Long-term fasting improves lipoprotein-associated atherogenic risk in humans

Abstract

Purpose Dyslipidemia is a major health concern associated with an increased risk of cardiovascular mortality. Long-term fasting (LF) has been shown to improve plasma lipid profile. We performed an in-depth investigation of lipoprotein composition. Methods This observational study included 40 volunteers (50% men, aged 32–65 years), who underwent a medically supervised fast of 14 days (250 kcal/day). Changes in lipid and lipoprotein levels, as well as in lipoprotein subclasses and particles, were measured by ultracentrifugation and nuclear magnetic resonance (NMR) at baseline, and after 7 and 14 fasting days. Results The largest changes were found after 14 fasting days. There were significant reductions in triglycerides (TG, − 0.35 ± 0.1 mmol/L), very low-density lipoprotein (VLDL)-TG (− 0.46 ± 0.08 mmol/L), VLDL-cholesterol (VLDL-C, − 0.16 ± 0.03 mmol/L) and low-density lipoprotein (LDL)-C (− 0.72 ± 0.14 mmol/L). Analysis of LDL subclasses showed a significant decrease in LDL1-C (− 0.16 ± 0.05 mmol/L), LDL2-C (− 0.30 ± 0.06 mmol/L) and LDL3-C (− 0.27 ± 0.05 mmol/L). NMR spectroscopy showed a significant reduction in large VLDL particles (− 5.18 ± 1.26 nmol/L), as well as large (− 244.13 ± 39.45 nmol/L) and small LDL particles (− 38.45 ± 44.04 nmol/L). A significant decrease in high-density lipoprotein (HDL)-C (− 0.16 ± 0.04 mmol/L) was observed. By contrast, the concentration in large HDL particles was significantly raised. Apolipoprotein A1 decreased significantly whereas apolipoprotein B, lipoprotein(a), fibrinogen and high-sensitivity C-reactive protein were unchanged. Conclusion Our results suggest that LF improves lipoprotein levels and lipoprotein subclasses and ameliorates the lipoprotein-associated atherogenic risk profile, suggesting a reduction in the cardiovascular risk linked to dyslipidemia. Trial Registration Study registration number: DRKS-ID: DRKS00010111 Date of registration: 03/06/2016 “retrospectively registered”.

Oxidized phospholipids and lipoprotein(a): An update

“…A low‐saturated‐fat diet resulted in interrelated increases in apoC‐III in apoB‐containing lipoproteins and Lp(a) as well 71 . Long‐term fasting does not alter Lp(a) levels, as shown in an observational study ( n = 40), despite improving the lipoprotein‐associated atherogenic risk 72 . In a meta‐analysis, statins compared with placebo increased plasma Lp(a) levels 73 .…”

“…71 Long-term fasting does not alter Lp(a) levels, as shown in an observational study (n = 40), despite improving the lipoprotein-associated atherogenic risk. 72 In a meta-analysis, statins compared with placebo increased plasma Lp(a) levels. 73 Both baseline and on-statin Lp(a) concentrations were associated with an almost linear increase in cardiovascular disease events, particularly in patients with Lp(a) levels >50 mg/dl.…”

Excretion of Heavy Metals and Glyphosate in Urine and Hair Before and After Long-Term Fasting in Humans

“…Some of them observed long-term fasting, defined as voluntary interruption of food intake for at least 2 days up to several weeks ( 27 ). A general improvement of health in subjects following this fasting program was found ( 28 – 31 ). Moreover, an increase in antioxidant capacity and reduced lipid peroxidation was documented in the cohort we describe in this article ( 32 , 33 ).…”

The Effect of Bariatric Surgery on Circulating Levels of Lipoprotein (a): A Meta‐analysis

“…Although an elevated Lp(a) level is independently associated with the incidence of cardiovascular events in the general BioMed Research International population and it is an established predictor of cardiovascular events in patients with ASCVD [55,56], the possibilities of decreasing elevated Lp(a) are still quite limited [57][58][59][60][61][62][63]. Unlike LDL-C and triglycerides, Lp(a) is relatively refractory to diet [64], lifestyle changes [65], and most drug interventions. Among medications, statins could increase plasma Lp(a) levels [66].…”