The Safety and Impact of a Model of Intermittent, Time-Restricted Circadian Fasting (“Ramadan Fasting”) on Hidradenitis Suppurativa: Insights from a Multicenter, Observational, Cross-Over, Pilot, Exploratory Study

Abstract

Hidradenitis suppurativa (HS) is a chronic-relapsing and debilitating disease, which affects the components of the folliculopilosebaceous unit and severely impacts on the perceived health-related quality of life. Among the possible treatments, dietary interventions, such as fasting, have been described to positively impact on HS. However, nothing is known about the effects of circadian, intermittent fasting, such as the Ramadan fasting. A sample of 55 HS patients (24 males (43.6%) and 31 females (56.4%), mean age 39.65 ± 8.39 years, average disease duration 14.31 ± 7.03 years) was recruited in the present study. The “Severity of International Hidradenitis Suppurativa Severity Score System” (IHS4) decreased significantly from 11.00 ± 5.88 (before Ramadan) to 10.15 ± 6.45 (after Ramadan), with a mean difference of −0.85 ± 0.83 (p < 0.0001). At the univariate analyses, the improvement was associated with HS phenotype (with a prominent improvement among those with ectopic type), treatment (with the improvement being higher in patients receiving topical and systemic antibiotics compared to those treated with biologics), the “Autoinflammatory Disease Damage Index” (ADDI), and Hurley scores. At the multivariate regression analysis, only the Hurley score (regression coefficient = 0.70, p = 0.0003) was found to be an independent predictor of change in the IHS4 score after fasting. The improvement in the IHS4 score was not, however, associated with weight loss. In conclusion, the Ramadan fasting proved to be safe and effective in HS patients. Considering the small sample size and the exploratory nature of the present investigation, further studies in the field are warranted, especially longitudinal, prospective and randomized ones.

New Zealand Bitter Hops Extract Reduces Hunger During a 24 h Water Only Fast

“…Additionally, IF confers benefits that extend well beyond weight loss. It replicates some health benefits associated with prolonged caloric restriction [16,24], is immunoregulatory [25], effects markers of skin health and dermatology [26,27,28], improves symptoms of arthritis [29], is associated with improved outcomes for cancer patients [30], and enhances glucose regulation post-fast [31]. While diet composition is not modified during fasting, feelings of hunger are increased [32,33], notably during the 16–24 h period of a 24 h water-only fast [34], that may negatively affect dietary restraint and potentially reduce long- and short-term compliance to the diet regime [35,36,37,38].…”

The Effectiveness of Intermittent Fasting to Reduce Body Mass Index and Glucose Metabolism: A Systematic Review and Meta-Analysis

“…A variety of diets have been used to study the effects of IF [5], including alternate-day fasting (ADF, consuming no calories on fasting days) [6], alternate-day modified fasting (ADMF, consuming less than 25% of baseline energy needs on fasting days) [7,8], time-restricted fasting (TRF, restricting food intake to specific time periods of the day) [9], and periodic fasting (PF, fasting only one to two day per week) [10]. In addition to the effect on weight loss, many studies have shown that through IF we can expect a powerful effect on improvement of glucose metabolism by lowering insulin resistance [11], improvement of systemic inflammatory diseases [12,13,14,15], protection against neurodegeneration, and even expansion of the life span [16].…”

The Effects of Intermittent Fasting Combined with Resistance Training on Lean Body Mass: A Systematic Review of Human Studies

“…Regardless of the reason or method of fasting, all involve extended periods of time with little or no nutritional intake. While there are many purported health benefits with fasting, including those linked to elevated body mass index and/or chronic inflammation [ 3 , 4 , 5 , 6 ], a potentially unfavourable consequence of energy restriction is loss of lean body mass (LBM). The maintenance of skeletal muscle mass (which is a large component of LBM), is determined by changes in rates of skeletal muscle protein synthesis (MPS) and skeletal muscle protein breakdown (MPB) [ 7 ].…”