Fasting Therapy - an Expert Panel Update of the 2002 Consensus Guidelines

Abstract

Fasting for medical purpose (fasting therapy) has a long tradition in Europe and is established as a defined therapeutic approach in specialized fasting hospitals or within clinical departments for integrative medicine. In 2002, the first guidelines for fasting therapy were published following an expert consensus conference; here we present a revised update elaborated by an expert panel. Historical aspects and definitions, indications, methods, forms, and accompanying procedures of fasting as well as safety and quality criteria of fasting interventions are described. Fasting has shown beneficial effects in various chronic diseases with highest level of evidence for rheumatic diseases. Preliminary clinical and observational data and recently revealed mechanisms of fasting and caloric restriction indicate beneficial effects of fasting also in other chronic conditions such as metabolic diseases, pain syndromes, hypertension, chronic inflammatory diseases, atopic diseases, and psychosomatic disorders. Fasting can also be applied for preventing diseases in healthy subjects. In order to guarantee successful use of fasting and to ensure adherence of all safety and quality standards it is mandatory that all interventions during fasting are guided/accompanied by physicians/therapists trained and certified in fasting therapy.

Changes in human gut microbiota composition are linked to the energy metabolic switch during 10 d of Buchinger fasting

“…All subjects fasted according to the fasting programme of the BWC which is documented in the guidelines of the fasting therapy (5) . They stayed under daily supervision of nurses and physicians specialised in fasting therapy.…”

Effect of Ramadan fasting on anthropometric, metabolic, inflammatory and psychopathology status of Egyptian male patients with schizophrenia

“…Therapeutic fasting is claimed to be generally safe and well tolerated, though there are some contraindications. Rather surprisingly, psychotic disorders have been considered among indications presenting a risk (Wilhelmi de Toledo et al, 2013).…”

“…We know, however, that metabolic disturbances are common in both drug naive and treatment experienced patients with schizophrenia (Britvic et al, 2013;Grover et al, 2012) and that fasting allegedly may improve these disturbances (Shariatpanahi et al, 2012). Yet, according to the latest consensus guidelines for fasting therapy, psychotic disorders are considered an 'indication presenting a risk' (Wilhelmi de Toledo et al, 2013), while as noted by Fond et al (2013), one cannot determine from the available literature the reason why fasting is risky in psychosis. Anecdotally, we are aware of patients with chronic schizophrenia who observe Ramadan fasting year after year with generally no problems.…”

Seven-day Fasting as a multimodal complex intervention for Adults with Type 1 Diabetes – Feasibility, Benefit and Safety in a Controlled Pilot Study

“…A multimodal, medical supervised fasting regimen, including medical, psychosocial and cognitive dimensions called "Buchinger Fasting" has a long tradition in Europe and is established as a de ned therapeutic approach in specialized fasting hospitals [5].This multimodal type of fasting intervention has been shown to be effective in a number of conditions that could potentially be relevant to people with type 1 diabetes, such as depressive disorders, exhaustion / fatigue, the metabolic syndrome including type 2 diabetes and autoimmune diseases such as rheumatoid arthritis [6], [7], [8]. A guideline on the method has been published [5]. The evaluation of 1422 subjects following a Buchinger fasting lasting 21 days showed that this intervention is safe and well tolerated in people without type 1 diabetes.…”