Eleanor Hayward – Health Editor at the Times reports – fasting diet ‘beats medicine’ for diabetes

She writes to say that research suggests that “The 5:2 intermittent fasting diet” made popular by Dr Michael Mosley is better than medication at treating type 2 diabetes,

In a clinical trial of 400 obese adults, those on the fasting programme lost twice as much weight and experienced greater improvement in blood sugar control as patients given standard diabetes drugs.

The diet involves restricting food intake to 500-600 calories on two days a week, while eating normally on the other five. It was popularised by Mosley, the TV doctor who died recently aged 67, after going missing while walking on the Greek island of Symi.

Mosley was diagnosed with type 2 diabetes in 2012, and credited the 5:2 diet with reversing his condition. He later wrote a bestselling book about the benefits. However, since then other studies have failed to back up his claims.

The latest study vindicates his work and provides the strongest evidence yet that the 5:2 diet is an effective treatment option for type 2 diabetes in its early stages. It involved 405 participants who had been newly diagnosed with type 2 diabetes, with an average age of 46. They were randomly divided into three groups: the first were put on the 5:2 diet, while the second group took the diabetes drug metformin, and the third took empagliflozin, a different diabetes medication.

Over four months, the participants in the 5:2 group saw “significantly greater” reductions in blood sugar levels than patients on the drugs. They also lost 10kg (22lb) on average, compared with 6kg (13lb) for those put on the medication. The 5:2 group also had the greatest reduction in blood fat levels, cholesterol and blood pressure.

The study was led by a team at the Chinese Academy of Medical Sciences in Beijing, and involved Chinese adults, who had not yet started medication for diabetes. It was published in Jama Network Open. Dr Liin Guo, the lead author, wrote that the 5:2 diet may “serve as an effective initial lifestyle intervention instead of anti-diabetic drugs for early-stage type 2 diabetes”.

More than four million people in Britain have type 2 diabetes, with cases doubling in the past two decades as a result of soaring obesity, meaning new treatment options are needed.

Guo added that the 16-week 5:2 programme could “serve as an initial lifestyle intervention for patients with type 2 diabetes, providing an alternative to the use of metformin and empagliflozin medication”. More than 25 million NHS prescriptions were issued for metformin last year, and it is the most commonly prescribed diabetes drug.

Experts cautioned that longer-term studies were needed. Naveed Sattar, professor of cardiometabolic medicine at the University of Glasgow, said: “This trial is relatively simple and shows what we already know: that weight excess is the key driver for diabetes and thus weight loss improves glucose levels meaningfully. The issue is whether such changes and the 5:2 diets are sustainable, especially as the trial was shortterm — six months long — with greater than expected weight losses in all three arms, based on existing literature.”