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Randomized cross-over trial of short-term water-only fasting: Metabolic and cardiovascular consequences

  • Author Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    B.D. Horne
    Correspondence
    Corresponding author. Intermountain Heart Institute, 5121 S. Cottonwood St., Salt Lake City, UT 84107, USA. Tel.: +1 801 507 4708; fax: +1 801 507 4792.
    Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    Affiliations
    Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, USA

    Genetic Epidemiology Division, Department of Medicine, University of Utah, Salt Lake City, UT, USA
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  • Author Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    J.B. Muhlestein
    Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    Affiliations
    Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, USA

    Cardiology Division, Department of Medicine, University of Utah, Salt Lake City, UT, USA
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  • Author Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    D.L. Lappé
    Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    Affiliations
    Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, USA

    Cardiology Division, Department of Medicine, University of Utah, Salt Lake City, UT, USA
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  • Author Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    H.T. May
    Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    Affiliations
    Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, USA
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  • Author Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    J.F. Carlquist
    Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    Affiliations
    Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, USA

    Cardiology Division, Department of Medicine, University of Utah, Salt Lake City, UT, USA
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  • Author Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    O. Galenko
    Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    Affiliations
    Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, USA
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  • Author Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    K.D. Brunisholz
    Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    Affiliations
    Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, USA
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  • Author Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    J.L. Anderson
    Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
    Affiliations
    Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, USA

    Cardiology Division, Department of Medicine, University of Utah, Salt Lake City, UT, USA
    Search for articles by this author
  • Author Footnotes
    1 For the Intermountain Heart Collaborative Study Group.
Published:December 10, 2012DOI:https://doi.org/10.1016/j.numecd.2012.09.007

      Abstract

      Background and aims

      Routine, periodic fasting is associated with a lower prevalence of coronary artery disease (CAD). Animal studies show that fasting may increase longevity and alter biological parameters related to longevity. We evaluated whether fasting initiates acute changes in biomarker expression in humans that may impact short- and long-term health.

      Methods and results

      Apparently-healthy volunteers (N = 30) without a recent history of fasting were enrolled in a randomized cross-over trial. A one-day water-only fast was the intervention and changes in biomarkers were the study endpoints. Bonferroni correction required p ≤ 0.00167 for significance (p < 0.05 was a trend that was only suggestively significant). The one-day fasting intervention acutely increased human growth hormone (p = 1.1 × 10−4), hemoglobin (p = 4.8 × 10−7), red blood cell count (p = 2.5 × 10−6), hematocrit (p = 3.0 × 10−6), total cholesterol (p = 5.8 × 10−5), and high-density lipoprotein cholesterol (p = 0.0015), and decreased triglycerides (p = 1.3 × 10−4), bicarbonate (p = 3.9 × 10−4), and weight (p = 1.0 × 10−7), compared to a day of usual eating. For those randomized to fast the first day (n = 16), most factors including human growth hormone and cholesterol returned to baseline after the full 48 h, with the exception of weight (p = 2.5 × 10−4) and (suggestively significant) triglycerides (p = 0.028).

      Conclusion

      Fasting induced acute changes in biomarkers of metabolic, cardiovascular, and general health. The long-term consequences of these short-term changes are unknown but repeated episodes of periodic short-term fasting should be evaluated as a preventive treatment with the potential to reduce metabolic disease risk.
      Clinical trial registration (ClinicalTrials.gov): NCT01059760 (Expression of Longevity Genes in Response to Extended Fasting [The Fasting and Expression of Longevity Genes during Food abstinence {FEELGOOD} Trial]).

      Keywords

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