Do the advantages of fasting expand to the intestinal microbioma?

reference

SU J, Wang Y, Zhang X, et al. Conversion of the intestinal microbioma during the Ramadan-associated intermittent fasting. am j Clin nutr . 2021; 113: 1332-1342.

objective

Analysis of the biological effects of a one-month Ramadan-associated intermittent fasting on the intestinal microbiom

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prospective study of 2 separate cohorts during Ramadan fasting

participant

There were 2 cohorts: a cohort of young adults and a middle -aged cohort. The middle -aged cohort had 10 non -fast participants who served as control; There was no control group within the cohort of young adults:

1. cohort 1 (young, healthy) Ramadan 2016: age 18.63 ± 1.75; n = 30 sober
2. cohort 2 (middle age, healthy) Ramadan 2018: age 39.9 ± 6.4; n = 27 sober, n = 10 not sober

All volunteers observed a nightly fast that took about 16 hours to celebrate Ramadan, the 9th month of the Muslim year, in which those who practice the Islamic faith fast for 30 days from sunrise to sunset. All participants in the young cohort were male, and 70 % of the participants in the middle age cohort were male. Due to regional differences in the diet of the 2 cohorts, it was reported that the young cohort had rice as a staple in their diet, while the staple food for the middle -aged cohort was wheat.

exclusion criteria were obesity, diabetes, high blood pressure, arthritis, chronic respiratory diseases and gastrointestinal diseases. The intake of prescription antibiotics per month before Lent was also excluded.

results measured

The primary result was the analysis of the composition of the intestinal microbiome before and after the Ramadan. In both cohorts, the intestinal microbiota was analyzed in both cohorts and 16S-ribosomal RNA gene sequencing as well as data processing techniques on composition, diversity and taxonomic frequency.

Healthy, young cohort: Only fecal samples were used for comparison. There were 3 times: Day one of Ramadan (T1), Day 15 (T2) and Day 30 (T3).

In view of these far -reaching effects, it makes sense that changes in the microbial composition could be a key factor for the diverse health benefits of the intermittent fasting.

Healthy middle -aged cohorts: stool samples were analyzed in the same way as with the young cohort. The times for the middle -aged cohort were the beginning of the Ramadan (T1), end of the Ramadan (T2) and 1 month after the end of the Ramadan (T3). In addition to stool samples, the researchers assessed the body composition as well as several blood parameters (comprehensive metabolic profile, hemoglobin A1C, lipid panel and uric acid). This cohort also filled out a food frequency Questionnaire (FFQ).

secondary endpoints were blood parameters, body composition and food intake.

important knowledge

During the fasting period, both cohorts experienced major changes in the composition of the microbiome, which were similar to each other, while the non -fast control in the middle -aged group did not experience any significant changes in the composition of the microbiome. In particular, both cohorts showed an enrichment of butyric acid production Lachnospiraceae . The authors point out that high concentrations of Lachnospiraceae are associated with a reduced risk of cancer, improved inflammatory intestinal disease, better mental health, less allergies and improved cardiaine -piratory health.

The young cohort had an increase in the overall diversity of the intestinal microbiota (Shannon-Weaver index), while this was not the case with the middle-aged cohort. In the middle -aged cohort, the microbial composition for most taxa has largely returned to the starting value 1 month after fasting, while shifts remained in some existence.

The fasting groups also learned weight loss and had improved liver enzyme activity.

practice implications

More than 24 % of the world population are Muslims. ^{1 The Ramadan offers a convenient way to assess the physiological changes of a 16-hour fasting in large population groups. It is expected that fasting during Ramadan, like fasting in general, should bring health benefits, and so far this seems to be the case. According to an analysis of 21 different studies from 2014, Ramadan fasting led to positive metabolic effects and weight loss. 2 This analysis and a study from 2021 showed that Ramadan fasting can reduce inflammation and strengthen immunity.}

2020, Journal of Naturopathy published a peer review paper on this topic, in which mechanisms of action and clinical applications of intermittent fasting were discussed. ^{showed a review of 12 different studies from 2019 that intermittent fasting reduced the BMI and glycemic control, insulin resistance and Obovocin concentration compared to adults who did not make intermittent fasting improved. 5 A review from 2020 showed that intermittent fasting not only reduces the risk of cardiovascular diseases, but also improves cognition in both obese and non-obese people.}

Shortly after the study discussed here, another small pilot study showed that fasting during the Ramadan led to significant changes in the intestinal microbiom. Implective for ramadan fasting that the time of day that fasts takes place (during the day vs. at night) does not change the overall effect of increasing diversity and the shift in the composition of the microbiota. The ability to change the composition of the microbiota has a broad clinical importance, since everything, from depression to diabetes, cardiovascular diseases to cancer and more, at least partially, at least partially to the intestinal microbioma. intermittent fasting could be.

interval fasting is not suitable for all patients because it is a burden on the body. As part of religious observations such as Ramadan, many population groups are encouraged to avoid fasting. This includes pre -pubertal children, older people, frail and pregnant women, to name just a few.

Fasting as a means of improving health may be one of the simplest and most economical tools that we have in integrative medicine. As with any therapy, however, caution is required for frail people, people with acute diseases and people who are considered contraindicated.

study restriction

A restriction of the study was the fact that there was no control group in the young male cohort, which affects the results of the young male cohort group. However, the control group in the middle -aged cohort confirmed that the microbial composition of the intestine hardly changed without fasting