Dr. Amy Nett: I don’t think a calorie-restricted diet would trigger an autoimmune condition because if anything, calorie-restricted diets, right now, you’re looking at fasting mimicking diet, those are showing significant benefit in terms of lowering inflammation and allowing for stem cell regeneration. A 45-year-old, type 1 diabetes, I would probably … the other question is, did you check for type 1.5 diabetes, LADA, looking for the GAD65 autoantibody. I would be more suspicious of that in a 45-year-old with type 1.5 diabetes.
Again I haven’t seen type 1 diabetes diagnosed in an adult. That’s not impossible, but I don’t think that calorie restriction alone would be a trigger because whenever there’s autoimmune disease, you’re thinking, what is it that triggered the immune system? If you’re not eating, if you’re really calorie restricted, generally that’s going to be lowering inflammation. That’s going to be lowering or removing potential triggers. I don’t think calorie restriction alone could be a trigger. I would be thinking about other toxin exposures, whether he’s just at this point had an accumulation of mercury, other heavy metals, environmental toxins, but I would dig a lot more before trying to say, “Yes, it was just the calorie restriction,” because again, I think long-term calorie restriction has its downside. You have to have the refeeding in there. You have to have refeeding to allow that caloric restriction to be beneficial and get that stem cell generation. But I think for the most part, calorie restriction is probably a little bit healthier than our standard American approach to eating more frequently and more than we need.