Journal Article 1 Mention
Intermittent fasting in the prevention and treatment of cancer
Katherine Clifton2021
X. CynthiaLuigi Fontana
Top 1% · 99th Percentile
162 citations · Physiology
Open Access

TLDR

Fasting may help control weight and reduce some treatment side effects, but it has not been proven to prevent cancer or improve survival. People receiving cancer treatment should only fast within a clinical trial, because it may sometimes cause harm.

Summary

1 Study Aim

The authors review whether intermittent fasting (IF), meaning repeated periods of little or no calorie intake, can prevent cancer or improve treatment outcomes. They compare IF with chronic calorie restriction (CR), meaning eating fewer calories every day. The review also examines fasting-mimicking diets (FMDs), which provide very few calories while resembling fasting. The authors assess biological explanations, animal evidence, human studies, treatment safety, and research gaps. The review asks whether fasting itself helps against cancer, beyond any benefits from losing weight.

2 Study Design

This narrative review evaluates studies in rodents, humans without cancer, cancer patients, and cancer survivors. It discusses alternate-day fasting, weekly fasting, time-restricted feeding (TRF), which limits eating to a daily window, prolonged fasting, and FMDs. The evidence includes laboratory experiments, tumor models, observational studies, feasibility studies, case series, pilot studies, and randomized clinical trials (studies assigning participants to different treatments by chance). Human cancer studies were generally small and varied in their fasting schedules, cancer types, and treatments. The review combines animal experiments with early clinical evidence rather than presenting a new patient trial.

3 Findings

The authors report that IF studies in rodents have mixed results. Some mouse studies showed slower tumor growth, fewer metastases, or better treatment responses, while rat studies sometimes found more aggressive liver or colon cancer after fasting and refeeding. Human evidence does not establish effects on cancer incidence, recurrence, progression, or survival. Short fasting studies during chemotherapy appeared feasible and sometimes reduced side effects, but benefits were inconsistent. A 131-person breast cancer trial found no difference in severe treatment toxicity with an FMD, although tumor response measures favored better adherence. The authors recommend IF for weight management only when appropriate, and advise against fasting during active treatment outside clinical trials. They call for larger, well-designed studies. Fasting may reduce treatment discomfort, but its cancer benefits and risks remain uncertain.

Abstract

Chronic caloric restriction (CR) has powerful anticarcinogenic actions in both preclinical and clinical studies but may be difficult to sustain. As an alternative to CR, there has been growing interest in intermittent fasting (IF) in both the scientific and lay community as a result of promising study results, mainly in experimental animal models. According to a survey by the International Food Information Council Foundation, IF has become the most popular diet in the last year, and patients with cancer are seeking advice from oncologists about its beneficial effects for cancer prevention and treatment. However, as discussed in this review, results from IF studies in rodents are controversial and suggest potential detrimental effects in certain oncologic conditions. The effects of IF on human cancer incidence and prognosis remain unknown because of a lack of high-quality randomized clinical trials. Preliminary studies suggest that prolonged fasting in some patients who have cancer is safe and potentially capable of decreasing chemotherapy-related toxicity and tumor growth. However, because additional trials are needed to elucidate the risks and benefits of fasting for patients with cancer, the authors would not currently recommend patients undergoing active cancer treatment partake in IF outside the context of a clinical trial. IF may be considered in adults seeking cancer-prevention benefits through means of weight management, but whether IF itself affects cancer-related metabolic and molecular pathways remains unanswered.

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