At the KAHN CENTER, we have used the Fasting Mimicking Diet (FMD or PROLON) since its release in 2017 to assist patients with optimal health. Subsequently, programs for type 2 diabetics (T2D) have been available from the maker, L-Nutra, and we have referred patients who have had successful experiences with a monthly 5 day FMD.
An
new study sought to evaluate the effects of a monthly 5-dayFMD for 1 year on left ventricular (LV) geometry and function in individuals with T2D using advanced cardiac imaging with MRI technology.
STUDY
This analysis of the prospective Fasting In diabetes Treatment trial included individuals with T2D randomized to monthly 5-day FMD or usual care for 12 months (November 2018−July 2020). MRI (3.0 T) was performed at baseline, 6 months, and 12 months. LV geometry and systolic function were assessed from two-dimensional cine images, and diastolic function was assessed from four-dimensional flow MRI. Intention-to-treat linear mixed models and linear regression were used to evaluate treatment effects and LV-metabolic associations.
RESULTS
A total of 82 participants (mean age, 63 years; 43 female) were included.
FMD reduced LV mass at 6 months but not at 12 months. End-diastolic volume remained stable in the FMD group versus controls.
Both the early-to-late peak filling ratio and the mitral annular early peak velocity increased at 12 months.
∆E/A was positively associated with change in hemoglobin A1c (HbA1c) level.
CONCLUSIONS
The 5 Day FMD positively influenced cardiac diastolic function (relaxation phase) by increasing E/A and Ea in participants with T2D.
E/A improvements were associated with reduced HbA1c levels.
Patients with T2D are at increased for congestive heart failure including the common "diastolic" heart failure also known as HFpEF (heart failure with preserved ejection fraction). This study suggestes that a monthly 5 day FMD may be of value in preserving more optimal diastolic function over the course of a year.
At the KAHN CENTER, we will continue to recommend the 5 day FMD (PROLON) to our patients and refer to the diabetic reversal program monitored by L-Nutra Health.
■ In a secondary analysis of a randomized controlled trial in 100 participants with type 2 diabetes, a monthly 5-day fasting-mimicking diet (FMD) improved the early-to-late ventricular filling velocity ratio (E/A) (P = .02) and mitral annular early peak velocity (P = .04) at 12 months.
■ The FMD stabilized the end-diastolic volume at 12 months (P = .045).
■ Improvements in E/A were positively associated with better glycemic control (standardized β = 0.47, P = .01).
