Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease.

M edically supervised, wat e r-only fasting is k n own to be an effective means of lessening the symptoms of autoimmune illnesses; in many cases, remission of the disease occurs. The challenge, how e v e r, is to maintain the benefits of the fast after re i n t roduction of foods. Those studies t h at have shown no long-term benefit to fasting have allow e d u n restricted food intake after the fasting period. -4 A few studies, h ow e v e r, have demonstrated long-term benefit from adherence to a vegan or lacto-vegan diet after fasting. 8 In our practice, we admit motivated patients suffering from autoimmune diseases to a facility where they are offered intensive education and support in vegan eating during a medically supervised, wat e r-only fast that varies in length from 1 to 3 weeks. Patients then maintain the vegan diet after the fast. We describe 6 re p re s e n t ative cases below. A recent meta-analysis of 31 scientific re p o rts on fasting foll owed by vegetarian diet in patients with rheumatoid arthritis concluded that this regimen may be useful in the tre atment of r h e u m atoid arthritis. Of the 31 studies identified, only 4 -13 w e re found to be controlled clinical trials that re p o rted follow-up dat a for at least 3 months after initiation of tre atment. The results of these 4 studies were pooled, and an effect size (d) and its standard d e v i ation for each study was calculated, demonstrating a significant beneficial effect of fasting followed by vegetarian diet (P < .0 01, r=. 3 8, d=.83). A separate pooling of the 2 ra n domized, cont rolled studies showed a significant improvement in the tre at m e n t g roups (P<.01, r =.2 8, d =.58). For most of the studies analyzed, the criterion for clinical improvement was a visual analog pain s c a l e .