MURRAY — Utah's low prevalence of heart disease may not only be due to its low smoking rate. It might be closely related to the age-old and particularly common religious practice of fasting.
And the benefits don't stop with heart disease. New research at Intermountain Medical Center's Heart Institute is pointing to abstinence from food as a way to derail the potentially debilitating track of diabetes.
"Fasting has the potential to become an important diabetes intervention," said Benjamin Horne, Intermountain's director of cardiovascular and genetic epidemiology. He recently led a study involving 12 Utah participants at risk for diabetes who were asked to fast 24 hours a week for six weeks.
None complained of any adverse effects, including headache or fatigue, and all of the participants experienced at least some health benefit.
"The average benefit was interesting and big enough that we feel we have enough evidence for a longer study," Horne said.
The study found that periodic and regular fasting — for at least 12 hours and, optimally, 20 hours — pushes cells into "self-preservation mode," optimizing their function, he said. It also sends the body foraging for other sources of energy, turning it from using blood sugar and glucose to digesting stores of fat. The process involves an increased production of human growth hormone that can protect lean muscle mass, decrease insulin production and avert diabetes.
"Among healthy individuals, fasting once a month is OK if you've done it for more than five years," Horne said. "We found, in three different populations of people, some of whom have been fasting for more than 40 to 50 years on a monthly basis, (they) have a lower risk of diabetes and a lower risk of coronary disease."
Because diabetes and heart disease develop over decades, Horne said, regular fasting over decades provides a cumulative benefit.
"If you are fasting for weight loss, fasting less than 20 hours at a time, you're not likely getting the optimal benefit," Horne said, adding that eating even a small amount partway through a day of fasting actually stops the body's production of human growth hormone, which is stimulated by fasting.
While the group of researchers wouldn't necessarily advocate that people start fasting more frequently or for a longer duration than they have in the past, there is some proof that a certain duration and certain frequency of fasting — yet to be determined — helps to decrease a patient's weight, bad cholesterol levels and insulin resistance.
Fasting can also lead to lower glucose levels, lower blood pressure and decreased triglycerides, as determined in a 2011 Intermountain study.
A separate study by the National Institute on Aging has also claimed that an intermittent fasting can lead to an increase in cognitive function in mice. And other institutions are conducting similar research outside of Utah, attempting to establish any weight loss benefits of fasting, although Horne said, "You get into a realm, a line you cross over, where the benefits are less than the harms when you're fasting too much."
He suggests checking with a doctor prior to any dietary changes to avoid dehydration, malnutrition, excessive weight loss and potential damages to the heart that are possible with fasting.
"We don't know the long-term risks of fasting too much," Horne said. "It's not a quick fix. There are potential harms and it needs to be done in a reasonable way."
While many groups are now studying fasting as a health practice, few have the long-term information that is available from Utah's population, which is primarily Mormon and already firmly embedded in regular fasting habits.
The Church of Jesus Christ of Latter-day Saints encourages its members to fast once a month for two consecutive meals during a 24-hour period and subsequently give a generous "fast offering" to help care for the poor and less fortunate.
Outside of Utah, it is more difficult for researchers to recruit willing participants and people who are familiar with the practice.
Horne presented the latest findings from the Utah facility at a conference of the American Diabetes Association in San Francisco on Saturday. He said the additional evidence of health benefits will help Intermountain secure more funding for future studies.
Horne and other researchers next plan to study whether the body seeks out other energy sources in the body in addition to fat cells. He hypothesizes that one source may be narrowings in the arteries, where cholesterol builds up.
While more and more is known about the long-standing practice of fasting, Horne said the benefits can be overridden by eating too much, not exercising and even bad genes. He cautions that fasting needs to be a part of a total healthy lifestyle for it to provide the best benefit.
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