Fasting and Fasting: Biochemical, Physiological and Ethical Differences

"Fasting" and "fasting" are terms that are commonly used to talk about restricting food intake or completely giving it up. Although both involve dietary restrictions, they differ biochemically, physiologically, and ethically.

Surprisingly, the term "fasting" is widely used in the context of health. Saying the word "starve" suggests something negative with the goal of achieving a positive result.

The use of the term fasting and its historical roots

In my opinion, the use of the term "fasting" in the professional lexicon of modern nutritionists and doctors should be corrected. Talk about a diet or nutritional regime,  using this term can create an image of something negative and undesirable for the patient. Fasting goes against the natural human need for nutrition. According to Maslow's hierarchy of needs, physiological needs, including eating, are added to the basic needs. Thus, complete abstinence from food or strict restriction of its intake, which some call "fasting", goes against our basic needs.  Health professionals must be careful in their choice of terminology to avoid creating misconceptions about healthy eating and its importance in our lives.

Influence of Russian culture and Soviet-era experience on terminology

It is possible that the choice of this word comes to us from a long-lasting impression of the Russian language. Also in Russian, the words "голод" (hunger) and "пост" (fasting) are different terms.  Each has its own meaning and historical connotation, especially considering the history of the Soviet Union.

Голод (hunger)

This term is most often associated with an extreme lack of food or insufficient availability of it. There were several periods of famine in the history of the Soviet Union. The most famous, but not the only one, was the great famine in Ukraine (Holodomor) in 1932-1933. in the year when over three million people died of starvation. A million people died of starvation during the blockade of Leningrad during World War II. Famine affected society's culture (frugality) and consciousness (fear of scarcity).

Post (fasting)

The term is associated with religious practices where people voluntarily limit or avoid certain foods in their diet. "Пост" is not related to the lack of food, but it is part of the religious duties of believers. The Russian Orthodox Church has established several fasting periods during the year. This practice of fasting is deeply rooted in Russian culture. The influence of the Soviet era on the use of this term is related to the official policy of atheism and the restriction of religious practice. Although the Soviet state limited the popularization of religion in various ways, despising it, fasting as a tradition was not forgotten in many Russian families.

In Soviet times, the word "голод" prevails. Food shortages imposed by external circumstances, later memories and reflections on it, were a painful part of Soviet people's lives.

Media and scientific literature in English

You will not find the words " starving diet " or " intermittent starvation " in the scientific literature in English. The term " fasting " is used there. The word " starving " is used in connection with lack of nutrients when studying starving people in the perioperative period (before and after surgery) as well as in cases of malnutrition, cachexia and anorexia.

In the scientific literature, the use of the terms " fasting " and " starving " can vary, depending on the context and the specific study. In general, " fasting " refers to voluntary abstinence from food and/or drink for a specified period of time, in most cases for religious or health reasons [1]. Fasting is being studied for its potential health benefits, such as weight loss, improved metabolic health, and reduced risk of chronic diseases such as cardiovascular disease, diabetes, and cancer [2,3].

The term " starving " is usually applied to extreme hunger and malnutrition, due to insufficient food intake or prolonged starvation [5]. Starvation can have severe negative effects on physical and mental health, including weight loss, muscle wasting, organ damage, and reduced cognitive function [5]. It is important to point out that hunger is generally considered a condition harmful to health.

It has gained popularity in recent years  dr. " Fasting mimicking diet " concept developed by Walter Longo. Its purpose is to imitate the biochemical and physiological mechanisms of fasting, while taking nutrients that maintain the body in a state of fasting, which could be called " fasted state ".

When health professionals use the term "fasting" in this context , one wonders if they understand the true meaning of the word . By saying that "hunger is when you are taken to the forest and there is nothing to eat", I am trying to highlight the tragedy of this forced situation created by external circumstances.

Cases of fasting

Hunger can be caused by various factors, such as:

• War : civil wars, ethnic conflicts, etc. can cause the food supply to stop, forcing people to survive on limited amounts of food.
• Natural disasters : drought, floods, etc. can lead to food shortages in certain areas.
• Psychological problems : Anorexia can cause a person to refuse food, even when it is available.
• Oncological diseases : Some forms of cancer can cause loss of appetite. This can lead to cachexia, which is a form of extreme weight loss.
• Social Isolation: People who live isolated from society, such as the elderly or those with physical disabilities, may face difficulties in obtaining food.

Recommending fasting is ethically wrong , even if the person who recommends it wants to do good. The patient may subconsciously perceive this suggestion as extreme and extreme, something to be avoided.

Biochemical and physiological differences

To understand the difference between fasting and fasting in the human body, it is necessary to know the basic principles of energy regulation.  Fasting protocols can be different, but the basic goal from a biochemical and physiological point of view is the same. In my opinion, the most acceptable insulin-carbohydrate model[6].

Accordingly, the primary goal of fasting is to reduce blood insulin levels by optimizing carbohydrate metabolism and improving insulin sensitivity, thereby promoting more efficient glucose utilization and cellular storage.

Why is this important?

