Prolonged water-only fasting followed by a whole-plant-food diet is a potential long-term management strategy for hyper-tension and obesity

Objective: This single-arm, pre–post interventional trial
(clinicaltrials.gov, NCT04515095) investigates the safety, feasibility,
and potential effectiveness of prolonged water-only fasting followed by a
whole-plant-food diet in the long-term management of hypertension and
other cardiometabolic disorders. Methods: Safety was assessed based on
adverse events (AEs) that were recorded according to Common Terminology
Criteria for Adverse Events (CTCAE) v5.0. Feasibility was assessed based
on retention rate, ability to complete minimal fast length, and
intervention acceptability. Twenty-nine participants with stage 1 and 2
hypertension and without type 2 diabetes were enrolled from a residential
fasting center. Results: Study retention was 100% at the end of the refeed
and 93% at the six-week follow-up visit. Median (range) fasting and
refeeding duration were 11 (7–40) and 5 (3–17) days, respectively, and 90%
of participants were able to complete at least 7 days of fasting. The
majority of AEs were mild (grade 1) and transient and there were no
higher-grade or serious AEs. At the end of the intervention, median
systolic/diastolic blood pressure had normalized to below 130/80 mmHg,
body weight reduced by >5%, and anti-hypertensive medication was
completely discontinued. These results were sustained for at least six
weeks and potentially up to one year. Conclusions: Our data suggest that
the intervention may be a feasible, well-tolerated, low-risk option for
lowering and managing high blood pressure, excess body weight, and other
cardiometabolic disorders in people with stage 1 and 2 hypertension.