Endocrinologist Dr. Roshani Sanghani shows us how this small lifestyle change can give you huge benefits in health
India has become the Diabetes Capital of the World. This disease is a silent killer and can cause loss of eyesight, foot problems, as well as organ failure. It has no cure and till recently, it was being managed with pills and insulin injections (in advanced cases). Endocrinologist Dr. Roshani Sanghani has helped many of her patients to reverse their Diabetes with Intermittent Fasting (IF).
We grilled Dr. Sanghani about her success with IF and how by making a small change in the way and what we eat, can benefit both diabetics as well as those wanting to avoid diabetes:
THRIIVE: Diabetes is said to be a lifestyle disease. What sort of lifestyle does one need to follow to avoid getting Diabetes?
DR. ROSHANI SANGHANI: Type 2 diabetes is a lifestyle disease. Agreed, there are genetic traits we can inherit from our families to increase the risk of type 2 diabetes, but, many people are able to reverse type 2 diabetes when they change their diet and lose weight and none of them refunded the DNA they got from their parents!
In a nutshell, the lifestyle changes that help are:
- Low carbohydrate diets
- Avoidance of snacking
- Avoidance of regular intake of processed, artificially sweetened foods, sugar substitutes
- Exercise 5-6 times a week (a mix of cardio, strength training and flexibility)
- Proper sleep routine (which means minimizing blue wavelength light pollution which spoils our late evening melatonin release: think tubelights, LED bulbs and LED screens)
- Stress management
- Intermittent fasting helps keep insulin levels low. This helps reduce insulin resistance which is the starting point of type 2 diabetes.
THRIIVE: You have said elsewhere that Type 2 diabetes is case of too much insulin. How can one control this other through the use of medicines?
DR. ROSHANI SANGHANI: The lifestyle changes mentioned above all are effective at reducing insulin levels. As a doctor, I have always emphasized lifestyle change over medication because I want to address the disease at the ROOT. Most medication does not work to reduce insulin levels. That’s often why you often hear that once a person starts medication or insulin for type 2 diabetes, the prescriptions don’t stop! If I have to prescribe drugs for a short period, I use medication that does not raise insulin levels. After learning about intermittent fasting, my prescriptions of insulin for type 2 diabetes have dropped by more than 95%. A fasting C-PEPTIDE test helps me show the patient that their body is still making it’s own insulin so why give insulin from the outside when a lifestyle change is what the patient really needs at the root level?
THRIIVE: How did you discover that Intermittent Fasting could help reverse Type 2 Diabetes?
DR. ROSHANI SANGHANI: I was invited to a diabetes reversal seminar in the fall of October 2017. That was the first time I came across Dr Jason Fung’s work. I was already insisting on lifestyle change with my patients but did not have fasting in my toolkit till then. Always curious to learn new ways of approaching diabetes, I went ahead and read all three of his books and watched all his YouTube videos. Everything I came across in his approach made scientific sense! I was in fact a bit upset as to why I hadn’t come across this approach earlier in my career! Once I was convinced about the clinical benefits, I started prescribing fasting. Also it’s important to say here that I have personally never fasted for religious or spiritual reasons but this logic made me embrace fasting for myself as well!! The fasting prescription differs from patient to patient. That is why when using it for Diabetes, it has to be medically supervised.
THRIIVE: I read somewhere that diabetics must eat the same amount and kind of food at the same time every day to keep the blood sugar stable. Also, diabetics are advised that fasting could be dangerous for them. If those statements are true, IF contradicts them so how can it still be beneficial for diabetics?
DR. ROSHANI SANGHANI: You are right in observing this contradiction. Patients who are given medication that INCREASE insulin, cannot fast without medical supervision because they are at risk of low blood sugar. The biggest misunderstanding is that people think the low blood sugar is happening because of Diabetes. It is not. The low blood sugar is happening because of the type of PRESCRIPTION that has been given. That is exactly why I don’t use the medications that make it dangerous to change lifestyle!
THRIIVE: How can the diabetic person get started with fasting?
DR. ROSHANI SANGHANI: To increase our patients’ chance of success we look at many factors simultaneously. An airplane can’t be flown safely by just making sure the windows are okay. The brakes, the fuel, the engine and all aspects of the aircraft have to be checked for flight-worthiness to ensure safe takeoff and landing. So, we first get patients started with a low carbohydrate diet all through the week. No particular food is banned or off limits but we encourage the patients to realize how certain foods affect their blood sugar levels. This means they need to start checking levels with a personal glucometer. A lot of patients have a phobia of needles and would prefer to just go to the lab and supply a sample to check fasting and PP blood sugar levels. This is not enough because we need the patient to directly understand how various aspects of their lifestyle are affecting the sugar levels on a day-to-day, moment to moment basis.
THRIIVE: Can IF help prevent diabetes in those who are pre-diabetic? How?
DR. ROSHANI SANGHANI: We have to understand that Diabetes and pre-Diabetes start initially as insulin resistance. In simple words, you don’t start off with high blood sugar. First, the lifestyle that promotes Type 2 Diabetes starts putting a high carbohydrate load on the system, and maybe there is additional family history, stress, lack of exercise and/or poor sleep. All this makes our insulin less effective at keeping blood sugar levels normal. So the body needs to circulate higher insulin levels to keep the blood sugar levels normal.
It’s time for us to increase our understanding of diabetes at the root: the first step in the disease is your body is forced into making too much insulin to cope with the lifestyle. That’s why intermittent fasting is an excellent way to reverse pre-diabetes because it lowers insulin.
Dr. Roshani Sanghani is an American board certified Endocrinologist. After practicing in Chicago for two years she relocated to Mumbai with her husband and two daughters to be closer to family. After a 4-year stint at Hinduja Hospital she left to start her own center for a holistic approach to diabetes and other hormone related conditions like obesity, PCOS and thyroid imbalance. Her goal is to help her patients reverse their medical conditions through a holistic lifestyle & lead by example by living a low carb fit lifestyle despite being a busy working parent.
To know more about her, visit www.aasaanhealth.com