On Trend: Can Intermittent Fasting Help with Inflammation Associated with Rheumatic Diseases?

You may be hearing about Intermittent Fasting (IF) a lot lately and been wondering what it is or is it effective, safe or sustainable?

This may seem like a trendy, new diet but it has roots in many religions such as Buddhism, Christianity, Hinduism, but most notably in the Islamic faith, who practice fasting for Ramadan.

Intermittent Fasting has had a lot of attention lately because of its potential health benefits, particularly in cardiometabolic diseases. This so-called fad diet has shown promise in reducing inflammation, but is it right for you?

What is Intermittent Fasting?

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There are a few ways to practice Intermittent Fasting, but it essentially means to abstain from food and drink during specific time periods.

One way is to eat normally for 2-3 days, then restrict yourself to significantly fewer calories for 2-3 days, for example, less than 500-600 kcals. If that sounds challenging, you are right!

There is an easier option which includes spending most of your fasting time while you are asleep. With this method, the fasting is time-restricted and you abstain from food and drink for 12-16 hours per day. In this scenario, you could fast from 8 p.m. until between 8-11 a.m. the next day.

Can it help?

Recent systematic reviews of the effectiveness of Intermittent Fasting compared with other calorie-restricted diets on factors such as weight loss, blood glucose regulation, and insulin resistance have found no significant evidence of benefit.

However, a few studies (1,2,3) have found benefits of this diet for chronic inflammatory diseases, including inflammatory arthritis. In these studies, they found that Intermittent Fasting may allow lower levels of insulin in your bloodstream, stimulate cellular repair processes such as waste removal, and reduce the number of pro-inflammatory cells circulating.

Time-restricted fasting, which is abstaining from food from evening into the next morning (12-16 hours fast), allows our bodies to follow circadian rhythms and the time needed for metabolic processes and the mobilization of stored fat.

The Most Common Intermittent Fasting Eating Cycles:

While there are a number of ways to follow an Intermittent Fasting schedule, the most common plans are the16:8 hour and the 5:2 day.

The 16:8 hour method of fasting requires fasters to restrict their eating hours to 8 to 10 hours each day, while fasting for the remaining 14 to 16 hours.

Fasters are encouraged to eat nutrient-dense meals during the 8- to 10-hour window. If the diet is being followed to reduce inflammation, following the Mediterranean or Anti-inflammatory diet would likely be recommended during eating periods.

The 5:2 day method of fasting requires fasters to eat normally for 5 days of the week, with 2 days of the week involving a highly restricted calorie intake. Similar to the 16:8 method, fasters should consume nutrient-dense, anti-inflammatory foods and follow the recommendations of their healthcare provider or Registered Dietitian.

Pros

• With the time-restricted version of intermittent fasting, the majority of your fasting hours are spent asleep, making it much easier to stick to the diet.

  
  

• A reduction in pro-inflammatory cells in the circulation may help reduce joint pain and swelling.

  
  

• Restricting eating hours can help reduce daily calorie intake, leading to weight reduction (if that is a concern) and potential heart health benefits, such as lower blood glucose and cholesterol levels.

Cons

• There is a strong biological urge to overeat after a period of fasting, and it can be hard to stick to any restricted diet; this one is no exception.

• Moderate exercise following the fasting period may be difficult or inadvisable.

• There is limited long-term evidence of the benefits available, as this is an emerging area of study.

• There is potential for this diet to contribute to disordered eating in those who are susceptible.

• As this is not a sustainable dietary pattern, many may find themselves “failing”, which creates an unhealthy relationship with food and eating.

Intermittent Fasting is a potentially promising approach to reducing the impact of chronic inflammatory diseases.

However, it isn’t right for everyone, particularly for those under 18 and over 65 years of age. Additionally, if you have any underlying health issues, this diet may not be right for you.

As always, it is important that you speak with your healthcare provider or a Registered Dietitian before attempting any restrictive diet or change in your regular dietary pattern.

Special thanks to Cheryl Anderson, a 4th-year nutrition student at Ryerson University, who assisted with the research and writing for this post.

See other posts in this series:

Low FODMAP diet, Sjögren’s Syndrome and Fibromyalgia: Is there a connection?

Plant-based diets: What is your trend?

On Trend: Is the Carnivore Diet an Option for Arthritis?

On Trend: The Autoimmune Protocol Diet - The good, the Bad and the Ugly

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I’m Cristina Montoya, a Registered Dietitian living with Sjögren’s disease and rheumatoid arthritis, and I share practical, evidence-based guidance through my Nourish & GLOW newsletter.