State of the science/evidence base for integrative modalities
Secondary Topic: Clinical skills-building
Medical fasting - state of the art
Rainer - Stange, PhD, Charité - Universitätsmedizin Berlin and Immanuel Hospital, Berlin, Germany; John S Finnell, ND, MPH, LAc, Bastyr University Research Institute, Austin, TX, United States; Valter Longo, PhD, FIRC Institute of molecular oncology, Los Angeles, CA, United States; Sebastian Brandhorst, PhD, , Los Angeles, CA, United States
Late Breaker: No
There exists a historical precedence for the use of various fasting modalities for both medical and religious purposes, which are held in common across many cultures. Well-characterized protocols for medically-supervised fasting for specific indications emerged in the U.S and in Europe within the 19th and 20th centuries, respectively. To date, however, there has been limited evidence supporting the efficacy and safety of these modalities. It is estimated that clinics in Europe and the U.S. specializing in medically-supervised fasting protocols treat approximately 100,000 patients with fasting each year. The predominant indications for fasting reported in the literature include metabolic disorders, hypertension, rheumatism and other pain conditions, and have recently expanded to include indications, such as cancer, neurodegenerative diseases, as well as the evaluation of novel protocols of time-restricted feeding and intermittent fasting. The interest in research on fasting protocols has increased as the need for novel approaches to treat chronic degenerative diseases has grown.
Fasting in different modalities has been common to many cultures and religions for centuries. Medically indicated, supervised and evaluated fasting, however, has emerged within the 19th century in the US and the 20th in several European countries and been given a limited amount of evidence as towards efficacy and safety so far. Some clinics in Europe and the US are specialized treating appr. 100,000 patients with fasting each year. Predominant indications are metabolic disorders, hypertension, rheumatism and other pain conditions. Within recent decades, there has been further support by preclinical research, pointing to further indications like cancer and neurodegenerative diseases, and evaluating new patterns of time restricted feeding or intermittent fasting.
Medically-supervised fasting is a growing integrative medicine modality that is being studied internationally. It is therefore necessary to characterize the evidence presented to date, describe best practices, and establish the further research needs in this emerging field of study.
Medically supervised fasting is already, resp. will be a growing part of integrative medicine everywhere. It therefore seems necessary to outline the scientific results given so far and directions of further research as well as good practice.
Outline the standard practices of medically-supervised fasting protocols, including the patient assessment and examination, contraindications and safety, and relevant outcome parameters. Develop standard guidelines for counseling about self-practice of time-restricted feeding and intermittent fasting.
Outline of practice of medical fasting including contraindications, safety exams and outcome parameters. Counselling about self-practice of time restricted feeding, resp. intermittent fasting.
each of four speakers should be given 18 minutes plus 4.5 minutes discussion summing up to 90 minutes
Valter Longo, Sebastian Brandhorst: Most important results of preclinical research including neurodegenerative and oncological diseases as well as first trials of time restricted feeding with healthy humans.
John Finnell: Practice of fasting and results of research on safety
Rainer Stange: Acceptance, clinical evidence by uncontrolled and controlled clinical trials with long-term (>5d) fasting, projects of present and future research. Outline of certified qualifications for MDs in Austria and Germany. Clinical evidence of fasting and oncological chemotherapy by so far 3 RCT.