www.njchiropractors.com I 19 associated with reductions in body weight, total cholesterol, triglycerides, glucose, insulin, interleukin 6 (IL-6), and TNF-, as well as with improvements in insulin sensitivity. Interestingly, positive health outcomes occurred despite the variable effects on weight loss.The long-term metabolic benefits associated with eating or not eating breakfast, or extending the nighttime fast until the lunch meal — are of great research and public interest. Satiety and appetite-regulating hormones and peptides were affected by prolonged morning fasting, but these alterations did not significantly affect calorie intake. In a six-week controlled trial, researchers observed no benefit with respect to weight change, glycemic control, lipids, or inflammatory markers for the group omitting the breakfast meal compared with the control group. Night time eating or not eating is another tool to consider. Data from the National Health and Nutrition Examina- tion Surveys (known as NHANES) have shown that each three-hour increase in nighttime fasting duration was associ- ated with significantly reduced odds of elevated HbA1c and significantly lower CRP concentrations in women who ate less than 30% of their daily calories after 5:00 pm. A published analysis of the nightly fasting interval in 2,337 breast cancer survivors in the Women’s Healthy Eating and Living (known as WHEL) Study indicated that cancer survivors who fasted less than 13 hours per night during seven years of follow up had an increased risk of recurrence. The same concept extends into prolonged, into the night, or night eating that we see in shift work. This is in part due to the circadian rhythm of insulin secretion and the insulin-impeding action of growth hormone, the pulsatile concentrations of which increase at night. Postprandial insulin and glucose responses to meals increase across the day and into the night. Thus, meals consumed at night are associated with greater postprandial glucose and insulin exposure than content-matched meals consumed during the day, leading to increased HbA1c levels and risk of Type 2 diabetes over time. Short-term intervention studies designed to mimic circadian rhythms in human participants have metabolic consequences. Inducing circadian misalignment in humans by extending the day from a 24-hour to a 28-hour cycle causes insulin resistance after only three cycles. So, fasting regimens also have the potential to foster modifiable health behaviors. A study in eight overweight young adults found that increasing the nightly fasting duration to 14 or more hours resulted in statistically significant decreases in energy intake and weight, as well as improvements in self-reported sleep satisfaction, satiety at bedtime, and energy levels. Modified fasting regimens appear to promote weight loss and may improve metabolic health. However, there are insufficient data to determine the optimal fasting regimen, including the length of the fasting interval, the number of fasting days per week, the degree of energy restriction needed on fasting days and recommendations for dietary behavior on non-fasting days. Which could potentially be successful with individual metabolic analysis for sustainable levels of deprivation. Fasting appears to have numerous beneficial effects, but that doesn’t mean it’s appropriate for everyone. Individuals with Type 2 diabetes can fast safely, but under medical supervision is advised. Individuals taking certain medications may be advised to avoid fasting or to be sure to work with their doctor to make any necessary adjustments to medications that are typically taken with food, or whose potency or pharmacology may be affected by fasting. Fasting is not recommended for women who are pregnant or breastfeeding, nor for adolescents in an active growth stage. It’s also not advised that anyone with an eating disorder or a history of eating disorder adopt a fasting practice. Another group of people for whom fasting is not recommended is the elderly, except under medical supervi- sion. Many older people are already are under-consuming protein. It wouldn’t be wise for an individual already experiencing sarcopenia or dynapenia to become even more protein-deficient or malnourished overall. As we know, some form of calorie restriction, especially in relation to sugar and starch-type foods, is a positive step for most for a metabolic upgrade. Because it is so impactful, it is prudent to tender with a clinical approach and some individual evaluation. Julianne Monica, DC, CNS, DCBCN, practices in Sea Girt with an emphasis on clinical nutrition with a functional, non-drug approach to manage chronic conditions and achieve optimal, meta- bolic status for her patients.