremeno gladovanje po shemi 5:2 testirana je za glikemijsku kontrolu u odraslih osoba s dijabetesom, s HbA1c kao primarnim ishodom [6]. Zamjena obroka uklanja veći dio problema s pridržavanjem dijete, što je možda razlog pozitivnog rezultata.
Randomizirana usporedba shema 16:8 i 14:10 s kontrolnom skupinom donijela je podatke o smanjenju tjelesne težine i metaboličkim parametrima [8], što potvrđuje da duljina prozora hranjenja nije aktivni čimbenik.
Dob je važna
Vrijedi pročitati pregled koji posebno istražuje rizike i koristi povremenog gladovanja za stareći kardiovaskularni sustav [3] ako imate više od 60 godina. Starije osobe imaju manje mišićne mase koju mogu izgubiti, više interakcija s lijekovima i veću vjerojatnost da razdoblje smanjenog unosa hrane izazove probleme koji bi u 30. godini bili zanemarivi. Ispitivanje objavljeno u časopisu Cell Metabolism, koje mjeri reakcije mozga na povremeno gladovanje u usporedbi s dijetom zdravog načina života u starijih osoba [7], jedno je od rijetkih studija osmišljenih upravo za tu populaciju.
Što ne stoji
- "Gladovanje poništava inzulinsku rezistenciju nezavisno od gubitka težine." Nije potvrđeno. Ispitivanja koja su izjednačila promjenu tjelesne težine ne pokazuju jasan nezavisan učinak.
- "Gladovanje popravlja kolesterol." Lipidi se mijenjaju s tjelesnom težinom i sastavom prehrane. Gladovanje samo po sebi nema utvrđen učinak specifičan za lipide.
- "Gladovanje smanjuje upalu." Upalni biljezi padaju s gubitkom masnog tkiva. Da bi se to pripisalo obrascu gladovanja, potrebna je kontrola koja u većini ispitivanja izostaje.
- "Postat ćete prilagođeni na masti i cijeli dan sagorijevati mast." Korištenje supstrata mijenja se tijekom gladovanja i vraća nakon jela. Dvadesetčetverosatna oksidacija masti određena je energetskom ravnotežom.
Često postavljana pitanja
Hoće li gladovanje poništiti moj predijabetes?
Znači li povećanje razine glukoze natašte da metoda ne djeluje?
Je li gladovanje dobro za kolesterol?
Mogu li gladovati ako imam dijabetes tipa 2?
References
Every citation below links to the original peer-reviewed record on PubMed or via DOI. Nothing here is a substitute for medical advice.
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