Fasting

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Fasting is the abstention from eating and sometimes drinking. From a purely physiological context, "fasting" may refer to the metabolic status of a person who has not eaten overnight (see "Breakfast"), or to the metabolic state achieved after complete digestion and absorption of a meal. [1] Metabolic changes in the fasting state begin after absorption of a meal (typically 3–5 hours after eating).

Contents

A diagnostic fast refers to prolonged fasting from 1 to 100 hours (depending on age) conducted under observation to facilitate the investigation of a health complication, usually hypoglycemia. Many people may also fast as part of a medical procedure or a check-up, such as preceding a colonoscopy or surgery, or before certain medical tests. Intermittent fasting is a technique sometimes used for weight loss that incorporates regular fasting into a person's dietary schedule. Fasting may also be part of a religious ritual, often associated with specific scheduled fast days, as determined by the religion, or by applied as a public demonstration for a given cause in a practice known as a hunger strike.

Health effects

Alternate-day fasting (alternating between a 24-hour "fast day" when the person eats less than 25% of usual energy needs, followed by a 24-hour non-fasting "feast day" period) has been shown to improve cardiovascular and metabolic biomarkers similarly to a calorie restriction diet in people who are overweight, obese or have metabolic syndrome. [2] [3] [4] [5]

A 2021 review found that moderate alternate-day fasting for two to six months was associated with reductions of body weight, body mass index, and cardiometabolic risk factors in overweight or obese adults. [6]

Medical application

Fasting is almost always practiced prior to surgery or other procedures that require general anesthesia because of the risk of pulmonary aspiration of gastric contents after induction of anesthesia (i.e., vomiting and inhaling the vomit, causing life-threatening aspiration pneumonia). [7] [8] [9] Additionally, certain medical tests, such as cholesterol testing (lipid panel) or certain blood glucose measurements require fasting for several hours so that a baseline can be established.

Mental health

In one review, fasting improved alertness, mood, and subjective feelings of well-being, possibly improving overall symptoms of depression, and boosting cognitive performance. [10]

Weight loss

There is little evidence to suggest that intermittent fasting for periods shorter than 24 hours is effective for sustained weight loss in obese adults. [11] [12]

Longevity

There is no sound clinical evidence that fasting can promote longevity in humans. [13]

Other effects

It has been argued that fasting makes one more appreciative of food, [11] [14] [15] [16] and possibly drink.

Political application

Fasting is often used to make a political statement, to protest, or to bring awareness to a cause. A hunger strike is a method of non-violent resistance in which participants fast as an act of political protest, or to provoke feelings of guilt, or to achieve a goal such as a policy change. A spiritual fast incorporates personal spiritual beliefs with the desire to express personal principles, sometimes in the context of social injustice. [17]

The political leader Gandhi undertook several long fasts as political and social protests. Gandhi's fasts had a significant impact on the British Raj and the Indian population generally. [18]

In Northern Ireland in 1981, a prisoner, Bobby Sands, was part of the 1981 Irish hunger strike, protesting for better rights in prison. [19] Sands had just been elected to the British Parliament and died after 66 days of not eating. 100,000 people attended his funeral, and the strike ended only after nine other men died. In all, ten men survived without food for 46 to 73 days.

César Chávez undertook several spiritual fasts, including a 25-day fast in 1968 promoting the principle of nonviolence and a fast of 'thanksgiving and hope' to prepare for pre-arranged civil disobedience by farm workers. [17] [20] Chávez regarded a spiritual fast as "a personal spiritual transformation". [21] Other progressive campaigns have adopted the tactic. [22]

Religious views

Fasting is practiced in various religions, and details of fasting practices differ.

Yom Kippur, Tisha B'av, Fast of Esther, Tzom Gedalia, the Seventeenth of Tamuz, the Tenth of Tevet, and Fast of the Firstborn are examples of fasting in Judaism. [23] Yom Kippur and Tisha B'Av are 25 hour fasts in which observers abstain from consuming any food or liquid from sunset until nightfall the next day and include other restrictions. The fasts of Esther, Gedalia, Tamuz, and Tevet all last from dawn until nightfall and therefore length varies depending on the time of the year. The Fast of the Firstborn is not biblically mandated and can therefore be ended early in the case of a seudat mitzvah.

Muslims fast during the month of Ramadan each year. The fast includes refraining from consuming any food or liquid from dawn until sunset. It is a religious obligation for all Muslims unless they are children or are physically unable to fast.

