Новое исследование о сухом голодании

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Fig. 1.a Chest circumference at axilla (CCA, 2), chest circumference at nipples (CCN, 3), waist circumference (WC, 4), hip circumference (HC, 5); b hip circumference oblique (HCO, 6).



As no parameters describing the change of the above mentioned circumferences per kg of weight lost have been found in the reviewed literature, new quotients of mean daily decrease of the circumferences for mean daily weight decrease (QNC, QCCA, QCCN, QWC, QHC, QHCO) were introduced. These parameters reflect the volume-to-weight change of the corresponding region. The ratios WHtR and WHR were also calculated [17].

In the context of clinical examination, systolic and diastolic blood pressure (SBP and DBP) were measured with a classical quicksilver apparatus (Focal no. FC113, Tokyo, Japan). Heart rate (HR) and hemoglobin oxygen saturation (SatO2) were measured with a pulse oxymeter (Bionics Palmcare, Seoul, Korea).

Serum K+, Na+, and Cl- ion concentrations were determined by ion selective electrodes (EasyLyte analyzer, Medica Corporation, Bedford, MA, USA). Serum urea, creatinine and glucose concentrations, and urine creatinine concentration were measured following standard laboratory methods (ABX Pentra, Horiba, Montpellier, France). Serum osmolality was measured by a cryoscopic osmometer (Osmomat 030 Gonotec, Berlin, Germany). Urine weight for each participant was calculated daily from urine volume and its specific gravity. Each participant noted the approximate weight of stools for all 5 days of FWD, and from these data the approximate mean daily stool discharge was calculated.

Anthropometric data and 24-hour urine volume are presented as additive mean change values per day. For the critical hemodynamic (SBP, DBP, HR, SatO2) and laboratory parameters (serum glucose, serum osmolality, K+, Na+, Cl-, urea, creatinine, creatinine clearance), the mean, maximum, and minimum values are presented, in order to show the degree of safety for each of the participants on a daily basis.

Statistical Analysis

Statistical analysis of data was carried out with the SPSS version 15.0.0 software package (Chicago, IL, USA). 2 nonparametric tests for correlated samples (Friedman and Wilcoxon tests) were used. The Friedman test was applied to all parameters and was used to detect differences from day 0 to day 5 of the intervention.

The parameters, for which cumulative values were used, were calculated as follows: Initially, for every participant the daily change of the relative anthropometric parameter was calculated by subtracting the daily value from the corresponding value of the previous day. Then, the mean daily change was calculated by adding all the daily change values and dividing the outcome by the number of participants. Finally, each mean change value was added to the sum of the predecessor mean values. Data are presented as mean additive change per day.

The minimum, maximum, and mean values for glucose, serum osmolality, K+, Na+, Cl-, urea, creatinine, creatinine clearance, SBP, DBP, HR, and SatO2 are presented for each day. The Friedman test was employed for all values from day 0 to day 5. Differences were considered significant, if the probability (pf) that occurred by chance was < 0.05. Furthermore, the Wilcoxon test was performed to compare the values of day 0 and day 5 and determine pw. For serum glucose, an additional comparison of the values on day 0 and day 3 was made and pw3 was determined. The significance level was regarded positive when pw < 0.05.

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Results

Clinical Signs

The clinical examination of the participants showed a satisfactory physical condition of the participants during all 5 days of FWD. On day 2 and 3, 7 participants showed signs of fatigue, 2 nausea, 1 headache, and 3 muscle pains. However, these symptoms were easily relieved through rest or warm bath and subsided 24-36 h later. On day 4 and 5, all participants had a controllable feeling of thirst, but none showed any signs of dehydration. Interestingly, all participants described intervals of stamina and euphoria.

Hemodynamic Stability

SBP, DBP, HR, and SatO2 did not change significantly from day 0 to day 5, indicating hemodynamic stability of the participants (fig. 2). Heart auscultation and digital graph on pulse oxymeter showed no arrhythmias or pulse abnormality.357718?image=000357718_f02.JPG

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Fig. 2.A Systolic blood pressure (SBP), B) diastolic blood pressure (DBP), C heart rate (HR), and D hemoglobin oxygen saturation (SatO2) before, during, and after food and water deprivation (FWD). Data are given as mean, minimum (min), and maximum (max) values.



