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Prolonged fasting outperforms short-term fasting in terms of glucose tolerance and insulin release: a randomised controlled trial

Published online by Cambridge University Press:  03 March 2023

Rima Solianik Open the ORCID record for Rima Solianik [Opens in a new window] ,
Katerina Židonienė ,
Nerijus Eimantas  and
Marius Brazaitis
Rima Solianik*
Affiliation:
Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
Katerina Židonienė
Affiliation:
Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
Nerijus Eimantas
Affiliation:
Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
Marius Brazaitis
Affiliation:
Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
*
*Corresponding author: Rima Solianik, email rima.solianik@lsu.lt
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Abstract

Fasting is related to glucose intolerance and insulin resistance, but it is unknown whether the duration of fasting influences these factors. We explored whether prolonged fasting increases norepinephrine and ketone concentrations and decreases core temperature to a greater extent than short-term fasting; if so, this should lead to improved glucose tolerance. Forty-three healthy young adult males were randomly assigned to undergo a 2-d fast, 6-d fast or the usual diet. Changes in rectal temperature (TR), ketone and catecholamine concentrations, glucose tolerance and insulin release in response to an oral glucose tolerance test were assessed. Both fasting trials increased ketone concentration, and the effect was larger after the 6-d fast (P < 0·05). TR and epinephrine concentration increased only after the 2-d fast (P < 0·05). Both fasting trials increased the glucose area under the curve (AUC) (P < 0·05), but the AUC remained higher than the baseline value after participants returned to their usual diet in the 2-d fast group (P < 0·05). Neither fasting had an immediate effect on the insulin AUC, although it increased after return to their usual diet in the 6-d fast group (P < 0·05). These data suggest that the 2-d fast elicited residual impaired glucose tolerance, which may be linked to greater perceived stress during short-term fasting, as shown by the epinephrine response and change in core temperature. By contrast, prolonged fasting seemed to evoke an adaptive residual mechanism that is related to improved insulin release and maintained glucose tolerance.

Keywords

Energy restrictionGlucose intoleranceInsulin sensitivityMenStarvationStress
Type
Research Article
Information
British Journal of Nutrition , Volume 130 , Issue 9 , 14 November 2023 , pp. 1500 - 1509
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society

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