Fasten – ein potentes Therapeutikum der Moderne

Fasten als Therapie hat im letzten Jahrzehnt durch eine Fülle an Grundlagenstudien und experimentellen Arbeiten sowie zunehmende klinische Forschung seinen Einzug in die moderne Medizin gehalten. Es ist ein Verfahren mit jahrtausendealter Tradition und dadurch verschiedenartigen Durchführungsmöglichkeiten. Gemeinsam ist ihnen die Reduktion der täglichen Nahrungsaufnahme für begrenzte Zeit. Diese hat vielfältige Wirkungen auf Stoffwechsel, Zellen und Organsysteme, die es zu einem potenten Mittel im ärztlichen Handeln machen können.

Abstract

Therapeutic fasting has found its way into modern medicine in the last decade through a multitude of experimental work and animal studies as well as increasing clinical research. It is a procedure with a tradition dating back thousands of years and thus comes with a variety of different practices. What they all have in common, is the reduction of daily food intake for a limited period of time. This has a variety of effects on metabolism, cells and organ systems, which can make it a potent tool in medical practice.

Schlüsselwörter

Heilfasten - Prävention - prolongiertes Fasten - Langlebigkeit - Autophagie - Prolonged Fasting - Therapeutic Fasting - Prevention - Longevity - Autophagy

