The Leader • Saturday, June 13, 2020 • Page 1B
Intermittent fasting can have lasting benefits
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By Betsy Denson betsy@theleadernews.com
Maybe you are one of the few people who has managed to maintain their weight or even shed unwanted pounds during the pandemic. If not, consider a weight-loss strategy that has picked up steam in recent years – intermittent fasting. As explained by Sharon Smalling, a clinical dietitian specialist within the Memorial Hermann Health System, there are several types of intermittent fasting: alternate day fasting; modified fasting, such eating normally for five days and severely restricting calories for two days; and timerestricted fasting, in which meals are eaten during 12 hours with a fast for the other 12 hours. “The one with the highest adherence rate and probably the easiest to follow is time-restricted,” Smalling said. “(The 12-hour) is very popular and works well with most people’s work schedule as well as being easiest to maintain for a significant amount of time.” Smalling added that the alternate day fasting model has the highest dropout rate in studies. If fasting is done correctly, you might see the evidence on your scale. “If it causes one to eat fewer calories then it will promote weight loss,” Smalling said. “But if you eat the same amount of calories just in a shorter time frame, weight loss most likely will not occur or not be as much.” Besides weight loss, Smalling said intermittent fasting can contribute to improved markers of chronic disease, including improved blood glucose control, decreased insulin levels and weight as well as body fat loss, leading to decreased triglyceride levels. “The time-restricted seems to be the most feasible with (12-hour plus) nightly fast and is associated with blunting growth of breast tumors, lowering body weight, decreasing insulin and A1c levels, and decreased inflammation,” Smalling said. “Prolonged night fasting impacts gut microbiota, which has its own circadian
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Stock photo Intermittent fasting, in which people avoid eating at certain times of day, can be beneficial for those who utilize the diet.
rhythm. Fasting may induce changes in the microbiota that reduce risk factors such as adiposity, insulin resistance and inflammation.” Smalling also said diet restrictions decrease IGF-1, an insulin-like growth factor in which a deficiency is good because it protects us from disease, including decreased incidence of diabetes and cancer. It also improves insulin sensitivity. “(Fasting) also increases cellular maintenance and protection, (leads to) increased activation of stress resistance pathways (and) removal and replacement of damaged or dysfunctional cells and decreased inflamma-
tion, thus protecting from aging and disease,” she said. Smalling said a professional can best help you chart a path forward. “Best to work with a dietitian to help establish the best time span to meet your needs as well as help in determining an appropriate calorie level to attain while meeting nutrient needs,” she said. “And how to spread your food intake, balancing macronutrients across the day to insure maintaining energy level for peak performance at work and during exercise.” Several area residents have tried intermittent fasting, with positive
Health disparities exist among Texans By Shana Tatum RD, LD statum@wellness-collaborative.com
The recent news has been filled with more and more emotion. The brutality and racial injustice continue in cities across the country. Our city has been participating in a mostly strong and peaceful way, and Houston highlighted the celebration of George Floyd’s life at his funeral this week. It has been known for some time that disparities exist in our healthcare system. Not only in large U.S. cities like New York and Los Angeles, but here at home, too. A disparity is defined as a difference between groups, a higher percentage of people experiencing an injury or illness, disease or disability over another group. According to the Urban Institute, Texas has the largest population of uninsured people in the country. With a population of 27 million, close to 5 million are uninsured, and many are from the black (16 percent) and American Indian (18 percent) populations. Even with the Affordable Care Act, blacks remain 1.5 times more likely to be uninsured compared to whites. Lack of insurance can lead to a lack of preventive care. Continuity of care has been shown to reduce risk. This lack oftentimes leads to a decline in health and a rise in chronic disease. Look at obesity, defined as abnormal or excessive fat that poses a risk to health and currently determined by the Body Mass Index. Rates of obesity in the African-American population are at 47 percent, according to the Behavioral Risk Factor Surveillance System (BRFSS). High rates continue for pre-diabetes and type 2 diabetes - at 63 percent of the black population. Equally as concerning is high blood pressure at 41 percent. With the current pandemic, a recent study in Respiratory Journal noted that patients with diabetes or hypertension yielded poorer clinical outcomes from COVID-19 than those without these conditions. These disparities continue to affect our communities that are suffering from racial injustice. And on top of these alarming statistics, food security plays a role in a person’s health. A person’s zip code may play a more significant role than their genetic code. Most people know what to eat, but if there is no access to healthy food, having the knowledge will not make much of
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a difference. According to the University of Houston, 17 percent of Harris County residents are food insecure. Living 1 mile or more from a supermarket means living in a food desert. Healthy People 2020 shares these categories of social determinants of health: • Economic stability - employment, income, medical bills and debt • Neighborhood and physical environment – housing, transportation, parks • Education – literacy, language, early childhood education • Food – hunger and access to healthy options • Community and social context – social integration and support systems • Health care system- health coverage and provider availability These disparities are not inevitable. They are preventable. However, they encompass large systems that require thoughtful change and close evaluation. Policy changes and citizen advocacy nationwide are needed to help reverse the negative consequences that result from these disparities. Dr. Ezemenari Obasi from the UH HEALTH Research Institute suggests partnerships between the National Institutes of Health, the Department of Education and Department of Agriculture work synergistically to begin to remove food, health and educational disparities in our country. But, what can we do about it? • Advocate with city leaders for affordable healthcare and to have access to integrative health practices for black and indigenous people of color (BIPOC).
• Vote in local, state and national elections. • Follow and share healthcare leaders from BIPOC on social media • Invest in healthy food systems (local farmer’s markets) and the wellbeing of farmers and farm workers. • Advocate to increase housing quality, affordability, stability and proximity to resources. • Support opportunities for physical activity from an early age to prevent chronic illnesses and promote physical and mental health. • Encourage community health fairs that institute culturally and linguistically appropriate screening, counseling and health care treatment for high-risk groups. Some resources of where to volunteer or make contributions: • Diabetes Awareness and Wellness Network (DAWN), http:// www.houstontx.gov/health/Community/dawn/index.html# • Houston Food Bank, https:// www.houstonfoodbank.org/findhelp/ • Texas Health Insurance, http:// www.texashealthoptions.com • Harris County Medical Society, https://www.hcms.org/tmaimis/ HARRIS/Community%20Health/ Community_Health_Resources.aspx • Houston Health Foundation works to address critical public health needs impacting the Houston region’s most underserved families and children. http://houstonhealthfoundation.org/donate • Kids Meals provides summer meals to children in the Houston area, https://www.giveffect.com/ checkout/4136 • Doctors for Change Houston is a nonprofit organization working to improve access to care, https:// doctorsforchange.org/donate-todfc/
things to say. Recommended books about the topic from readers include “Delay Don’t Deny” and “The Obesity Code.” “(Fasting) can be as simple as eating only between 8 a.m. and 4-5 p.m.,” Heights resident Alison Schmieder said. Added Garden Oaks’ Morgan Shields: “I fast every day until about 1 p.m. I usually have my last meal about 6 p.m. It has helped me feel more energetic and allowed me to not focus on food so much. Been at it for about a year now and though it was difficult at first, now I find it to be pretty flexible and easy to maintain.”
DR. STEPHANIE FULTON Stephanie Fulton, M.D. 1740 W. 27 St. Suite 301 Houston, TX 77008 713-880-2727 www.fultonobgyn.com Major Hospitals
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