DEPARTMENT OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN

FEDERATION
APPLICATION fasting-diet therapy (RDT) in Rehabilitation Medicine
A Manual for Physicians
Moscow, 2005 TRAINING INSTITUTE
"APPROVED"
Chairman of the Section on regenerative medicine, balneology and physiotherapy of the
Scientific Council of Ministry of Health of Russia, Academician of RAMS, Professor AN
Razumov
APPLICATION fasting-diet therapy (RDT) in Rehabilitation Medicine
Manual for physicians trained Institute of Advanced Studies of the Federal Agency for
Biomedical and Extreme Problems Health Ministry of Russia (Rector Reva VD).
Compiled by prof. Korchazhkina NB, MD Ashikhmina M., MD Gurvich VB, Lebedev O., MD
Kotenko KV
Abstract
The manual for doctors sets out the methodological approaches and practical recommendations
for using fasting-diet therapy (RDT) in clinical practice and regenerative medicine. The manual
outlines the scientific basis of the division of the RTD for different periods, each of which plays
an important role in enhancing the effectiveness of fasting-diet therapy.
Fasting-diet therapy combines well with other drug-free methods (reflexology, Su-Jok therapy,
physiotherapy, herbal medicine, homeopathy, etc.) and can be used in medical and spa facilities.
Application of this method in the treatment of some diseases can reduce the dose of drugs,
reduce treatment time. RTD helps to optimize the prevention and rehabilitation schemes.
The manual is intended for a wide range of clinicians and regenerative medicine physicians.
Introduction.
Recently, great interest is the method of fasting-diet therapy (RDT), or fasting. This interest is
due to several factors.
Thus, in recent years an increase in the number of patients with combined pathology, and related
existing diseases increases with age, the patient, which often leads to the need for coadministration of multiple drugs.
This is accompanied by an increase in the number of complications of medical therapy, including
allergic reactions, drug intolerance. Often there is resistance to drug treatment [15,16].
The spectrum of application of the RTD is very wide and it can be used for comorbidity,
providing both curative effects on many organs and systems.
The method of RTD deprived of a number of significant shortcomings inherent in drug

treatments, thus particularly indicated for patients resistant to therapy, with poor tolerance to
drugs and allergic reactions.
With a number of diseases (certain types of asthma, allergic, psoriasis, hypertension, ankylosing
spondylitis, etc.), therapeutic effect of fasting is not inferior to the effect of drugs, ie, the method
of choice [1,11,12,18,21].
Many years of experience with the RTD has shown that this method compares favorably with
known methods of treating a number of advantages [14, 15,20,26]. RTD has a wide range of
indications in contraindications sravnitelnonebolshom including beneficial effects on many
comorbidities, contributes to the normalization of metabolism and function of the cardiovascular
system, improves the general condition of the patient (the appearance of cheerfulness,
normalization of sleep, improved mental processes) [5,6,7] is a potent prophylactic agent [29],
and normalizes the immune system [28]. Development of numerous modifications of fasting
allows management to implement the healing process with regard to age, body weight, mental
status of the patient [4].
All this is a consequence of nonspecific effects and obscheozdoravlivayuschim RTD on the
human body as a whole, increasing its reactivity, stability to adverse factors (microorganisms,
cold, hypoxia, etc.).
The development of fasting-diet therapy alone as a method can be considered complete,
however, given the frequent co-polymorphism
pathology, the focus of clinicians and researchers is directed to the combination of fasting with
other methods of conventional and regenerative medicine. Recently, special attention is paid to
the search for new modifications of the RTD, a combination method of fasting with other drugfree methods [2,3,8,15,31]. Many experts point to a significant increase in the effect of therapy
with concomitant use of traditional methods [3,14,15].
RTD specialist physician may be one of the clinical specialties, the last course of fasting-diet
therapy. He should be able to develop individual recovery and rehabilitation programs that
provide comprehensive application of non-drug methods to restore optimal health a person.
General information about the method of fasting-diet therapy (RDT).
Based on many years of clinical and biological research in the RTD are 6 stages through which
the patient passes successively in the course of treatment - three for three on the discharge and
recovery period (Table 1). Table 1. Stages and clinical stages of fasting-diet therapy.
Stages
Clinical stage
fasting (fasting period)
1. EPEP
(Phase transition to endogenous nutrition)
Stage I - Stage Food
excitation stage alarm.

II - stage of transition to endogenous nutrition, stage of "perestroika"

switching.
2. EKEP
(Phase compensated supply endogenous)
III - The stage of compensation and adaptation.
3. EP (Transition)
realimentatsiya (recovery period)
1. ELKIR
(Phase lag compensation
resources expended)
I - asthenic, stage of growth of food arousal, sensory-graded saturation.
II - stage of intensive rehabilitation, secondary food arousal, sensory-metabolites licheckogo
saturation.
2. EGKR
(Stage overcompensation resources)
III-stage normalization
3. ES
(Stabilization phase)
I stage - the stage of alimentary excitation (step "alarm") usually lasts for the first 2-4 days and is
characterized by an increased feeling of hunger, headaches, "sucking" pain in the intestines,
patients sensitive to the sight and smell of food. Diurnal body weight loss is 1-2 kg [14].
In stage I, a recurring motor activity of the gastrointestinal tract, increases the concentration of
enzymes, stomach, pancreas, bile components [15].
Studies have shown that after a few hours after a meal activates the anaerobic breakdown of
glycogen to form glucose [17, 30, 32, 33]. Glycolysis predominates in the first 16-18 hours of
fasting. Somewhat later, the sensory starvation joined the so-called "metabolic starvation," which

