title: [Effects of fasting and endurance training on energy metabolism and physical fitness in obese patients].
abstract: BACKGROUND
  Buchinger therapeutic fasting, based on a low caloric (<500 kcal/d) fluid diet (juice-broth), is a traditional natural-healing strategy to reduce body weight and cure cardiometabolic complications in obese patients. Although there are some anecdotal reports about a serious protein loss during this type of fasting, there are no validated data that support this claim.
  
  
  OBJECTIVE
  Is Buchinger fasting associated with a critical protein loss and is this loss aggravated by additional endurance training which might lead to cardiac symptoms?
  
  
  METHODS
  A therapeutic concept for 'complex re-conditioning of obese patients', a combination of Buchinger fasting and endurance training was tested in obese patients for 28 days. Parameters of energy, carbohydrate, lipid, and protein metabolism were studied in several subgroups either with or without endurance training of defined intensity.
  
  
  RESULTS
  Additional endurance training resultet in a greater loss of body mass (12.2 +/- 3.2 vs. 10.4 +/- 2.2 kg; p < 0.001) and fat mass (8.1 +/- 1.6 vs. 5.9 +/- 1.3 kg; p < 0.001), and in improved lipid utilisation, physical efficiency, and a smaller decrease in metabolic rate per kilogram fat-free mass (-7.6 +/- 12.4 vs. -14.3 +/- 12.2%; p < 0.001). Without training, total protein loss over 28 days was about 1,000 and 650 g for men and women, respectively. With training, there was an additional protein loss of 130 g / 28 d (p < 0.01) in men.
  
  
  CONCLUSIONS
  Endurance training is an important, safe and necessary component of a 28-day Buchinger fasting therapy.
authors.affiliation: Universitätsmedizin Charité Berlin, Campus Buch, Franz-Volhard-Centrum für Klinische Forschung am Experimental and Clinical Research Center, Berlin, Deutschland. jochen.steiniger@charite.de
authors.forename: Jochen
authors.initials: J
authors.lastname: Steiniger
authors.forename: Annemarie
authors.initials: A
authors.lastname: Schneider
authors.forename: Sabine
authors.initials: S
authors.lastname: Bergmann
authors.forename: Michael
authors.initials: M
authors.lastname: Boschmann
authors.forename: Klaus
authors.initials: K
authors.lastname: Janietz
mesh_terms: D000273:Adipose Tissue / Q000502:physiology; D000328:Adult; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D004038:Diet, Reducing / Q000379:methods*; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005215:Fasting; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D010807:Physical Endurance / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology*; D012737:Sex Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology