生物与医学2019ncbi.nlm.nih.gov
短期禁食对癌症治疗的影响
Effects of short-term fasting on cancer treatment
入门 · 约 45 分钟读完前置知识：基础肿瘤学概念、营养代谢基础
导读
这篇综述探讨了短期禁食作为癌症治疗辅助手段的效果。作者梳理了相关动物实验和少量人体研究，初步结果显示短期禁食在化疗期间可能减轻副作用且未见明显危害，但现有证据非常有限，尚不能断定其有效性。
HN 关注点：禁食与癌症治疗的关系涉及代谢、自噬等热门健康话题，HN 读者关注其实际疗效证据是否充分，以及医学界如何看待这类非传统干预手段。
HN 评论精选
这几条评论里：质疑 2 补充 1 亲历 1
质疑医学从业者提醒：证据仅来自 5 项研究 88 人，远不足以证明有效性
我要在这里泼一大盆冷水。这是一篇综述研究，梳理了该技术在癌症领域的现有文献——总共只有 5 项研究、88 名人类受试者。我们医学界完全不知道它是否有效。唯一能说的是，初步试验显示它没有特别的危害，但随着数据增多这一点也可能改变。他们还综述了大量小鼠研究和理论，这很好。但这一切加起来只说明：在得出任何结论之前应该做更多研究。考虑到癌症研究经费有限，我甚至不清楚它该占多大优先级。
joshgel查看英文原文
Can I just throw a big dose of caution here? This is a review study, looking at the available literature of this technique on cancer. They found a total of FIVE studies with 88 total human participants across all 5 studies. We, the medical community, still has no idea whether this is effective or not. The only thing we can say is that initial trials don't show it to be particularly harmful. That could change with more data. They review a lot of mice studies and theory, which is great. But all this adds together to indicate that we should study this more before drawing any conclusions. With limited funding for cancer research, its not even clear to me from this what priority it should take
补充补充历史资料：苏联曾大规模研究长期禁食疗法，但文献未译成英文
苏联时期曾对禁食作为多种疾病（从自身免疫病到精神疾病）的潜在疗法进行过大量研究。数万人在持续监护和检测下接受了 14-40 天的清水禁食，约三分之二的人报告了不同程度的疗效。我想这些研究大部分从未被翻译成英文。
dharma1查看英文原文
Fasting was extensively researched in Soviet Russia as a potential cure for many ailments, from auto-immune diseases to mental illness. Tens of thousands of people were treated with 14-40 day water fasts (under constant supervision and testing), roughly 2/3rds reported various levels of success. I don't think much of the studies have ever been translated into English.
亲历亲历者分享两年禁食经验：身体改善之外，最大收获是心理韧性
分享一个样本量为 1 的发现……我禁食约两年了，做过几次 5 天和 7 天的清水禁食，过去 250 天一直坚持 16:8，偶尔加 23:1。我之前就健康，但之后感觉更好了：肠胃平静、睡眠更好、更有力量（尽管运动更少）、专注力提升，心态也更平和。我以前练习冥想，但过去一年已觉得不需要了——身体平静且休息充分，心自然正念。禁食最大的好处（以及冷水澡等其他非常规习惯）是心理韧性：每次你发现不吃东西也能表现良好甚至更好，就获得一次自信提升，这种效应会随时间复利，也让养成其他习惯变得更容易。一天吃 5 顿容易，吃 1 顿很难——做到了你就成长了一点。
mickel查看英文原文
I'd like to share my findings from a sample size of one... I've been fasting for about 2 years now. I've done a couple of 5-days water fasts, and a few 7-days water fasts. The past 250 days I've been consistently following 16:8 and adding in a few 23:1's in there for good measure. I was healthy before I started, but have since then felt even better. My stomach feels calm, I sleep better, I feel stronger (even though I exercise less) and my overall focus has improved. This results in a better mental state, somehow calming my mind. I've been a practitioner of meditation before, but have not felt the need for it the past year. My body is calm and well-rested => my mind is mindful. But the number 1 benefit of fasting (and all other non-conventional habits, such as cold showers in the morning), is mental resilience. Every time you realize that you perform well, if not even better, without food, you get a confidence boost. This effect compounds with time. I've found out that this in turn makes it easier to take on other habits as well, because your habit muscles are stronger now than before. Eating 5 meals a day is easy... eating 1 is hard => you grow a little if you manage to do it.
质疑提出疑问：生酮饮食或许能达到禁食的代谢效果而无需挨饿
文章指出营养不良和低体重者通常被禁止禁食，显然禁食不能长期进行，否则会变成饥饿。我在想：与维持热量摄入的生酮饮食相比，热量限制/禁食是否真有额外好处？关键似乎在于消除促进胰岛素的碳水化合物、耗尽糖原，从而迫使代谢进入酮症、降低生长因子、促进分解代谢和自噬。
gnode查看英文原文
The article explains that fasting is often prohibited by malnutrition and low body weight. Obviously fasting cannot be undertaken long-term, as it results in starvation. I wonder whether there is any benefit to caloric restriction / fasting, versus maintenance calorie intake with a ketogenic diet. The crucial thing seems to be the elimination of insulin promoting carbohydrate, and depletion of glycogen which forces metabolism into ketogenesis, reduces growth factors, and promotes catabolism and autophagy.
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