Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects

Only few studies document longer periods of fasting in large cohorts including non-obese participants. The aim of this study was to document prospectively the safety and any changes in basic health and well-being indicators during Buchinger periodic fasting within a specialised clinic. In a one-year...

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Published in:	PloS one Vol. 14; no. 1; p. e0209353
Main Authors:	Wilhelmi de Toledo, Françoise, Grundler, Franziska, Bergouignan, Audrey, Drinda, Stefan, Michalsen, Andreas
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 02.01.2019 Public Library of Science (PLoS)
Subjects:	Adolescent Adult Aged Aged, 80 and over Aging Biology and Life Sciences Biomarkers - blood Blood Cell Count Blood Coagulation Blood Glucose - metabolism Blood Pressure Brain research Cardiovascular diseases Clinical trials Cohort Studies Electrolytes - blood Emotions Energy intake Fasting Fasting - adverse effects Fasting - blood Fasting - physiology Feasibility studies Female Free radicals Gene expression Health aspects Health Promotion - methods Health risks Humans Hunger Inflammation Mediators - blood Integrative medicine Ketone Bodies - urine Ketones Kidney - physiology Laboratory testing Lipids Lipids - blood Liver - enzymology Male Medicine Medicine and Health Sciences Metabolism Middle Aged Nutrition research Obesity Observational studies Oxidative stress Parameters Physical Sciences Prospective Studies Risk analysis Risk factors Safety Side effects Social Sciences Time Factors Uric acid Waist Circumference Weight Loss Weight reduction Well being Young Adult France United States > US Colorado Germany
ISSN:	1932-6203, 1932-6203
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Abstract	Only few studies document longer periods of fasting in large cohorts including non-obese participants. The aim of this study was to document prospectively the safety and any changes in basic health and well-being indicators during Buchinger periodic fasting within a specialised clinic. In a one-year observational study 1422 subjects participated in a fasting program consisting of fasting periods of between 4 and 21 days. Subjects were grouped in fasting period lengths of 5, 10, 15 and 20±2 days. The participants fasted according to the Buchinger guidelines with a daily caloric intake of 200-250 kcal accompanied by a moderate-intensity lifestyle program. Clinical parameters as well as adverse effects and well-being were documented daily. Blood examinations before and at the end of the fasting period complemented the pre-post analysis using mixed-effects linear models. Significant reductions in weight, abdominal circumference and blood pressure were observed in the whole group (each p<0.001). A beneficial modulating effect of fasting on blood lipids, glucoregulation and further general health-related blood parameters was shown. In all groups, fasting led to a decrease in blood glucose levels to low norm range and to an increase in ketone bodies levels (each p<0.001), documenting the metabolic switch. An increase in physical and emotional well-being (each p<0.001) and an absence of hunger feeling in 93.2% of the subjects supported the feasibility of prolonged fasting. Among the 404 subjects with pre-existing health-complaints, 341 (84.4%) reported an improvement. Adverse effects were reported in less than 1% of the participants. The results from 1422 subjects showed for the first time that Buchinger periodic fasting lasting from 4 to 21 days is safe and well tolerated. It led to enhancement of emotional and physical well-being and improvements in relevant cardiovascular and general risk factors, as well as subjective health complaints.
