Modified Alternate Day Fasting

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Fasting is a great way to reduce insulin levels

The information in this blog is not medical advice. Before making any changes to your diet, consult with a health care professional.

I was 7 months into my keto journey, when I first considered to add fasting to my keto routine. Initially I was able to reduce exogenous insulin, but had to slowly increase back to 50 units, as my glucose levels kept climbing. Then bounced between 40 and 50 units without progress.

I was kind of OK with that, because I didn't know anything about hyperinsulinemia and the involved health risks.


Did you know that a Type 2 diabetic with excellent control and a healthy A1c is still at risk for diabetic complications, when they are controlled with insulin, insulin stimulating drugs and drugs that trick the body to be more accepting of insulin? The risk is reduced, but delaying the onset or slowing the progression is simply not good enough.

Study links:

The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus

Insulin use and increased risk of mortality in type 2 diabetes: a cohort study

Insulin: too much of a good thing is bad

If I couldn't get off insulin, I would continue to suffer from hyperinsulinemia and the accompanying health risks. Dr. Ken Berry MD and Dr. Ben Bikman PhD discuss the risks of hyperinsulinemia (insulin resistance).

Hyperinsulinemia Risks: Dr.s Bikman & Berry Discuss (Insulin Resistance)

When I learned that a stellar A1c would not protect me from diabetic complications, I was frustrated and disappointed. All the work I had put in the previous 7 months seemed to be for nothing. I thought I was battling an unwinnable war. How would I ever be able to get off insulin, if keto alone didn't do the trick?

Dr. Jason Fung MD to the rescue

That's when I found Dr. Jason Fung. He explained fasting, how it works and how it is not starving.

At the beginning of my keto journey, I saw many people writing about fasting and how awesome it was. I honestly thought these people were crazy. I enjoyed eating way too much to even consider skipping meals or going days without eating. I thought I would be starving myself.

But that changed when I came across a video series by Dr. Jason Fung MD. He is a nephrologist based in Toronto. He now runs a successful weight loss clinic.

The videos on "The Aetiology of Obesity" are a six-part series, about 1 hour each, worth watching every minute.

Dr. Jason Fung Diabetes - The Obesity Code Lecture (Why do we get Fat?) Part 1

Dr. Jason Fung Diabetes - Hormones in Weight Loss (The Obesity Code Lecture part 2)

Dr. Jason Fung Diabetes - Reversing Insulin Resistance (The Obesity Code Lecture part 3)

Dr. Jason Fung Diabetes - Fructose and Fasting (The Obesity Code Lecture 4)

Dr. Jason Fung Diabetes - Diet and Disease (The Obesity Code Lecture part 5)

Dr. Jason Fung Diabetes - Is Saturated Fat Bad? (Science says... No!) Obesity Code Lecture 6

The information in these videos convinced me to give daily intermittent fasting a try. I started with 16:8. That is 16 hour fasting window followed by an 8 hour feeding window. I ate my first meal at 1 PM, dinner at 6 PM, and a snack at 9 PM. It wasn't really a snack, but a mix of ACV, magnesium and MCT oil.

If you think 16 hours fasting is too hard, it's not. It is actually just skipping breakfast. Most of the 16 hours happen while sleeping.

Amazingly it took only 2 weeks or intermittent fasting to get completely off insulin. During that time I wore a Libre and had constant feedback on how my glucose levels were doing.

  • 14.05.2020: 40 units - start intermittent fasting
  • 16.05.2020: 35 units
  • 18.05.2020: 30 units
  • 21.05.2020: 25 units
  • 22.05.2020: 20 units
  • 23.05.2020: 15 units
  • 24.05.2020: 10 units
  • 26.05.2020: 5 units
  • 27.05.2020: 0 off insulin
  • 28.06.2020: off Metformin
Type 2 diabetes successfully reversed

I had reversed my Type 2 diabetes. I was off all diabetes medication and my A1c kept stable ate 5.2 for the year to follow. My last A1c was 4.8.

It turns out T2D is not chronic progressive. It can be reversed. This may not work for everyone, but adding insulin to a disease marked by high insulin is just the wrong approach.

What have I learned from doing IF?

T2 diabetics do not need 6 meals per day to keep their glucose levels stable. Eating every 2 to 3 hours is a sure way to keep insulin levels elevated and crush any possibility of improvement.

I also became aware that advice given by diabetes organizations do nothing to improve the health of diabetics. They actually do quite the opposite.

This video by Dr. Sarah Hallberg MD explains why.

Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU

Going back to ADF - alternate day fasting

ADF in a nutshell: eat one day, don't eat the next day and so forth.

I tried ADF in July of 2020 and almost passed out after a week. While I was getting plenty of electrolytes on my eating days, I drank too much water on my fasting days without supplementing electrolytes.

It seems I am very sensitive to a lack of electrolytes. Out of the blue, my blood pressure dropped and I had to lie down so I wouldn't pass out. Until a week ago I never considered ADF again.

This changed when I heard about "modified" ADF. The modification means eating up to 500 calories on fasting days. Of course the food still has to be keto compliant.

The idea is to mimic fasting. Some good options are lean chicken, eggs, protein sparing bread. I will try Maria Emmerich's bread recipe too.

How did modified ADF affect me?

Initially I lost all the water weight from eating too many keto treats over the Christmas break. I dropped 3 pounds after the first fasting day, gained 1 the following feeding day, dropped another 2 pounds. Gained and dropped again. In total the weight is trending down. Which makes me very happy.

Sustainable changes

Any dietary changes we make should be sustainable long-term. A drastic calorie restriction may fire back, when the basic metabolic rate drops making further weight loss difficult if not impossible.

Many of us deal with food addictions and obsessive thoughts about food. The great thing about ADF is, whatever food I think of (keto compliant) isn't off the menu. I just have to delay it by a day. So yes, this is sustainable.

Odd side effect. I really loved my keto treats over the Christmas break. A little too much to be honest, and I had a hard time breaking that habit again. With this modified ADF, my sweet cravings disappeared just like that.

Tweaking my diet every now and then has made me more in tune with my body. I am getting better at listening to my body's cues. I am learning the difference between hunger, cravings, and my brain just trying to trick me into eating what I shouldn't.

To read more about modified ADF and our group challenge, join our Facebook group.

Final thought: There is no one solution that fits everyone. That is why I love keto and fasting. The options are endless.

Written by Roxana Soetebeer
Published: January 22th, 2022


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