Intermittent #fasting and its impact on #health 1/n What is intermittent fasting (IF)?
A variety of eating patterns in which no or few calories are consumed for prolonged time periods
that can range from 12 hours to several days,
on a recurring basis. #diet#nutrition
2/n What are the different ways of Intermittent Fasting? 1. Alternate-day fasting, 2. 5:2 or 6:1 intermittent fasting (fasting 2 days or 1 day each week), 3. Daily time-restricted feeding (Eating within 8-12 hour window and fasting during the rest of the day) #MedTwitter
3/n Definition of various types of intermittent fasting
4/n Benefits of intermittent fasting 1. Reduces the risk of #diabetes, lowers fasting blood glucose in diabetics 2. Reduces total and LDL #cholesterol and triglycerides, 3. Lowers systolic #BP 4. Reduces #body#weight
5/n- Benefits of IF (continued) 5. Improves focus, attention, concentration and #memory 6. Reduces the rate of cognitive impairment and reduces the risk of #Alzheimers disease, 7. Reduces the risk of #stroke, 8. Increases the lifespan (effect on longevity seen with>5 yrs of IF)
6/n Cellular, molecular & physiological responses to intermittent fasting
During fasting, cells undergo adaptive stress resulting in range of effects, including increased production of antioxidants, DNA repair, autophagy (removal of damaged or dead cells)& decreased inflammation
7/n Mechanisms involved in IF 1. Metabolic switch: Body’s preferential shift from utilization of glucose from glycogenolysis to fatty acids and fatty acid-derived ketones.
Ketones are the preferred fuel for both the brain and body during periods of fasting and extended exercise.
8/n Of relevance to weight management, this switch represents a shift from lipid synthesis and fat storage to mobilization of fat in the form of free fatty acids (FFAs) and fatty-acid derived ketones.
9/n Who should not attempt intermittent fasting?
Those who are 1. underweight, 2. under 18 years old, 3. pregnant or breastfeeding women, 4. having a history or currently struggling with eating disorders
Conclusions 1. Intermittent fasting (IF) is safe for most, 2. IF has beneficial effects against obesity, diabetes, high BP & cholesterol, 3. IF reduces the risk of dementia and stroke, 4. IF increases longevity 5. IF regimen needs to be modified as per individual goals and needs.
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Why do some #doctors do not include advice on #diet and #exercise in their #treatment plan for #patients? 1. It is clear that with modifications in diet & #lifestyle and exercise; we can prevent, control, reduce the severity or cure diseases and improve patient's quality of life.
2. Still we see that patients are given options of medicines and surgery but very little advice about diet and exercise, even though these don't cost much (in comparison to other medical interventions). Patients almost always ask for these advices though.
3. What could be the reasons?
a. There are fewer research papers on role of diet and exercise in disease prevention and treatment. This is not a surprise, as most of the research is pharma-funded, and #Pharmaceuticals have little to gain if diet/exercise prove to be beneficial.
Testimony of a cancer conqueror regarding benefits of intermittent fasting 1/n Story of Sejal Bhavin Upadhyay, 50 yrs
Her world shattered when she was diagnosed to have multiple myeloma in August 2020.
She started 16 hour fasting (8 hour eating window) on a daily basis. #CANCER
2/n Her disease was brought under control within third cycle of chemotherapy. She has continued to practice intermittent fasting since then (>2 yrs).
She also practices complete fasting for 48 hours at the time of #chemotherapy. #fasting#nutrition#diet
3/n She practices intermittent fasting (+complete fasting for 2 days every 15 days), ensuring she doesn't lose weight. (Her weight is ideal for her height). Lower body weight (than ideal) can lower immunity.
She also practiced fasting during Navratri, inspired by @narendramodi ji
Recurrent seizures: Consider Vitamin B12 deficiency, if cause is not obvious
#Vitamin#B12 plays a vital role in keeping nervous system healthy. Deficiency of B12 can lead to dementia, neuropathy, spinal cord disease and psychosis. Here I report a case of #Epilepsy . #MedTwitter
2. I saw this patient in 2004, when vitamin B12 deficiency was not an established cause of seizures. This young man had features of behavioral changes, dementia and seizures. Treatment with risperidone and carbamazepine did not result in improvement. #neurotwitter#nutrition
Repeated abdominal pain and vomiting could be a sign of "Abdominal Epilepsy"
1/n Abdominal pain & vomiting are common symptoms of many gastrointestinal disorders. However, in some patients, no obvious cause can be found despite extensive investigations.
Case report #MedTwitter
2/n 22-year old woman presented with repeated episodes of epigastric #abdominal#pain associated with #vomiting of three months duration. Symptoms occurred almost on daily basis, more in evenings, post which she felt tired and lethargic. She was evaluated by gastroenterologist.
3/n Extensive investigations- upper GI endoscopy, CT and ultrasound of abdomen, LFT, serum amylase, etc were normal. Symptomatic treatment also did not help. At this point she was referred for my opinion. #gastroenterology#internalmedicine
#Stroke after the neck-crack & head massage by a barber after haircut 1. I saw a 22-year old being brought to the emergency room on a stretcher (1999 @OffCMCVellore. He had developed dizziness, followed by weakness of limbs and breathing difficulty after neck-crack by barber.
2. He was perfectly well prior to going for hair cut. Symptoms started soon after head massage and neck-crack by the barber. MRI brain showed infarcts in left cerebellar hemisphere and medulla. MR angiogram showed features of left vertebral artery dissection.
3. He was intubated & mechanically ventilated. Anticoagulation with heparin was started. He was gradually weaned off the ventilator and was discharged after 7 days with minor deficits. He made a gradual recovery after three months with warfarin and physiotherapy. #MedTwitter
1. I recently saw a 50-year old woman with symptoms of dizziness, nausea & vomiting, which started during her hair wash with shampoo in a beauty parlor. Initially, she was taken to a gastroenterologist, who treated her symptomatically. #Medtwitter
2. Symptoms did not improve, the next day she developed mild imbalance while walking. She was referred for my opinion. She had mild right cerebellar signs. MRI brain revealed infarct in right posterior inferior cerebellar territory, MR angiogram showed left vertebral hypoplasia
3. A diagnosis of #beauty#parlor stroke syndrome involving right PICA territory was made. Possible mechanism is kinking of vertebral artery during hyperextension & turning of neck towards wash-basin while washing hair with shampoo. She had well controlled #Hypertension too.