AbstractList	Only few studies document longer periods of fasting in large cohorts including non-obese participants. The aim of this study was to document prospectively the safety and any changes in basic health and well-being indicators during Buchinger periodic fasting within a specialised clinic. In a one-year observational study 1422 subjects participated in a fasting program consisting of fasting periods of between 4 and 21 days. Subjects were grouped in fasting period lengths of 5, 10, 15 and 20±2 days. The participants fasted according to the Buchinger guidelines with a daily caloric intake of 200–250 kcal accompanied by a moderate-intensity lifestyle program. Clinical parameters as well as adverse effects and well-being were documented daily. Blood examinations before and at the end of the fasting period complemented the pre-post analysis using mixed-effects linear models. Significant reductions in weight, abdominal circumference and blood pressure were observed in the whole group (each p<0.001). A beneficial modulating effect of fasting on blood lipids, glucoregulation and further general health-related blood parameters was shown. In all groups, fasting led to a decrease in blood glucose levels to low norm range and to an increase in ketone bodies levels (each p<0.001), documenting the metabolic switch. An increase in physical and emotional well-being (each p<0.001) and an absence of hunger feeling in 93.2% of the subjects supported the feasibility of prolonged fasting. Among the 404 subjects with pre-existing health-complaints, 341 (84.4%) reported an improvement. Adverse effects were reported in less than 1% of the participants. The results from 1422 subjects showed for the first time that Buchinger periodic fasting lasting from 4 to 21 days is safe and well tolerated. It led to enhancement of emotional and physical well-being and improvements in relevant cardiovascular and general risk factors, as well as subjective health complaints. Only few studies document longer periods of fasting in large cohorts including non-obese participants. The aim of this study was to document prospectively the safety and any changes in basic health and well-being indicators during Buchinger periodic fasting within a specialised clinic. In a one-year observational study 1422 subjects participated in a fasting program consisting of fasting periods of between 4 and 21 days. Subjects were grouped in fasting period lengths of 5, 10, 15 and 20±2 days. The participants fasted according to the Buchinger guidelines with a daily caloric intake of 200-250 kcal accompanied by a moderate-intensity lifestyle program. Clinical parameters as well as adverse effects and well-being were documented daily. Blood examinations before and at the end of the fasting period complemented the pre-post analysis using mixed-effects linear models. Significant reductions in weight, abdominal circumference and blood pressure were observed in the whole group (each p<0.001). A beneficial modulating effect of fasting on blood lipids, glucoregulation and further general health-related blood parameters was shown. In all groups, fasting led to a decrease in blood glucose levels to low norm range and to an increase in ketone bodies levels (each p<0.001), documenting the metabolic switch. An increase in physical and emotional well-being (each p<0.001) and an absence of hunger feeling in 93.2% of the subjects supported the feasibility of prolonged fasting. Among the 404 subjects with pre-existing health-complaints, 341 (84.4%) reported an improvement. Adverse effects were reported in less than 1% of the participants. The results from 1422 subjects showed for the first time that Buchinger periodic fasting lasting from 4 to 21 days is safe and well tolerated. It led to enhancement of emotional and physical well-being and improvements in relevant cardiovascular and general risk factors, as well as subjective health complaints.Only few studies document longer periods of fasting in large cohorts including non-obese participants. The aim of this study was to document prospectively the safety and any changes in basic health and well-being indicators during Buchinger periodic fasting within a specialised clinic. In a one-year observational study 1422 subjects participated in a fasting program consisting of fasting periods of between 4 and 21 days. Subjects were grouped in fasting period lengths of 5, 10, 15 and 20±2 days. The participants fasted according to the Buchinger guidelines with a daily caloric intake of 200-250 kcal accompanied by a moderate-intensity lifestyle program. Clinical parameters as well as adverse effects and well-being were documented daily. Blood examinations before and at the end of the fasting period complemented the pre-post analysis using mixed-effects linear models. Significant reductions in weight, abdominal circumference and blood pressure were observed in the whole group (each p<0.001). A beneficial modulating effect of fasting on blood lipids, glucoregulation and further general health-related blood parameters was shown. In all groups, fasting led to a decrease in blood glucose levels to low norm range and to an increase in ketone bodies levels (each p<0.001), documenting the metabolic switch. An increase in physical and emotional well-being (each p<0.001) and an absence of hunger feeling in 93.2% of the subjects supported the feasibility of prolonged fasting. Among the 404 subjects with pre-existing health-complaints, 341 (84.4%) reported an improvement. Adverse effects were reported in less than 1% of the participants. The results from 1422 subjects showed for the first time that Buchinger periodic fasting lasting from 4 to 21 days is safe and well tolerated. It led to enhancement of emotional and physical well-being and improvements in relevant cardiovascular and general risk factors, as well as subjective health complaints.