• Literatur

• 1 Wilhelmi de Toledo F, Grundler F, Bergouignan A. et al. Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects. PLoS One 2019; 14: e0209353
• 2 Wilhelmi de Toledo F, Buchinger A, Burggrabe H. et al. Fasting therapy – an expert panel update of the 2002 consensus guidelines. Forsch Komplementmed 2013; 20: 434-443
• 3 Gwinnutt JM, Wieczorek M, Balanescu A. et al. 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases. Ann Rheum Dis 2022;
• 4 Mobasheri N, Ghahremani L, Fallahzadeh Abarghooee E. et al. Lifestyle Intervention for Patients with Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial Based on the Theory of Planned Behavior. Biomed Res Int 2022; 2022: 3465980
• 5 Bradley T, Campbell E, Dray J. et al. Systematic review of lifestyle interventions to improve weight, physical activity and diet among people with a mental health condition. Syst Rev 2022; 11: 198
• 6 Ring RM, Eisenmann C, Kandil FI. et al. Mental and Behavioural Responses to Baha'i Fasting: Looking behind the Scenes of a Religiously Motivated Intermittent Fast Using a Mixed Methods Approach. Nutrients 2022; 14: 5
• 7 Hartmann AM, Dell’Oro M, Spoo M. et al. To eat or not to eat-an exploratory randomized controlled trial on fasting and plant-based diet in rheumatoid arthritis (NutriFaststudy). Front Nutr 2022; 9: 1030380
• 8 Muller H, de Toledo FW, Resch KL. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol 2001; 30: 1-10
• 9 Salvadori G, Mirisola MG, Longo VD. Intermittent and Periodic Fasting, Hormones, and Cancer Prevention. Cancers (Basel) 2021; 13: 4587
• 10 Alirezaei M, Kemball CC, Flynn CT. et al. Short-term fasting induces profound neuronal autophagy. Autophagy 2010; 6: 702-710
• 11 Eisenberg T, Abdellatif M, Schroeder S. et al. Cardioprotection and lifespan extension by the natural polyamine spermidine. Nat Med 2016; 22: 1428-1438
• 12 Hofer SJ, Carmona-Gutierrez D, Mueller MI. et al. The ups and downs of caloric restriction and fasting: from molecular effects to clinical application. EMBO Mol Med 2022; 14: e14418
• 13 Longo VD, Di Tano M, Mattson MP. et al. Intermittent and periodic fasting, longevity and disease. Nat Aging 2021; 1: 47-59
• 14 Cantó C, Jiang LQ, Deshmukh AS. et al. Interdependence of AMPK and SIRT1 for metabolic adaptation to fasting and exercise in skeletal muscle. Cell Metab 2010; 11: 213-219
• 15 Jalanka J, Salonen A, Salojärvi J. et al. Effects of bowel cleansing on the intestinal microbiota. Gut 2015; 64: 1562-1568
• 16 Zeb F, Wu X, Chen L. et al. Effect of time-restricted feeding on metabolic risk and circadian rhythm associated with gut microbiome in healthy males. Br J Nutr 2020; 123: 1216-1226
• 17 Di Francesco A, Di Germanio C, Bernier M. et al. A time to fast. Science 2018; 362: 770-775
• 18 Choi IY, Piccio L, Childress P. et al. A Diet Mimicking Fasting Promotes Regeneration and Reduces Autoimmunity and Multiple Sclerosis Symptoms. Cell Rep 2016; 15: 2136-2146
• 19 Varkaneh-Kord H, Tinsley GM, Santos HO. et al. The influence of fasting and energy-restricted diets on leptin and adiponectin levels in humans: A systematic review and meta-analysis. Clin Nutr 2021; 40: 1811-1821
• 20 Longo VD, Mattson MP. Fasting: molecular mechanisms and clinical applications. Cell Metab 2014; 19: 181-192
• 21 Vernieri C, Fucà G, Ligorio F. et al. Fasting-Mimicking Diet Is Safe and Reshapes Metabolism and Antitumor Immunity in Patients with Cancer. Cancer Discov 2022; 12: 90-107
• 22 Li C, Ostermann T, Hardt M. et al. Metabolic and psychological response to 7-day fasting in obese patients with and without metabolic syndrome. Forsch Komplementmed 2013; 20: 413-420
• 23 Finnell JS, Saul BC, Goldhamer AC. et al. Is fasting safe? A chart review of adverse events during medically supervised, water-only fasting. BMC Complement Altern Med 2018; 18: 67
• 24 Heyman SN, Bursztyn M, Szalat A. et al. Fasting-Induced Natriuresis and SGLT: A New Hypothesis for an Old Enigma. Front Endocrinol (Lausanne) 2020; 11: 217
• 25 Lee KW, Loh HC, Ching SM. et al. Effects of Vegetarian Diets on Blood Pressure Lowering: A Systematic Review with Meta-Analysis and Trial Sequential Analysis. Nutrients 2020; 12: 1604
• 26 Pettersen BJ, Anousheh R, Fan J. et al. Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2). Public Health Nutr 2012; 15: 1909-1916
• 27 Yokoyama Y, Nishimura K, Barnard ND. et al. Vegetarian diets and blood pressure: a meta-analysis. JAMA Intern Med 2014; 174: 577-587
• 28 Michalsen A, Li C. Fasting therapy for treating and preventing disease – current state of evidence. Forsch Komplementmed 2013; 20: 444-453
• 29 Grundler F, Mesnage R, Michalsen A. et al. Blood Pressure Changes in 1610 Subjects With and Without Antihypertensive Medication During Long-Term Fasting. J Am Heart Assoc 2020; 9: e018649
• 30 Maifeld A, Bartolomaeus H, Löber U. et al. Fasting alters the gut microbiome reducing blood pressure and body weight in metabolic syndrome patients. Nat Commun 2021; 12: 1970