Metabolic and Electrolyte Changes

We found that serum glucose decreased significantly to the lowest mean value of 3.4 mmol/l (60 mg/dl) on day 3 (pw3 = 0.007) followed by an increase on days 4 and 5, whereas serum osmolality increased gradually during FWD, reaching its maximum mean value of 302 mOsm/l on day 5 (fig. 3). On the other hand, after 3 days of FWD, urea, Na+, and Cl- gradually increased, reaching the highest mean values of 8.2 mmol/l (49 mg/dl), 148 meq/l, and 105 meq/l on day 5. K+ increased slightly and showed the highest mean value 5.29 meq/l on day 2 (fig. 4). K+ level in 1 participant came close to the critical value of 7 meq/l but did not reach it. The participant had no complaints and no heart rhythm abnormalities.
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Fig. 3. Serum glucose (left) and serum osmolality (right) before, during, and after food and water deprivation (FWD). Data are given as mean, minimum (min), and maximum (max) values. Normal range for glucose: 3.3-6.6 mmol/l; normal range for osmolality: 275-295 mOsm/l; Pw3: Pw value resulted from the comparison between day 0 and day 3.357718?image=000357718_f04.JPG

Fig. 4. Serum concentrations of A Na+ (normal range 135-152 mmol/l); B K+ (normal range 3.5-5.5 mmol/l); C Cl- (normal range 95-107 mmol/l); D urea (normal range 1.7-8 mmol/l) before, during, and after food and water deprivation (FWD). Data are given as mean, minimum (min), and maximum (max) values.



Creatinine Levels and Creatinine Clearance

In order to evaluate indicative factors for renal function, we determined the levels of serum creatinine and creatinine clearance. Serum creatinine increased slightly, reaching the highest mean value of 8 μmol/l (0.96 mg/dl) on day 5. Interestingly, there was a considerable increase in creatinine clearance. The mean values were 150 ml/min on day 0 (before FWD), 229 ml/min (+53%) on day 1, 222 ml/min (+49%) on day 2, 181 ml/min (+21%) on day 3, 250 ml/min (+67%) on day 4, and 207 ml/min (+38%) on day 5. 3 days after FWD (day 8), the creatinine clearance was diminished to 125 ml/min (-17%) (fig. 5). Although statically significant, the creatinine increase was not substantial. On the other hand, the increase of creatinine clearance was impressive and without exception. The different magnitude of its increase among the participants could not be correlated with BMI or age.

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Fig. 5. Serum creatinine (left, normal range 4.2-10.0 μmol/l) and creatinine clearance (right, normal range 60-150 ml/min) before, during, and after food and water deprivation (FWD). Data are given as mean, minimum (min), and maximum (max) values.



Changes of Anthropometric Parameters

The mean weight loss was 1,390 ± 60 g/day of FWD, whereas the mean urine discharge was 730 ± 80 g/day (fig. 6, table 2). Only 1 participant defecated daily, 4 participants twice (on day 1 and day 3), and 5 participants just once (on day 1). The mean stool discharge was 65 g/day. The remaining 595 g/day plus incorporated inspired O2 equal the insensible water loss plus expired CO2.

Table 2. Average daily change of anthropometric parameters during food and water deprivation (FWD) and on the third day of re-eating

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Fig. 6. Mean cumulative weight loss and urine discharge during food and water deprivation (FWD; left) and mean cumulative body mass index (BMI) change (right) before, during, and after FWD.



The daily circumferences' decrease was considerable. WC showed the most outstanding reduction whereas NC exhibited the lowest alteration. On the third day of re-eating, all these parameters, except for NC and HC, increased between 12 and 34% versus the total decrease (fig. 7, table 2).
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Fig. 7.A Mean cumulative changes in waist and neck circumference (WC and NC); B hip circumference (HC) and hip circumference oblique (HCO); C circumferences at axilla (CCA) and nipples (CCN); D waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR).



