Buchinger Wilhelmi

Type 2 diabetes mellitus (T2DM) is a common metabolic disorder typically managed with medication; however, fasting has recently attracted attention for its potential benefits in glycemic control, weight management, and even potential remission. This case report examines the effects of repeated long-term fasting on weight reduction, glycemic control, and medication requirements in a 57-year-old man with T2DM. The patient, who had a history of inadequate glycemic control despite conventional treatment, opted for repeated long-term fasting under medical supervision. He completed several fasts ranging from 11 to 20 days each, with each fasting period followed by a gradual reintroduction of food via a hypocaloric lactovegetarian diet (800–1,800 kcal) over 4 to 16 days. The intervention resulted in sustained weight loss and improved blood sugar control. Notably, clinically meaningful improvements occurred in fasting blood glucose levels, which necessitated adjustments in his antidiabetic medications. Enhanced insulin sensitivity was evidenced by decreased HbA1c levels and a reduced dependence on hypoglycemic agents. Additionally, post-fasting evaluations indicated improvements in inflammatory markers and a reduction in fatty liver disease. In summary, repeated long-term fasting in this patient was associated with sustained weight loss, improved glycemic control, and reduced medication requirements, thereby enhancing the overall management of T2DM. Further research, including randomized controlled trials, is needed to better understand the long-term safety and effectiveness of this intervention.

Fasting shows promise for public health, but concerns about muscle loss hinder its acceptance, particularly among the elderly. We explored the impact of long-term fasting (12 days, 250 kcal/day) on muscle structure, metabolism and performance. We prospectively assessed muscle volume, composition, relaxometry data and lipid metabolism in 32 subjects (16 men; 50% over 50 years old) before fasting, at the end of fasting and 1 month post-fasting. Techniques included high-resolution 3D Dixon MR imaging, multiecho CSE and single-voxel MR spectroscopy. Dynamic 31P-MRS, quantitative MRI, maximal voluntary contraction (MVC) measurements and exercise testing (VO2peak) were repeated throughout the protocol. Although the average body weight loss was 5.9 kg (7.4%, p < 0.001), the skeletal muscle volume change measured on the right calf muscle was 271 mL (5.4%, p < 0.001). This closely aligns with expected losses of glycogen (1%-2%) and bound water (3%-4%), estimated to total 404-505 mL. MVC (anaerobic lactic metabolism) remained preserved in both thighs and calf muscles, regardless of sex or age. Unchanged T2 showed that fasting did not induce structural or inflammatory changes. MRI/MRS revealed fat redistribution among tissues, with subcutaneous fat decrease (by 417.2 cm3, p < 0.01) and total fat fraction increase (by 0.2%, p < 0.05) in muscle. The intramyocellular lipid pool increased by 2.2 times (p < 0.05), whereas the extracellular lipid pool decreased to 1.4 times (p < 0.05), revealing rapid lipid trafficking and adaptation. During fasting, the T2* value increased by 1.2 ms (p < 0.001), likely because of changes in the configuration of intracellular lipid droplets, with an increased proportion of lipid droplets of smaller size, optimizing accessibility of lipid fuels and mitochondrial FA. Exercise testing (VO2peak) showed no change in maximal oxygen uptake, but fat oxidation improved with a 10% decrease in the exercise respiratory exchange ratio (p < 0.001). Mitochondrial oxidative capacity and PCr resynthesis rates in muscle were maintained. Females improved their mitochondrial function by D + 12, with τPCr decreasing to 29.61 s (p < 0.01), surpassing males and demonstrating better fat oxidation capabilities. Long-term fasting did not alter muscle metabolism or performance, nor induced structural or inflammatory changes. The decrease in muscle volume is minor when accounting for glycogen and water depletion during fasting. Fat is relocated to the intracellular compartment of myocytes. Both anaerobic and aerobic metabolic pathways remain unchanged after 12 days of fasting in both sexes and older subjects. This suggests that human muscles, like those in animals, have evolved to withstand seasonal food shortages and endure long fasting periods.

