This short synopsis from the available literature provides an analysis and overview of current thinking on the benefits of the various types of fasting , their potential clinical applications , potential areas for further research in the context of chemotherapy outcomes and quality of life , and the reduction of physical side effects from chemotherapy toxicity .
It is important to note there is a paucity of human trials , and that available studies are conducted on small cohort numbers and well-nourished patients [ 2 ]. Well-nourished in this context are those patients who are within the recommended body mass index ( BMI ) and are seen to be in good health with no comorbidities or clinical nutrient deficiencies . From the current evidence , it remains unclear whether cachexic patients would benefit from a fasting approach [ 3 ].
Cellular response to caloric deprivation
Caloric deprivation as seen in fasting regimes triggers a cascade of physiological events that protect normal cells . It is proposed that the observed protection against tumour growth associated with fasting stems from a phenomenon known as differential stress resistance ( DSR ). This process involves the process of fasting inducing a state of nutrient deprivation , which is believed to inhibit tumour growth and proliferation while allowing healthy cells to remain intact in a stress-response mechanism [ 4,5 ]. DSR promotes metabolic pathways aimed at cell maintenance , thereby reducing cellular damage accumulation , and enhancing reproduction in healthy cells . Stress resistance safeguards normal cells from the toxic effects of chemotherapy , thereby reducing treatment-related side effects , and enhancing QoL . In a review of the potential benefits , fasting was found to have the potential to reduce organ damage , immunosuppression , toxicity , weight loss , tumour growth and metastasis , and improve prognosis [ 3 ]. In animal models , various cycles of fasting and re-feeding demonstrate beneficial reductions in gastrointestinal disruptions and ensuing mucositis with lower inflammatory markers [ 4 ]. Importantly , during fasting periods cancer cells fail to trigger the same stress resistance response , rendering them more susceptible to the effects of chemotherapy and thereby heightening its efficacy [ 6 ].
Another primary effect of fasting is reducing circulating blood glucose and insulin levels ( and therefore insulin growth factor 1 ( IGF-1 )) which are involved in tumour expansion in many cancer types [ 1,6 ]. As several types of tumour cells rely on glucose as a primary energy source , the deprivation of glucose as a fuel may impede cell proliferation and impact cell survival . Fasting additionally increases autophagy , a process that degrades and
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