The decrease of each circumference per kg of weight loss, as expressed in the values of the quotients QNC, QWC, QHC, QHCO, QCC and QCCN, reflects a considerable volume decrease for the corresponding part of the body per kg of weight loss (table 3).
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Table 3. Volume decrease for the corresponding part of the body per kg of weight loss

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Discussion


To the best of our knowledge, this paper presents for the first time daily hemodynamic, metabolic, renal, and anthropometric data during FWD. The described anthropometric parameters can be measured quickly, reliably, and reproducibly, since they refer to definite lines and points of the body. The laboratory measurements are simple and cost-effective and can be performed in conventional diagnostic laboratory units. Therefore, monitoring of FWD participants is an easy procedure for physicians without requiring support of advanced equipment.

5 days of FWD contain a triple risk: hypovolemia, hypertonicity, and hypoglycemia. However, our participants have tolerated the dry fasting well and none of them showed hypotension or any noteworthy disorder in HR, SatO2, electrolyte concentration, serum osmolality, and glucose level. It seems that a potent hormonal and nervous contra-regulation results in the effective management of FWD risks.

There is no definite explanation for the temporary K+ increase on day 2. However, no complaints were reported and no heart rhythm changes were registered by any of the participants. Serum glucose decrease on days 1-3 could be attributed to the interruption of food supply, whereas its increase on days 4-5 is probably a result of hormonal contra-regulation.

The mechanism of increased creatinine clearance during FWD could not yet be explained. However, the reported positive association between urine osmolality and GFR and negative association between 24-hour urine volume and GFR [8,9] are consistent with our findings of decreased urine volume and increased serum osmolality along with GFR increase. We hypothesize that the increasing values of serum osmolality may play a role in the mechanisms of edema mobilization and generalized volume reduction, since they create an increasing osmotic gradient between tissue fluid and blood. This facilitates extra tissue water to be passed to the blood. Extra tissue water from renal parenchyma could also be passed to the blood resulting in decongestion of kidney tissues, improvement of renal microcirculation, and increase of GFR. Furthermore, increasing serum osmolality may cause a gradual declining of the water content of the intestinal walls and lumen, thus decreasing abdominal volume and taking effect on the intestinal flora.

With weight loss of 1,390 ± 60 g/day, FWD seems to be the most effective dietary protocol, since the magnitude of weight reduction is 50-100% more than observed during juice or water fasting [3,31]. It has to be further investigated whether the impressive weight loss and the remarkable reduction of body circumferences during FWD have any impact on disease risks.

Among the 6 circumferences measured in this study, WC changed most dramatically. The total decrease in WC during FWD corresponds to a huge decrease of the abdominal volume within 5 days. Such a massive and rapid volume decrease can hardly be attributed to the reduction of visceral fat. In view of the total weight loss, urine discharge, and the additional insensible water loss, this volume decrease could be mainly attributed to elimination of edema fluids from the abdominal organs. According to these results, the terms ‘visceral fat', ‘central obesity', and ‘abdominal obesity' or ‘adiposity' used in various reports [16,18,20,21,23,32] may need reconsideration. The risks related to increased WC might be related rather to the edema than to the fat tissue of the abdominal organs. On the other hand, the decrease in NC reflects a considerable volume reduction for such a small part of the body. Removal of muscle spasms in this region could be a conceivable mechanism for this NC reduction. HC and HCO can be seen as volume change detectors for the hip region. HCO is additionally a unique volume change indicator for the lower abdomen and, in this sense, complements the findings on WC in evaluating any changes of the abdominal volume. Consequently, the decreases of HC and HCO reflect a volume reduction in the hip region and lower abdomen during FWD. The CCA and CCN are detectors of thoracic volume changes. Their reduction may result from of the declining of the lung volume. Further research is required to determine any association between this reduction and an increase of the forced expiratory volumes FEV and FEV1, as described with regard to reduction of WC [19,30].

The new quotients QNC, QCCA, QCCN, QWC, QHC, and QHCO quantify the capability of a weight decreasing method to reduce the volume-related circumferences. They provide an indispensable tool for monitoring the correspondence of body weight changes and changes of volume-related circumferences. This parallel shows the effectiveness of the diet applied and participants' compliance. Although the association of some circumferences with disease risk is quite well investigated [15,16,17,20,21], an eventual correlation between the above mentioned quotients and disease risk is yet to be studied.