IntroductionLong‐term fasting (LF) activates an adaptative response to switch metabolic fuels from food glucose to lipids stored in adipose tissues. The increase in free fatty acid (FFA) oxidation during fasting triggers health benefits. We questioned if the changes in lipid metabolism during LF could affect lipids in cell membranes in humans. We thus analysed the FA composition in erythrocyte membranes (EM) during 12.6 ± 3.5 days of LF and 1 month after food reintroduction.MethodsA total of 98 subjects out of three single‐arm interventional studies underwent a medical supervised long‐term fasting (12.6 ± 3.5 days) programme. The distribution pattern of 26 FA as well as the HS‐Omega‐3 Index were assessed in the EM using gas chromatography.ResultsEighteen of 26 FA showed significant changes. Within the group of saturated FA, myristic (14:0) and stearic acid (18:0) decreased while palmitic (16:0) and arachid acid (20:0) increased. While most monounsaturated FA increased, trans fatty acids decreased or remained unchanged. Within the polyunsaturated FA, arachidonic (20:4n6) and docosahexaenoic (22:6n3) acid increased, while linoleic (18:2n6), alpha‐linolenic (18:3n3) and eicosapentaenoic acid (20:5n3) decreased. Consequently, the HS‐Omega‐3 Index increased. 11 out of the 18 FA with significant changes returned to baseline levels 1 month afterwards. Levels of linoleic and alpha‐linolenic acid increased over baseline levels.ConclusionsLong‐term fasting triggers changes in the FA composition of EM.

Background/Objectives: Efforts are underway worldwide to design and deploy food labeling systems that provide consumers with the information needed to shift dietary patterns toward nutrient dense, healthier foods. Despite a compelling need for progress, worrisome public health trends persist that are rooted in the popularity of unhealthy, heavily processed foods. Methods: The nutrition and health-related content on the packaging of nine common foods sold in the US and Europe is analyzed and compared. The current scope of nutrient-specific messaging is characterized, including messages highlighting health-related benefits stemming from the mix and levels of mostly macronutrients in food products. Results: An average of 6.9 unique nutrition-related messages appear on the packaging of nine US food products, while EU food products contain an average of 5.0. Messaging around the ingredients in food products accounts for the largest share, e.g., "100% whole grain", "Vegan", and "No artificial preservatives". The macronutrients of fat, fiber, cholesterol, salt, sugar, and protein are the focus of most messaging around health benefits. The degree of food processing and essential vitamin, mineral, and phytochemical micronutrients receive little or no attention, despite their importance in positive health outcomes. Conclusions: Current nutrition-related labeling fails to inform consumers of the enormous differences in the contribution of food products in meeting nutritional needs. Existing metrics and rating systems do not effectively account for the critical relationship between nutrient density and caloric content. Existing metrics and systems do not reflect the impacts of processing on food nutritional quality in ways that provide consumers meaningful information. New concepts, metrics, and label elements are described that could promote healthier dietary patterns. Clear and mandatory nutrition labeling could begin shifting market share toward healthier options, and this could trigger and guide changes in manufactured food recipes that make brand-name products healthier, benefiting all consumers.

Tolérance, gains en santé, bien-être et effets&#13;\nthérapeutiques d’un jeûne périodique&#13;\nde 4 à 21 jours observés sur une cohorte&#13;\nde 1 422 sujets, de&#13;\nFrançoise Wilhelmi de Toledo. Une triade synergique de chimiothérapie,&#13;\nd’inhibiteurs de points de contrôle&#13;\nimmunitaire et de mimétiques de la restriction&#13;\ncalorique éradique des tumeurs&#13;\ndans un modèle préclinique murin, de Sarah Lévesque, Guido Kroemer,Jonathan G. Pol. La pratique du jeûne en France :&#13;\nun état des lieux contrasté, de &#13;\nJacques Rouyer (Rennes)

This prospective observational trial investigated effects and safety of periodic fasting in subjects with and without type 2 diabetes mellitus (T2DM). The primary end point was set as the change of fatty liver index (FLI) as a surrogate parameter of non-alcoholic fatty liver disease (NAFLD). Six-hundred and ninety-seven subjects (38 with T2DM) were enrolled. A baseline FLI ≥ 60 (the threshold for fatty liver) was found in 264 subjects (37.9%). The mean duration of fasting was 8.5 ± 4.0 days (range 6–38). FLI decreased significantly (−14.02 ± 11.67; p < 0.0001), with a larger effect in individuals with T2DM (−19.15 ± 11.0; p < 0.0001; p = 0.002 compared to non-diabetic subjects). Body mass index (BMI) decreased by −1.51 ± 0.82 kg/m2, and 49.9% of the subjects lost ≥5% body weight. After fasting, nearly half of the 264 subjects with FLI ≥ 60 (highest risk category) shifted to a lower category. The improvement of FLI correlated with the number of fasting days (r = −0.20, p < 0.0001) and with the magnitude of BMI reduction (r = 0.14, p = 0.0001). Periodic fasting with concomitant weight reduction leads to significant rapid improvement of FLI in subjects with and without T2DM.