activates the hypothalamic area through the "hungry blood," that is perceived as an emotionally
hungry.
In addition, in the hypothalamus more potent motivational arousal hungry "blocks" other
excitations, thus depriving the pathological lesions in the cortex, "the blind force of the
subcortex" (according to Pavlov).
Stage II - transition to endogenous nutrition, the growing phase of ketoacidosis, the stage of
"perestroika". At this time, the sensation of hunger, there is breath, coated tongue, there is a
moderate bradycardia, decreased blood pressure, stroke volume, the occurrence of orthostatic
reactions [14,15].
During this period, developing acidosis associated with the fall of alkali reserve of blood and the
accumulation of ketone bodies, which gradually increases, generally up to 7-9 days of fasting.
Later in the day or even several hours phenomena acidosis rapidly subsides. This period is
known as "acidotic peak" (F. Benedict, 1915) [4,11,14,15,17,21,33].
It should be noted that during the course of the RTD is considered advisable to achieve
ketoatsidoticheskogo peak, but often to reduce the duration and severity of its need to minimize
the discharge time period in the treatment of elderly patients, patients with cardiovascular
disease, with neurosis, drawn-reactive state, in immunodeficient states [10,13,19].
In stage II, the body begins to function more economically, reduces the basal metabolic rate (up
to 30% from baseline), daily weight loss of 0.3-0.7 kg [14].
6-8 days there is a periodic cessation of activity of the gastrointestinal tract and there is a socalled "spontaneous" gastric secretion, formed a secret contains 25% protein, which is reabsorbed. This phenomenon is seen as an adaptive mechanism that provides the body with a
constant influx of amino acids, used as plastic material for the construction and protein synthesis,
the most important organs. Body goes on endogenous nutrition, which produces endogenous
saturation of blood and nutrients to the blood becomes "endogenous sated" [9].
The first and second stages of starvation are the phase transition to endogenous nutrition (EPEP)
- Stage 1.
Stage III - the stage of compensation or adaptation, is the first 15-20 days after the acidotic peak,
which corresponds to the second phase of the compensated supply of endogenous (EKEP). In
these terms ketonemia reduced and compensated metabolic acidosis, which appears to improve
patient well-being a decrease in feelings of weakness, hunger, headaches. In patients with
increased mood, disappear or diminish the phenomenon of exacerbation of chronic diseases
[14,15]. Daily weight loss of 0.2-0.5 kg. At this time no substantial changes in structures of the
body, from 70 to 90% of the total energy consumption is provided by the oxidation of fat depots
of triglycerides and ketone bodies.
Adaptation to conditions of starvation becomes more sophisticated, there is a relative
stabilization of the metabolism, decreased energy expenditure function of physiological systems.
Approximately 20 days comes the second acidotic peak, like its clinical and paraclinical
manifestations at first, but less pronounced.
This stage lasts up to a physiologically acceptable level of spending depotkanevyh resources.
The exhaustion of resources, the blood is likely to become again "hungry", there are activating
pulses, the feeling of hunger (food secondary stimulation). Duration of this stage - the strictly
individual rate, which depends on the one side of the defenses and compensatory capacity of the
organism, and the other from the old and the severity of the disease.

The end of this stage is determined by a number of objective and subjective symptoms (by S.
Brown) [20,21]:
The appearance of increased appetite, increased feelings of hunger.
Purification of the language of flying down to its root.
Reducing emissions from enema (feces in the wash water is practically not allocated, the
liquid comes out clear.)
The appearance of light eyes, blue sclera and purity.
Sustained improvement of clinical symptoms of existing disease.
The emergence of "good color" of the face.
The appearance of these symptoms corresponds to a weight loss that constitutes 13-17% of the
original.
The identification of these signs is important because if they are "neuznavaniya" physician
subsequent starvation will be the "starvation disease" (PP Aurora, VV Pashutin).
It should be noted that out of all of the most significant features is the appearance of the patient's
appetite, because presence of plaque in the language is found not in all patients, the same
characteristics as the appearance of light eyes and a "good face color" is not always possible to
trace in some patients.
This shows the relevance of the search for other objective evidence, are sensitive to the dynamics
of patients on RDT. After the 2nd stage of the RTD (EKEP) begins a transitional phase (PE),
duration of 1-2 days. Both of these steps correspond to the clinical stage III RTD.
The recovery process (out of starvation, realimentatsii, preadaptation to endogenous nutrition)
consists of three stages.
Stage I - asthenic (stage "of growing food on a background of excitation irritable weakness"). In
most cases, it lasts 2-3 days.
The peculiarity of this stage is that the patient's saturation occurs very quickly and after taking
small amounts of food, but after 15-30 minutes, again, the feeling of hunger. By the end of this
stage, as a rule, there is an increased appetite.
Stage II recovery period - the stage of secondary food arousal (intense rehabilitation). It may take
5-7 days or more, depending on the length of the discharge period. Satiety is held 3-4 hours,
frequency of meals is reduced to 3-4 times a day. Appetite increased, which requires great care,
patients begin to gain weight, set a regular normal stools, improved mood and well-being, there
is an increase of physical strength, there is courage. A normalization of blood biochemical
parameters.
Stage III - the stage of normalization. Appetite is moderate, the mood is even. Stage III is
characterized by a complete recovery of all physiological functions of the body, stabilizing body
weight.
I and II clinical stages are a single phase lag compensation resources expended (ELKIR). After
him comes the stage of overcompensation resources (EGKR), during which reliably detected the
phenomenon of "activation" of metabolism and protective forces. This stage lasts up to 3-4
months, after it comes the stage of stabilization (ES), during which revealed the phenomenon of
"trend toward normalization" of higher nervous activity and metabolism.
Indications and contraindications for RTD.
On the main important indications for the RTD:

hypertension I-II degree;

