TrueNorth Health Foundation, Santa Rosa, CA 95404, USA.
Department of Research, American College of Lifestyle Medicine, Chesterfield, MO 63006, USA.
Nutrients. 2022 Oct 15;14(20):4313. doi: 10.3390/nu14204313.
(1) Background: Chronic inflammation and insulin resistance are associated with cardiometabolic diseases, such as cardiovascular disease, type 2 diabetes mellitus, and non-alcoholic fatty liver disease. Therapeutic water-only fasting and whole-plant-food refeeding was previously shown to improve markers of cardiometabolic risk and may be an effective preventative treatment but sustained outcomes are unknown. We conducted a single-arm, open-label, observational study with a six-week post-treatment follow-up visit to assess the effects of water-only fasting and refeeding on markers of cardiometabolic risk. (2) Methods: Patients who had voluntarily elected and were approved to complete a water-only fast were recruited from a single-center residential medical facility. The primary endpoint was to describe changes to Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) scores between the end-of-refeed visit and the six-week follow-up visit. Additionally, we report on changes in anthropometric measures, blood lipids, high-sensitivity C-reactive protein (hsCRP), and fatty liver index (FLI). Observations were made at baseline, end-of-fast (EOF), end-of-refeed (EOR), and six-week follow-up (FU). (3) Results: The study enrolled 40 overweight/obese non-diabetic participants, of which 33 completed the full study protocol. Median fasting, refeeding, and follow-up lengths were 14, 6, and 45 days, respectively. At the FU visit, body weight (BW), body mass index (BMI), abdominal circumference (AC), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein (LDL), hsCRP, and FLI were significantly decreased from baseline. Triglycerides (TG) and HOMA-IR scores, which had increased at EOR, returned to baseline values at the FU visit. (4) Conclusion: Water-only fasting and whole-plant-food refeeding demonstrate potential for long-term improvements in markers of cardiovascular risk including BW, BMI, AC, SBP, DBP, blood lipids, FLI, and hsCRP.
（1）背景：慢性炎症和胰岛素抵抗与心血管疾病、2 型糖尿病和非酒精性脂肪肝等代谢性疾病相关。仅用水禁食和全植物食物再喂养的治疗方法已被证明可以改善心血管代谢风险标志物，并且可能是一种有效的预防治疗方法，但持续的效果尚不清楚。我们进行了一项单臂、开放标签、观察性研究，并在治疗后 6 周进行了随访，以评估仅用水禁食和再喂养对心血管代谢风险标志物的影响。
（2）方法：从一家单中心住院医疗设施中招募了自愿选择并获准完成仅用水禁食的患者。主要终点是描述再喂养结束访视和 6 周随访之间的稳态模型评估的胰岛素抵抗（HOMA-IR）评分变化。此外，我们还报告了人体测量指标、血脂、高敏 C 反应蛋白（hsCRP）和脂肪肝指数（FLI）的变化。观察在基线、禁食结束（EOF）、再喂养结束（EOR）和 6 周随访（FU）时进行。
（3）结果：该研究纳入了 40 名超重/肥胖的非糖尿病患者，其中 33 名完成了完整的研究方案。中位禁食、再喂养和随访时间分别为 14、6 和 45 天。在 FU 访视时，体重（BW）、体重指数（BMI）、腰围（AC）、收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、低密度脂蛋白（LDL）、hsCRP 和 FLI 均显著低于基线值。在 EOR 升高的甘油三酯（TG）和 HOMA-IR 评分在 FU 访视时恢复到基线值。
（4）结论：仅用水禁食和全植物食物再喂养显示出改善心血管风险标志物的潜力，包括 BW、BMI、AC、SBP、DBP、血脂、FLI 和 hsCRP。
