Non-pharmaceutical approach to lowering hemoglobin A1c using time-restricted eating | Ruth Patterson

[Rhonda]: A couple of points that you mentioned,
I just want to circle back to the glycated hemoglobin you mentioned, that basically fasting
in the evening had a pretty robust effect in reducing that. [Ruth]: Yeah. [Rhonda]: And that’s a marker obviously, it’s
a marker of your long-term, you know, blood glucose levels. [Ruth]: Absolutely, they use that to approve
diabetes drugs. You know, if a diabetes drug reduces hemoglobin
A1C, that’s how it gets approved. So it’s a pretty powerful marker of risk. [Rhonda]: So we’re talking about, for example,
metformin… [Ruth]: Yes. [Rhonda]: which is a very… [Ruth]: Any diabetes drugs has to move hemoglobin
A1C down a certain amount before it can be approved. So if we can do this with a non-pharmacologic
approach, just rechanging when you stop eating and the fasting interval, I mean, that’s pretty
exciting. [Rhonda]: It’s in the brain. [Ruth]: Yeah. [Rhonda]: Yeah. [Ruth]: It’s really exciting because the truth
is all these drugs have side effects, they’re not that pleasant to take. A lot of people simply discontinue them on
their own. You know, so pills aren’t necessarily always
the answer, and this offers people a lifestyle choice. [Rhonda]: And you mentioned that you’re…there
were women that were involved that you had basically…they made changes, they started
fasting in the evening and they also reduced their H1. [Ruth]: In our pilot studies, we were really
focused on the feasibility and acceptability of it. So we didn’t have any biomarkers, we were
testing, could they do it and how hard was it for people to do. [Rhonda]: Okay. [Ruth]: So that was really a test of…because
there’s no point in recommending something if people can’t do it. [Rhonda]: Right. [Ruth]: And that…so that’s what we really
focused on there, in our personal pilot work, is just could they do it. And truthfully, the vast…they almost all
did it and they also all said they would recommend it as an eating pattern to their friends,
so they would recommend the study, you know, which told us, okay, this is feasible and
this is acceptable. And, you know, that’s what we’re interested
in, is not, you know, if it works but it’s like impossible to do, then it’s not a valuable
public health intervention. [Rhonda]: Yeah. I was wondering, what I was trying to get
at is how quick or how soon do you think it could change… [Ruth]: Yeah. [Rhonda]: …those… [Ruth]: We don’t have data on that. [Rhonda]: …levels that would… [Ruth]: Right. [Rhonda]: …be very interesting to see… [Ruth]: Yeah. [Rhonda]: …if some of that can be moved
pretty quickly or, you know, if it takes longer. I don’t know how quick these other…like
metformin works. [Ruth]: Oh, yeah, most of them…the thing
about hemoglobin A1C is since it reflects average blood sugar over the past three months,
it takes about three months to move it. [Rhonda]: Okay. [Ruth]: Even with a really effective intervention,
it just…since it reflects the whole vast three months of cycling through, you have
to go whole three months to see it. [Rhonda]: Red blood cells to turn over. Yeah. [Ruth]:Yeah. [Rhonda]: Right, that makes sense. [Ruth]: Other markers may be faster, but the…you
know, because we already know that if you want to measure these markers, you want people
to be fasting. So we know just even one fast, one night’s
fast makes a difference, right? [Rhonda]: Right. [Ruth]: If you do one night’s fast, a lot
of these markers will be flatter in the morning than if somebody eats breakfast, right, before
they come in. You know, so you’re really…what you’re doing
is you’re extending the period of time where you have very low basal levels of a lot of
these markers. [Rhonda]: Right.


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