Abstract
Fasting is deeply entrenched in evolution, yet its potential applications to today’s most common, disabling neurological diseases remain relatively unexplored. Fasting induces an altered metabolic state that optimizes neuron bioenergetics, plasticity, and resilience in a way that may counteract a broad array of neurological disorders. In both animals and humans, fasting prevents and treats the metabolic syndrome, a major risk factor for many neurological diseases. In animals, fasting probably prevents the formation of tumors, possibly treats established tumors, and improves tumor responses to chemotherapy. In human cancers, including cancers that involve the brain, fasting ameliorates chemotherapy-related adverse effects and may protect normal cells from chemotherapy. Fasting improves cognition, stalls age-related cognitive decline, usually slows neurodegeneration, reduces brain damage and enhances functional recovery after stroke, and mitigates the pathological and clinical features of epilepsy and multiple sclerosis in animal models. Primarily due to a lack of research, the evidence supporting fasting as a treatment in human neurological disorders, including neurodegeneration, stroke, epilepsy, and multiple sclerosis, is indirect or non-existent. Given the strength of the animal evidence, many exciting discoveries may lie ahead, awaiting future investigations into the viability of fasting as a therapy in neurological disease.
Highlights
Fasting has surged in popularity over the new millennium
The fasting-mediated effects on heart rate, blood pressure, heart rate variability, and cardiovascular stress adaptation are thought to result from increases in brain-derived neurotrophic factor (BDNF), which enhances the cholinergic activity of brainstem cardiovagal neurons [3]
The respiratory chain is impaired in Parkinson’s disease (PD) and Alzheimer’s disease (AD), especially PD, which demonstrates a marked deficit at complex I [125]. Both PD and AD show impairments in neuron glucose metabolism and insulin signaling [126,127], especially AD, which is characterized by brain insulin deficiency as well as resistance, leading to AD being described as a form of brain-specific, “type 3” diabetes [128]
Summary
Fasting has surged in popularity over the new millennium. Much of its newfound enthusiasm has been driven by a growing public perception that fasting may be beneficial for many aspects of human health. Despite the purported health benefits of fasting, it remains somewhat foreign to conventional medical practice, this situation is not exactly new; fasting has historically fallen in and out of fashion in its relationship to medicine. In an era of rising healthcare costs and an increasing prevalence of disabling neurological disorders, the impact of a self-empowering, cost-free, effective therapy alongside conventional medical approaches would be substantial and positive. On this background, the definition, origins, mechanisms, and various regimens of fasting are discussed, followed by a summary of the evidence supporting fasting in the prevention and treatment of a variety of neurological disorders, followed lastly by a discourse on the most common adverse effects and misconceptions associated with fasting
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