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PERIODICAL
FASTING AND CALORIC RESTRICTION FOR LIFE EXTENSION,
DISEASE TREATMENT AND CREATIVITY.
(clinical and experimental data)
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FASTING AND CALORIC RESTRICTION PREVENT AND CURE DISEASES
(Evidence) |
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2004
Department of Physical Medicine
and Rehabilitation, Ataturk University, Erzurum, Turkey.
OBJECTIVE: To investigate the
effect of individualized diet challenges consisting
of allergenic foods, defined by the skin prick test
(SPT), on tumour necrosis factor-alpha (TNF-alpha)
and interleukin-1beta (IL-1beta) levels in patients
with rheumatoid arthritis (RA). METHODS: Twenty patients
with a positive SPT response for food extracts and
20 with a negative SPT response were enrolled. None
of the patients had active disease. All patients were
fasted for the most common allergenic foods for 12
days and then allocated to two groups according to
SPT results. Food challenges were performed with allergenic
foods in the prick-positive group (PPG) and with corn
and rice in the prick-negative group (PNG) for a period
of 12 days. Then, allergenic foods were excluded from
the PPG patients' diet and corn and rice were removed
from the PNG patients' diet. Clinical examinations
were performed after fasting (baseline), at the end
of the challenge phase and at the end of the re-elimination
phase. Stiffness, pain, tender and swollen joint counts,
health assessment questionnaire (HAQ), Ritchie's articular
index, erythrocyte sedimentation rate (ESR), C-reactive
protein (CRP) and serum TNF-alpha and IL-1beta levels
were measured. RESULTS: TNF-alpha (P < 0.01), IL-1beta
(P < 0.05), ESR (P < 0.05) and CRP (P = 0.001)
levels and all of the clinical variables, except HAQ,
were increased with food challenges in the PPG. These
increases were also recorded after the re-elimination
phase. In the PNG, no significant change was seen
in any of the variables, except pain (P < 0.05).
During the study, important differences were observed
for most of the variables between the two groups.
Thirteen (72%) patients in the PPG and three (18%)
in the PNG experienced disease exacerbation with challenges.
This aggravation continued after elimination. CONCLUSIONS:
Our results suggest that individualized dietary revisions
may regulate TNF-alpha and IL-1beta levels in selected
patients with RA.
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Department of Public Health,
Hamamatsu University School of Medicine, Japan.
Low-energy diets and fasting
have suppressive effects on rheumatoid arthritis.
It was reported recently that urine levels of pentosidine
(i.e., an advanced glycation end product formed by
glycosylation) is associated with the activity of
rheumatoid arthritis. We conducted a regimen of caloric
restriction combined with fasting in patients with
rheumatoid arthritis, and then evaluated urinary pentosidine
levels. Ten patients with rheumatoid arthritis underwent
a 54-day caloric restriction program. Urinary pentosidine
levels were measured and the Lansbury Index were determined
by examining the clinical features, blood biochemistry
and the inflammation activity of rheumatoid arthritis
on days 0, 25 and 54. On day 0, the mean urinary pentosidine
level of patients with rheumatoid arthritis was significantly
higher than that of the control subjects. On day 54,
the mean body weight had reduced due to caloric restriction.
The mean values of the erythrocyte sedimentation rate
and the Lansbury Index of patients both significantly
decreased during the study. In addition, although
the urinary pentosidine levels showed no significant
difference between day 0 and 25, it was significantly
decreased at the end of the study (day 54). The study
showed that under a low energy diet a reduction of
disease activity in rheumatoid arthritis was accompanied
with a reduction of the urinary pentosidine.
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2002
Abteilung fur Innere Medizin
V, Naturheilkunde und Integrative Medizin, Kliniken
Essen Mitte, Essen.
BACKGROUND: Fasting followed
by vegetarian diet has shown to be an effective treatment
for rheumatoid arthritis, moreover fasting is frequently
used as an adjunctive treatment in chronic pain and
stress/exhaustion syndromes. Data on well-being and
the frequency of side effects during fasting are mostly
retrospective. Mineral supplements are frequently
used in order to compensate for fasting-induced tissue
acidosis and to reduce side effects. There are only
limited data that support this practice. OBJECTIVE:
To study the effects of oral mineral supplements on
common side effects and well-being during short-term
fasting. PATIENTS AND METHODS: 209 consecutive inpatients
with chronic pain/exhaustion syndromes were recruited.
In a controlled non-randomised study design all patients
underwent fasting (250 kcal; 3 l fluid intake/day)
over 7 days, in study phase 1 without (n = 103) and
in study phase 2 with (n = 106) concomitant prescription
of standardised oral mineral supplements (3 x 2 to
3 x 3 Bullrich's Vital). Weight, blood pressure and
urinary pH were recorded daily. Well-being and mood
as well as common side effects (i.e. fatigue, hunger,
heart burn, headache) were assessed with standardised
self-reports. RESULTS: Baseline characteristics of
the 209 patients (mean age 54.7 +/- 10.5 years; 83.3%
female) were balanced. Both groups showed a fasting-induced
decrease of blood pressure, a slight decrease in mood
and well-being on days 3 and 4 with consecutive increase
and moderate hunger, i.e. in the evening. Side effects
and general tolerability of fasting as well as well-being
and mood were not different between the groups. There
were no serious side effects in both groups. CONCLUSIONS:
Short-term fasting in inpatients with pain and stress
syndromes is safe and well tolerated, concomitant
mineral supplements have no additive benefit.
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2001
Balneology and Rehabilitation
Sciences Research Institute (FBK), Bad Elster, Germany.