1. Role of insulin: Insulin is a hormone produced by the pancreas in response to increased blood glucose levels after a meal. Its main function is to help cells take up glucose so it can be used as an energy source or stored as glycogen.
2. Insulin resistance: If insulin levels in the blood are too high over a long period of time, cells can become resistant to insulin. This means that they need more insulin to take in the same amount of glucose. This can lead to type 2 diabetes.
3. Glycogen storage: Glycogen is how our body stores glucose. It occurs mainly in the liver and muscles. After fasting, when we eat again, glucose is taken up into the cells and stored as glycogen, providing energy reserves.
4. Proper energy supply : Efficient use and storage of glucose in cells ensures that our body has the energy it needs when it needs it. It also reduces the accumulation of excess glucose in the blood.

Fasting is an effective way to optimize the action of insulin in our body, improving carbohydrate metabolism and reducing the risk of chronic diseases.  By reducing insulin levels and improving insulin sensitivity , the human body uses glucose more efficiently and accumulates it in cells. It ensures proper energy supply and reduces the risk of unwanted complications (obesity, metabolic syndrome, CD2).

	Fasting	Fasting
Definition	Voluntary temporary dietary restriction.	Prolonged malnutrition can be voluntary or involuntary.
Energy Sources	Initially glycogen reserves are used, then fat.	Glycogen is used first, then fat, muscle and internal organs.
Hormonal Changes	Insulin levels decrease, peptide Y norepinephrine and human growth hormone increase.	Insulin levels decrease, cortisol increases.
Nutrient deficiency	Short-lived and less pronounced.	A long-term deficiency of vitamins and minerals that causes health problems.
Recommended Duration	From 16 hours to a few days.	Not recommended without medical supervision.
Health Benefits	Improves insulin sensitivity, carbohydrate metabolism and health indicators.	Prolonged fasting can cause serious  health problems and death.
Risk	Low if done correctly, prudently and under the supervision of a health professional.	Nutrient deficiencies, muscle loss, hormonal changes and health risks, death.

The difference between fasting and fasting

Fasting definition and personal experience

Fasting is a conscious choice by a person to avoid food or a combination of certain nutrients  in a specific (limited) period of time, with the aim of improving  your health . This approach is not just theoretical. I have been practicing this since 2014, fasting almost every day. My personal fasting protocol today is one meal a day, ie dinner. On sports days, I take proteins and fats in the morning, providing the body with the necessary nutrients to avoid catabolism.

In addition to that, I have also integrated prebiotics into my diet, specifically the galacto-oligosaccharide (GOS) product PreImmu ,  which I have developed myself. These prebiotics not only feed the beneficial gut microflora, but also help maintain an optimal intestinal pH without raising insulin levels. Taking prebiotics during fasting also improves the gut microbiome.

On the other hand, to provide the body with important trace elements, I also use vitamin D together with magnesium chelate and vitamin K2. Magnesium is essential for the activation of vitamin D and its combination ensures optimal levels of vitamin D in the body[7].

A conscious approach to fasting requires both knowledge and discipline, as in any health field, it is also important to consult with specialists and perform regular health checks when fasting. Each individual has their own specific nutritional needs and response to a particular nutritional regimen, so individualizing the approach I practice with my patients and clients is essential.

I would like to emphasize the importance of the choice of terminology in the field of health. The words we choose can influence a patient's attitude toward a particular treatment or nutritional approach. They can both attract and create resistance and repel. Fasting, as a conscious choice to improve health, may be valuable to many, but its practice must be deliberate and scientifically based. It should be done under the guidance of a health professional. Fasting as a forced situation or as a method used without proper understanding will be harmful. Health professionals should be responsible and choose words that accurately reflect their work and do not misrepresent it. We need to promote a healthy and balanced approach to nutrition, taking into account each person's individual needs and cultural context.

References:

[1] Visioli, F., Mucignat-Caretta, C., Anile, F., & S, P. (2022). Traditional and medical applications of fasting. Nutrients, 14(3), 433.

[2] Armutcu, F. (2019). Fasting may be an alternative treatment method recommended by physicians. Electronic Journal of General Medicine, 16(3), em138.

[3] Scharf, E., Hwang, S., Thompson, N., Gilbert, M., Alexandrakis, F., Bonjour, M., … & Myers, T. (2020). A pilot study on the effects of medically supervised, water-only fasting and refeeding on cardiometabolic risk.

[4] Horne, B., Muhlestein, J., & Anderson, J. (2015). Health effects of intermittent fasting: hormesis or harm? a systematic review. American Journal of Clinical Nutrition, 102(2), 464-470.

[5] Kueper, J., Beyth, S., Liebergall, M., Kaplan, L., & Schroeder, J. (2015). Evidence for the adverse effect of starvation on bone quality: a review of the literature. International Journal of Endocrinology, 2015, 1-7.

[6] David S Ludwig, Louis J Aronne, Arne Astrup, Rafael de Cabo, Lewis C Cantley, Mark I Friedman, Steven B Heymsfield, James D Johnson, Janet C King, Ronald M Krauss, Daniel E Lieberman, Gary Taubes, Jeff S Volek, Eric C Westman, Walter C Willett, William S Yancy, Jr, Cara B Ebbeling, The carbohydrate-insulin model: a physiological perspective on the obesity pandemic, The American Journal of Clinical Nutrition, Volume 114, Issue 6, 2021, Pages 1873-1885.

[7] Uwitonze, Anne Marie and Razzaque, Mohammed S.. "Role of Magnesium in Vitamin D Activation and Function" Journal of Osteopathic Medicine, vol. 118, no. 3, 2018, pp. 181-189.