Many millennia before fasting became of interest for medical reasons, the practice of fasting — abstaining from all meals — was seen as a way to achieve a higher spiritual purpose.
The main religions often have annual fasts, and some have rites of passage, that include fasting so that one can undergo “purification.” The Hindus and Buddhists do, “atonement” through the Jewish tradition of Yom Kippur or the Catholic tradition of Lent, for clarity of religious purpose or become close to God as the Muslims do for Ramadan. And so on.
It is clear, through the passage of time and tradition, that there is a benefit – spiritual, emotional, and sometimes physical – to the practice of fasting.
Recently, fasting has become vogue but it is stemming from the resurgent scientific literature showing great promise in various fields including cancer therapy, metabolic diseases like diabetes and obesity, and an anti-aging and longevity practice, cardiovascular disease, neurodegenerative disease like Alzheimer’s and dementia and autoimmunity.
The definition of fasting is the abstinence of food, drink or both. The various fasting that science is starting to look at has much more nuance to it than just plain not eating.
The popular 5:2 intermittent fast for weight loss was popularized first in the UK. It features a normal eating schedule 5 days a week and 2 days of the week calories are restricted to about 500.
The more specific intermittent fast, known as time-restricted feeding, has now been gaining more momentum. With intermittent fasting, you abstain from eating for anywhere from 13-16 hours of the day and keep food consumption during the other hours.
The weight loss that occurs with this approach is supported by studies stemming from Dr. Satchin Panda’s work at the Salk Institute. His research looks at the connection between the time you don’t eat and how it plays into the workings of the circadian rhythm, our internal clocks that can govern metabolism and sleep, for example. Recently, the University of Illinois at Chicago enlisted 23 obese volunteers and had them eat only between 10AM and 6PM. They lost weight and dropped their blood pressure significantly.¹
At the other extreme of fasting are those that abstain from anything aside from water sometimes for a day, but sometimes up to 7-10 days. Other variations include bone broth or vegetable broth fasts often diluted. And there are now low calorie versions of packaged fasts called “fasting mimicking diets” that are essentially 500 cal per day over five days.
Promising Research on Fasting & Autoimmunity
The only study that looked at the role of fasting on autoimmunity in humans were on people who fasted for Ramadan, the ninth month of the Islamic calendar. Fasting periods are typically around 12-16 hours but there is variation set by the individual. A systemic review did find a mild effect on the immune system but that was transient and returned to baseline once they resumed their regular eating schedule. Lipids improved in some and there was a reduction of oxidative stress markers in others.²
The most persuasive evidence of the benefits of fasting on autoimmunity come from animal studies. Mice that were bred to mimic an autoimmune disease similar to Multiple Sclerosis were used in the study. Multiple sclerosis is a neurodegenerative disorder marked by the demyelination of neurons in the brain that affect nerve conduction. This is in part thought to be due to the body’s own immune system causing the damage.
The mice were put into 2 groups, one a ketogenic diet (high-fat ultra low-carb) or a fasting mimicking diet (very low calorie and protein) for 3 days every 7 days for a month.
Researchers found was that mice on the fasting mimicking diet had reduced levels of inflammatory cytokines, increase in endogenous corticosteroids and improvements in T cell immunity. Aside from markers they saw that mice actually had REMYELINATION meaning the damaged components of the neurons regenerated what was damaged by the body’s autoimmune process. This was specifically though to happen during the re-feeding periods. Amazingly 20% of the mice had a complete recovery and all mice had a reduction in symptoms.³
This is certainly a very fascinating finding that will spur on further research to elucidate the utility of fasting in certain autoimmune conditions and we’ll hear more as time goes on.
I am big proponent of fasting in certain circumstances and I utilize the full spectrum of fasting methods in the right person. Would I have this discussion on fasting in an autoimmune patient, yes. But given the current data in autoimmunity it is not a methodology that I advocate early on.
Caution: Fasting is something that one can consider exploring on their own if they are not within the extremes of ages, healthy and without any active disease for which they are taking medication but if one does not fit in this category, it is advised that they seek the guidance of a knowledgeable physician who can advise and monitor them through this process or to be able to assess if they are the right candidate to go through the process.
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