{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:12:36Z","timestamp":1792789956044,"version":"4.5.0"},"reference-count":65,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Immanuel Hospital Berlin"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Preliminary clinical data suggest that pain reduction through fasting may be effective for different diagnoses. This uncontrolled observational clinical study examined the effects of prolonged modified fasting on pain and functional parameters in hip and knee osteoarthritis. Patients admitted to the inpatient department of Internal Medicine and Nature-based Therapies of the Immanuel Hospital Berlin between February 2018 and December 2020 answered questionnaires at the beginning and end of inpatient treatment, as well as at 3, 6, and 12 months after discharge. Additionally, selected blood and anthropometric parameters, as well as subjective pain ratings, were routinely assessed during the inpatient stay. Fasting was the only common intervention for all patients, being performed as part of a multimodal integrative treatment program, with a daily caloric intake of &lt;600 kcal for 7.7 \u00b1 1.7 days. N = 125 consecutive patients were included. The results revealed an amelioration of overall symptomatology (WOMAC Index score: \u221214.8 \u00b1 13.31; p &lt; 0.001; d = 0.78) and pain alleviation (NRS Pain: \u22122.7 \u00b1 1.98, p &lt; 0.001, d = 1.48). Pain medication was reduced, stopped, or replaced by herbal remedies in 36% of patients. Improvements were also observed in secondary outcome parameters, including increased quality of life (WHO-5: +4.5 \u00b1 4.94, p &lt; 0.001, d = 0.94), reduced anxiety (HADS-A: \u22122.1 \u00b1 2.91, p &lt; 0001, d = 0.55) and depression (HADS-D: \u22122.3 \u00b1 3.01, p &lt; 0.001, d = 0.65), and decreases in body weight (\u22123.6 kg \u00b1 1.65, p &lt; 0.001, d = 0.21) and blood pressure (systolic: \u22126.2 \u00b1 15.93, p &lt; 0.001, d = 0.43; diastolic: \u22123.7 \u00b1 10.55, p &lt; 0.001, d = 0.43). The results suggest that patients with osteoarthritis of the lower extremities may benefit from prolonged fasting as part of a multimodal integrative treatment to improve quality of life, pain, and disease-specific functional parameters. Confirmatory randomized controlled trials are warranted to further investigate these hypotheses.<\/jats:p>","DOI":"10.3390\/nu15122695","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T08:37:33Z","timestamp":1686299853000},"page":"2695","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Effects of Prolonged Fasting during Inpatient Multimodal Treatment on Pain and Functional Parameters in Knee and Hip Osteoarthritis: A Prospective Exploratory Observational Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Daniela A.","family":"Koppold","sequence":"first","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"},{"name":"Department of Internal Medicine and Nature-Based Therapies, Immanuel Hospital Berlin, 14109 Berlin, Germany"},{"name":"Department of Pediatrics, Division of Oncology and Hematology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3071-7902","authenticated-orcid":false,"given":"Farid I.","family":"Kandil","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"},{"name":"Department of Pediatrics, Division of Oncology and Hematology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"G\u00fcttler","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"},{"name":"State Institute of Forensic Medicine Berlin, 10559 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Steckhan","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"},{"name":"Connected Healthcare, Hasso Plattner Institute, University of Potsdam, 14482 Potsdam, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Mei\u00df","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Breinlinger","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"},{"name":"Department of Internal Medicine and Nature-Based Therapies, Immanuel Hospital Berlin, 14109 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Nelle","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0135-9643","authenticated-orcid":false,"given":"Anika M.","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"},{"name":"Department of Dermatology, Venereology and Allergology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3277-9090","authenticated-orcid":false,"given":"Michael","family":"Jeitler","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"},{"name":"Department of Internal Medicine and Nature-Based Therapies, Immanuel Hospital Berlin, 14109 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Hanslian","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3495-6495","authenticated-orcid":false,"given":"Jan Moritz","family":"Fischer","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Michalsen","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"},{"name":"Department of Internal Medicine and Nature-Based Therapies, Immanuel Hospital Berlin, 14109 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7794-8375","authenticated-orcid":false,"given":"Christian S.","family":"Kessler","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 10117 Berlin, Germany"},{"name":"Department of Internal Medicine and Nature-Based Therapies, Immanuel Hospital Berlin, 14109 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"ref_1","unstructured":"RKI (2022, December 11). 12-Monats-Pr\u00e4valenz von Arthrose in Deutschland. 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