Audience	Academic
Author	Michalsen, Andreas Drinda, Stefan Grundler, Franziska Wilhelmi de Toledo, Françoise Bergouignan, Audrey
AuthorAffiliation	2 Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany 7 Institute of Social Medicine, Epidemiology and Health Economics, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany 6 UMR 7178 Centre National de la Recherche Scientifique (CNRS), Strasbourg, France 1 Buchinger Wilhelmi Clinic, Überlingen, Germany 3 Division of Endocrinology, Metabolism, and Diabetes and Anschutz Health and Wellness Center, University of Colorado, School of Medicine, Aurora, Colorado, United States of America Università degli Studi di Milano, ITALY 4 Division of Geriatric Medicine, University of Colorado, School of Medicine, Aurora, Colorado, United States of America 8 Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany 5 Institut Pluridisciplinaire Hubert Curien,
AuthorAffiliation_xml	– name: 2 Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany – name: 4 Division of Geriatric Medicine, University of Colorado, School of Medicine, Aurora, Colorado, United States of America – name: Università degli Studi di Milano, ITALY – name: 3 Division of Endocrinology, Metabolism, and Diabetes and Anschutz Health and Wellness Center, University of Colorado, School of Medicine, Aurora, Colorado, United States of America – name: 7 Institute of Social Medicine, Epidemiology and Health Economics, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany – name: 1 Buchinger Wilhelmi Clinic, Überlingen, Germany – name: 6 UMR 7178 Centre National de la Recherche Scientifique (CNRS), Strasbourg, France – name: 8 Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany – name: 5 Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, CNRS, Strasbourg, France
Author_xml	– sequence: 1 givenname: Françoise orcidid: 0000-0002-4578-5812 surname: Wilhelmi de Toledo fullname: Wilhelmi de Toledo, Françoise – sequence: 2 givenname: Franziska surname: Grundler fullname: Grundler, Franziska – sequence: 3 givenname: Audrey surname: Bergouignan fullname: Bergouignan, Audrey – sequence: 4 givenname: Stefan surname: Drinda fullname: Drinda, Stefan – sequence: 5 givenname: Andreas surname: Michalsen fullname: Michalsen, Andreas
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/30601864$$D View this record in MEDLINE/PubMed
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Copyright	COPYRIGHT 2019 Public Library of Science 2019 Wilhelmi de Toledo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2019 Wilhelmi de Toledo et al 2019 Wilhelmi de Toledo et al
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DocumentTitleAlternate	Safety, health and well-being during periodic fasting
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Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 ObjectType-Undefined-3 Competing Interests: FWT is member of the Directory Board of the Buchinger Wilhelmi Clinic (BWC), where the study was performed. As managing director of Amplius GmbH, FWT executes the scientific leadership at BWC. Amplius GmbH is a company that conceives, coordinates and develops fasting research on behalf of BWC. FG is currently employed, and SD was formerly employed, at BWC. AM is a consultant at BWC and receives financial compensation for this role from Amplius GmbH. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.
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Snippet	Only few studies document longer periods of fasting in large cohorts including non-obese participants. The aim of this study was to document prospectively the...
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SubjectTerms	Adolescent Adult Aged Aged, 80 and over Aging Biology and Life Sciences Biomarkers - blood Blood Cell Count Blood Coagulation Blood Glucose - metabolism Blood Pressure Brain research Cardiovascular diseases Clinical trials Cohort Studies Electrolytes - blood Emotions Energy intake Fasting Fasting - adverse effects Fasting - blood Fasting - physiology Feasibility studies Female Free radicals Gene expression Health aspects Health Promotion - methods Health risks Humans Hunger Inflammation Mediators - blood Integrative medicine Ketone Bodies - urine Ketones Kidney - physiology Laboratory testing Lipids Lipids - blood Liver - enzymology Male Medicine Medicine and Health Sciences Metabolism Middle Aged Nutrition research Obesity Observational studies Oxidative stress Parameters Physical Sciences Prospective Studies Risk analysis Risk factors Safety Side effects Social Sciences Time Factors Uric acid Waist Circumference Weight Loss Weight reduction Well being Young Adult
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Title	Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects
URI	https://www.ncbi.nlm.nih.gov/pubmed/30601864 https://www.proquest.com/docview/2162764103 https://www.proquest.com/docview/2163010814 https://pubmed.ncbi.nlm.nih.gov/PMC6314618 https://doaj.org/article/c2d007a21efa419baee05424256c0cce http://dx.doi.org/10.1371/journal.pone.0209353
Volume	14
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