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Body composition, energy expenditure and physical activity

Effects of a 48-h fast on heart rate variability and cortisol levels in healthy female subjects

European Journal of Clinical Nutrition volume 67, pages 401–406 (2013)Cite this article

Subjects

Abstract

Background/objectives:

The physiological changes that occur during fasting are not completely understood, regardless of the cause for fasting (for example, medical, lifestyle, religious, political or famine). The purpose of this study was to examine the effects of a 48-h fast on heart rate variability (HRV) and cortisol levels in healthy young female volunteers.

Subjects/methods:

A total of 16 young healthy female volunteers underwent 48 h of total fasting under 24-h medical surveillance. Psychological (subjective feeling of hunger) as well as physiological data (HRV, diurnal cortisol profiles) were measured upon admission (Day 1), and after 24 (Day 2) and 48 h (Day 3) of fasting.

Results:

There was a measured weight loss from Day 1 to Day 3 that resulted in significant body mass index (BMI) reduction across all subjects (P<0.001). The slope of the diurnal cortisol profile significantly shifted towards lower values from baseline to the end of experiment (P=0.002). HRV during resting showed a significant (P<.001) decrease in standard deviation of the normal-to-normal interval (SDNN) and root mean square of successive differences (RMSSDs) from Day 1 to Day 3 of the experiment, with a small increase after 24 h that did not reach statistical significance. A 48 h of fasting also induced a significant (P<.001) decrease of mean interbeat intervals (IBIs), SDNN, RMSSD and log high-frequency (HF) power during head-up tilt testing.

Conclusions:

An acute (48 h) total fast induced parasympathetic withdrawal with simultaneous sympathetic activation. These changes appear to reflect stress. Further studies are needed to demonstrate the specificity of these changes to fasting.

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Acknowledgements

NM was supported by a stipend from KAAD Germany, and the study was supported by a grant from the interfaculty Center of Nutritional Medicine of the Universities of Tübingen and Stuttgart-Hohenheim, Germany (11 A.II) for PE and SCB.

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Authors and Affiliations

  1. Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany

    N Mazurak, A Günther, F S Grau, S Zipfel & P Enck

  2. Department of Clinical and General Pathophysiology, Odessa National Medical University, Odessa, Ukraine

    N Mazurak & M Pustovoyt

  3. Department of Psychology, Clemson University, Clemson, SC, USA

    E R Muth

  4. University of Stuttgart-Hohenheim, Institute for Nutritional Medicine, Stuttgart, Germany

    S C Bischoff

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  1. N Mazurak
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Correspondence to P Enck.

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Contributors: NM performed the statistical analysis and wrote the manuscript, FSG and AG recruited the volunteers and performed the investigations, ERM helped with statistics and writing the manuscript, MP assisted in writing, SCB and SZ were responsible for the clinical assessments at investigational site and PE had the idea for the study and supervised data recording, statistics and the writing of the paper.

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Mazurak, N., Günther, A., Grau, F. et al. Effects of a 48-h fast on heart rate variability and cortisol levels in healthy female subjects. Eur J Clin Nutr 67, 401–406 (2013). https://doi.org/10.1038/ejcn.2013.32

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