Objectives: The aim of this study was to investigate the feasibility of measuring the effects of a 14-day Periodic Fasting (PF) intervention (<200 cal) on multi-organs of primary interest (liver, visceral/subcutaneous/bone marrow fat, muscle) using non-invasive advanced magnetic resonance spectroscopic (MRS) and imaging (MRI) methods.Methods: One subject participated in a 14-day PF under daily supervision of nurses and specialized physicians, ingesting a highly reduced intake: 200 Kcal/day coupled with active walking and drinking at least 3 L of liquids/day. The fasting was preceded by a 7-day pre-fasting vegetarian period and followed by 14 days of stepwise reintroduction of food. The longitudinal study collected imaging and biological data before the fast, at peak fasting, and 7 days, 1 month, and 4 months after re-feeding. Body fat mass in the trunk, abdomen, and thigh, liver and muscle mass, were respectively computed using advanced MRI and MRS signal modeling. Fat fraction, MRI relativity index T2* and susceptibility (Chi), as well as Fatty acid composition, were calculated at all-time points.Results: A decrease in body weight (BW: −9.5%), quadriceps muscle volume (−3.2%), Subcutaneous and Visceral Adipose Tissue (SAT −34.4%; VAT −20.8%), liver fat fraction (PDFF = 1.4 vs. 2.6 % at baseline) but increase in Spine Bone Marrow adipose tissue (BMAT) associated with a 10% increase in global adiposity fraction (PDFF: 54.4 vs. 50.9%) was observed. Femoral BMAT showed minimal changes compared to spinal level, with a slight decrease (−3.1%). Interestingly, fatty acid (FA) pattern changes differed depending on the AT locations. In muscle, all lipids increased after fasting, with a greater increase of intramyocellular lipid (IMCL: from 2.7 to 6.3 mmol/kg) after fasting compared to extramyocellular lipid (EMCL: from 6.2 to 9.5 mmol/kg) as well as Carnosine (6.9 to 8.1 mmol/kg). Heterogenous and reverse changes were also observed after re-feeding depending on the organ.Conclusion: These results suggest that investigating the effects of a 14-day PF intervention using advanced MRI and MRS is feasible. Quantitative MR indexes are a crucial adjunct to further understanding the effective changes in multiple crucial organs especially liver, spin, and muscle, differences between adipose tissue composition and the interplay that occurs during periodic fasting.

Die Pravalenz des Typ-2-Diabetes in Deutschland betragt annahernd 10 %. Eine kausale Therapie muss darauf abzielen, das viszerale Fett wieder seiner ursprunglichen und naturlichen Bestimmung zuzufuhren - als Speicher fur schlechte Zeiten, der regelmasig wieder entleert wird. Die Fastentherapie nach Buchinger kann kombiniert mit Bewegung, Entspannung, den Ausgleich von Mikronahrstoffmangel durch Aktivierung von Reparaturgenen und Autophagie sowohl zu einer oft lange anhaltenden Stoffwechselverbesserung fuhren als auch die notwendige Motivation zur Lebensstilanderung erzeugen.

To measure static and dynamic changes of retinal vessels in response to normobaric hypoxia (NH, study A) and hypobaric hypoxia (HH, study B). Study A included 10 healthy individuals exposed to a simulated altitude of 5500 meters in a NH chamber; study B included 17 individuals studied after ascent to 3000-meter altitude. Retinal vessel diameter, response to flicker light, retinal oxygen saturation and retinal venous pressure were measured at baseline, under the corresponding hypoxia condition. The effects of macitentan, an endothelin receptor antagonist, were examined in study B. The mean age of participants was 34.6±9.3 years in study A and 36.7±10.8 years in study B. Retinal arterial and venous diameter increased, arterial and venous response to flicker light decreased, while retinal oxygen saturation remained stable under both experimental conditions. Retinal venous pressure increased in six individuals after ascent to 3000 meters and normalized after macitentan treatment. The occurrence of acute mountain sickness (AMS) correlated only with the decrease of arterial constriction after ascent to 3000 meters. Retinal arterial and venous vessels react to NH and HH with a diameter increase and an impaired response to flicker light. Macitentan was capable to normalize the increased retinal venous pressure observed at high altitudes.