Lent is a common period of fasting in Christianity. Eastern Orthodox Christians fast during specified fasting seasons of the year, which include not only the better-known Great Lent, but also fasts on every Wednesday and Friday (except on special holidays), together with extended fasting periods before Christmas (the Nativity Fast), after Easter (the Apostles Fast) and in early August (the Dormition Fast). Members of the Church of Jesus Christ of Latter-day Saints (Mormons) generally abstain from food and drink for two consecutive meals in a 24-hour period on the first Sunday of each month and use the money they save for charity. [24]

Fasting is a feature of ascetic traditions in religions such as Hinduism and Buddhism. Mahayana traditions that follow the Brahma's Net Sutra may recommend that the laity fast "during the six days of fasting each month and the three months of fasting each year". [25] Members of the Baháʼí Faith observe a Nineteen Day Fast from sunrise to sunset during March each year.

In alternative medicine

Although practitioners of alternative medicine promote "cleansing the body" through fasting, [14] the concept of "detoxification“ is marketing myth with few scientific basis for its rationale or efficacy. [26] [27]

During the early 20th century, fasting was promoted by alternative health writers such as Hereward Carrington, Edward H. Dewey, Bernarr Macfadden, Frank McCoy, Edward Earle Purinton, Upton Sinclair and Wallace Wattles. [28] All of these writers were either involved in the natural hygiene or new thought movement. [28] Arnold Ehret's pseudoscientific Mucusless Diet Healing System espoused fasting. [29]

Linda Hazzard, a notable quack doctor, put her patients on such strict fasts that some of them died of starvation. She was responsible for the death of more than 40 patients under her care. [30] [31]

In 1911, Upton Sinclair authored The Fasting Cure , which made sensational claims of fasting curing practically all diseases, including cancer, syphilis, and tuberculosis. [32] [33] Sinclair has been described as "the most credulous of faddists" and his book is considered an example of quackery. [33] [34] In 1932, physician Morris Fishbein listed fasting as a fad diet and commented that "prolonged fasting is never necessary and invariably does harm". [35]

See also

Related Research Articles

Dieting is the practice of eating food in a regulated way to decrease, maintain, or increase body weight, or to prevent and treat diseases such as diabetes and obesity. As weight loss depends on calorie intake, different kinds of calorie-reduced diets, such as those emphasising particular macronutrients, have been shown to be no more effective than one another. As weight regain is common, diet success is best predicted by long-term adherence. Regardless, the outcome of a diet can vary widely depending on the individual.

<span class="mw-page-title-main">Metabolic syndrome</span> Medical condition

Metabolic syndrome is a clustering of at least three of the following five medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL).

<span class="mw-page-title-main">Obesity</span> Medical condition in which excess body fat harms health

Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it can potentially have negative effects on health. People are classified as obese when their body mass index (BMI)—a person's weight divided by the square of the person's height—is over 30 kg/m2; the range 25–30 kg/m2 is defined as overweight. Some East Asian countries use lower values to calculate obesity. Obesity is a major cause of disability and is correlated with various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.

<span class="mw-page-title-main">Atkins diet</span> Low-carbohydrate fad diet devised by Robert Atkins

The Atkins diet is a low-carbohydrate fad diet devised by Robert Atkins in the 1970s, marketed with claims that carbohydrate restriction is crucial to weight loss and that the diet offered "a high calorie way to stay thin forever".

<span class="mw-page-title-main">Ketosis</span> Using body fats as fuel instead of carbohydrates

Ketosis is a metabolic state characterized by elevated levels of ketone bodies in the blood or urine. Physiological ketosis is a normal response to low glucose availability, such as low-carbohydrate diets or fasting, that provides an additional energy source for the brain in the form of ketones. In physiological ketosis, ketones in the blood are elevated above baseline levels, but the body's acid–base homeostasis is maintained. This contrasts with ketoacidosis, an uncontrolled production of ketones that occurs in pathologic states and causes a metabolic acidosis, which is a medical emergency. Ketoacidosis is most commonly the result of complete insulin deficiency in type 1 diabetes or late-stage type 2 diabetes. Ketone levels can be measured in blood, urine or breath and are generally between 0.5 and 3.0 millimolar (mM) in physiological ketosis, while ketoacidosis may cause blood concentrations greater than 10 mM.

<span class="mw-page-title-main">Starvation</span> Severe deficiency in caloric energy intake, below the level needed to maintain an organisms life

Starvation is a severe deficiency in caloric energy intake, below the level needed to maintain an organism's life. It is the most extreme form of malnutrition. In humans, prolonged starvation can cause permanent organ damage and eventually, death. The term inanition refers to the symptoms and effects of starvation. Starvation by outside forces is a crime according to international criminal law and may also be used as a means of torture or execution.

<span class="mw-page-title-main">Weight loss</span> Reduction of the total body mass

Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat, or lean mass. Weight loss can either occur unintentionally because of malnourishment or an underlying disease, or from a conscious effort to improve an actual or perceived overweight or obese state. "Unexplained" weight loss that is not caused by reduction in calorific intake or increase in exercise is called cachexia and may be a symptom of a serious medical condition.

