The Effects of Three-Week Fasting in the Extremely Obese

Can fasting normalize blood pressure, decrease cholesterol, and improve diabetes in the extremely obese?

That question was answered in a study that was published in 2007. The study included 110 patients with the following characteristics:

33 male, 77 females
Ages 35 +/- 1 year
Body weights are 131.7 +/- 2.6 kg (289 +/- 5.7 lbs)
BMI or Body mass indexes of 45.4 +/- 0.8 or extremely obese. (As a reference, Normal BMI is 18.5 – 24.9, Overweight = 25–29.9, Obese is >30.)
4% of the patients are diabetic, 76% are not, and 21% have borderline diabetes. The determination was done with the oral glucose tolerance test (OGTT).

Method

All the patients were hospitalized for observation and monitoring for the three week study period. Their over-all well-being, the blood pressure and heart rate, blood glucose, lipid profiles, and insulin levels were monitored

A very low-calorie diet containing 200 to 800 kcal per day was given to the participants. Starvation is a diet of fewer than 200 kcal a day. A low-calorie diet is more than 800 kcal a day.

They drank only mineral water ((2-2.5 liters per day). From the fourth day, they were given multivitamin preparations. No physical activity was organized during the three-week reduction diet.

800px-Charles_Mellin_(attributed)_-_Portrait_of_a_Gentleman_-_Google_Art_Project (1) — The Extremely Obese Tuscan General Alessandro del Borro attributed to Charles Mellin, 1645

Study Results

Weight Loss

All of the participants’ body weight decreased from an average of 131.7 to 117.7 kg—a loss of 14 kg or 30.8 lbs. The BMI lowered from 45.4 to 40.8.

Blood Pressure

Blood pressures significantly declined in both sexes. The systolic blood pressure decreased from 143 +/- 2 to 132 +/- 2 mm Hg. The diastolic blood pressure also lowered from 92 +/- 2 to 85 +/- 2 mm Hg.

Cholesterol Profile

After seven days of fasting, the triglyceride levels decreased. At three-weeks of the fasting period, the total cholesterol and LDL cholesterol also decreased. All reductions were statistically significant.

The HDL levels also decreased but are not statistically significant. Statistical significance means the difference is “real” and not secondary to chance.

The effects were equally present in men and women.

Diabetes

The oral glucose tolerance test (OGTT) is used to screen for diabetes. At the start, 76% have normal OGTT, 4% of the patients are diabetic, and 21% have borderline diabetes or prediabetic.

After the fasting diet, OGTT was normal in 88% of patients, whereas 12% of patients still had signs of glucose intolerance.

There is also a significant increase in insulin sensitivity at the end of the diet. Insulin sensitivity means the body responds better to the action of insulin, which is to store glucose in the muscles and the liver.

Insulin sensitivity leads to less insulin production and thereby less stress to the pancreas. Lower insulin levels are healthy since high insulin levels or hyperinsulinemia can damage internal organs. Lower insulin levels also allow the body to use the stored fat as an energy source.

Side note: If you read the English version of the study in Pubmed, it says that insulin resistance is increased. But, if you Google translate the original research in Serbian, it is the insulin sensitivity that is increased and not insulin resistance.

Take Away Message

I see patients regularly who have multiple medical problems. They see different specialists, have frequent hospitalizations, and the cost of their medications are high even with medical insurance.

What is common to most of them is being overweight. The participants in the study mentioned here are fortunate because they realized that weight loss has many beneficial effects on their blood pressure, cholesterol, and blood sugar at a relatively early age of 35.

Hypertension, high triglycerides, low HDL, obesity, and diabetes are components of the metabolic syndrome. All of them work together in different combinations to cause diseases all over the body from head to toes. There is no one exempted from it.

Losing weight, if one is overweight, is one of the kindest, cheapest, and the best thing anyone can do for their health. The benefits are not just short term but also long term as it prevents degenerative diseases of the brain like dementia.

There are many variations of fasting. It can be 16, 18 hours, or longer. Fasting can also be done on alternate days or just 2 days a week. The most important thing is to get started. It gets easier with practice.

Just remember to talk to your physicians first before doing fasting, especially if you are taking medicines for diabetes and hypertension since adjustments may have to be made.

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Reference:

Beleslin B, Cirić J, Zarković M, Vujović S, Trbojević B, Drezgić M. Srp Arh Celok Lek.[The effects of a three-week fasting diet on blood pressure, lipid profile, and glucoregulation in extremely obese patients] 2007;135(7-8):440-446. doi:10.2298/sarh0708440b

Image Credit The Tuscan General Alessandro del Borro, By Charles Mellin – WgF1LrUvFdNysA at Google Cultural Institute, zoom level maximum, Public Domain, https://commons.wikimedia.org/w/index.php?curid=13334241

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