title: Metabolic and psychological response to 7-day fasting in obese patients with and without metabolic syndrome.
abstract: BACKGROUND
  Extended modified fasting is a frequently practiced tradition in Europe. It is claimed to improve the cardiometabolic state and physical and psychological well-being by an evolutionary co-developed adaptation response. We aimed to investigate the cardiometabolic and psychological effects of a 7-day fast and differences of these responses between patients with or without metabolic syndrome (MetS).
  
  
  METHODS
  We investigated 30 female subjects (49.0 ± 8.1 years, BMI 30.4 ± 6.7 kg/m(2)) with (n = 12) and without (n = 18) MetS. All subjects participated in a 7-day fast according to Buchinger with a nutritional energy intake of 300 kcal/day and stepwise reintroduction of solid food thereafter. Outcomes were assessed baseline and after fasting and included measures of metabolic and glucoregulatory control, adipokines as well as psychological well-being as assessed by Profile of Mood States (POMS) and Hospital Anxiety and Depression Scale (HADS).
  
  
  RESULTS
  Mean weight decreased from 85.4 ± 18.8 kg to 79.7 ± 18.2 kg accompanied by systolic/diastolic blood pressure (BP) reduction of -16.2 mm Hg (95% CI: -9.1; -23.3 mm Hg) and -6.0 mm Hg (95% CI: -1.8; -10.3 mm Hg), each p < 0.001 and p = 0.005. Fasting led to marked decreases of levels of LDL-cholesterol, leptin, and insulin and increases of levels of adiponectin, leptin receptors, and resistin. Fasting-induced mood enhancement was reflected by decreased anxiety, depression, fatigue, and improved vigor. Patients with MetS showed some greater changes in B P, LDL-cholesterol, triglycerides, adiponectin, leptin, and sleep quality. Fasting was well-tolerated.
  
  
  CONCLUSIONS
  Our results point to marked beneficial responses to 7-day modified fasting and a potential role in the prevention of the MetS. Randomized trials with longer observation periods should test the clinical effectiveness of fasting in metabolic diseases.
authors.affiliation: Department of Traditional Chinese Medicine, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Chenying
authors.initials: C
authors.lastname: Li
authors.forename: Thomas
authors.initials: T
authors.lastname: Ostermann
authors.forename: Monika
authors.initials: M
authors.lastname: Hardt
authors.forename: Rainer
authors.initials: R
authors.lastname: Lüdtke
authors.forename: Martina
authors.initials: M
authors.lastname: Broecker-Preuss
authors.forename: Gustav
authors.initials: G
authors.lastname: Dobos
authors.forename: Andreas
authors.initials: A
authors.lastname: Michalsen
mesh_terms: D054392:Adipokines / Q000097:blood; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D008078:Cholesterol, LDL / Q000097:blood; D015897:Comorbidity; D004734:Energy Metabolism / Q000502:physiology; D005215:Fasting / Q000502:physiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D024821:Metabolic Syndrome / Q000178:diet therapy* / Q000503:physiopathology / Q000523:psychology; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000503:physiopathology* / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D054411:Receptors, Leptin / Q000097:blood; D052243:Resistin / Q000097:blood; D011795:Surveys and Questionnaires
chemical_list: D054392:Adipokines; D001786:Blood Glucose; D008078:Cholesterol, LDL; D007328:Insulin; D020738:Leptin; D054411:Receptors, Leptin; D052243:Resistin