cardiopsychoneurosis in hypertensive and mixed type (restriction on the amount NTSTS
hypotonic type - there is the possibility of orthostatic collapse);
coronary heart disease, angina I, II and III functional class;
chronic obstructive bronchitis;
asthma;
pulmonary sarcoidosis stage I and II;
chronic gastritis with secretory insufficiency and giperatsidnyh state gastroduodenitis;
chronic cholecystitis and pancreatitis nekalkulezny;
biliary dyskinesia, irritable bowel syndrome);
Diseases of the musculoskeletal inflammatory and degenerative origin;
Neuroendocrine abnormalities in chronic salpingoofaritah;
prostate adenoma;
alimentary-constitutional, diencephalic obesity;
resistance to drug therapy;
Skin allergies (chronic allergic dermatitis, atopic dermatitis, psoriasis, eczema);
neuroses, depression, sluggish schizophrenia, food and (or) drug allergy.
Contraindications to the RTD:
Absolute contraindications:
pronounced deficit in body weight (more than 15% of predicted values);
Malignant tumor;
active tuberculosis of the lungs and other organs;
bronchiectasis;
systemic blood diseases;
diabetes mellitus type I;
hyperthyroidism;
cardiac arrhythmia, and (or) conductivity of any origin;
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concoctions. An example of such a diet for the release of their 7-day fasting is given in Appendix
3.
In the case of fasting-diet therapy in preventive and restorative goal for healthy people the
regime does not change.
Possible complications during the RTD, the activities of their cupping and Prevention.
Exacerbation of chronic foci of infection.
In long-term fasting, more than two weeks can be observed exacerbation of chronic foci of
infection. It is assumed that after 15 days of discharge period, the majority of patients have
transient immunosuppression of all parts of the immune system. The clinical picture is
sharpening depends on the existing site of infection (chronic tonsillitis, pyelonephritis, adnexitis)
and obscheintoksikatsionnym syndrome (fever, weakness, sweating, etc.). Typically, the
following preventive measures:
exception of supercooling of the body;
compliance with adequate drinking water treatment (at least 1.5 liters), while in the presence
of chronic urinary tract infections (you can assign uroseptichekuyu herbal medicine);
2-weekly disposable tyubazhi (Carlsbad salt, sorbitol, xylitol) in the presence of chronic
cholecystitis;
Daily 1 - 2 meals a day rinse mouth with a weak solution of potassium permanganate or
furatsilina the presence of chronic
tonsillitis. Perhaps the use of herbs.


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Literature
.., .., ..
. // . "
". - .,1993.-.63.
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-

 .// - .- 1998, 10, . 137-138.

..
- .//-
. Sat . - -., 2003. - . 108-110.
..
- . . .
.... 24 . M., 1998.
.., .., .., ..
. // .
" ". - .,1993.-.45.
.., .., .., ..
. // . "
".-.,1993.- .45-46.
..
. // . " - ".-., 1976.
.., .., ..
- . //
.. - 1998, 8, .41-45.
.., .., ..
- . //. " "..,1993.- .76-77.
.. . //
.. " . . . ".- .,1978.
.. - . . ..... 28 . -., 1996.
3 .. . // . "
". - .,1993.- .63-64.
.. . //
... " ". -.,1978. -.5-9.
.., .., .. . -
. - -., - ., 1994, 56 .
.., BC :
. - , - , 1995 185.
..
.//. . - 1982, 1. - . 15-20.
() -
. , 1990. .28.
..
. //.. " .
."-.,1969.- .57.- .243-249
.., .., .., .., .. . //.. " . .
. ".-., 1978.

 .. -
. // . " - ". -.,1976.
.. - " ". - .,1969.
.. ,
.// -
: - : , 2001. .87-89.
.. . // . "
". - .,1993.-.110-113.
-
, - .
.,., 1998. ( .., ..,
.., BC).
.
.
//.. " .."-.,1969.-.57.-.99-102.
.. . //
.. " . . . ".- .,1978.
.., ..

.// . " ".- .,1993.- .113-115.
.., .. . //
. " - ".-.,1976.
.., ., .. .
. //.. " ..".,1969.-.57.-.205-216.
. . , ,
. , 1996.
.. -
.// - :
- - :
, 2001. .118-120.
Beneedict FG A study of prolonged fasting.- Washington, 1915.
Kernolt PK, Nanghton JL, Driscoll CL Fasting: the history, pathophysiology and
complications. // West. J. Med. 1982, v.137, p.379-399.

condition after suffering a heart attack macrofocal;

Heart Failure II B - III degree;
chronic hepatitis and cirrhosis of the liver;
chronic renal and kidney failure of any origin;
thrombophlebitis.
Relative contraindications:
ischemic heart disease with arrhythmia and heart failure than II A stage;
severe hypotension;
cholelithiasis;
urolithiasis;
gastric ulcer and duodenal ulcer;
chronic venous insufficiency;
diabetes mellitus type II;
gout;
febrile conditions;
pregnancy and lactation;
childhood and old age patients.
Description of the method of fasting-diet therapy (RDT).
The method of dosed fasting designed YS Nikolayev and in subsequent years much
supplemented by other experts in the RTD is the voluntary abstinence from eating with an
unlimited (in the case of total starvation) use of water and holding a series of detoxification
hygiene (water treatment, daily cleansing enemas, etc.), followed by reducing dietary food for
special scheme.
Fasting-diet therapy can be performed in a hospital specialized units in the extended care facility,
in some cases, the acceptability of treatment as outpatients.
Fasting period with a discharge period 14 days or more is recommended in the specialized
department of a hospital.

In carrying out preparatory RTD release, discharge and recovery period.

