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1: Isr Med Assoc J 2000
Mar;2(3):215-9
Effect of prolonged fasting on
plasma lipids, lipoproteins and apolipoprotein B in 12 physicians participating in a
hunger strike: an observational study.
Fainaru M, Schafer Z
Lipid Research Laboratory, Rabin
Medical Center, Petah Tiqva, Israel. [email protected]
BACKGROUND: Dyslipidemia and obesity
serve as risk factors for the development of atherosclerotic cardiovascular disease.
Fasting is sometimes recommended for treating these conditions. This study was undertaken
to try to resolve conflicting results reported in the literature. OBJECTIVES: To study the
effect of fasting (0 calories, with free intake of fluids) for 3-5 days on plasma
concentration of triglyceride, cholesterol and apolipoprotein B. METHODS: Physicians,
about to begin a hunger strike, were divided into four groups: normolipidemic non-obese
men (group 1), two moderately obese men and two men with type IV hyperlipidemia (group 2),
healthy non-obese women (group 3), and healthy non-obese women on oral contraceptives
(group 4). Adherence to fasting was monitored daily by detailed interviews, loss of
weight, drop in plasma glucose, presence of ketonuria, progressive rise in serum
creatinine and uric acid, and decrease in plasma pH. We monitored their serum glucose,
electrolytes, liver function, lipids, lipoproteins and apolipoprotein B on days 0, 3, and
5. RESULTS: Physicians who adhered to complete fasting lost more than 1.5% of their body
weight after 3 days of fasting (n = 12), and more than 3.2% at 5 days (n = 5). All
non-obese normolipidemic males and females (groups 1 and 3) showed an increase in plasma
triglyceride (by 28-162%) and very low density lipoprotein cholesterol (by 22-316%) after
3 days of fasting. The obese and hyperlipidemic men (group 2) showed a decrease of 17-63%
in their VLDL cholesterol, and the women on oral contraceptives (group 4) showed a 20%
decrease in their plasma triglyceride on day 3. Low density lipoprotein cholesterol
increased by 13% in group 2, decreased by 7.3% in group 4, and remained unchanged in group
1 and 3. Apolipoprotein B level correlated well with LDL cholesterol in all groups. High
density lipoprotein cholesterol changes were inconsistent. CONCLUSIONS: These results help
to explain and reconcile previous published reports. The metabolic background of the
individual together with the amount of energy consumed affect the behavior of plasma
lipids and lipoproteins levels during fasting.
PMID: 10774270, UI: 20236085 |
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