• 31 Stange R, Pflugbeil C, Michalsen A. et al. Therapeutic fasting in patients with metabolic syndrome and impaired insulin resistance. Forsch Komplementmed 2013; 20: 421-426
• 32 Li C, Sadraie B, Steckhan N. et al. Effects of A One-week Fasting Therapy in Patients with Type-2 Diabetes Mellitus and Metabolic Syndrome – A Randomized Controlled Explorative Study. Exp Clin Endocrinol Diabetes 2017; 125: 618-624
• 33 Drinda S, Grundler F, Neumann T. et al. Effects of Periodic Fasting on Fatty Liver Index-A Prospective Observational Study. Nutrients 2019; 11: 2601
• 34 Horne BD, Muhlestein JB, Lappe DL. et al. Randomized cross-over trial of short-term water-only fasting: metabolic and cardiovascular consequences. Nutr Metab Cardiovasc Dis 2013; 23: 1050-1057
• 35 Varady KA, Cienfuegos S, Ezpeleta M. et al. Cardiometabolic Benefits of Intermittent Fasting. Annu Rev Nutr 2021; 41: 333-361
• 36 Snorek M, Hodyc D, Sedivy V. et al. Short-term fasting reduces the extent of myocardial infarction and incidence of reperfusion arrhythmias in rats. Physiol Res 2012; 61: 567-574
• 37 Kjeldsen-Kragh J, Haugen M, Borchgrevink CF. et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet 1991; 338: 899-902
• 38 Schmidt S, Stange R, Lischka E. et al. Uncontrolled clinical study of the efficacy of ambulant fasting in patients with osteoarthritis. Forsch Komplementmed 2010; 17: 87-94
• 39 Bahr LS, Bock M, Liebscher D. et al. Ketogenic diet and fasting diet as Nutritional Approaches in Multiple Sclerosis (NAMS): protocol of a randomized controlled study. Trials 2020; 21: 3
• 40 Rangan P, Choi I, Wei M. et al. Fasting-Mimicking Diet Modulates Microbiota and Promotes Intestinal Regeneration to Reduce Inflammatory Bowel Disease Pathology. Cell Rep 2019; 26: 2704-2719 e6
• 41 Raffaghello L, Lee C, Safdie FM. et al. Starvation-dependent differential stress resistance protects normal but not cancer cells against high-dose chemotherapy. Proc Natl Acad Sci USA 2008; 105: 8215-8220
• 42 Raffaghello L, Safdie F, Bianchi G. et al. Fasting and differential chemotherapy protection in patients. Cell Cycle 2010; 9: 4474-4476
• 43 Lee C, Longo VD. Fasting vs dietary restriction in cellular protection and cancer treatment: from model organisms to patients. Oncogene 2011; 30: 3305-3316
• 44 de Groot S, Pijl H, van der Hoeven JJM. et al. Effects of short-term fasting on cancer treatment. J Exp Clin Cancer Res 2019; 38: 209
• 45 Koppold-Liebscher D, Kessler CS, Steckhan N. et al. Short-term fasting accompanying chemotherapy as a supportive therapy in gynecological cancer: protocol for a multicenter randomized controlled clinical trial. Trials 2020; 21: 854
• 46 Safdie F, Brandhorst S, Wei M. et al. Fasting enhances the response of glioma to chemo- and radiotherapy. PLoS One 2012; 7: e44603
• 47 Lee C, Raffaghello L, Brandhorst S. et al. Fasting cycles retard growth of tumors and sensitize a range of cancer cell types to chemotherapy. Sci Transl Med 2012; 4: 124ra27
• 48 Safdie FM, Dorff T, Quinn D. et al. Fasting and cancer treatment in humans: A case series report. Aging (Albany NY) 2009; 1: 988-1007
• 49 de Groot S, Lugtenberg RT, Cohen D. et al. Fasting mimicking diet as an adjunct to neoadjuvant chemotherapy for breast cancer in the multicentre randomized phase 2 DIRECT trial. Nat Commun 2020; 11: 3083
• 50 Valdemarin F, Caffa I, Persia A. et al. Safety and Feasibility of Fasting-Mimicking Diet and Effects on Nutritional Status and Circulating Metabolic and Inflammatory Factors in Cancer Patients Undergoing Active Treatment. Cancers (Basel) 2021; 13: 4013
• 51 Bauersfeld SP, Kessler CS, Wischnewsky M. et al. The effects of short-term fasting on quality of life and tolerance to chemotherapy in patients with breast and ovarian cancer: a randomized cross-over pilot study. BMC Cancer 2018; 18: 476
• 52 Brandhorst S. Fasting and fasting-mimicking diets for chemotherapy augmentation. Geroscience 2021; 43: 1201-1216
• 53 Caffa I, Spagnolo V, Vernieri C. et al. Fasting-mimicking diet and hormone therapy induce breast cancer regression. Nature 2020; 583: 620-624
• 54 Longo VD, Anderson RM. Nutrition, longevity and disease: From molecular mechanisms to interventions. Cell 2022; 185: 1455-1470
• 55 Fond G, Macgregor A, Leboyer M. et al. Fasting in mood disorders: neurobiology and effectiveness. A review of the literature. Psychiatry Res 2013; 209: 253-258
• 56 Ruff WE, Greiling TM, Kriegel MA. Host-microbiota interactions in immune-mediated diseases. Nat Rev Microbiol 2020; 18: 521-538
• 57 Witasek A, Traweger Ch, Gritsch P. et al. Einflüsse von basischen Mineralstoffgemisches auf den menschlichen Organismus unter standardisierter Ernährungsbedingungen. Erfahrungsheilkunde 1996; 8: 477-488
• 58 Laurens C, Grundler F, Damiot A. et al. Is muscle and protein loss relevant in long-term fasting in healthy men? A prospective trial on physiological adaptations. J Cachexia Sarcopenia Muscle 2021; 12: 1690-703