title: Effect of a 21 day Daniel Fast on metabolic and cardiovascular disease risk factors in men and women.
abstract: BACKGROUND
  Dietary modification via caloric restriction is associated with multiple effects related to improved metabolic and cardiovascular health. However, a mandated reduction in kilocalories is not well-tolerated by many individuals, limiting the long-term application of such a plan. The Daniel Fast is a widely utilized fast based on the Biblical book of Daniel. It involves a 21 day ad libitum food intake period, devoid of animal products and preservatives, and inclusive of fruits, vegetables, whole grains, legumes, nuts, and seeds. The purpose of the present study was to determine the efficacy of the Daniel Fast to improve markers of metabolic and cardiovascular disease risk.
  
  
  METHODS
  43 subjects (13 men; 30 women; 35 ± 1 yrs; range: 20-62 yrs) completed a 21 day period of modified food intake in accordance with detailed guidelines provided by investigators. All subjects purchased and prepared their own food. Following initial screening, subjects were given one week to prepare for the fast, after which time they reported to the lab for their pre-intervention assessment (day 1). After the 21 day fast, subjects reported to the lab for their post-intervention assessment (day 22). For both visits, subjects reported in a 12 hr fasted state, performing no strenuous physical activity during the preceding 24-48 hrs. At each visit, mental and physical health (SF-12 form), resting heart rate and blood pressure, and anthropometric variables were measured. Blood was collected for determination of complete blood count, metabolic panel, lipid panel, insulin, HOMA-IR, and C-reactive protein (CRP). Subjects' self-reported compliance, mood, and satiety in relation to the fast were also recorded. Diet records were maintained by all subjects during the 7 day period immediately prior to the fast (usual intake) and during the final 7 days of the fast.
  
  
  RESULTS
  Subjects' compliance to the fast was 98.7 ± 0.2% (mean ± SEM). Using a 10 point scale, subjects' mood and satiety were both 7.9 ± 0.2. The following variables were significantly (p < 0.05) lower following the fast as compared to before the fast: white blood cell count (5.68 ± 0.24 vs. 4.99 ± 0.19 103.μL-1), blood urea nitrogen (13.07 ± 0.58 vs. 10.14 ± 0.59 mg.dL-1), blood urea nitrogen/creatinine (14.74 ± 0.59 vs. 11.67 ± 0.68), protein (6.95 ± 0.07 vs. 6.77 ± 0.06 g.dL-1), total cholesterol (171.07 ± 4.57 vs. 138.69 ± 4.39 mg.dL-1), LDL-C (98.38 ± 3.89 vs. 76.07 ± 3.53 mg.dL-1), HDL-C (55.65 ± 2.50 vs. 47.58 ± 2.19 mg.dL-1), SBP (114.65 ± 2.34 vs. 105.93 ± 2.12 mmHg), and DBP (72.23 ± 1.59 vs. 67.00 ± 1.43 mmHg). Insulin (4.42 ± 0.52 vs. 3.37 ± 0.35 μU.mL-1; p = 0.10), HOMA-IR (0.97 ± 0.13 vs.0.72 ± 0.08; p = 0.10), and CRP (3.15 ± 0.91 vs. 1.60 ± 0.42 mg.L-1; p = 0.13), were lowered to a clinically meaningful, albeit statistically insignificant extent. No significant difference was noted for any anthropometric variable (p > 0.05). As expected, multiple differences in dietary intake were noted (p < 0.05), including a reduction in total kilocalorie intake (2185 ± 94 vs. 1722 ± 85).
  
