Intermittent Fasting- A Paradigm Shift In Cancer Prevention and Treatment: A Scoping Review
Abstract
Background: Cancer, a dreadful disease, is one of the most prominent and prevalent causes of mortality across the globe. The well-being of every human society is impacted by this serious issue. Intermittent fasting has gained popularity due to its potential in enhancing the efficacy of cancer treatment and limiting its detrimental effects.
Method: The literature review focuses on illuminating its beneficial role, suggesting that Intermittent fasting has the transformative potential to work as a complementary approach to cancer prevention and treatment.
Results: It has been observed that fasting can protect normal cells from the damaging effects of chemotherapy while stimulating the regeneration in normal tissues.
Conclusion: By elucidating its mechanisms of action and summarizing current evidence, this scoping overview aims to inform future research directions and clinical guidelines in the pursuit of improved outcomes for cancer patients.
Keywords
DOI: 10.33371/ijoc.v19i2.1230
Article Metrics
Abstract View: 552, 
PDF Download: 516
References
Tiwari S, Sapkota N, Han Z. Effect of fasting on cancer: A narrative review of scientific evidence. Cancer Sci 2022;113:3291–302. https://doi.org/10.1111/cas.15492.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021;71:209–49.
https://doi.org/10.3322/caac.21660.
Miranda-Filho A, Bray F, Charvat H, Rajaraman S, Soerjomataram I. The world cancer patient population (WCPP): An updated standard for international comparisons of population-based survival. Cancer Epidemiol 2020;69:101802. https://doi.org/10.1016/j.canep.2020.101802.
Patterson RE, Sears DD. Metabolic Effects of Intermittent Fasting. Annu Rev Nutr 2017;37:371–93. https://doi.org/10.1146/annurev-nutr-071816-064634.
Clifton KK, Ma CX, Fontana L, Peterson LL. Intermittent fasting in the prevention and treatment of cancer. CA Cancer J Clin 2021;71:527–46. https://doi.org/10.3322/caac.21694.
Mattson MP, Longo VD, Harvie M. Impact of intermittent fasting on health and disease processes. Ageing Res Rev 2017;39:46–58.
https://doi.org/10.1016/j.arr.2016.10.005.
Nencioni A, Caffa I, Cortellino S, Longo VD. Fasting and cancer: molecular mechanisms and clinical application. Nat Rev Cancer 2018;18:707–19. https://doi.org/10.1038/s41568-018-0061-0.
Mager DE, Wan R, Brown M, Cheng A, Wareski P, Abernethy DR, et al. Caloric restriction and intermittent fasting alter spectral measures of heart rate and blood pressure variability in rats. The FASEB Journal 2006;20:631–7. https://doi.org/10.1096/fj.05-5263com.
Varady KA, Hellerstein MK. Alternate-day fasting and chronic disease prevention: a review of human and animal trials. Am J Clin Nutr 2007;86:7–13. https://doi.org/10.1093/ajcn/86.1.7.
Bakhit AA, Kurdi AM, Wadera JJ, Alsuwaida AO. Effects of Ramadan fasting on moderate to severe chronic kidney disease. Saudi Med J 2017;38:48–52. https://doi.org/10.15537/smj.2017.1.17566.
Melkani GC, Panda S. Time‐restricted feeding for prevention and treatment of cardiometabolic disorders. J Physiol 2017;595:3691–700. https://doi.org/10.1113/JP273094.
Lessan N, Ali T. Energy Metabolism and Intermittent Fasting: The Ramadan Perspective. Nutrients 2019;11:1192. https://doi.org/10.3390/nu11051192.
Nencioni A, Caffa I, Cortellino S, Longo VD. Fasting and cancer: molecular mechanisms and clinical application. Nat Rev Cancer 2018;18:707–19. https://doi.org/10.1038/s41568-018-0061-0.
Li C, Sadraie B, Steckhan N, Kessler C, Stange R, Jeitler M, et al. Effects of A One-week Fasting Therapy in Patients with Type-2 Diabetes Mellitus and Metabolic Syndrome – A Randomized Controlled Explorative Study. Experimental and Clinical Endocrinology & Diabetes 2017;125:618–24. https://doi.org/10.1055/s-0043-101700.
Al‐Jafar R, Zografou Themeli M, Zaman S, Akbar S, Lhoste V, Khamliche A, et al. Effect of Religious Fasting in Ramadan on Blood Pressure: Results From LORANS (London Ramadan Study) and a Meta‐Analysis. J Am Heart Assoc 2021;10. https://doi.org/10.1161/JAHA.120.021560.
