Effects of short-term fasting on quality of life as an add-on option during chemotherapy
Dr Daniela Koppold-Liebscher - Charité Universitätsmedizin Berlin, Berlin, Germany
The study we presented was about fasting, short-term fasting around chemotherapy and breast cancer patients. It was a randomised controlled multi-centre study. We started recruiting in 2017 and we recruited breast cancer patients in early breast cancer that had no underweight and no history of any eating disorder and so on. What we actually did was to have two groups of dietary interventions so it was two active comparators. One was a short-term fasting group, and they fasted around the first four chemotherapies they had in a three-weekly cycle for around 60-72 hours around each chemotherapy, starting approximately two days before and finishing 24 hours after the end of the chemotherapy. The other group, in exactly the same time, they would eat a vegan diet without a lot of sugar. In between chemotherapies both groups had the same diet.
What were the results?
The results were quite interesting for us because the active comparator of the plant-based diet actually had some of the components, some of the biochemical pathways, are activated that would be activated in fasting, so we were still very stunned actually to see that there is a difference, not only a statistical difference but also a clinical difference in the primary outcome which was quality of life. Obviously short-term fasting patients didn’t have as much negative impact from chemotherapy than the control group had.
One of the secondary outcomes also is very interesting and we should focus our next study on that. It was on fatigue. The short term fasting group didn’t even actually show signs of clinical fatigue in general compared to the other group that did, as you would expect in any chemotherapy actually.
How can these results impact quality of life of patients?
We actually also looked at anxiety and depression, that was the same in both groups. Probably the quality of life improvement that we saw in the short term fasting group has to do with the quality of life around chemotherapy. We are still looking at the consequences from chemotherapy that patients had, we haven’t got that data yet, but probably that way that really quality of life specifically during chemotherapy can be elevated through fasting. This might have various reasons, we have to look into that. Some things that I can imagine could be the reason is that one of the things patients reported to me, for example, is that they didn’t have any aversions against any foods because they didn’t have any foods during chemotherapy and when others became nauseated or would avoid certain foods because they just had them and then they’d feel bad about them. Fasting patients reported they wouldn’t have such problems, even they lost less weight than the control group, which is interesting, you would have expected otherwise, right?
Another thing is that because of the fatigue that they didn’t feel, some of them reported that they didn’t even really feel they had had chemotherapy. They felt so well and their families were even more surprised then themselves that they were actually doing well and would be able to cope with their everyday lives. I think these are some components that show the potential also for this intervention during chemotherapy.
Anything else to add?
There are a lot of studies needed to get further information on how fasting works during chemotherapy but also which pathways fasting activates which this low protein, low sugar diet wouldn’t. Then it might be interesting also to target them through other therapies because they seem to enhance quality of life. Even in patients that cannot maybe do the fasting, if we have other ways to trigger those pathways, it would be very interesting. It’s promising research, but it still needs a lot of funding also because fasting or dietary interventions don’t really have a lot of money behind them so it would be good to have more and more people join the efforts.