Preparatory period.
In the preparatory period is carried out individual and collective information preparing patients
for this treatment method because the method of fasting involves the active participation of the
patient, and he must be familiar with the essence of the method, timing, major changes in the
organism during food deprivation, with a treatment regimen.
For the treatment of dosed fasting allocated a special chamber.
Period of discharge (directly starvation).
Duration of fasting dosed individually based on age, initial body weight, disease patient.
In most cases the rate of fasting between 7 and 21 days. Typically, the therapeutic effect is
achieved precisely at a given duration of the discharge period.
As a preventive measure we can recommend a short-term fasting period of the discharge period
from 3 to 7 days.
During the entire period of discharge must be maintained the principle of voluntariness.
The recovery period (out of starvation or realimentatsiya).
The recovery period for the duration must be equal to or slightly longer than two-thirds of the
discharge period. It is held with a view to switching the patient from endogenous to exogenous
feeding.
Restoration is performed using vegetable-dairy diet with a strict daily gradual increase as the
assortment of food, and amount of foods and dishes, with a gradual decrease in the number of
meals from 7-10 to 3-4 times a day.
The basic principles of restorative nutrition are the physiology and the adequacy of the diet, the
gradual expansion of the diet, fractional power.
When you exit from starvation there is a need of the individual destination diet based nosological
form of the disease the patient's initial body weight, length of discharge period, the onset of the
peak ketoatsidoticheskogo [4]. The result of the program is painted by day diet, printed sheet
purposes.
In the case of fasting-diet therapy in preventive and restorative goal for healthy people the
regime does not change.
Types of fasting-diet therapy (RDT).
Distinguish absolute (no food or water), complete (no food intake with water), incomplete
(insufficient intake of water) and different types of qualitative fasting (protein, fat, carbohydrate,
vitamins, etc.).
Full or "wet" fasting (without restriction of water) is most widely used in clinical practice RTD.
Dates of the stage during this fasting described above.
Absolute or "dry" hunger.
From a physiological point of view of the body during starvation does not feel substantial fluid
deficits, as per kilogram of fat mass split (or glycogen) is released up to 1 liter of endogenous
(metabolic) water. Loss of body fluid on skin and lung perspiration and diuresis under normal
temperature conditions are low, ranging from 1.5 to 2 L / day. Thus, the water deficit does not
exceed 0.5-1 liters daily, which under conditions of reduced metabolism is the main
physiologically well tolerated. If the absolute lack of food and water no more than 3-4 days, then
dehydration does not go beyond a mild degree.
In clinical practice, usually used for a short, 1-3 daily absolute starvation. Laxatives and
cleansing enemas prior to absolute starvation and in the process it is usually not appointed.

Dates of the stages of unloading period of decline, the stage of alimentary excitation lasts for
several hours, the stage of growing ketoacidosis - from 1 to 3 nights.
When using the "dry" hunger is observed early onset and a more complete decomposition of
deposited fat. At absolute starvation reached a higher concentration of biologically active
substances, hormones, immunoglobulins and immunokompitentnyh cells in body fluids [10.19].
"Dry" hunger, despite popular belief, objectively better tolerated "wet." In many diseases
(asthma, hypertension, allergies, etc.) shows the higher efficiency of the "dry" 3-starvation,
compared with 3 daily "wet" fast. We may assume that 3 days of absolute fasting days
correspond to 9.7 total fasting without water.
The combined absolute and complete fasting. The method of successive 2-3-daily absolute and
10 of 14 total daily fasting.
With this method within 1-3 days (according to individual tolerance) to patients to refrain from
taking food and water, cleansing enemas are not appointed. From 2 to 4 days, patients resume
water intake, limiting it to 10-12 mg / kg body weight per day during the discharge period, and
continue to starvation by the usual method of RTD.
A number of researchers [15.27] pointed out that the combined use of fasting allows to reach an
earlier onset of acidotic peak, more fat reduction in body weight. In the case of patients with
hypertension, normalization of blood pressure occurs earlier, which shortens the discharge time
and, accordingly, the duration of hospitalization of patients. The above method is the method of
choice for complications of the underlying disease and obesity edema. In addition, the
combination of wet and dry starvation was well tolerated, has a therapeutic effect while reducing
the total duration of RDT, optimizes the timing of its conduct as a result of an earlier onset of
acidotic crisis.
Fractional fasting.
This type of fasting has several (usually 3), repeated and consecutive cycles (fractions) RTD.
The average duration of the discharge at the same time period is 14 days, the total duration of
treatment - 6 months. You can use and complete, and combined fasting.
Stepped fasting.
At the same time as reducing the duration of fasting provides the discharge period before the first
clinical signs of the appearance of acidotic peak, ie transition to endogenous nutrition. This is
followed by the recovery period, equal to half the length of the discharge (1st stage), and a new
fast "to peak" (Stage 2). Only 3-4 steps.
The application of this technique is useful when poor tolerability of prolonged periods of fasting
with hypertension, especially for patients older than 55 years [15]. The technique may be the
method of choice in patients with increased risk of RTD.
METHODS fasting-diet therapy (RDT)
Due to the fact that the most common in clinical practice, complete fasting, consists in the refusal
to accept any food without liquid (water).
After a preparatory period of fasting begins the true (from 7 to 21 days).
Discharge period. On the first day of fasting to cleanse the bowel the patient takes a laxative salt
(magnesium sulfate usually 30-40 g dry weight, or 150-200 ml of 25% solution), the evening is
done enema.
In the following days and are 1-2 times daily enema total volume of 1.0-1.5 liters of water in
body temperature. In addition, the assigned therapeutic exercise, fresh air (at least 3-4 hours per
day) water treatment (circular shower, shower, salt-pine baths, swimming pool), massage and

