Stages of therapeutic fasting and recovery period
Therapeutic fasting is one of the methods of prevention and treatment of a number of diseases. With complete starvation, several stages are distinguished.
The stages of therapeutic fasting
The first stage – food arousal – lasts 2-3 days. At this time, a strong feeling of hunger can be expressed. The type of food, its smell can irritate, cause some aggressiveness. There may be a rumbling in the stomach, “sucking” in the stomach, salivation. Sleep worsens, pulse quickens somewhat. Blood pressure may increase, which in patients with essential hypertension in some cases leads to a hypertensive crisis.
In the first three days of fasting, the maximum weight loss (0.8-2 kg per day) is observed due to the excretion of water and the consumption of glycogen in the liver.
From the first day of fasting, water procedures are recommended (circular shower, underwater massage shower, Charcot shower), sauna 2 times a week, massage, physiotherapy exercises, it is necessary to carefully monitor the purity of the skin and tongue. The tongue is brushed with a soft toothbrush several times a day to remove plaque, which most often appears on the third day of abstinence from food. Daily walks in the fresh air for at least 3 hours are required, obese patients should walk 15-20 km, all procedures help to cleanse the body of ketone bodies and improve the general condition of the body.
In the presence of allergic diseases, you should not wear synthetic clothes and use cosmetics, washing powders. During fasting, smoking is undesirable because of the possible development of collapse, as well as in connection with the irritating effect on the gastric mucosa of nicotine swallowed with saliva.
Second stage– increasing acidosis – occurs on the fourth or sixth days of fasting. A strong odor appears from the mouth, a thick coating of white or gray forms on the tongue. The skin and lips become dry, and the teeth become mucus. Headache, weakness, dizziness, lethargy, nausea often develop. The feeling of hunger practically disappears. The type of food does not cause those reactions that could be seen in the 1st stage. Blood sugar drops to the lower limits of the norm. During this period, hungry people consume more water, up to 1.5 liters per day, but at the same time, diuresis also increases, and the specific gravity of urine decreases. In some cases, a short-term loss of consciousness is possible when moving from a horizontal position to a vertical one. Patients, as a rule, are pale, there is often an exacerbation of symptoms of chronic somatic diseases.
The third stage is compensation, or adaptation. On the seventh to tenth day of fasting, an acidotic crisis sets in, after which the patients’ health improves dramatically. This happens quickly, within a few hours, more often at night. Patients become alert, even somewhat euphoric. The smell of acetone from the mouth and plaque on the tongue decrease, the complexion improves, the eyes shine, the symptoms of exacerbation of diseases disappear. The water-salt balance is normalized. The duration of this stage is individual, on average it is 20-25 days. It ends with the cleansing of the tongue, often the appearance of “food” dreams and appetite. Cleansing the tongue and the appearance of appetite is a signal to stop fasting.
The optimal fasting period, according to the supporters of this method, is 2-3 weeks, and the maximum loss of body weight is observed in the first two weeks. With longer fasting, the recovery period is more difficult to tolerate, complications are more often observed.
Therapeutic fasting is a safe and simple method of healing the body. The recovery period is no less important than the course of medical fasting. It is also divided into several stages.
The first stage is asthenic, 12 days. In patients who have experienced a feeling of hunger. After the first intake of 100-200 g of juice, there is a feeling of satiety, even overeating, weakness, unstable mood. The pulse quickens, sometimes blood pressure drops. The smell of acetone is further reduced or completely disappears. The longer the fasting period, the more likely dyspepsia (diarrhea), heaviness in the stomach, belching, heartburn can occur. In the first two days of coming out of fasting, body weight continues to decrease by an average of 100-200 g per day.
From the beginning of the recovery period, all procedures and walks are canceled, semi-bed rest is recommended. On the second or third day, an independent chair appears. If not, you need to do a cleansing enema.
The second stage – intensive recovery – lasts 3-4 days. Mood improves, appetite increases, dyspeptic symptoms disappear. Body weight begins to increase. Euphoria appears, even more pronounced than in the stage of compensation, increased efficiency. At this time, patients tend to overestimate their capabilities. The chamber is dominated by food talk and the exchange of culinary recipes. At this stage, you can often observe fluid retention in the body, edema, especially in case of violation of the diet and the use of table salt, even in minimal quantities.
The third stage is normalization. The appetite becomes moderate, and the mood becomes even and calm. Blood biochemical parameters are normalized. When returning to the usual diet (diet No. 8 according to the classification generally accepted in dietetics), patients gain their initial body weight. On a low-calorie diet, body weight increases by 2-3 kg due to the restoration of intestinal contents, liver glycogen and water content in body tissues.
Both in the period of fasting and in the recovery period, it is not always possible to clearly distinguish certain stages.
The recovery period is very responsible, since violation of the rules for its conduct can lead to serious complications. Moreover, there have been described cases of death in persons who spent the recovery period without medical supervision. The duration of the recovery period is equal to the duration of the period of abstinence from food.
The main rules for the recovery period are a gradual food load, the exclusion of meat and meat products, fish, poultry, salt in order to avoid difficult-to-eliminate edema. There are different points of view regarding meat consumption. Most fasting advocates do not recommend meat. Patients are prescribed a plant-milk diet, and only women with iron deficiency anemia are allowed to boiled beef from the 8th day of the recovery period. It should be noted that in some cases, therapeutic fasting reveals latent iron deficiency.
For the recovery period, various diet options have been developed: using juices, whey from yogurt, cereals. It is better to use freshly squeezed juices, but you can also use canned ones: apple, peach, apricot, plum, pear, quince. You should not use tomato juice rich in sodium ions, which often causes fluid retention in the body, grape juice – because of the cloying taste and the possible development of flatulence; chokeberry juice, which provokes nausea and vomiting in many. Citrus juices (lemon, tangerine, orange) are undesirable in the presence of allergic diseases.
