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CME

Regular Fasting May Improve CVD Risk

  • Authors: News Author: Shelley Wood
    CME Author: Désirée Lie, MD, MSEd
  • CME Released: 11/14/2007
  • THIS ACTIVITY HAS EXPIRED
  • Valid for credit through: 11/14/2008
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Target Audience and Goal Statement

This article is intended for clinicians who want to maintain a current understanding of recent research and evidence in the association between fasting, religious affiliation, and cardiovascular disease risk.

The goal of this activity is to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care.

  1. Inform clinicians of the latest medical information on the association between being affiliated with the Latter-day Saints Mormon faith and cardiovascular risk as presented at the American Heart Association 2007 Scientific Sessions.
  2. Describe the relevance of the findings on the association between fasting and not fasting irrespective of religious affiliation to clinicians in the care of their patients with cardiovascular risk factors.


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Author(s)

  • Shelley Wood

    Shelley Wood is a journalist for theheart.org, part of the WebMD Professional Network. She has been with theheart.org since 2000, and specializes in interventional cardiology. She studied literature at McGill University and the University of Cape Town and received her graduate degree in journalism from the University of British Columbia, specializing in health reporting. She can be reached at [email protected]

    Disclosures

    Disclosure: Shelley Wood has disclosed no relevant financial relationships.

Editor(s)

  • Brande Nicole Martin

    Brande Nicole Martin is the News CME editor for Medscape Medical News.

    Disclosures

    Disclosure: Brande Nicole Martin has disclosed no relevant financial information.

CME Author(s)

  • Désirée Lie, MD, MSEd

    Clinical Professor, Family Medicine, University of California, Orange; Director, Division of Faculty Development, UCI Medical Center, Orange, California

    Disclosures

    Disclosure: Désirée Lie, MD, MSEd, has disclosed no relevant financial relationships.


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CME

Regular Fasting May Improve CVD Risk

Authors: News Author: Shelley Wood CME Author: Désirée Lie, MD, MSEdFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED

CME Released: 11/14/2007

Valid for credit through: 11/14/2008

processing....

from Heartwire — a professional news service of WebMD

The supporter had no role in selecting the study or interview sources for news coverage, and it did not review or approve the news article before publication.

November 14, 2007 (Orlando) — Regular fasting among Mormons may account, at least in part, for their lower risk of cardiovascular disease, a new study suggests [1]. According to researchers in Utah, fasting was the strongest predictor of reduced heart disease among people who identified themselves as members of the Church of Jesus Christ of the Latter-day Saints (LDS), but also among people who routinely fasted for nonreligious reasons.

Dr Benjamin Horne (Intermountain Medical Center, Murray, UT) presented the results of the study during the American Heart Association (AHA) 2007 Scientific Sessions last week. In an interview with heartwire , Horne explained that studies dating back three decades have indicated that the LDS population lives longer than non-LDS Americans, a finding attributed partly to the fact that the religion forbids smoking. "But smoking isn't the only risk factor for CVD [cardiovascular disease], and because the lower risk is so substantial, we felt there could be other factors," he said.

For the first part of the study, Horne and colleagues looked at more than 4600 participants in the Intermountain Heart Collaborative Study registry and stratified coronary heart disease risk according to religious preference. Compared with 1467 people who identified themselves as being non-LDS, people who identified themselves as LDS Mormons had a significantly reduced incidence of coronary artery disease (CAD; 66% vs 61%, odds ratio [OR] = 0.81, p=0.009).

In a second analysis, Horne et al surveyed 515 patients scheduled to undergo coronary angiography about religious practices and other behaviors relating to religion that might affect CAD risk. They found that those who said they fasted regularly—regardless of religious beliefs—were significantly less likely to have CAD identified on coronary angiogram. For the purposes of the study, fasting was defined as no food or drink for at least two consecutive meals.

Roughly 8% of people surveyed said they fasted regularly but were not LDS, and these men and women also had reduced CAD, Horne noted.

CAD according to Fasting Status

Group Fasting (%) Nonfasting (%) 95% CI p
All patients 59 67 0.38-0.97 0.037

According to Horne, 70% of the population of Utah is LDS, making this a "sizable" group in whom to study the effects of fasting: LDS Mormons fast once a month for 24 hours. While the study does not conclusively link fasting to cardioprotection, there are a number of possible hypotheses that might explain the effect.

The most plausible, he said, is that recurring, temporary food deprivation might have an effect on body metabolism, serving as a reminder to the body to delve into its stores for nutrients, rather than relying on food intake. "Fasting could have some effect on resensitizing the body to glucose and insulin," Horne said, citing an animal study published in Nature earlier this year that suggested that animals subjected to periods of fasting lived longer than animals eating a normal diet and that certain genes upregulated during the fasting period seemed to have some benefit on glycogen, the molecule that stores glucose.

Another possible explanation is that people who fast may also have better awareness and control over their diet generally, enabling them to exercise better restraint in their day-to-day lives. Horne pointed out that other recent studies have also shown that people who practice "caloric restriction"—eating 20% to 30% less than the general population—also seem to have greater longevity.

"Obviously we need to follow up on several different questions raised by these data," Horne said. "The implication is that people could fast periodically and potentially receive some cardiac benefit, even if they're not fasting for religious purposes. There could be some interaction with diet that could have positive coronary artery disease-reducing benefits.... There are more questions than answers, but it's a very interesting concept that I think people could adopt in their lifestyle and have some coronary benefit."

Diabetics, however, should not try fasting to improve their CVD risk profile, he added.

Source

  1. McClure BS, May HT, Muhlestein JB, et al. Fasting may reduce the risk of coronary artery disease. American Heart Association 2007 Scientific Sessions; November 6, 2007; Orlando, FL. Abstract 3642.

The complete contents of Heartwire , a professional news service of WebMD, can be found at www.theheart.org, a Web site for cardiovascular healthcare professionals.

Pearls for Practice

  • People who self-identify as LDS Mormons vs those who self-identify as non-LDS Mormons have a significantly reduced risk for CAD.
  • Among those scheduled for coronary angiography, regardless of religious affiliation, regular fasting behavior, defined as no food or drink for at least 2 consecutive meals, is associated with reduced risk for CAD.

CME Test

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