Fasting for Long Covid?

Whilst most people understand the concept of fasting, not everyone knows about Intermittent fasting (IF), which is an eating strategy where you have deliberate alternating cycles of eating and going without food. It works by prolonging the period when your body has burned through the calories consumed during your last meal and begins burning fat.

This fat burning state is responsible for many health benefits, which are now well established in the scientific literature, and include; weight loss, reduced blood pressure, lower insulin resistance, lower oxidative stress and improved gut microbiome.

What are the different types of IF?

The three main types of Intermittent fasting are: Alternate Day Fasting (ADF), the 5:2 diet, and Time-Restricted Eating (TRE). The figure below illustrates the basic differences between them. All of the diets have shown beneficial effects, but my favourite is TRE, which I’ve been following for many years. Basically, I don’t eat between 8pm and midday, and therefore fast for 16 hours minimum every 24 hours.  

The three types of intermittent fasting.

On top of the general health benefits, IF has been shown to reduce inflammation in the body and trigger a process called autophagy which cleans up our cells. These processes are potentially beneficial to people with long covid. 

Fasting and inflammation

Fasting has been shown to suppress inflammation via its effect on something called the NLRP3 inflammasome, which is implicated in chronic low-grade inflammation associated with various disease states, including obesity, type 2 diabetes, atherosclerosis, Alzheimer's disease, and Parkinson's disease.

After about 12 hours of fasting the body starts to use fat as an energy source and produces  a molecule called  beta-hydroxybutyrate (BHB) which acts on the NLRP3 inflammasome. This  leads to a  reduction in the production of pro-inflammatory molecules called cytokines. 

Fasting and Autophagy

Fasting leads to the switching on of an amazing  natural cellular cleaning process called autophagy, where cells begin to  break down and remove damaged cell components (organelles) and damaged or misfolded proteins. Generally, autophagy starts to kick in after about 12 to 16 hours of fasting. 

Could IF help with long covid?

Like most aspects of long covid research, it’s still early days, but theoretically, IF could help people with long covid in a number of ways. Firstly, it could help reduce some of the chronic inflammation seen in long covid patients, who often have elevated cytokine levels.

Secondly, it could help patients clear spike protein from their bodies cells by promoting autophagy, which is a process known to clear out unwanted proteins. Finally, IF could help reduce some of the general risk factors associated with long covid, like insulin sensitivity, body weight, and oxidative stress levels. 

As discussed in an earlier blog, the leading theory for the mechanism behind the symptoms associated with long covid is the persistence of viral spike protein particles throughout the body. These spike proteins can be present either due to a SARSCOV2 infection or from vaccination, and are thought to be causing chronic widespread inflammation in the body, typified by elevated cytokine levels.  As fasting has been shown to reduce chronic inflammation in a number of conditions, in theory it should also help reduce the inflammation  seen in long covid. 

As fasting is also known to induce autophagy, it could also help the body to clear out the damaging spike proteins from the body. As discussed earlier, during autophagy cells will undergo a process of cleaning house and will break down and remove damaged and misfolded proteins from cells, which may include the foreign spike protein particles. 

Are there any scientific studies?

A small study in late 2023 looked at the effects of fasting on 14 people with long covid. It found that 13 out of the 14 noted less fatigue, breathlessness, and muscle and joint pains. They also reported less cognitive impairment, and fewer problems with smell and taste. In addition, they had improvements in their body weight and other risk factors. It’s worth noting that the people in the study did longer fasts of between 6 and 16 days rather than IF, but the underlying fasting mechanism is the same.

There have also been a few studies looking at fasting and SARS-CoV-2 covid infections. Whilst these are not looking at long covid specifically, there is a cross-over between the mechanisms and symptoms of covid infections and long covid, so I believe they are  relevant. 

A 2022 study looked at the effect of different IF regimens  on the inflammation and oxidative stress seen with SARS-CoV-2 infection. The study found that IF reduced  a number of different inflammatory markers associated with infection, namely; interleukins, IGF-1 and Interferon Gamma. In addition, a key marker of oxidative stress, 8-Isoprostane, was significantly reduced by IF.  The study also found that supplementing with Vitamin D, quercetin, omega-3 fatty acids and probiotics also helped to reduce inflammation. 

Another 2022 study looked at the possible mechanisms that might make  IF effective against SARS-CoV-2 infections. It noted that IF’s strong anti-inflammatory effect, its ability to trigger autophagy and its positive effect on the microbiome were all protective against infection. It also noted that IF could reduce the risk and the prevalence of morbidities that were associated with worse prognosis after COVID-19 diagnosis, such as coronary artery disease, myocardial infarction, heart failure, and diabetes. Of note, this study went into some depth about how being in a fasted state interfered with the ability of the SARS-CoV-2 spike protein to bind to cells. 

Is IF safe?

IF is generally considered to be safe and well-tolerated by most people. The main risks centre around low blood sugar levels and dehydration. However, certain people need to be cautious about trying it, and should work with their doctors before doing so. These include children and people with diabetes or other diagnosed chronic diseases, histories of heart attacks or strokes, or inflammatory bowel conditions.  If in doubt, speak to your doctor before trying IF.

Interested in finding out more about IF?

There are a number of excellent Youtube channels which are dedicated to covering IF, but the guy who’s been talking about it the longest is DR Berg. Below is a link to a recent video in which he covers everything you need to know about how fasting works and how to get started. Remember, If you are not sure if fasting is safe for you to start, please discuss it with your doctor first.

If you are looking for an Osteopath  near Forest Row or East Grinstead please get in touch with:

Cliff Russell, Registered Osteopath

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