Periodic fasting may lower severity of Covid-19 infection: BMJ

In individuals with COVID-19, routine periodic fasting was linked to a decreased risk of hospitalization or fatality, says an article published in BMJ Nutrition, Prevention & Health.

Intermittent fasting reduces inflammation while enhancing some host defense systems. Greater survival and a decreased likelihood of comorbidities connected to COVID-19 are both linked to lower frequency of fasting. Benjamin D. Horne and colleagues undertook this investigation in order to assess the relationships between periodic fasting and COVID-19 severity and, subsequently, SARS-CoV-2 initial infection.

This was a longitudinal prospective observational cohort research study. For this, research was conducted at a single-center secondary care facility in Salt Lake City, Utah, with follow-up at 24 hospitals in an integrated healthcare system. Patients who had been registered in the INSPIRE registry between 2013 and 2020 were examined for the primary outcome if they tested positive for SARS-CoV-2 between March 2020 and February 2021 (n = 205), or for the secondary outcome if they had any SARS-CoV-2 test results (n = 1524). Individuals reported their personal histories of regular periodic fasting over the course of their lives; no treatment allocations were made. The primary outcome was a composite of death or hospitalization, which was assessed by Cox regression until February 2021, with multivariable analyses taking 36 covariables into account. The patient's SARS-CoV-2 test result was the secondary outcome.

The key findings of this study were as follows:

1. Periodic fasting was practiced by the subjects (n=73, 35.6%) for 40.4±20.6 years (max: 81.9 years) before the COVID-19 diagnosis.

2. 11.0% of periodic fasters and 28.8% of non-fasters experienced the composite result (p=0.013), with an HR of 0.61 favoring fasting.

3. This connection was verified by multivariable analysis.

4. Age, Hispanic ethnicity, prior MI, prior TIA, renal failure, with tendencies for race, smoking, hyperlipidemia, diabetes, coronary disease, heart failure, and anxiety, but not alcohol use, were further predictors of hospitalization or death.

5. In a secondary study, 14.3% of fasters and 13.0% of non-fasters had COVID-19 diagnoses (p=0.51).

In conclusion, fasting could be an additional treatment to vaccination that might enhance the immune system and reduce inflammation both during and after the pandemic.

Reference: 

Horne, B. D., May, H. T., Muhlestein, J. B., Le, V. T., Bair, T. L., Knowlton, K. U., & Anderson, J. L. (2022). Association of periodic fasting with lower severity of COVID-19 outcomes in the SARS-CoV-2 prevaccine era: an observational cohort from the INSPIRE registry. In BMJ Nutrition, Prevention & Health (p. e000462). BMJ. https://doi.org/10.1136/bmjnph-2022-000462