<span class="mw-page-title-main">Fad diet</span> Popular diet with claims not supported by science

A fad diet is a diet that is popular, generally only for a short time, similar to fads in fashion, without being a standard scientific dietary recommendation, and often making unreasonable claims for fast weight loss or health improvements; as such it is often considered a type of pseudoscientific diet. Fad diets are usually not supported by clinical research and their health recommendations are not peer-reviewed, thus they often make unsubstantiated statements about health and disease.

<span class="mw-page-title-main">Low-carbohydrate diet</span> Diets restricting carbohydrate consumption

Low-carbohydrate diets restrict carbohydrate consumption relative to the average diet. Foods high in carbohydrates are limited, and replaced with foods containing a higher percentage of fat and protein, as well as low carbohydrate foods.

<span class="mw-page-title-main">Weight cycling</span> Cyclical loss and gain of weight

Weight cycling, also known as yo-yo dieting, is the repeated loss and gain of weight, resembling the up-down motion of a yo-yo. The purpose of the temporary weight loss the yo-yo diet delivers is to lure the dieting into the illusion of success, but due to the nature of the diet, they are impossible to sustain, therefore the dieter gives up, often due to hunger or discomfort, and gains the weight back. The dieter then seeks to lose the regained weight, and the cycle begins again. Other individuals cycle weight deliberately in service of bodybuilding or athletic goals. Weight cycling contributes to increased risk of later obesity, due to repeated signals being sent to the body signalling that it's in starvation mode; therefore it learns to be better and better at storing fat, and increases the strain on vital organs, likely promoting cardiometabolic disease.

Calorie restriction is a dietary regimen that reduces the energy intake from foods and beverages without incurring malnutrition. The possible effect of calorie restriction on body weight management, longevity, and aging-associated diseases has been an active area of research.

<span class="mw-page-title-main">High-protein diet</span> A diet high in protein

A high-protein diet is a diet in which 20% or more of the total daily calories come from protein. Many high protein diets are high in saturated fat and restrict intake of carbohydrates.

<span class="mw-page-title-main">Healthy diet</span> Type of diet

A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.

<span class="mw-page-title-main">Very-low-calorie diet</span> Diet with very or extremely low daily food energy consumption

A very-low-calorie diet (VLCD), also known as semistarvation diet and crash diet, is a type of diet with very or extremely low daily food energy consumption. VLCDs are defined as a diet of 800 kilocalories (3,300 kJ) per day or less. Modern medically supervised VLCDs use total meal replacements, with regulated formulations in Europe and Canada which contain the recommended daily requirements for vitamins, minerals, trace elements, fatty acids, protein and electrolyte balance. Carbohydrates may be entirely absent, or substituted for a portion of the protein; this choice has important metabolic effects. Medically supervised VLCDs have specific therapeutic applications for rapid weight loss, such as in morbid obesity or before a bariatric surgery, using formulated, nutritionally complete liquid meals containing 800 kilocalories or less per day for a maximum of 12 weeks.

A diabetic diet is a diet that is used by people with diabetes mellitus or high blood sugar to minimize symptoms and dangerous complications of long-term elevations in blood sugar.

A protein-sparing modified fast or PSMF diet is a type of a very-low-calorie diet with a high proportion of protein calories and simultaneous restriction of carbohydrate and fat. It includes a protein component, fluids, and vitamin and mineral supplementation.

Intermittent fasting is any of various meal timing schedules that cycle between voluntary fasting and non-fasting over a given period. Methods of intermittent fasting include alternate-day fasting, periodic fasting, such as the 5:2 diet, and daily time-restricted eating.

<span class="mw-page-title-main">Diet and obesity</span> Effect of diet on obesity


Diet plays an important role in the genesis of obesity. Personal choices, food advertising, social customs and cultural influences, as well as food availability and pricing all play a role in determining what and how much an individual eats.

<span class="mw-page-title-main">Weight management</span> Techniques for maintaining body weight

Weight management refers to behaviors, techniques, and physiological processes that contribute to a person's ability to attain and maintain a healthy weight. Most weight management techniques encompass long-term lifestyle strategies that promote healthy eating and daily physical activity. Moreover, weight management involves developing meaningful ways to track weight over time and to identify the ideal body weights for different individuals.

Grape therapy or grape diet, also known as ampelotherapy, is a diet that involves heavy consumption of grapes, including seeds, and parts of the vine, including leaves, that is a form of alternative medicine. The concept was developed in the 19th century Germany in spas, like Bad Duerkheim or Merano. The concept has no scientific basis and is regarded as quackery by scientific institutions like the American Cancer Society.

References

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Further reading