Fasting-enhanced immune effector mechanisms in obese subjects

doi:10.1016/0002-9343(83)91172-5

The American Journal of Medicine

Volume 75, Issue 1, July 1983, Pages 91-96

https://doi.org/10.1016/0002-9343(83)91172-5 Get rights and content

Abstract

Acute nutritional deprivation occurs frequently in clinical practice, yet little data exist on its effect on immune host defenses. To investigate this question, various immune parameters were studied in 15 obese subjects before and after a 14-day fast. Blood monocyte bactericidal activity and natural killer cell cytolytic activity were enhanced by fasting: monocyte killing increased in 12 of 14 subjects (p < 0.05) and natural killer cell activity increased an average of 24 percent in 13 subjects tested (p < 0.02). Starvation also enhanced parameters of humoral immunity as evidenced by increases in serum concentrations of IgG, IgA, and IgM (p < 0.01). By contrast, lymphocyte blastogenic responses to the mitogen phytohemagglutinin were modestly decreased. Peripheral blood leukocyte counts, including neutrophils, T cells, and B cells, did not decrease significantly. These results indicate that fasting has differential influences on immune function rather than a uniformly deleterious effect. Of potential import, this nutritional alteration appears to actually enhance certain effector functions of the host defense system.

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One set of experiments found that mice subjected to 24–72 h of food deprivation before inoculation with Listeria monocytogenes exhibited lower mortality rates compared to mice that were allowed to feed freely prior to inoculation (Wing & Young, 1980). A study of human participants who were obese at baseline (and therefore had substantial metabolic reserves) found that natural killer cell cytolytic activity and blood monocyte bactericidal activity were enhanced after a 14-day fast (compared to before the fast) which suggests that there is a physiological tradeoff between food metabolism and some aspects of innate immune function (Wing, Stanko, Winkelstein, & Adibi, 1983). Taken together, these findings suggest that reduced food intake during, or even shortly before, infection provides a direct immunological benefit to the host.
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^☆: This study was supported in part by grants from the Health Research and Services Foundation and the National Institutes of Health (CA-2449 AM-15855 and RR-00056), Bethesda, Maryland.

¹: From the Department of Medicine, University of Pittsburgh School of Medicine, Montefiore Hospital, Pittsburgh, Pennsylvania.

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Clinical studyFasting-enhanced immune effector mechanisms in obese subjects☆

Abstract

Lancet

Lancet

Clin Immunol Immunopathol

Role of nutrition in immunologic function

Physiol Rev

Malnutrition and the immune response

Cell-mediated immunity in nutritional imbalance

Acute starvation protects mice against Listeria monocytogenes

Infect Immun

Suppression of infection by famine and its activation by refeeding—a paradox?

Perspect Biol Med

Modulation of leucine oxidation and turnover by graded amounts of carbohydrate intake in obese subjects

Metabolism

Clinical study
Fasting-enhanced immune effector mechanisms in obese subjects☆