The Buchinger Wilhelmi Clinic in Überlingen, Germany, is a specialized facility where people can stay for several days and undergo supervised therapeutic fasting.
It was started by a German physician Otto Buchinger, credited to being the first to document the health effects of fasting on several diseases. His book, “The Therapeutic Fasting Cure,” published in 1935, described his fasting method.
A study published recently in PLOS One describes the results in 1422 patients who underwent fasting at the Wilhelmi Buchinger Clinic (WHC). The paper gives an inside look at the fasting process at the WHC and its effects on the participants. [1]
1,422 patients with an average age of 55.4 years, with 59.1% women and 40.9% men, were included.
They were classified by Body Mass Index or BMI as follows:
- 63.4% are non-obese (BMI <30)
- 19.5% Grade I obesity (BMI 31 to 35)
- 10.3% Grade II obesity (BMI≥ 35)
The participants are divided into four groups based on the duration of their personal choice of fasting periods.
- F5d underwent a fasting period of 5±2 days, with an average of 5.4 (number = 695)
- F10d – 10±2 days, with an average of 8.6 (n = 530)
- F15d – 15±2 days, with an average of 14.1 (n = 196)
- F20d – 20±2 days, with an average of 20.1 (n = 37)
Subjects who chose to fast for 20 days tend to have the highest BMI and waist circumference.
The Fasting Program at the Wilhelmi Buchinger Clinic
The participants were physically examined by physicians 2 to 3 times a week. Vital signs and blood samples were obtained.
The day before the fast, the participants were given 600 kcal of a vegetarian diet divided into three rice, vegetables, or fruit meals, depending on their preference.
At the beginning of the fast, the intestinal tract was emptied with a laxative. During the fast, all subjects are asked to drink 3 L of water or non-caloric herbal tea daily with an optional portion of 20 g of honey.
An organic fruit or vegetable juice (250 ml) was served at noon, and vegetable soup (250 ml) was provided in the evening for a total calorie intake of 200-250 kcal and 25-35 gm of carbohydrate a day.
Participants had a light physical exercise program alternating with rest and non-physical treatments like hydrotherapy or physiotherapy. An enema or laxative was applied every second day.
On the last day of fasting, food was gradually introduced during an average of 4 days with an organic ovo-lacto vegetarian diet consisting of eggs, dairy, meat, fish, and poultry.
The Fasting Study Results and Their Meaning
Decreased weight and abdominal circumference
Weight, abdominal circumference, and blood pressure significantly decreased in all four groups. The weight loss increased with the fasting period and varied between 3.2 kg or 7 lbs for F5d and 8.6 kg or 18.92 lbs for F20d.
The waist circumference decreased significantly from 4.6 cm or 1.8 for F5d and 8.8 cm or 3.46 on for F20d. The decrease in weight and abdominal girth was more significant in males than in all groups.
The change in waist circumference reflects the decrease in the amount of visceral fat. Visceral fat is inside the abdominal cavity, and in excess, it is one of the sources of inflammation responsible for many diseases.
Visceral fat can also coat and infiltrate internal organs like the liver and pancreas. The fat interferes with the organ’s functions and leads to conditions like fatty liver and fatty pancreas.
Lower Blood Pressure
The average blood pressure value for the whole group decreased significantly from 131.6 to 120 for the systolic blood pressure and 83.7 to 77.9 for the diastolic blood pressure.
The reduction in the blood pressure was higher in the groups that fasted longer in both sexes. The whole group had an average blood pressure of 120/78. There were no abnormally low blood pressures reported.
The decrease in the blood pressure may be from the increase of the parasympathetic nervous system that dilates the blood vessels and slows the heart rate. A reduction in sodium in the blood also plays a role—the decrease in sodium results from the increased sodium excretion in urine.
Improved Well-Being
Both emotional well-being and physical well-being were significantly enhanced in the course of the fast. This applies to both genders in the study. All groups reached similar levels of well-being at the end of their stay.
Fasting has been associated with a metabolic switch from glucose use to ketone production. The increase in ketones enhances memory, mood, motor, and improvement in the autonomic nervous system (ANS).
The ANS is responsible for the unconscious control of the blood pressure, heart rate, and breathing, including the sexual response.