Browning JD, Baxter J, Satapati S, Burgess SC. The effect of short-term fasting on liver and skeletal muscle lipid, glucose, and energy metabolism in healthy women and men. J Lipid Res 2012;53:577–86. https://doi.org/10.1194/jlr.P020867.
Sundfør TM, Svendsen M, Tonstad S. Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial. Nutrition, Metabolism and Cardiovascular Diseases 2018;28:698–706. https://doi.org/10.1016/j.numecd.2018.03.009.
Longo VD, Mattson MP. Fasting: Molecular Mechanisms and Clinical Applications. Cell Metab 2014;19:181–92. https://doi.org/10.1016/j.cmet.2013.12.008.
Antoni R JKCARMD. Effects of intermittent fasting on glucose and lipid metabolism. Proc Nutr Soc 2017;76:361–8.
Patterson RE SDD. Metabolic effects of intermittent fasting. . Annu Rev Nutr 2017;37:371-393 2017;37:371–93.
Nencioni A CICSLVD. Fasting and cancer: molecular mechanisms and clinical application. . Nat Rev Cancer 2018;18:707–19.
Zimmermann S KFPM et al. Reduced body size and decreased intestinal tumor rates in HDAC2- mutant mice. . Cancer Res 2007;67:9047–54.
Newman JC VE. Ketone bodies as signaling metabolites. . Trends in Endocrinology & Metabolism 2014;25:42-52 2014;25:42–52.
Shimazu T HMNJ et al. Suppression of oxidative stress by β- hydroxybutyrate, an endogenous histone deacetylase inhibitor. . Science (1979) 2013;339:211–4.
Campbell JE PADAHTRMC. Adipogenic and lipolytic effects of chronic glucocorticoid exposure. . Am J Physiol Cell Physiol 2011;300:C198–209.
Byun S SSKY et al. Fasting- induced FGF21 signaling activates hepatic autophagy and lipid degradation via JMJD3 histone demethylase. . Nat Commun 2020;11:807.
Salvadori G MMLVD. Intermittent and periodic fasting, hormones, and cancer prevention. Cancers (Basel) 2021;13:4587.
Rigiracciolo DC NNLR et al. IGF- 1/IGF- 1R/FAK/ YAP transduction signaling prompts growth effects in triple- negative breast cancer (TNBC) cells. Cells 2020;9:1010.
Buono R LVD. Starvation, stress resistance, and cancer. . Trends Endocrinol Metab 2018;29:271–80.
Bowers LW REOC deGraffenried LHSD. The role of the insulin/IGF system in cancer: lessons learned from clinical trials and the energy balance- cancer link. . Front Endocrinol 2015;6:77 2015;6:77.
Mizushima N LB. Autophagy in human diseases. N Engl J Med 2020;383:1564–76.
Onorati AV DMORARK. Targeting autophagy in cancer. . Cancer 2018;124:3307–18.
Li X HSMB. Autophagy and autophagy- related proteins in cancer. . Mol Cancer 2020:19–12.
Amaravadi RK KADJ. Targeting autophagy in cancer: recent advances and future directions. . Cancer Discov 2019;9:1167–81.
Sadeghian M RSKSHE. A review of fasting effects on the response of cancer to chemotherapy. . Clin Nutr 2021;40:1669–81.
Aventaggiato M VEBFRMTM. Sirtuins’ control of autophagy and mitophagy in cancer. Pharmacol Ther 2021;221:107748.
Singh CK CGNMG-PLMNAN. The role of Sirtuins in antioxidant and redox signaling. Antioxid Redox Signal 2018;28:643–61.
Clifton KK MCFLPLL. Intermittent fasting in the prevention and treatment of cancer. . CA Cancer J Clin 2021;71:527–46.
Yang Y K-UGP-PL et al. Autophagy promotes mammalian survival by suppressing oxidative stress and p53. . Genes Dev 2020;34:688–700.
Di Biase S LVD. Fasting- induced differential stress sensitization in cancer treatment. . Mol Cell Oncol 2016;3:e1117701.
