Key findings of the study at a glance
- A medically supervised 14-day fast in accordance with the Buchinger Wilhelmi fasting programme improved the lipoprotein profile in 20 women and 20 men after seven days, and even more after 14 days.
- The LDL cholesterol and triglyceride levels in their blood dropped as a result, with small dense low-density lipoproteins (sdLDL) – the most dangerous particles – showing the most significant reduction. In contrast, there was little change in the protective HDL (high-density lipoproteins) subclass. In this way, it was possible to reduce the lipoprotein-associated cardiovascular risk.
What are lipoproteins
Lipoproteins act as vehicles to transport cholesterol and triglycerides in the blood. Several of these lipoproteins, especially those from LDL subclasses, can penetrate the artery walls and contribute to the formation of plaque. This leads to a constriction of the arteries, increasing the risk of a heart attack or stroke. The causes are mainly malnutrition and excess nutrition as well as a lack of exercise. A change in lifestyle is therefore the first therapeutic step, even if drugs are widely used to reduce lipid levels.
Lipoproteins are divided into subclasses (or subfractions) depending on the size and density of their particles. As well as HDL and LDL, they include IDL (intermediate density lipoproteins) and VLDL (very low-density lipoproteins). The smaller and denser the LDL particles, the more they promote the formation of plaque. Determining lipoprotein subclasses can help to assess the cardiovascular risk more precisely than with routine cholesterol and triglyceride measurements.
Results of the study
Using state-of-the-art research methods such as density gradient ultracentrifugation, the present study showed improvements, above all in subfractions with a high cholesterol content. LDL cholesterol (LDL-C) decreased by 16 % (LDL1-C) or 23 % (LDL2-C), depending on the subgroup, while small, dense, highly atherogenic LDL3-C dropped by 30 % after 14 days of fasting. The cholesterol content of VLDL fell by 39 %. The triglyceride content of VLDL decreased most significantly. Nuclear magnetic resonance (NMR) was used to confirm the reduction of large and small LDL particles after 14 days of fasting. HDL changed least, which is a positive result, as HDL has a protective function by transporting cholesterol from peripheral tissues back to the liver. An increase in large HDL particles was even observed. Furthermore, participants experienced an average weight loss of 4.5 kg after seven days of fasting and 7.0 kg after 14 days. Their waist circumference was reduced by 7.5 cm overall. Participants exercised considerably more during the Buchinger Wilhelmi fasting programme than they did before: The time they spent on physical activity increased from 4.2 hours/week to 13.9 hours/week.
In general, the emotional and physical well-being of participants in the study improved in the course of the fasting programme, which is available in Buchinger Wilhelmi clinics in Überlingen and Marbella.
Franziska Grundler, Dietmar Plonné, Robin Mesnage, Diethard Müller, Cesare R Sirtori, Massimiliano Ruscica, Françoise Wilhelmi de Toledo (2021): Long-term fasting improves lipoprotein-associated atherogenic risk in humans. European Journal of Nutrition
Dr. Françoise Wilhelmi de Toledo