Evidence map›Paper›PMID 30601864›Full record

Observational studyPloS one2019

Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects.

Françoise Wilhelmi de Toledo, Franziska Grundler, Audrey Bergouignan, Stefan Drinda, Andreas Michalsen

3 registry-linked trialsOpen access · goldAbstract readObservational Study
In one paragraph

Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 126 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
126citing papers in PubMed, 5 pooled it
15.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07155993 enrolling by invitationnot on this mapstarted 2024, after this paper: background citation

FastForward: A Prospective Analysis of Long-term Fasting and Subsequent Food Reintroduction in Humans

Typeobservational_patient_registrySponsorBuchinger Wilhelmi Development & Holding GmbHRan2024 to 2026Enrolled300ConditionsDiabetes (DM), Pre Diabetes, Overweight (BMI &gt, 25)
NCT07440784 nacompletednot on this mapstarted 2022, after this paper: background citation

Impact Of Intermittent And Water-Only Fasting On Gene Expression And Tumor Markers In Breast Cancer

TypeinterventionalSponsorKhyber Medical University PeshawarRan2022 to 2026Enrolled60ConditionsBreast CancerArmsConventional Chemotherapy, Intermittent Fasting (23:1 Regimen), Ketogenic Diet, Water-Only Fasting
NCT07651462 narecruitingnot on this mapstarted 2025, after this paper: background citation

Preoperative Metabolic Optimization: Influence of Intermittent and Buchinger-Type Fasting on the Gut Microbiome, Immune Profile, and Postoperative Complications in Patients Undergoing Primary Total Hip Arthroplasty - A Randomized Controlled Trial

TypeinterventionalSponsorCharite University, Berlin, GermanyRan2025 to 2026Enrolled130ConditionsHip Osteoarthritis, Arthroplasty, Replacement, Hip, Postoperative Complications, Surgical Wound InfectionArmsBuchinger Fastenbox + intermittent fasting (20-day preoperative schedule)
3 · Its place in the literature

Who cites it

126 citing papers in PubMed, 5 syntheses or guidelines pooled it, 237 citations in OpenAlex.

  1. Pooled it
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  4. Intermittent fasting for the prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2021
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  15. Five Days Periodic Fasting Elevates Levels of Longevity RelatedInternational journal of molecular sciences · 2021
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66 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 3 countries.

Françoise Wilhelmi de ToledoBuchinger Wilhelmi Clinic, Überlingen, Germany.ORCID 0000-0002-4578-5812
Franziska GrundlerBuchinger Wilhelmi Clinic, Überlingen, Germany.
Audrey BergouignanDivision of Endocrinology, Metabolism, and Diabetes and Anschutz Health and Wellness Center, University of Colorado, School of Medicine, Aurora, Colorado, United States of America.
Stefan DrindaBuchinger Wilhelmi Clinic, Überlingen, Germany.
Andreas MichalsenInstitute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Buchinger Wilhelmi · DEHumboldt-Universität zu Berlin · DECentre National de la Recherche Scientifique · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Only few studies document longer periods of fasting in large cohorts including non-obese participants. The aim of this study was to document prospectively the safety and any changes in basic health and well-being indicators during Buchinger periodic fasting within a specialised clinic. In a one-year observational study 1422 subjects participated in a fasting program consisting of fasting periods of between 4 and 21 days. Subjects were grouped in fasting period lengths of 5, 10, 15 and 20±2 days. The participants fasted according to the Buchinger guidelines with a daily caloric intake of 200-250 kcal accompanied by a moderate-intensity lifestyle program. Clinical parameters as well as adverse effects and well-being were documented daily. Blood examinations before and at the end of the fasting period complemented the pre-post analysis using mixed-effects linear models. Significant reductions in weight, abdominal circumference and blood pressure were observed in the whole group (each p<0.001). A beneficial modulating effect of fasting on blood lipids, glucoregulation and further general health-related blood parameters was shown. In all groups, fasting led to a decrease in blood glucose levels to low norm range and to an increase in ketone bodies levels (each p<0.001), documenting the metabolic switch. An increase in physical and emotional well-being (each p<0.001) and an absence of hunger feeling in 93.2% of the subjects supported the feasibility of prolonged fasting. Among the 404 subjects with pre-existing health-complaints, 341 (84.4%) reported an improvement. Adverse effects were reported in less than 1% of the participants. The results from 1422 subjects showed for the first time that Buchinger periodic fasting lasting from 4 to 21 days is safe and well tolerated. It led to enhancement of emotional and physical well-being and improvements in relevant cardiovascular and general risk factors, as well as subjective health complaints.

Indexed as

AdolescentAdultAgedAged, 80 and overBiomarkersBlood Cell CountBlood CoagulationBlood GlucoseBlood PressureCohort StudiesElectrolytesFastingFemaleHealth PromotionHumansInflammation MediatorsBiomarkersBlood GlucoseElectrolytesInflammation MediatorsKetone BodiesLipids

Identifiers

PMID30601864
PMCPMC6314618
OpenAlexW2907649002

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.