In Orthodox Christianity, there are four Great Lent periods during the year, plus Mondays and Fridays each week (with the exception of a few weeks when these days are also open).
In total, fasting Christians spend approximately 180-200 days a year fasting.
The main principle of Orthodox fasting is abstinence.
In terms of nutrition, this includes: banning meat, dairy products, eggs, and on some days, fish from the diet.
Changes in diet
According to the rules of fasting, the main components of the diet remain: vegetables, legumes, cereals, nuts, seeds, and fruits.
These products are rich in complex carbohydrates and fiber and are free of saturated fat.
In general, Orthodox Christian fasting is a dietary pattern that is lower in refined carbohydrates and higher in complex carbohydrates and fiber, which is a contributing factor to: improving human health, preventing metabolic disorders, and chronic diseases.
While observing the fast perfectly, fasting people also avoid desserts and other particularly delicious foods, which also reduces the amount of simple carbohydrates in their diet.
General impact on health
Based on the analysis of the results of several dozen studies, fasting has shown positive effects on glucose and lipid control reduction of insulin resistance. The data on arterial hypertension have not been fully clarified. However, some small studies have shown improvements in this regard as well.
The impact also extends to body weight control. People who fasted reported a lower caloric intake and a reduced body mass index after the fast.
Fasting also has a positive effect on mental health. Interestingly, according to research, most monks are distinguished by a high quality of life and good mental health.
Providing macro and micronutrients
How does the consumption of different food groups change during fasting:
Carbohydrates – consumption increases due to an increase in complex carbohydrates and fiber (cereals, vegetables, fruits).
Fats – Consumption is decreasing mainly due to a reduction in saturated animal fats. Healthier sources of unsaturated fats (nuts, vegetable oils) remain in the diet.
Protein – consumption is decreasing, but despite this, studies have not found a deficiency of essential amino acids. In all cases, it is important to include sufficient amounts of permitted protein sources in the diet (legumes, nuts, mushrooms, plant-based milk, fish and seafood – when permitted).
Consumption of vitamins and minerals:
Iron – Consumption remains adequate and there are fewer cases of deficiency developing as a result of fasting.
Folate – Consumption remains adequate or may even increase.
Magnesium – consumption is increasing.
Calcium – Consumption is decreasing due to the ban on dairy products. Deficiencies may occur, although this usually does not affect bone metabolism and mineral density.
Due to the reduced consumption of vitamins B2 and B12, a decrease in their concentration in the blood may be observed, especially in those who were already deficient in these microelements before the start of the fast. Therefore, caution is required in this regard.
Fasting and diabetes
The general effects described obviously apply even in the setting of a diagnosis of diabetes.
More specifically, in relation to diabetes:
- Fasting improves the body's sensitivity to insulin by reducing insulin resistance;
- Reduces body mass index;
- Reduces cholesterol levels;
- It has the potential to reduce fasting blood glucose levels and glycosylated hemoglobin levels.
However, this is where attention and caution are needed so that these processes do not cause a sharp drop in blood sugar – Hypoglycemia.
And after the fast ends, there is a high risk that returning to the diet of the desired foods will lead to overeating and, as a result, an increase in blood glucose levels - hyperglycemia.
Recommendations to reduce risks:
Frequent self-monitoring of glycemia is necessary – the issue of continuing fasting should be reconsidered if hypoglycemia is detected – blood sugar level <70 mg/dL (3.8 mmol/L); or severe hyperglycemia – blood sugar level <300 mg/dL (16.6 mmol/L).
To prevent hypoglycemia – If the dietary regimen changes dramatically during fasting, especially its carbohydrate component, it may be necessary to change the dosage of prescribed medications, of course, with the involvement of the attending physician. Particular attention is required if this medication is insulin or a representative of the sulfanylurea group (which enhances the secretion of its own insulin by the pancreas).
To prevent hyperglycemia – after the fast is over, it is important to slowly reintroduce foods into the diet, paying attention to and continuing to consume fiber and healthy fats.
To prevent protein deficiency, plant sources of protein should be included in the diet in sufficient quantities - legumes (beans, peas, soybeans, lentils, etc.), nuts, seeds, mushrooms, plant-based milk (almond, coconut, soy).
To prevent vitamin and mineral deficiencies – Before starting the fast, attention should be paid to ensuring adequate calcium and vitamin B12 levels in the body. Especially if you are prescribed metformin, long-term use of which is already associated with vitamin B12 deficiency.
If necessary, the Church has allowed dietary restrictions to be relaxed as an exception for various diseases, including Even with diabetes. For example, in such cases, dairy products should be used.
Author: Elga Giorgadze (MD of Endocrinology)
Sources used:
https://pmc.ncbi.nlm.nih.gov; https://www.diabetes.org.uk; https://www.sciencedirect.com; https://www.holyorthodox.org; https://www.mdpi.com; https://www.researchgate.net; https://diabetesjournals.org
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