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Published (Version of record)CC BY V4.0, Open
Journal article
Effects of Fasting and Lifestyle Modification in Patients with Metabolic Syndrome: A Randomized Controlled Trial
Journal of Clinical Medicine, Vol.11(16), pp.1-15
14/08/2022
PMCID: PMC9410059
PMID: 36012990
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Abstract
Background: Lifestyle interventions, such as fasting, diet, and exercise, are increasingly used as a treatment option for patients with metabolic syndrome (MS). This study assesses the efficacy and safety of fasting followed by lifestyle modification in patients with MS compared to lifestyle modification only. Methods: Single-blind, multicenter, parallel, randomized controlled trial in two German tertiary referral hospitals in metropolitan areas. Interventions: (a) 5-day fasting followed by 10 weeks of lifestyle modification (modified DASH diet, exercise, mindfulness; n = 73); (b) 10 weeks of lifestyle modification only (n = 72). Main outcomes and measures: Co-primary outcomes were ambulatory systolic blood pressure and the homeostasis model assessment (HOMA) index at week 12. Further outcomes included anthropometric, laboratory parameters, and the PROCAM score at weeks 1, 12, and 24. Results: A total of 145 patients with metabolic syndrome (62.8% women; 59.7 ± 9.3 years) were included. No significant group differences occurred for the co-primary outcomes at week 12. However, compared to lifestyle modification only, fasting significantly reduced HOMA index (Δ = −0.8; 95% confidence interval [CI] = −1.7, −0.1), diastolic blood pressure (Δ = −4.8; 95% CI = −5.5, −4.1), BMI (Δ = −1.7; 95% CI = −2.0, −1.4), weight (Δ = −1.7; 95% CI = −2.0, −1.4), waist circumference (Δ = −2.6; 95% CI = −5.0, −0.2), glucose (Δ = −10.3; 95% CI = −19.0, −1.6), insulin (Δ = −2.9; 95% CI = −5.3, −0.4), HbA1c (Δ = −0.2; 95% CI = −0.4, −0.05;), triglycerides (Δ = −48.9; 95% CI = −81.0, −16.9), IL−6 (Δ = −1.2; 95% CI = −2.5, −0.005), and the 10-year risk of acute coronary events (Δ = −4.9; 95% CI = −9.5, −0.4) after week 1. Fasting increased uric acid levels (Δ = 1.0; 95% CI = 0.1, 1.9) and slightly reduced eGRF (Δ = −11.9; 95% CI = −21.8, −2.0). Group differences at week 24 were found for weight (Δ = −2, 7; 95% CI = −4.8, −0.5), BMI (Δ = −1.0; 95% CI = −1.8, −0.3), glucose (Δ = −7.7; 95% CI = −13.5, −1.8), HDL (Δ = 5.1; 95% CI = 1.5, 8.8), and CRP (Δ = 0.2; 95% CI = 0.03, 0.4). No serious adverse events occurred. Conclusions: A beneficial effect at week 24 was found on weight; fasting also induced various positive short-term effects in patients with MS. Fasting can thus be considered a treatment for initializing lifestyle modification for this patient group; however, it remains to be investigated whether and how the multilayered effects of fasting can be maintained in the medium and longer term.
Details
- Title
- Effects of Fasting and Lifestyle Modification in Patients with Metabolic Syndrome: A Randomized Controlled Trial
- Creators
- Holger Cramer - University of Duisburg-EssenChristoph Hohmann - Humboldt-Universität zu BerlinRomy Lauche - Southern Cross UniversityKyung-Eun Choi - Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, GermanyNadia Schneider - University of Duisburg-EssenNico Steckhan - Humboldt-Universität zu BerlinFlorian Rathjens - University of Duisburg-EssenDennis Anheyer - University of Duisburg-EssenAnna Paul - University of Duisburg-EssenChristel von Scheidt - Immanuel KrankenhausThomas Ostermann - Witten/Herdecke UniversityElisabeth Schneider - Humboldt-Universität zu BerlinDaniela A. Koppold-Liebscher - Humboldt-Universität zu BerlinChristian S. Kessler - Humboldt-Universität zu BerlinGustav Dobos - University of Duisburg-EssenAndreas Michalsen - Humboldt-Universität zu BerlinMichael Jeitler - Humboldt-Universität zu Berlin
- Publication Details
- Journal of Clinical Medicine, Vol.11(16), pp.1-15
- Publisher
- MDPI AG
- Grant note
- This work was supported by Corona-Foundation, Essen, Germany (funding number: S199/10056/2012). We acknowledge financial support from the Open Access Publication Fund of Charité-Universitätsmedizin Berlin and the German Research Foundation (DFG).
- Identifiers
- 991013047413002368
- Copyright
- © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
- Academic Unit
- Faculty of Health; National Centre for Naturopathic Medicine
- Language
- English
- Resource Type
- Journal article