The present work is a pilot study on FWD. The participants were healthy individuals with normal renal function, the sample size was rather small, the clinical and laboratory parameters were monitored daily, and the physician was experienced. Under these conditions, the method proved to be safe. A deeper insight in the physiology of FWD can be obtained by analyzing the hormonal, hematological, and biochemical profile including oxidative stress parameters. However, the practice of FWD requires further systematic investigation in order to determine limitations and advantages of this method.

[Reasonable]

Олег1099, спасибо что не поленились

Меня особенно порадовало это:

Interestingly, all participants described intervals of stamina and euphoria.
= все участники описывали периоды подъёма сил (выносливости) и эйфории.

Интересно про калий. Это объясняет почему KCl мне совершенно не катит в первые 10 дней голода:

after 3 days of FWD, urea, Na+, and Cl- gradually increased, reaching the highest mean values of 8.2 mmol/l (49 mg/dl), 148 meq/l, and 105 meq/l on day 5. K+ increased slightly and showed the highest mean value 5.29 meq/l on day 2 (fig. 4). K+ level in 1 participant came close to the critical value of 7 meq/l but did not reach it. The participant had no complaints and no heart rhythm abnormalities.

Они определили работу почек по креатинину:

On the other hand, the increase of creatinine clearance was impressive and without exception.

Я когда эту статью прочитала, погуглила по поводу почек, воды, соли (натрий) и креатинина. Выяснилось что много воды затрудняет работу почек именно в связи с вымыванием натрия -- то есть часть процесса происходит за счёт банальной осмолярности, и когда она низка, почкам становится трудно.

Эта статья мне подтвердила что много воды пить вредно, сосбенно на голоде -- но и не сподвинула на СГ. Всё хорошо в меру и уж точно без экстримов и фанатизма. Я сама больше 48ч насухо не голодала -- пока шло оч понравилось. Безусловно есть состояния когда СГ особо показано (отёки, асциты и пр.), но мне кажется что орг. об этом и сам скажет именно отсутствием жажды.

Про почки однако оч поучительно.



PS_________________
Кстати, это немцы написали, так что есть и на немецком, для тех кто не читает en.

.

[qaz]

Сообщение от alnic_

Ну... это ощущается, что сухой голод круче))). Например, восстановление происходит гораздо медленнее после него. (по крайней мере, у меня было так)

Что значит круче? Восстановление происходит гораздо медленнее - это критерий деструктивных изменений.

Сообщение от Вадим Асадулин

Есть еще одно НО, показания к такому голоданию должны определяться не диагнозом, а Конституцией! (Типом Телосложения)!

Несомненно! Или запасом жира.

Сообщение от Reasonable

Выяснилось что много воды затрудняет работу почек именно в связи с вымыванием натрия -- то есть часть процесса происходит за счёт банальной осмолярности, и когда она низка, почкам становится трудно.

Многие на ЛГ NaCl едят и отмечают что с поеданием NaCl голод легче переносится.

Сообщение от Reasonable

Я сама больше 48ч насухо не голодала -- пока шло оч понравилось.

2 дня насухо это не голод. 5 дней СГ, что в исследовании, у не инвалидов легко проходит. Все самое интересное начинается за сроком в 5 дней, но туда исследователи почему то испугались заглянуть.

Сообщение от Reasonable

Эта статья мне подтвердила что много воды пить вредно, сосбенно на голоде

Какой конкретно воды пить вредно много? Пьют обычно по потребности, мазохисты и аскеты могут зачастую терпеть жажду.
Какой конкретно воды пить вредно много на голоде?

[idaforever (рая)]

Смысл СГ ИМХО - смена внутри и около клеточной жидкостей, которые являются ресурсом, из которого в основном орг берет и удалает все
Мне лень выклодывать, но у меня есть кн Ресурсы организма" от коллектива авторов из СПБ военной академии - д-ра и к.м.н
И мне вспоминается эпизод из книги П Брэгга, где описывается когда кточную ткань цыпленка поместили в физ раствор, и когда его систематически отчисщали от орг отходов,эта клетка жила и жила, пока не помер сам исследователь
Что говорит о смерти как не обязательной для всего живого