other methods of physical treatment of wax, electric, mud etc.). The volume of physical therapy
is determined strictly tailor made to suit the existing condition.
For deep cleansing of the intestine and enhance the cleansing effect of method can be used
hydrotherapy. After washing of the testimony may be administered herbal and bifidopreparaty.
The number of procedures gidrokolonotershii - 1 to 3 times a week. Recommended to perform a
procedure at the beginning of one of starvation and after the onset of acidotic peak [22].
Sauna is carried out in the first days of fasting, when there are not pronounced orthostatic
reaction.
Mode is assigned, as a rule, active - and free ward.
During the entire period of discharge patients are encouraged adherence to the day, in
accordance with their age and existing medical conditions. As drinking water is used patients
(mineral, distilled, bottled or spring water), a decoction of rose, water with lemon juice, weakly
brewed green tea, slightly alkaline water. Drinking used without restrictions - from 1 to 1.5
(sometimes more) liters per day, which provides detoxification of the body by maintaining
adequate urine output. In the presence of chill water can be consumed in the form of heat.
During fasting stops or significantly reduces the amount of medication. In some cases (severe
hypertension, hormone bronchial asthma, etc.) is acceptable technique of lower doses of
medication for 3-7 days handling time. Strongly throughout the discharge period is forbidden to
smoke, take alcohol.
Night's sleep should be at least 8-10 hours
It is also recommended at least 2-3 times a day, hygienic toilet mouth (brushing teeth, removing
plaque from the tongue). Before going to bed a warm shower. In severe dry skin creams can be
applied hygiene.
In connection with the possible onset of orthostatic reactions in the form of dizziness, blackout,
etc., especially at night, when the predominant effect p.vagus should warn patients about the
need for a smooth, unsharp rise from bed.
Every day a doctor examined patients measured blood pressure, heart rate. She has a history
marked dynamics of the patient, the tolerance of fasting.
When you are sick for a long time, frequent vomiting, headache, abdominal pain, are shown
receiving bicarbonate mineral water, cleansing enemas with 2% soda solution. Carrying out these
procedures can improve the condition of patients. When the uncontrollable vomiting and
electrolyte disorders treatment is necessary to stop hunger.
With the cessation of hunger canceled cleansing enemas, massages, all physiotherapy. In the
absence of an independent chair to be appointed within three days of enema (available with a
decoction of herbs laxatives) or herbal laxatives.
For the first 4-5 days assigned sparing regimen with limited physical activity. Gradually, the
boundaries of motor activity expands patient depending on his health.
Recovery begins with the use of vegetable-milk diet with a strict daily capacity
stupenchatoobraznym power as to the assortment and quantity to the reduced number of meals
from 7-10 in the first days to 3-4 per day thereafter.
In the early days of recovery time in patients with rapidly comes a feeling of fullness, even when
taking small amounts of food. In such cases, should not overcome this feeling of fullness and do
not necessarily consume the entire portion of the offered food. Typically, after 1-2 h in these
individuals appears again the feeling of hunger that is the basis for the next regularly scheduled
portion of juice, yogurt, etc.
At the first methods of food concentration is low (dilute juice with water saturation, grain

processing broth, etc.), with repeated receptions, it gradually increases.

When you exit the fast appointed replacement diet, which feature in the early days of the diet is
to eliminate the salt and protein foods: legumes, eggs, mushrooms, fish and meat.
In the recovery period is better to include dietary food freshly prepared juice of green apples,
oranges, carrots, cabbage or tomatoes. Tomatoes can be used only in the season and in the
absence of joint disease ipozvonochnika. With the increased gastric secretion, which is usually
accompanied by heartburn should be diluted with juice 4 times. Possible to use the juice shop in
the same range, from baby food juices, which do not contain sugar or salt.
For people with diseases of the cardiovascular system, metabolic disorders (obesity,
dorsopathies, etc.) offers you the option juice-vegetable diet (Appendix 1) for persons with
asthma, allergic diseases, diseases of the gastrointestinal tract offers hypoallergenic diet cereal
broths (option number 2, Appendix 2).
It is also possible and the mixed option, when given a diet with a reception and juices, and cereal
concoctions. An example of such a diet for the release of their seven-day fasting is given in
Appendix 3.
In the case of fasting-diet therapy in preventive and restorative goal for healthy people the
regime does not change.
Possible complications during the RTD, the activities of their cupping and Prevention.
Exacerbation of chronic foci of infection.
In long-term fasting, more than two weeks can be observed exacerbation of chronic foci of
infection. It is assumed that after 15 days of discharge period, the majority of patients have
transient immunosuppression of all parts of the immune system. The clinical picture is
sharpening depends on the existing site of infection (chronic tonsillitis, pyelonephritis, adnexitis)
and obscheintoksikatsionnym syndrome (fever, weakness, sweating, etc.). Typically, the
following preventive measures:
exception of supercooling of the body;
compliance with adequate drinking water treatment (at least 1.5 liters), while in the presence
of chronic urinary tract infections (you can assign uroseptichekuyu herbal medicine);
Two-weekly disposable tyubazhi (Carlsbad salt, sorbitol, xylitol) in the presence of chronic
cholecystitis;
Daily 1 - 2 meals a day rinse mouth with a weak solution of potassium permanganate or
furatsilina the presence of chronic
tonsillitis. Perhaps the use of herbs.
In cases of severe exacerbation of chronic foci of infection should be abolished fasting and
restorative power to appoint, in combination with therapeutic interventions to conventional
methods.
It is also recommended various methods of non-pharmacological therapy to relieve exacerbations
of chronic lesions - Su-Jok acupuncture, homeopathic remedies appointment [2,3,8,20,24,31].
Severe stages of growing ketoacidosis.
In 3-5% of cases, usually during the growing stage of ketoacidosis may experience debilitating
nausea, multiple (up to the indomitable) vomiting, cramping abdominal pain and severe fatigue.
In these cases, recommend the use of alkaline mineral waters (Borjomi, Slavyanovskaya, Arzni,
etc.) or reception of sodium bicarbonate to 2.0-3.0 g every 2-3 hours

