Dr. Sagar Ramesh Makode
Cardiology
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Patient's Query
Hello doctor,
I have read several studies on the effect of autophagy on aterial fibrilation. I cannot understand most of the conclusions and need some help with this. I basically follow a regime where I eat every other day and fast at least 24 to 30 hours at a time. As I believe, autophagy is activated and can have a positive or negative effect on the heart, in particular, the atrium and remoddeling of electrics. Can you please tell me if you think what I am doing could possible cause afib or remoddeling of my heart? I have no current issues, low cholesterol and BP, no family history and have a structually normal heart. However due to my years of excess I have this fear of getting afib. I am male, 35 years old, mixed ethnicity.
Hello,
Welcome to icliniq.com.
Firstly, there is no good evidence for or against this rigorous fasting. Studies atleast have shown no significant increase in atrial fibrillation with such fasting. Practically, we do not have good evidence for it. Now if we consider theoretically, then yes fasting may stimulate autophagy and may have a beneficial effects on heart/ atrial fibrillation. It does improve your lipid profile and risk of myocardial ischemia which is a risk factor for atrial fibrillation. It may also reduce obesity/ bodily inflammation, which is again a risk factor for atrial fibrillation. So, there is no evidence to suggest that it induces afib or remodeling, but such rigorous fasting is not recommended based on current evidence. We are also not sure whether you are meeting the daily requirement of essential nutrients. Dehydration should be strictly avoided. You can share some studies with me so that I can clarify on them. So, fasting for few days say for one to five days a month is acceptable.
Patient's Query
Hello doctor,
Thank you for the reply, it is helpful for me to hear this. I have attached the document in question but I believe it was in subject who already had AF. I take full minerals and electrolytes on fasting days and live on a plant based diet most of the year with no oil. I live with schizophrenia and the fasting helps with that as does keeping my endothelium cells happy. But I am left with hypochondria particularly over again.
Hello,
Welcome back to icliniq.com.
This is not a good article and study in your context (attachment removed to protect patient identity). Firstly, they have studied it in the Afib patient and there might be significant differences between normal and Afib population. As in cancer, it helps to prevent cancer but sometimes may lead to increase in spread of tumor in cancer patients. So, its functions and pathways are poorly understood and difficult to come one particular conclusion. Also, in this study, the two populations compared were different like medicines they were taking which has got significant effect on afib. Also, sample size was small. And as I mentioned earlier, practically there is no evidence till date that it increases Afib. If we consider the literature, there are mixed results. There are studies which suggest increased autophagy in Afib, but whether this is a cause or effect is not known. So overall, we cannot come to any definite conclusion, but practically no evidence of increased evidence. I will keep on searching research work on this topic.
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Cardiology
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