Is fasting the best way to start a diet? For people with metabolic syndrome, the answer is yes

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  • A new study investigated the effects of diet combined with fasting on patients with metabolic syndrome
  • The study focused on the role of fasting in metabolic syndrome patients with cardiovascular risk
  • Researchers found that fasting changes the gut microbiome, leading to a drop in blood pressure 


Existing scientific literature suggests that there is a high prevalence of metabolic syndrome in Sub-Saharan Africa, especially in Southern Africa. The World Health Organisation (WHO) defines metabolic syndrome as a pathologic condition characterised by obesity, insulin resistance, high blood pressure and abnormal cholesterol levels, which can ultimately lead to stroke or heart attack.

Health practitioners often prescribe treatments to aid weight loss in such patients, and this includes medication and a low-calorie diet. However, the effects of nutrition on the immune system and overall health are not fully understood.

A new study, led by Dr Sofia Forslund and Professor Dominik N. Müller, was the first to investigate the effects of a modified diet combined with fasting on patients with metabolic syndrome.

The study specifically focused on the role fasting plays in metabolic syndrome patients with cardiovascular risk.

DASH diet and fasting

The researchers recruited 71 volunteers with elevated systolic blood pressure and metabolic syndrome, and divided them into two groups. 

While both were instructed to follow the DASH (Dietary Approach to Stop Hypertension) diet for a period of three months, one of the groups did not consume solid foods for five days before starting the diet. The DASH diet is a Mediterranean-style diet designed to combat high blood pressure.

The scientists observed changes in the immune cells by combining gut microbiome analysis and immunophenotyping (a test to monitor the immune system).

Because bacteria in the gut work closely with the immune system, the researchers looked at stool samples to study the effect fasting has on the gut microbiome. They found that fasting drastically changes the gut microbiome, and that bacteria that lower blood pressure tend to multiply. “Body mass index, blood pressure and the need for antihypertensive medication remained lower in the long term among volunteers who started the healthy diet with a five-day fast,” explained co-author, Dominik Müller.

Mediterranean diets even better with fasting

Sometimes, changing a diet to high-fibre and low-fat does not provide such positive results. “Those who have this problem often feel that it is not worth the effort and go back to their old habits,” the researchers explained. 

They go on to recommend combining such a diet with fasting: “Fasting acts as a catalyst for protective microorganisms in the gut. Health clearly improves very quickly, and patients can cut back on their medication or even often stop taking tablets altogether.” 

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