Repeated vomiting is recommended gastric lavage 3-5% solution of sodium bicarbonate,

repeated enemas solution of the same concentration, with no effect - intravenous infusions of
300-500 ml of 5% soda solution. In cases of uncontrollable vomiting, fasting is interrupted and
assigned to the reductive power. In some cases, persistent psychological setting of the patient to
treatment famine allowed so-called "step" when, after 2-3 days of recovery feeding newly
appointed full famine. Typically, during the second stage of the growing rate of ketoacidosis
tolerated more easily, and it allows a full course of unloading therapy.
Severe stages of increasing acidosis is usually observed in patients with long-term chronic
illnesses, and patients in old age, when the crisis occurs later, usually for 8-12 days of hunger.
Orthostatic syncope (collapse).
In some cases, usually in patients prone to hypotension, orthostatic reaction may occur in the
form of syncope (collapse). Therefore patients should be warned to slow getting out of bed,
especially at night. They should avoid sudden movements. Smoking is strictly prohibited.
In the event of syncope is usually used in such cases, action: giving the patient a horizontal
position with lower limbs elevated, providing fresh air, oxygen inhalation, inhalation of
ammonia, the introduction of caffeine, half the dosage in kordiamina (against hunger sensitivity
to different drugs increases) .
Convulsions.
In rare cases, long terms of fasting (over 23-25 days.) Can cause tonic convulsions finger, calf
and (or) the chewing muscles. This is usually caused by changes in water-salt metabolism. In
such situations it is sufficient purpose 1% solution of sodium chloride in an amount of 150-200
ml inside. Salt solution is given in the form of heat 4-5 times a day.
Renal colic.
Prevention of this complication - the observance of adequate drinking water treatment - drinking
plenty of fluids, at least 1.5 liters a day and use of hydrocarbon mineral waters at the stage of
growing ketoacidosis. With the development of renal colic held conventional medical therapies:
appointed antispasmodics, anticholinergics, analgesics, heat, and on the lower back or a warm
bath.
Heart rhythm disturbances and conduction.
Rarely observed. Usually, if cardiovascular disease in history. At the core, as a rule, is reducing
the concentration of potassium ions in the blood and body tissues. Most often seen in the
ventricular arrythmia. In cases where it appeared prescribers potassium (Panangin, Asparcam
potassium and other drugs) and?-Blockers (propranolol or obzidan, a quarter or half a dose). In
the absence of the effect and persistence beats over the next 1-2 days fasting and abolished
regenerative power is assigned in combination with the continuing drug intake of potassium.
Acute erosive and ulcerative changes in gastric and duodenal ulcers.
This complication is extremely rare. Prognostic criteria of possible complications of the
gastroduodenal mucosa in RTD has not yet been developed. This requires an endoscopic control,
especially at first conducted the course of fasting. The indications for the existence of a stable
fibrogastroduodenoscopy epigastric pain, heartburn, belching, persistent for a long time. In the
presence of acute erosive-ulcerative mucosal changes that have emerged against the background
of the discharge period, the fasting period is terminated, assigned replacement diet (option
number 2), medications (Almagel, Vikalin, etc.). As a rule, against the background of these
events is rapid (within 10 - 14 days) available epithelialization of erosions or ulcers acute that
can be regarded as a manifestation of the stress syndrome.

"Salt" swelling.
"Salt" swelling may occur during the recovery period RTD non-compliance with the assigned
diet and premature use of salt, causing a swelling of the subcutaneous fat, especially around the
eyes. Violation of the diet can be expressed not only in the use of sick just salt, but its
introduction and over-the food (black bread, salted butter, cheese, etc.).
Edema is accompanied by a feeling of heaviness in the head or headache, lethargy, decreased
urine output, a significant increase during the day body weight (1.5-2 kg). In such cases, a saltfree diet is usually prescribed, and within 1-2 days, swellings disappear on their own. To speed
up their disappearance, prescribe diuretics (kidney tea, gipotiazid) or laxatives (magnesium
sulfate, 20-30 g). Prevention consists in the elimination of salt for the entire recovery period.
Syndrome "food overload".
May occur in the early days of recovery nutrition is most often prescribed in patients with noncompliance with diet and nutrition (overeating). There are a feeling of heaviness and fullness in
the epigastrium, nausea, vomiting, impaired the chair. In the case of overeating should be as fully
as possible to free the digestive tract of food intake and gastric lavage of laxatives, then within a
day patient to abstain from eating. Prevention activities are in strict compliance with prescribed
nutrition and diet.
The indications for the termination of the course of fasting are:
patient refusal to continue the RTD;
Severe ketoacidosis, not kupiruemoe hydrocarbons;
appearance of general weakness, reaching adynamia;
recurrent orthostatic syncope;
the emergence of resistant sinus tachycardia (110 - 120 beats / min or more) or severe sinus
bradycardia (50 beats / min and
less);
Persistent irregular heart rhythm, and (or) conductivity;
the appearance of signs of increasing heart failure;
occurrence of acute erosive-ulcerous changes of gastroduodenal mucosal area;
the emergence of acute hepatic or renal colic;
increase in alanine aminotransferase, aspartatamino-traisferazy and (or) direct bilirubin more
than 2 times higher than normal; In conducting short courses of fasting in healthy subjects
control over the level of enzymes is not required
weight loss of more than 15% of the original.
The combination of fasting-diet therapy with other methods of non-pharmacological treatment.
Recently, special attention is paid to finding new
modifications of the RTD, a combination of fasting method with other methods of non-drug
treatment (breathing exercises, Su-Jok therapy, acupuncture, hydro, etc.). The study focused on
the RTD implementation in practice of complex treatment of patients. Many experts point to a
significant increase in the effect of therapy with concomitant use of traditional methods, building
even in a rule bound by a combination of maximum possible number of non-drug methods
[2,3,15].
In general the use of additional methods of non-pharmacological treatment during the RTD can

