A Six-Week Follow-Up Study on the Sustained Effects of Prolonged Water-Only Fasting and Refeeding on Markers of Cardiometabolic Risk

(1) Background: Chronic inflammation and insulin resistance are associated with cardiometabolic diseases, such as cardiovascular disease, type 2 diabetes mellitus, and non-alcoholic fatty liver disease. Therapeutic water-only fasting and whole-plant-food refeeding was previously shown to improve mar...

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Published in:	Nutrients 2022-10, Vol.14 (20), p.4313
Main Authors:	Gabriel, Sahmla, Ncube, Mackson, Zeiler, Evelyn, Thompson, Natasha, Karlsen, Micaela C, Goldman, David M, Glavas, Zrinka, Beauchesne, Andrew, Scharf, Eugene, Goldhamer, Alan C, Myers, Toshia R
Format:	Article
Language:	eng
Subjects:	Biological markers Blood lipids Blood pressure Body mass Body mass index Body size Body weight C-reactive protein Calories cardiometabolic health Cardiovascular diseases Cholesterol Complications and side effects Control Development and progression Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diet Diet therapy Disease Electrolytes Fasting Fatty liver Food Fruits Glucose Health aspects Health risks Health services hyperlipidemia Hypertension Insulin Insulin resistance Lipids Liver Liver diseases Low density lipoprotein Low density lipoproteins Markers Medical personnel Medicine, Preventive Metabolism Methods Obesity Onsite Overweight Physiological aspects Prevention Preventive health services prolonged fasting Quality of life Rheumatism Risk Risk factors Triglycerides Type 2 diabetes Vegetables Vegetarianism Vital signs water-only fasting
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Summary:	(1) Background: Chronic inflammation and insulin resistance are associated with cardiometabolic diseases, such as cardiovascular disease, type 2 diabetes mellitus, and non-alcoholic fatty liver disease. Therapeutic water-only fasting and whole-plant-food refeeding was previously shown to improve markers of cardiometabolic risk and may be an effective preventative treatment but sustained outcomes are unknown. We conducted a single-arm, open-label, observational study with a six-week post-treatment follow-up visit to assess the effects of water-only fasting and refeeding on markers of cardiometabolic risk. (2) Methods: Patients who had voluntarily elected and were approved to complete a water-only fast were recruited from a single-center residential medical facility. The primary endpoint was to describe changes to Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) scores between the end-of-refeed visit and the six-week follow-up visit. Additionally, we report on changes in anthropometric measures, blood lipids, high-sensitivity C-reactive protein (hsCRP), and fatty liver index (FLI). Observations were made at baseline, end-of-fast (EOF), end-of-refeed (EOR), and six-week follow-up (FU). (3) Results: The study enrolled 40 overweight/obese non-diabetic participants, of which 33 completed the full study protocol. Median fasting, refeeding, and follow-up lengths were 14, 6, and 45 days, respectively. At the FU visit, body weight (BW), body mass index (BMI), abdominal circumference (AC), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein (LDL), hsCRP, and FLI were significantly decreased from baseline. Triglycerides (TG) and HOMA-IR scores, which had increased at EOR, returned to baseline values at the FU visit. (4) Conclusion: Water-only fasting and whole-plant-food refeeding demonstrate potential for long-term improvements in markers of cardiovascular risk including BW, BMI, AC, SBP, DBP, blood lipids, FLI, and hsCRP.
ISSN:	2072-6643 2072-6643