Doctors recommend fasting

Therapeutic fasting

Therapeutic fasting has a millennia-old tradition and is intended to purify body, mind and soul. Therapeutic fasting is used by healthy people, to start weight loss and for certain diseases.

Therapeutic fasting is a form of fasting that goes back to the doctor Otto Buchinger (1878 - 1966). This fasting method can be used both for health prevention and for therapy for certain diseases. In contrast to total fasting, therapeutic fasting supplies the body with a small amount of energy. According to Buchinger, therapeutic fasting works not only on a medical level, but also on a psychosocial and spiritual level. These 3 dimensions together form a unit that cannot be separated. Buchinger therefore also spoke of a "Diet of the soul“While fasting. The fasting person should devote himself to beautiful things such as music, books, nature and meditation and avoid media consumption and daily stress.

In order to ensure the successful use of fasting, the fasting should be supervised by doctors or therapists who are certified for fasting therapy. Since 1996, doctors have been able to acquire the advanced training certificate “fasting doctor” from the Medical Association for therapeutic fasting and nutrition e. V. acquire a proven qualification.

A Classification of therapeutic fasting On the one hand, using the State of health take place (therapeutic fasting, preventive fasting, fasting for healthy people) or after Type of care (inpatient with accompaniment by doctors in clinics, fasting outside the clinic with medical care, fasting supervision by a fasting leader).

Course of a therapeutic fasting cure

The traditional Buchinger fast begins with a on the day before the fast Energy reduction to about 1,000 kcal / d. The supply of caffeine, alcohol and nicotine is stopped at this point at the latest. Moderate to normal physical activity is recommended, as is emotional preparation for fasting (avoiding stress, more rest). According to the guidelines for fasting therapy, fasting therapy should best be carried out in a group under medical supervision.

At the beginning of the first day of fasting, the "Colon cleansing“Taking 1 liter of water with 30 - 40 g of Glauber's salt within 20 minutes. The taste can be enhanced with lemon juice. After 30 minutes, a further 0.5 - 1.0 liter of liquid (water or tea) is absorbed.

During the fasting days there is a daily intake of:

  • Vegetable broth (0.25 l),
  • Fruit or vegetable juices (0.25 l) (freshly squeezed if possible) and
  • Honey (30 g) as well
  • At least 2.5 liters of liquid per day through herbal tea or water.

The maximum permitted energy supply is 250 - 500 kcal / d. For longer-lasting fasting cures, the intake of buttermilk is also allowed (Fahrner 1991).

According to Buchinger, this is optimal fasting duration 2 - 4 weeks, whereby individual aspects should be taken into account. Often, shorter fasting periods are easier to implement or are preferred for medical reasons. Especially healthy people who do not fast for therapeutic reasons also benefit from shorter periods. Longer periods of fasting - up to 6 weeks - may be indicated for certain indications. The Medical Association for Therapeutic Fasting and Nutrition (ÄGHE) recommends planning a standard duration of 7-10 days plus 1 preparation day and then 3 days to normalize eating behavior for a therapeutic fasting cure.

Fasting typically ends with the so-called Breaking the fast. To do this, the fasting person slowly eats a raw, ripe or boiled apple. In the evening there is a potato soup. The diet after breaking the fast (refeeding) consists of a light ovo-lacto-vegetarian diet (made from fresh organic products), which contains foods rich in fiber, more unsaturated fats (cold-pressed vegetable oils) and only a few saturated fats. The food should be chewed slowly and consciously. On the first day, the body is supplied with around 800 kcal, on the second around 1,000 kcal, on the third around 1,200 kcal and on the fourth around 1,600 kcal. Fasters still need plenty of fluids between meals. Spontaneous bowel movements and bowel movements should occur no later than the fourth day.

Therapeutic fasting - an overview of the scientific study situation

For the following diseases there are beneficial effects of fasting:

  • Metabolic syndrome
  • chronic inflammation
  • chronic cardiovascular diseases
  • chronic pain conditions
  • atopic diseases
  • psychosomatic diseases.

There is level 1 evidence for the treatment of rheumatoid arthritis based on a systematic review of randomized studies (Müller et al. 2001).

Preliminary evidence from smaller, non-randomized studies or observational studies exists for metabolic syndrome, osteoarthritis, fibromyalgia, high blood pressure, chronic pain in the musculoskeletal system, migraines, assistance with lifestyle changes, psychological well-being, assistance with chemotherapy and improvement in mood (summarized in Wilhelmi de Toledo et al. 2013).

The patient's desire to fast is an important part of the success of the therapy. The doctor's experience also determines the success.

The following side effects may occur during fasting:

  • slight circulatory problems
  • mild hypoglycemia
  • Electrolyte disorders,
  • Hyponatremia
  • Headache migraine
  • acute back pain
  • Muscle spasms
  • temporarily poor eyesight
  • temporary fluid retention
  • Changes in sleep behavior

It is advisable to discontinue therapeutic fasting therapy if the fasting person is not compliant, cardiac arrhythmias, stomach problems and reflux occur, serious electrolyte disorders (K+ <3.0 mmol / l or Na+ <125 mmol / l or Cº <90 mmol / l) or circulatory collapse (HR <45 / min, RRsys <70 mm Hg and / or RRdia <40) occurs. When taking certain Medication may have to. Adjustments in dosage respectively. These include non-steroidal anti-inflammatory drugs (NSAIDs), systemic corticoids, antihypertensive drugs (especially beta blockers and diuretics), drugs for diabetes mellitus, contraceptives (weakened effect), anticoagulants, psychotropic drugs (especially neuroleptics and lithium) and anti-epileptics.

Conclusion and nutritional evaluation

Medical fasting (fasting therapy) has a long tradition in Europe and is established as a clearly defined therapeutic approach in special fasting clinics or in clinical departments for integrative medicine. Guidelines for fasting therapy were published for the first time in 2002 (Wilhelmi de Toledo et al. 2002). A group of experts revised and updated the version in 2013 (Wilhelmi de Toledo et al. 2013).

These guidelines recommend therapeutic fasting both preventively for healthy people and for certain diseases such as rheumatoid arthritis or the metabolic syndrome to improve the state of health.

In addition to the compliance of the fasting person, the support of experienced fasting doctors or specially trained fasting leaders is decisive for the success of therapeutic fasting therapy. Individual problems such as medication adjustments must be taken into account in any case.

Therapeutic fasting is only partially recommended for weight loss. However, it can possibly represent an introduction to a change in diet.

Source: German Nutrition Society: therapeutic fasting, alkaline fasting, intermittent fasting - an overview. DGEinfo (2/2018) 18-25