be used:
for the relief of various complications during the discharge period - with dyspepsia, with
worsening ronicheskogo disease, cardiac conduction and rhythm;
to treat the underlying disease;
as detoxification activities;
for nonspecific amplification of hunger and increased reactivity of the patient.
Let us consider some features of these methods in the practice of fasting
Acupuncture. Many experts point to a strengthening of RTD therapeutic effect by combined use
of fasting and acupuncture (RTI) [2,8,15].
Reflexology is effective in relieving and complications. Investigation of biologically active
points on the method of Nakatani in patients undergoing RDT [4.24] showed that during fasting
healthy subjects revealed a pattern of fasting, characterized by reduced values of the activity
indicators meridians IG, P, MS, C, and higher values of meridians RP and V as compared with
baseline.
A distinctive feature of the pattern of fasting in patients with hypertension is the increased
activity of the meridians and MS C in comparison with these figures in the group of healthy
individuals.
With treatment selection and biological point for exposure is recommended that the following
rules [24]:
1.C caution is necessary to impact on the meridians, which would be "smoothed" pattern of
fasting - to increase the activity of the meridian, MS, P, IG, and reduce the activity of the
meridians RP and V.
Avoid exposure to those meridians markers whose condition does not meet the pattern of
fasting. In this case the state of the meridians is assessed by electro-diagnostic for Nakatani.
Can be any at the discretion of the doctor-reflex effects on those meridians that are not
meridians - markers (TR, GI, F, R, VB, E).
Homeopathic treatment. The action of homeopathic drugs, which include vegetable products,
mineral and animal origin, not aimed at specific disease, but on the subtle mechanisms of
regulation systems. Homeopathic remedies are harmless, areaktogennymi have no adverse
reactions, which is important when combined with homeopathic medical starvation, since the
most recent use of medications is strongly discouraged (allopathic) funds.
In the preparatory and recovery periods, the RTD may be used any form of homeopathic
preparations (drops, powders, tinctures, granules, butter, opodeldoc, etc.). During the discharge
period are used per os pellets produced on the basis of milk sugar, should be dissolved in cold
water (the rate of 8-10 granules per 50 ml. Water), mix well after dilution and take on-line
regimens, and other dosage forms to accept as normal .
Consider the possible uses of homeopathy during an RTD [3].
In the preparatory period appropriate to appoint drainage products. Drainage facilities - is
organotropnye, okalnodeystvuyuschie tools to improve metabolism and eliminating endogenous
intoxication at the cellular level, reinforcing excretory function of an organ. Almost all patients
in the preparatory period can be assigned to drainage products colon - Chelidonium D3, Berberis
D3, Nuxvomica D3. In the fasting period - drainage preparations of liver and gall bladder -

Chelidonium D3, Berberis D3, Chamomila D3. Depending on the nosological form can be given
drugs drainage broncho-pulmonary system, blood vessels, kidneys,
pancreas, stomach, etc.
In the fasting period RDT use homeopathic medicines in some cases, to successfully cope with
complications. For example, the nausea should prescribe mint, with palpitation of the drugs
prescribed Cactus D3, Spigelia D3, Kalmia D3, Kalium carbonicum D3, etc.
In addition, prescription of homeopathic remedies that are picked up individually with the many
attributes and characteristics, as the disease itself, and strengthens the patient's therapeutic effect
of RTD.
Su-Jok therapy. One method of impact on the acupuncture points. Is lightweight and easy to
develop a method for finding points.
Su-Jok therapy can be applied to an exacerbation of chronic lesions - 1 or more systems an
impact on the point of the hands and feet corresponding to the sick organ or part of the body. For
example, the methods of Su-Jok therapy used to relieve pain syndromes in renal or biliary colic.
An example of treatment of the underlying disease - impact on the points corresponding to the
joints, the fingers of patients with chronic rheumatoid arthritis [31].
Methods of Physical Therapy. Methods of modern physical therapy is very diverse, so they can
be applied not only to enhance the excretory and detoxifying effect in RTDs (sauna, various
water treatments, hydro, etc.), but also for the relief of exacerbation of chronic diseases in the
discharge period (plating, pulse electrotherapy, laser therapy , magnetic therapy, mud pack, etc.).
Physiotherapy can significantly enhance therapeutic effect RTD in chronic diseases. Thus, when
applied bronihialnoy asthma mud pack and chest compressions, special breathing exercises,
hypoxic procedure.
Herbal medicine. Accumulated a lot of data on the successful use of herbal medicine in the RTD.
Decoction used as washing liquid for cleansing enema, in wrapping, rinse the throat of tyubazhey
etc.
Vegetable uroseptiki used to prevent urogenital infections during the discharge period. As a
supportive therapy in diseases of the cardiovascular system during the famine appointed
infusions and decoctions of herbs (Leonurus, fennel, valerian, chamomile, burdock, etc.).
Tyubazh gall bladder, liver and bile ducts. This procedure is shown to hold not only in the above
cases, but in 90% of cases in otherwise healthy people, when ultrasound revealed signs of stasis
in the gallbladder and bile ducts. An additional indication for tyubazha is occurring in the early
days of the discharge period of stagnation of bile in the gall bladder and biliary tract. That
clinically dyspepsia as nausea, bitter taste in the mouth.
Before and after the ultrasound control tyubazha conducted to identify contraindications and
assessment of purifying effect tyubazha.
One of the options presented tyubazha in Appendix 4.
Effective adoption of RTD
The method of fasting-diet therapy has been used 453 patients with different pathologies
associated with constitutional-alimentary obesity II and III level. The results are shown in Table
2.
Table 2 The effectiveness of the method of fasting-diet therapy for various diseases (with 14 day
course).
Nosological form

Number of patients
The effectiveness of treatment
Pronounced clinical effect (weight loss of 10% to 15% of initial body weight)
little effect
(Weight loss of 5% to 7% of initial body weight)
deterioration
Constitutional-alimentary obesity of degree II
78
71 (91%)
7 (9%)
Constitutional-alimentary obesity III level
120
115 (95.8%)
5 (4.2%)
Diencephalic obesity
35