Endogenous endorphins, the brain’s natural pain reliever, increased in 10-day fasting based on another study. [2] The endorphins improve mood and increase fasting compliance.
Mild symptoms and adverse effects
1311 of the 1422 participants returned the questionnaires about observed mild symptoms.
0.35% reported muscular cramp, which was the least frequent mild symptom, and
14.94% sleep disturbances, which was the most frequent mild symptom
The mild symptoms like muscle pain, sleep disturbances, headaches, and hunger occurred mainly in the first days of the fast.
Surprisingly, hunger was not felt by 92% of the subjects.
A 75-year older adult had a heart attack and had to be admitted to the hospital. After three days, he returned to the BWC.
A 67-year-old woman had a one-day hospital stay because of vomiting, dizziness, and diarrhea on the 4th fasting day. After returning to the BWC, she received an 800 kcal/diet.
Another adverse effects were low-grade cardiac arrhythmia that was treated without stopping the fasting. The other is transitory low blood sugar. One person who was previously treated for gout had acute gout. All were treated symptomatically.
Muscle cramps, arrythmias, and gout attacks result and can be worsened by electrolyte imbalances.
As insulin sensitivity increases during fasting, the excess retained fluid is urinated. With the urine, electrolytes like sodium are excreted. That is why it is critical to increase the salt intake to replenish the salt loss and prevent the side effects.
Improvements in Major Health Complaints
A questionnaire was handed out to the participants to self-report if they had a significant health complaint before the program and how the fasting affected that condition.
Out of the 404 subjects of 1311 who returned the questionnaire, 84.4% reported their major health complaints improved. 8.7% reported unchanged, and 6.9% reported worsening.
Better Blood Sugar and Cholesterol
Blood Glucose
The blood sugar or glucose decreased without differences in the fasting period length. It stabilized at an average value of 4.7 mmol/L or 84.68 mg/dl.
The glycosylated hemoglobin or HbA1c is a measure of blood sugar control for the previous three months. In this study, there was a significant decrease in HbA1c from 1.2 for F5d and 2.6 for F20d.
The improvements in the blood sugar and HbA1c mean better blood sugar regulation, which is necessary for diabetes and affects the overall well-being by decreasing the circulating hormones insulin and leptin.
Lower Cholesterol, LDL and Triglycerides
Fasting reduced triglyceride levels by 0.44 mmol/L or 38.94 mg/dl on average and was similar to all groups.
The decrease in Total cholesterol was significant and higher in groups that fasted for a longer duration. There was no difference in Total Cholesterol changes during fasting between men and women.
LDL decreased significantly, and the decrease was higher in the groups with a longer fasting duration. The LDL/HDL ratio was not affected by fasting. The LDL/HDL ratio is a tool to measure the risk of heart disease.
HDL decreased significantly. The reduction was higher in the groups that fasted longer and in women than men. HDL is increased with exercise. This highlights the need for physical activity to be coupled with fasting.
Complete Blood Count
The leucocytes or white blood cells (WBC) decreased in all groups. The longer the fast, the more significant the decrease. This is the same for both sexes.
WBCs increase during infection and inflammation. The lower WBC means a lower state of inflammation. Common diseases like hypertension, atherosclerosis, and diabetes are a result of chronic inflammation.
The red blood cells (RBC) were increased in all groups. Hemoglobin, the oxygen carrier in the red blood cell, was also increased. More hemoglobin means better oxygen-carrying capacity and delivery to the organs.
The hematocrit is the concentration or the ratio of the cells to the liquid part of the blood that remains unchanged. The unchanged hematocrit is means the blood did not become more concentrated. Thicker blood increases blood clot formation, leading to strokes and heart attacks.
The platelets showed a significant reduction and are influenced by fasting length. The more extended fasting showed a greater reduction. Platelets play an essential role in atherosclerotic complications, initiating blood clot formation.
Less tendency for Blood Clotting
The blood tests, Partial Thromboplastin Time (PTT), and the International Normalization Ratio (INR) increased during fasting. Again, the longer the fasting period, the more significant the increase.
This result is significant clinically. Many diseases, like heart attacks, strokes, or abnormal blood clot formation, result from blood vessel blockage.
A higher PTT and INR mean a lower risk of developing the aforementioned conditions.
