An overview of evidence-based clinical studies on fasting therapy

Tags: Poster
Lu CL1, Jin XY2, Qiao SY1, Tian ZY3, Liu XH1, Bu FL1, Li X1, Robinson N4, Liu JP1
1Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, 2The Third Affiliated Hospital of Beijing University of Chinese Medicine, 3Dongzhimen Hospital of Beijing University of Chinese Medicine, 4School of Health and Social Care, London South Bank University

Background: obesity and metabolic syndrome have become a public problem recently. People are looking for a more effective, more convenient and safer dietary approach to calorie restriction and weight loss. Fasting therapy refers to calorie and diet restriction for different diseases/conditions, and many clinical studies are paying increased attention to its safety and health benefits.

Objectives: we aim to provide an overview of fasting therapy and summarize current clinical studies of fasting for health management.

Methods: we searched six English and Chinese databases from their inception to July 2018 to identify relevant clinical studies, and extracted data in duplicate. Data were presented by counts, percentage and frequency.

Results: we identified 49 studies (involving 20,357 participants) published in 1990 to 2018, mainly including 30.6% randomized clinical trials (RCTs), 28.6% case series or case reports, and 18.4% cohort studies. Four main modalities of fasting therapy have now been accepted, including intermittent fasting, modified fasting, Bigu (a modality of Chinese medicine), and Ramadan fasting. Intermittent fasting and modified fasting involves lowering calorie intake with vegetables and fruits on alternate days or on five continuous days during one week. Bigu only requires the intake of less water, honey and fruits, and to do Qigong at the same time. Ramadan fasting follows time-restricted feeding and lasts for 11 to 22 hours. The top three diseases/conditions were type-2 diabetes, obesity and metabolic syndrome. Most studies were conducted in China, Germany and the UK. Eighteen studies applied fasting for prevention, 29 studies for cure, and two studies for both two purposes. The course lasted for periods of 1-4 weeks and continued to 1-2 years. 29 (59.2%) studies used fasting alone whilst others combined it with conventional symptomatic treatment. The most frequently reported outcomes were weight, BMI, blood pressure and blood glucose level. 67.3% studies reported positive effects, 24.5% studies reported uncertain effects and 8.2% studies reported negative effects. No serious adverse events related to fasting were reported.

Conclusions: with limited evidence, fasting therapy is applied in diseases/conditions measured by weight and blood indices. Well-designed, adequately powered and further rigorous studies are recommended to confirm its effects.

Patient or healthcare consumer involvement: different fasting therapy modalites can be acceptable for patients and healthcare consumers to prevent and cure in daily life. Modern people can try this natural and green diet style to keep fit.