Visioli Francesco, Mucignat-Caretta Carla, Anile Francesca, Panaite Stefan-Alexandru
Department of Molecular Medicine, University of Padova, Viale G. Colombo, 335121 Padova, Italy.
IMDEA-Food, 28049 Madrid, Spain.
Nutrients. 2022 Jan 19;14(3):433. doi: 10.3390/nu14030433.
Fasting has been practiced for millennia, for religious, ethical, or health reasons. It is also commonplace among different species, from humans, to animals, to lower eukaryotes. Research on fasting is gaining traction based on recent studies that show its role in many adaptive cellular responses such as the reduction of oxidative damage and inflammation, increase of energy metabolism, and in boosting cellular protection. In this expert review, we recount the historical evolution of fasting and we critically analyze its current medical applications, including benefits and caveats. Based on the available data, we conclude that the manipulation of dietary intake, in the form of calorie restriction, intermittent fasting, dietary restriction with the exclusion of some nutrients, prolonged fasting, and so forth, is anthropologically engraved in human culture possibly because of its positive health effects. Indeed, many studies show that fasting ameliorates many biochemical parameters related to cardiovascular and cancer risk, and neurodegeneration. Mechanistic studies are plentiful, but largely limited to cell cultures or laboratory animals. Understandably, there are no controlled trials of any form of fasting that gauge the effects on [any cause] mortality. Physicians should be aware that misinformation is pervasive and that their patients often adopt dietary regimens that are far from being clinically validated. Moreover, doctors are often unaware of their patients' religious or traditional fasting and of its potential health effects. Based on current evidence, no long-term fasting should be undertaken without medical supervision until future research will hopefully help shed further light on fasting and its effects on human health.
禁食已延续了数千年,其原因包括宗教、伦理或健康等方面。在从人类到动物再到低等真核生物的不同物种中,禁食也很常见。基于最近的研究,禁食研究越来越受到关注,这些研究表明禁食在许多适应性细胞反应中发挥作用,如减少氧化损伤和炎症、增加能量代谢以及增强细胞保护。在这篇专家综述中,我们讲述了禁食的历史演变,并批判性地分析了其当前的医学应用,包括益处和注意事项。根据现有数据,我们得出结论,以热量限制、间歇性禁食、排除某些营养素的饮食限制、长时间禁食等形式对饮食摄入进行调控,在人类文化中有着深刻的印记,这可能是因为其对健康有积极影响。的确,许多研究表明禁食能改善许多与心血管疾病、癌症风险和神经退行性变相关的生化参数。机制研究很多,但大多限于细胞培养或实验动物。可以理解的是,尚无任何形式的禁食对照试验来评估其对[任何原因]死亡率的影响。医生应该意识到错误信息很普遍,他们的患者常常采用远未经过临床验证的饮食方案。此外,医生往往不了解患者的宗教或传统禁食情况及其潜在的健康影响。基于目前的证据,在没有医学监督的情况下,不应进行长期禁食,直到未来的研究有望进一步阐明禁食及其对人类健康的影响。