  
  CONCLUSIONS
  A 21 day period of modified dietary intake in accordance with the Daniel Fast is 1) well-tolerated by men and women and 2) improves several risk factors for metabolic and cardiovascular disease. Larger scale, randomized studies, inclusive of a longer time period and possibly a slight modification in food choice in an attempt to maintain HDL cholesterol, are needed to extend these findings.
authors.affiliation: Cardiorespiratory/Metabolic Laboratory, The University of Memphis, Memphis, TN 38152, USA. rbloomer@memphis.edu
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Bloomer
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Kabir
authors.forename: Robert E
authors.initials: RE
authors.lastname: Canale
authors.forename: John F
authors.initials: JF
authors.lastname: Trepanowski
authors.forename: Kate E
authors.initials: KE
authors.lastname: Marshall
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Farney
authors.forename: Kelley G
authors.initials: KG
authors.lastname: Hammond
mesh_terms: D000328:Adult; D000339:Affect; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D031204:Caloric Restriction / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D000529:Complementary Therapies / Q000009:adverse effects / Q000523:psychology; D014676:Diet, Vegetarian / Q000009:adverse effects / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012307:Risk Factors; D012528:Satiety Response; D055815:Young Adult
chemical_list: D007328:Insulin; D002097:C-Reactive Protein; D002784:Cholesterol
references.citation: J Gerontol A Biol Sci Med Sci. 2010 Jul;65(7):695-703
references.pmid: 20371545
references.citation: Genes Dev. 2003 Feb 1;17(3):313-21
references.pmid: 12569120
references.citation: Am J Clin Nutr. 1977 Sep;30(9):1414-22
references.pmid: 900057
references.citation: Arch Intern Med. 2009 Jun 8;169(11):1046-54
references.pmid: 19506174
references.citation: J Am Coll Nutr. 1998 Jun;17(3):285-90
references.pmid: 9627917
references.citation: Lancet. 2002 Nov 9;360(9344):1455-61
references.pmid: 12433513
references.citation: Clin Interv Aging. 2006;1(1):11-31
references.pmid: 18047254
references.citation: Altern Med Rev. 2004 Dec;9(4):420-8
references.pmid: 15656713
references.citation: Am J Epidemiol. 2006 Feb 1;163(3):222-31
references.pmid: 16357111
references.citation: Am J Clin Nutr. 1999 Sep;70(3):412-9
references.pmid: 10479204
references.citation: Am J Clin Nutr. 1988 Sep;48(3 Suppl):712-38
references.pmid: 3046302
references.citation: Biochim Biophys Acta. 2008 Nov;1780(11):1337-47
references.pmid: 18252204
references.citation: Proc Nutr Soc. 2006 Feb;65(1):35-41
references.pmid: 16441942
references.citation: Ageing Res Rev. 2010 Jul;9(3):324-53
references.pmid: 19853062
references.citation: Pediatrics. 2003 Mar;111(3):488-94
references.pmid: 12612226
references.citation: Nutr Rev. 1998 Dec;56(12):347-53
references.pmid: 9884582
references.citation: Exp Gerontol. 2007 Aug;42(8):709-12
references.pmid: 17482403
references.citation: Am J Clin Nutr. 2007 Jul;86(1):7-13
references.pmid: 17616757
references.citation: Trends Endocrinol Metab. 2009 Sep;20(7):325-31
references.pmid: 19713122
references.citation: Aging (Albany NY). 2009 Oct 22;1(10):875-80
references.pmid: 20157561
references.citation: Am J Clin Nutr. 2000 Oct;72(4):922-8
references.pmid: 11010932
references.citation: Am J Clin Nutr. 2007 Apr;85(4):1157-63
references.pmid: 17413119
references.citation: Science. 1996 Jul 5;273(5271):59-63
references.pmid: 8658196
references.citation: Diabetes Care. 2004 Dec;27(12):2777-83
references.pmid: 15562184
references.citation: Mech Ageing Dev. 2005 Sep;126(9):913-22
references.pmid: 15885745
references.citation: Am J Clin Nutr. 2005 Feb;81(2):380-7
references.pmid: 15699225
references.citation: JAMA. 2000 Sep 13;284(10):1263-70
references.pmid: 10979113
references.citation: Diabetologia. 1985 Jul;28(7):412-9
references.pmid: 3899825