The other clinical relevance of this finding is among people taking blood thinners like warfarin. More frequent testing or dose adjustments may be needed to prevent the blood from getting too thin and increase the risk of bleeding.
Liver Function Test
The liver enzymes SGOT (AST) and SGPT (ALT) increased during the fasting but stayed within normal for the whole study duration. The authors explain the increase in the liver enzymes to be from an increase in liver detoxification.
The Gamma-glutamyl transferase (GGT) is lower and tells us that there are no severe effects on the liver from the increased activity.
Blood Markers of Inflammation
C-reactive protein or CRP increased during fasting in all groups and both men and women but stayed within the normal range.
Research has shown that regulatory enzymes like adrenalin and cortisol increase and maintain blood sugar levels during fasting.[3] This can reflect as a higher CRP. As mentioned in another investigation, the changes in the total cholesterol, LDL, and triglycerides can also increase the CRP.
The ESR or erythrocyte sedimentation rate decreased more with the group that fasted longer. Just like the other findings of lower visceral fat and WBCs, the lower ESR is a marker of less inflammation in the body.
This can be felt as fewer aches and pains and shows why the majority of the participants have a higher feeling of well-being.
Fasting also improves the body’s antioxidants and reduces pro-inflammatory cytokines. Cytokines are signaling proteins that act as messages between the cells. Pro-inflammatory cytokines play a role in making prolonging inflammation.
Kidney Function and Uric Acid
An increase in uric acid was observed which is not entirely bad. Uric acid is an antioxidant similar to Vitamin C and glutathione. Thus the increase in uric acid can reflect more excellent antioxidant activity and lesser inflammation.
The increase in uric acid level is from the breakdown of proteins. Other than muscle there are other proteins in the body like old, dead, defective cells and dead germs are examples. During fasting, these proteins are recycled to make new and valuable cells—a process called autophagy.
That is why fasting will not make the skeletal muscles shrink.
Urea levels decreased in all groups and were more significant in the more extended fasting periods. Creatinine increased with both men and women but without differences in the groups. There is no deterioration in kidney functions. That is why the subjects were asked to drink three liters of water a day.
Electrolytes
The sodium concentration decreased but remained in the normal range. Calcium levels increased, potassium decreased, and magnesium levels stayed within normal limits.
Take-Away Message
This study highlights the beneficial effects of fasting to decrease systemic inflammation by allowing the body to use its fat stores, lower blood pressure, cholesterol, and triglyceride levels, and improve blood sugar control—all of which are components of metabolic syndrome.
Metabolic syndrome leads to many other common diseases that plague our times. Metabolic syndrome affects more people than COVID-19.
Fasting is an inexpensive alternative or adjunct to dealing with many medical problems. You can book yourself a stay at the Buchinger Wilhelmi Clinic, or you can do it at home and save a lot of money.
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Related:
- The Metabolic Syndrome
- Diseases Associated with the Metabolic Syndrome
- How to Do Intermittent Fasting
- The Kaizen Way of Fasting
- Early Time-Restricted Feeding is Intermittent Fasting In Sync with the Circadian Rhythm
- Will Fasting Make My Muscles Shrink?
- Are You Skipping Breakfast?
- The 20/80 Rule for Health
- Autophagy – How to Recycle Yourself
- A Case Report of 3 Diabetic Patients that are Weaned Off Insulin
- The 80/20 Rule Applied to Diseases
- Cancers Associated with Metabolic Syndrome
References:
- Toledo et al. “Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects.” PloS one vol. 14,1 e0209353. 2 Jan. 2019, doi:10.1371/journal.pone.0209353
- Komaki et al. Plasma beta-endorphin during fasting in man. Horm Res. 1990;33(6):239-43. doi: 10.1159/000181525. PMID: 2289782.
- Li et al. Metabolic and psychological response to 7-day fasting in obese patients with and without metabolic syndrome. Forsch Komplementmed. 2013;20(6):413-20. doi: 10.1159/000353672. Epub 2013 Jun 28. PMID: 24434755.
Image Credit: Intermittent Fasting By Signimu & Google & Penubag – File:Emoji_u1f37d.svg, Apache License 2.0, https://commons.wikimedia.org/w/index.php?curid=82899383
Lime juice Photo by Alina Karpenko on Unsplash
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