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Routine periodic fasting is associated with reduced incidence of coronary artery disease and diabetes, according to findings from the Intermountain Heart Collaborative Study.

Routine periodic fasting is associated with reduced incidence of coronary artery disease (CAD) and diabetes, according to findings from the Intermountain Heart Collaborative Study conducted in Utah, and reported in the October 1st issue of the American Journal of Cardiology.

The Utah population has one of the lowest rates of death from cardiovascular disease in the US, likely due to the lifestyle of members of the Church of Jesus Christ of Latter-day Saints (LDS) - particularly low rates of smoking - lead investigator Dr. Benjamin D. Horne noted in correspondence with Reuters Health.

However, "as other states have had their smoking prevalences drop, Utah has retained its status as having one of the lowest cardiac disease death rates," Dr. Horne said. "There should have been some convergence of disease rates because Utah's smoking prevalence can't decline as much as other states', but that is not what we have observed."

To investigate that paradox, Dr. Horne and colleagues at the Intermountain Medical Center in Murray first compared the prevalence of CAD among 4629 patients who underwent coronary angiography from 1993 to 2002. Close to 70 per cent belonged to LDS.

The findings confirmed that the prevalence of CAD was lower among members of the LDS, 61 per cent vs 77 per cent, the investigators report. The odds ratio after adjusting for smoking and other CAD risk factors was 0.81 (p = 0.009).

The research team evaluated a second set of patients (n = 448) between 2004 and 2006, to determine which lifestyle factors were cardioprotective. Routine periodic fasting, "taught in the LDS population from early youth," was associated with lower risk of CAD (adjusted odds ratio 0.46, p = 0.007).

Fasting may represent "a good marker of other low-risk behaviors, but we adjusted statistically in our analysis for demographics, other cardiac risk factors, and other behavioral factors including alcohol use, tea, coffee, social support, physical activity level, and socioeconomic status, and fasting's effect on risk was not reduced by any of them, so we doubt that this is the explanation for our findings," Dr. Horne noted.

Routine periodic fasting was also associated with reduced prevalence of diabetes, the authors report. By contrast, fasting did not significantly alter BMI or hypertension.

"Most people fast for fewer than three days at a time," Dr. Horne said, "so the primary influence of fasting on the body in that period is likely on the glucose/insulin pathways and not on obesity per se."

He concluded, "We are encouraged that, even if this study's finding was an unusually strong effect, fasting shows great promise and deserves to be studied further."

Am J Cardiol 2008;102:814-819