Clinical experience suggests
that fasting followed by vegetarian diet may help
patients with rheumatoid arthritis (RA). We reviewed
the available scientific evidence, because patients
frequently ask for dietary advice, and exclusive pharmacological
treatment of RA is often not satisfying. Fasting studies
in RA were searched in MEDLINE and by checking references
in relevant reports. The results of the controlled
studies which reported follow-up data for at least
three months after fasting were quantitatively pooled.
Thirty-one reports of fasting studies in patients
with RA were found. Only four controlled studies investigated
the effects of fasting and subsequent diets for at
least three months. The pooling of these studies showed
a statistically and clinically significant beneficial
long-term effect. Thus, available evidence suggests
that fasting followed by vegetarian diets might be
useful in the treatment of RA. More randomised long-term
studies are needed to confirm this view by methodologically
convincing data.
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1999
Clinical Research Laboratory,
Sunstar Co. Ltd., Takatsuki.
There is little objective information
about diet therapy for rheumatoid arthritis (RA) in
Japan. We studied 14 patients with RA who stayed in
the Koda hospital for 55 days. They basically took
a 1200 kcal vegan diet consisting of unpolished rice
gruel, juice of raw vegetables, soya bean curd and
sesame seeds, and undertook a 3-5-day fast three times.
During the 55-day stay, average body weight decreased
by 5.1kg. Lansbury index and ESR decreased whereas
CRP did not change. WBC decreased and the differential
cell counts showed a decrease of neutrophils, eosinophils
and monocytes without a change in lymphocytes or basophils.
RBC, hemoglobin and MCV increased. LDL-C decreased,
while HDL-C increased. There was no change in total
protein or albumin. These data suggest that this combination
of a low calorie vegan diet and fasting may contribute
to improve RA with little undesirable effects on the
patient's general conditions.
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1996
Institute of Immunology and Rheumatology,
The National Hospital, Olso, Norway.
Patients with rheumatoid arthritis
(RA) have a higher proportion of agalactosyl IgG than
healthy individuals. Glycosylation status was examined
in 26 RA patients who fasted for 7-10 days and afterwards
followed a vegetarian diet for 3.5 months. The decrease
in the proportion of agalactosyl IgG correlated significantly
with the clinical improvement after the fasting period,
but not after the vegetarian diet period. Although
the glycosylation status of IgG may have played a
role in the improvement of disease during the fasting
period, it did not seem to be associated with, and
therefore responsible for, the clinical improvement
observed after the vegetarian diet.
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1995
Medizinische Poliklinik und Rheumaeinheit
der LMU, Munich, Germany.
The effects of a conventional
1000 kcal diet, and of a further restriction of dietary
fat by a fat substitute, on the concentrations of
vitamin A and E in plasma and LDL, the formation of
lipid peroxides and eicosanoids were investigated
in 10 obese volunteers. In vitro copper catalyzed
oxidation of conjugated dienes, lipid peroxides and
TBARS activity, measured in LDL samples after week
2 (supplementation with 140 mg/d alpha-tocopherol
and 5000 IU retinol-acetat for two weeks), week 6
(conventional diet) and week 10 (fat substitute),
increased with vitamin E depletion statistically significant
after week 10 compared to the values after week 2.
Concomitantly, PGE2 and LTB4, determined by RIA, increased
to 344% and 166%, respectively, compared to the values
after week 2. PGM, determined as tetranorprostanedioic
acid by GC-MS, increased to 120%. Stimulation of lipid
peroxidation and eicosanoid formation was more pronounced
in persons with initially low (19 - 26 micromol/l
plasma) than in those with high (37 - 70 pmol/l plasma)
concentrations of alpha-tocopherol. We conclude that
fat restricted diets can lead to an unwanted stimulation
of lipid peroxidation and eicosanoid formation, which
may be relevant in states of disease, e. g. arteriosclerosis
or rheumatoid arthritis.
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Department of Medicine, University
of Texas Health Science Center, San Antonio 78284-7874,
USA.
The present study was carried
out to determine whether restricting dietary calories
prevents salivary gland abnormalities and modulates
expression of transforming growth factor beta and
proinflammatory cytokines, IL-6, and TNF alpha in
major salivary glands (SG) of autoimmune lupus-prone
(NZB x NZW)F1 (B/W) female mice. These mice develop
focal lymphocytic interstitial and periductal round
cell infiltrates in salivary glands similar to those
of humans with Sjogren's syndrome. Weanling B/W mice
were fed a nutritionally adequate semipurified diet
either ad libitum (AL) or a calorie-restricted (CR;
40% less calories than AL) diet. The mice were sacrificed
at 3.5 months (young) and 8.5 months (old) of age.
Histopathologic and histomorphometric analyses as
well as growth factor and cytokine protein and mRNA
expression were carried out in the SG. Histomorphometric
analysis of SG from young mice showed no differences
between AL and CR mice, but old AL (vs old CR) had
a 7.3-fold higher focus score and a 34-fold increase
in percentage area inflammation. mRNA analysis revealed
significantly higher levels of TGF beta 1 in SG of
old CR (6.8-fold) mice. In contrast, CR reduced mRNA
expression of proinflammatory cytokines (IL-6, 2.9-fold
for young and 4.8-fold for old; TNF alpha, old 3.9-fold).
By immunoblotting, significantly higher levels of
TGF beta 1 protein was detected in old CR mice (vs
old AL; 13.2-fold). IL-6 and TNF alpha proteins were
undetectable in both young and old CR groups, whereas
an increase in IL-6 (4.7-fold) and TNF alpha (9.3-fold)
was observed in old AL mice. These results indicate
that amelioration of the histological severity of
disease in SG of B/W mice is paralleled and possibly
mediated by increased expression of immunosuppressive
TGF beta 1 and decreased expression of proinflammatory
cytokines.
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