The impact of fasting on cardiovascular risk control in patients with metabolic dysfunction-associated steatotic liver disease

Introduction: Optimal control of cardiovascular risk factors remains challenging in non-classical patient groups, including those with metabolic dysfunction-associated steatotic liver disease (MASLD). Dietary restrictions are among the interventions that may be helpful in such cases.

Aim: To evaluate if the declared type of fasting influences the most common cardiovascular risk factor control in patients with MASLD.

Material and methods: Body mass index, systolic blood pressure, diastolic blood pressure, heart rate, and basic blood parameters representative for control of cardiovascular risk factors were assessed in participants before and after self-declared fasting during Lent. Participants were divided into 2 groups. Group A declared an intensive fast for 40 days (avoiding alcohol consumption, meat, sweets, snacks, and sweetened drinks), while group B fasted only on Good Friday. The study consisted of 210 adults with MASLD, who were at a mean age of 56.0 ±6.6 years, and 148 (70.5%) were male.

Results: After 40 days of fasting, in group A (104 participants) a beneficial decrease in almost all parameters was observed, whereas in group B (106 participants) no differences were noted. Moreover, in group B there was a slight increase in the HbA_1C levels (7.44% vs. 7.52%) and blood pressure values (132.97 mm Hg vs. 133.9 mm Hg for systolic and 81.28 mm Hg vs. 81.3 mm Hg for diastolic blood pressure). The most significant differences were observed in total cholesterol levels (178.71 mg/dl vs. 165.55 mg/dl, p = 0.004) and LDL-C (163.87 mg/dl vs. 148.9 mg/dl, p = 0.004).

Conclusions: Fasting can significantly impact cardiometabolic health measures as part of complex lifestyle modification, thus playing a role in cardiovascular prevention in patients with MASLD.