Therapeutic fasting, the stages of which have been considered, requires the supervision of a physician. During the entire course of fasting, and especially during the recovery period, it is necessary to control water-salt metabolism.
Treating obesity with fasting is an extremely difficult and thankless task, especially given the long-term results. With extraordinary efforts in fasting therapy, significant weight loss can be achieved in a few months, but then a return to a normal diet or an emotional breakdown reverses the course of the process, and the weight is quickly restored. The biochemical mechanism of this is easy to understand if we consider that it takes several weeks to “turn off” the enzymes that provide the formation of fat, and the restoration of their activity occurs a few hours after the first meal. It is very easy to regain your original body weight after fasting, it is much more difficult to maintain the achieved results or even continue to lose weight. Before the course of fasting, an obese patient should be guided that medical fasting is only the first stage of treatment, after which it is necessary to follow a special diet and exercise for life. The ultimate success of obesity treatment depends mainly on the willpower of the patient, and therapeutic fasting is a powerful impetus to work on oneself.
In many guidelines on fasting, diets are given, the calorie content of which reaches 2500-3200 kcal per day by the end of the recovery period, which exceeds the physiological requirements for energy for people of mental labor and is unacceptable for obese patients. Before being discharged from the hospital, each patient must determine the ideal body weight and individual physiological need for energy. Then the diet is calculated, which patients follow after the end of the recovery period until the normalization of body weight. To do this, the caloric content of the diet required in accordance with energy consumption is reduced by 30-50%, depending on the degree of obesity: the higher it is, the greater the decrease. There is another way to calculate the chemical composition of the diet: proteins – 1.7 g per 1 kg of ideal body weight, fats – 1.2 g / kg, carbohydrates – 2 g / kg, energy value – 25 kcal / kg. Patients should be familiarized with the sample menu and the basic principles of diet therapy for obesity:
- reducing the energy intensity of the diet;
- restriction of carbohydrates, especially sugars (it is recommended to use sweeteners);
- limiting fat intake and increasing the proportion of vegetable fats up to 50% of their total amount;
- exclusion of foods and dishes that stimulate the appetite (strong broths, smoked meats, pickles, spices, alcohol, etc.);
- the use of significant in volume, but low-calorie foods and dishes (vegetables, berries, fruits, mousses, etc.);
- fractional, five to six meals a day, which helps suppress hunger;
- refusal from plentiful dinners;
- the last meal should be no later than 3-4 hours before bedtime;
- slow chewing of food, contributing to the timely appearance of a feeling of satiety;
- restriction of table salt to 5 g per day and liquid to 1-1.5 liters due to the tendency to water retention in the body of obese patients.
Against the background of a diet, fasting days can be carried out 1-2 times a week. A lot of them have been developed, but dairy (1.5 liters of warm milk per day) and rice-compote (50 g of rice, cooked without salt, and 1 liter of dried fruit compote) should be especially noted, since on these fasting days the work of urinary systems. Some patients fast 1 day a week without prior preparation.
Subject to the above recommendations, patients do not gain weight, and some continue to lose weight. Repeated courses of fasting can be carried out, as a rule, after 4-6 months.
During fasting and in the recovery period, the following complications may occur: therapeutic fasting can provoke weakness, dizziness, headache, nausea, indomitable vomiting, convulsions due to dehydration and sodium chloride deficiency, fainting when moving from a horizontal position to a vertical position, heart rhythm disturbances from – for a decrease in the level of potassium in the body, hypertensive crisis (in the first 3 days of fasting), renal or hepatic colic, bleeding in patients with peptic ulcer disease, acute respiratory diseases.
For a long time, since the time of Hippocrates, the saying is known: “Do no harm”, as well as the golden rule of surgeons: “The risk of an operation should not exceed the risk of being left without an operation.”
Fasting obesity treatment
Treating obesity with fasting violates basic medical principles and harms rather than benefits. During fasting, already on the third or fourth day, significant changes occur in the liver cells: droplets of fat are deposited in them, that is, fatty degeneration of the liver begins. Prolonged therapeutic fasting (more than seven to ten days) leads to a violation of the immune system.
In the treatment of obesity, the main goal is to lose fat mass while maintaining lean muscle mass. However, when fasting for 25-30 days, not only the reserves of the fat depot are depleted, but vital proteins are also consumed, which contradicts the main task of treating obesity.
The stage of increasing acidosis on the 4-6th day of fasting and the acidotic crisis on the 7-10th day are the result of a decrease in blood glucose levels. The same violations occur due to an overdose of insulin in diabetes, dramatically disrupt the functions of the body and, in particular, can lead to encephalopathy, that is, insufficient brain function. Acidosis, both in diabetes and fasting, is caused by the use of fat for energy generation, that is, increased oxidation of fatty acids with the formation of toxic substances – ketones. In diabetes, the use of fat as an energy source can be caused by the inability to utilize glucose in the absence of insulin (hyperglycemic coma) or by a lack of glucose at high doses of injected insulin (hypoglycemic coma). Ketoacidosis in diabetes is a formidable complication.
It is clear that the rapid therapeutic effect after fasting for certain diseases, in particular bronchial asthma, eczema, psoriasis, neurodermatitis, allergic diseases, is impressive. It should be recognized that in these diseases, fasting is the method of choice and sometimes turns out to be the only effective method after prolonged unsuccessful treatment.
Treatment of obesity by fasting seems to be unjustified, since it is impossible to achieve a positive and stable result without changes in eating behavior and treatment according to a long-term program.