Strickaert A SMDG et al. Cancer heterogeneity is not compatible with one unique cancer cell metabolic map. . Oncogene 2017;36:2637–42.
de Groot S, Lugtenberg RT, Cohen D, Welters MJP, Ehsan I, Vreeswijk MPG, et al. Fasting mimicking diet as an adjunct to neoadjuvant chemotherapy for breast cancer in the multicentre randomized phase 2 DIRECT trial. Nat Commun 2020;11:3083. https://doi.org/10.1038/s41467-020-16138-3.
Schreck KC, Hsu F-C, Berrington A, Henry-Barron B, Vizthum D, Blair L, et al. Feasibility and Biological Activity of a Ketogenic/Intermittent-Fasting Diet in Patients With Glioma. Neurology 2021;97:e953–63. https://doi.org/10.1212/WNL.0000000000012386.
Zorn S, Ehret J, Schäuble R, Rautenberg B, Ihorst G, Bertz H, et al. Impact of modified short-term fasting and its combination with a fasting supportive diet during chemotherapy on the incidence and severity of chemotherapy-induced toxicities in cancer patients - a controlled cross-over pilot study. BMC Cancer 2020;20:578. https://doi.org/10.1186/s12885-020-07041-7.
Bauersfeld SP, Kessler CS, Wischnewsky M, Jaensch A, Steckhan N, Stange R, et al. The effects of short-term fasting on quality of life and tolerance to chemotherapy in patients with breast and ovarian cancer: a randomized cross-over pilot study. BMC Cancer 2018;18:476. https://doi.org/10.1186/s12885-018-4353-2.
Marinac CR, Nelson SH, Breen CI, Hartman SJ, Natarajan L, Pierce JP, et al. Prolonged Nightly Fasting and Breast Cancer Prognosis. JAMA Oncol 2016;2:1049–55. https://doi.org/10.1001/jamaoncol.2016.0164.
Dorff TB, Groshen S, Garcia A, Shah M, Tsao-Wei D, Pham H, et al. Safety and feasibility of fasting in combination with platinum-based chemotherapy. BMC Cancer 2016;16:360. https://doi.org/10.1186/s12885-016-2370-6.
de Groot S, Vreeswijk MPG, Welters MJP, Gravesteijn G, Boei JJWA, Jochems A, et al. The effects of short-term fasting on tolerance to (neo) adjuvant chemotherapy in HER2-negative breast cancer patients: a randomized pilot study. BMC Cancer 2015;15:652. https://doi.org/10.1186/s12885-015-1663-5.
Badar T IAAA. Safety and feasability of Muslim fasting while receiving chemotherapy. IOSR J Pharm 2014;4:15–20.
de Cabo R MMP. Effects of intermittent fasting on health, aging, and disease. N Engl J Med 2019;381:2541–51.
Gabel K CKVKGVT-HL. Current evidence and directions for intermittent fasting during cancer chemotherapy. . Adv Nutr 2021;13:667–80.
Longo VD FL. Calorie restriction and cancer prevention: metabolic and molecular mechanisms. . Trends Pharmacol Sci 2010;31:89–98.
Mattison JA RGBT et al. Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study. . Nature 2012;489:318–21.
Colman RJ ARJS et al. Caloric restriction delays disease onset and mortality in rhesus monkeys. . Science (1979) 2009;325:201–4.
Carlsson LMS SKJP et al. Life expectancy after bariatric surgery in the Swedish obese subjects study. . N Engl J Med 2020;383:1535–43.
Anveden Å TMPM et al. Long- term incidence of female- specific cancer after bariatric surgery or usual care in the Swedish obese subjects study. . Gynecol Oncol 2017;145:224–9.
Di Biase S LVD. Fasting- induced differential stress sensitization in cancer treatment. . Mol Cell Oncol 2016;3:e1117701.
Icard P OLFP et al. Perspective: do fasting, caloric restriction, and diets increase sensitivity to radiotherapy? A literature review. . Adv Nutr 2020;11:1089–101.
Liberti MV LJW. The Warburg effect: how does it benefit cancer cells? . Trends Biochem Sci 2016;41:211–8.
Lee C SFRL et al. Reduced levels of IGF- I mediate differential protection of normal and cancer cells in response to fasting and improve chemotherapeutic index. . Cancer Res 2010;70:1564–72.
Cheng CW AGPL et al. Prolonged fasting reduces IGF- 1/PKA to promote hematopoietic- stem- cell- based regeneration and reverse immunosuppression. . Cell Stem Cell 2014;14:810–23.
Arends J BVBH et al. ESPEN expert group recommendations for action against cancer- related malnutrition. Clin Nutr 2017;36:1187–96.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Email this article 