10 (28.6%)
25 (71.4%)
Hypertensive heart disease I or II
65
58 (89.2%)
7 (10.8%)
Eczema
26
18 (69.2%)
8 (30.8%)
Chronic atopic dermatitis
21
15 (71.4%)
6 (28.6%)

Neurodermatitis
18
13 (72.2%)
5 (27.8%)
Psoriasis
15
9 (60%)
6 (40%)
Neuroses, depression
24
16 (66.7%)
8 (33,3)
Irritable bowel syndrome

51
27 (52.9%)
24 (47.1%)
Total:
453
352 (77.7%)
101 (22.3%)
As can be seen from Table 2, marked clinical benefit from use of the method fasting-diet
therapy, which is manifested in loss of body weight by 10% or more regression and principal
clinical manifestations of various diseases was 77.7%. In the remaining patients (22.3%) weight
loss was less than 10%, which was accompanied by regression of individual symptoms.
Thus, fasting-diet therapy is an effective method of weight reduction and treatment of various
diseases in the pathogenesis of which plays an important role obesity.
Appendix 1.
Diet recovery period (option number 1, on the juice), after the discharge period for a period of 7
days.
day - during the day used the juice diluted with water (1:1), a total of 0.7-1.2 liters. The
concentration of juice increased by the end of the day, between meals can be consumed water.
day - before lunch, pure juice - 2-3 hours after dinner - fruit and vegetables, preferably in
grated form.
day - vegetables, fruit. We introduce the porridge on the water, bread, dried fruits.
day - the menu is added to boiled vegetables, fruit, vegetarian soups, sunflower oil.
day - is added to milk products (kefir, fermented baked milk, etc.), small amounts of butter.
day - in the diet is administered cheese, sour cream, salt.
day - add eggs, cottage cheese.

After 7 days recovery period to the diet gradually introduce foods that are high in protein, first
fish, legumes products, then poultry, meat.
Appendix 3.
Restorative diet after 7-day unloading period (mixed version).
The yield of hunger calculated at 7 days. Office hours are approximate and food can be shifted in
either direction, depending on the mode of the patient.
Day 1.
9:00. Oatmeal jelly at the rate of 1 tbsp. l. Hercules, with no domestic production of food
additives on a glass of water. Simmer for 10-15 minutes.
12 hours. Readmission jelly.
15 hours. Receive 50% juice, freshly prepared from the best of green apples or oranges or carrots
or cabbages or tomatoes. Tomatoes can be used only in the season and in the absence of diseases
of the joints and spine. With the increased gastric secretion, which is usually accompanied by
heartburn should be diluted with juice 4 times. Possible to use the juice shop in the same range,
from baby food juices do not contain sugar or salt.
18 hours. Readmission 50% juice.
21 hours. 0.5 cups of 50% juice.
Second day.
Receiving the same juice, but already 75%. In diseases of the gastrointestinal tract alternating
50% juice with oatmeal soup.
Third day.
9:00. In the absence of chairs - reception welded boiling water for 2 hours before receiving 7.6
prunes. When recovered bowel function instead of prunes received from 1 table spoon grated
carrots 10% cream.
12 hours. One of the following fruits: apple or an orange or tangerine or 2 1 cup berries of the
season.
15 hours. 75% juice.
18 hours. Cucumber salad, lettuce, parsley and dill. Season salad can be first tsp any vegetable
oil
21 hours. 0.5 cups of liquid to dried fruits to choose from: 1 tbsp raisins or 2 pcs. or 2 pieces of
dried apricots. prunes. In the following days to 21 hours are the same recommendations.
Day 4.
9:00. Nonfat or low-fat sour liquid dairy product, preferably with a "bio" crops: 1% "bio" yogurt,
nonfat yogurt.
12 hours. If during this period, the work of the intestine to normal, we recommend to prepare
salad: beets, carrots, 1 tablespoon sauerkraut, a small amount of potatoes, fennel, parsley, green
peas, 1 table spoon vegetable oil. In the absence of the chair - a salad, "Broom": fresh, grated
carrots and beets on one side and three parts of finely chopped cabbage, a quarter of a green
apple and 1 tablespoon vegetable oil. The volume increase of lettuce to 2 cups.
15 hours. Fruit. See above.
18 hours. Salad. Sm.3 Day.
Day 5.
9:00. 100 grams of dietary cheese.
12 hours. Buckwheat without adding milk and butter.
15 hours. Lettuce see 3rd day.
18 hours. 100 g grated cheese, white grapes, low-fat type "Circassian" or soaked cheese or

cottage cheese. Add to 1 cup of finely chopped greens.

Day 6.
9:00. One boiled egg, greens. When myomas egg substitute in dietary cheese.
12 hours. Fruit.
15 hours. All vegetables, except potatoes boiled or stewed. You can use frozen vegetable
mixture, cook vegetarian soup.
18 hours. 100 g of fatty fish is not, the caloric content does not exceed 40-50 kcal. Any method
of cooking, but frying. Combined with salad greens.
Day 7.
9:00. Liquid dairy product in the form of yogurt or buttermilk 1%.
12 hours. Salad. See third day.
15 hours. 100 grams of chicken without skin and fat. Any method of cooking, but frying. Green
salad.
18 hours. Fruit. See third day.
Appendix 4.
Tyubazh liver, gall bladder and bile ducts.
Prior to this procedure is assigned an ultrasound examination to identify contraindications for
tyubazha (usually the presence of large stones in the gallbladder). After tyubazha also performed
ultrasound for assessment of purifying effect.
Before tyubazhom preferably open the bowels - a deep cleansing of the intestine (hydro).
For the reflex to act upon the liver unit used magnetic therapy "MILTA" possibly an additional
impact by taking the Su-Jok acupuncture or classical.
On the day of the patient is taking tyubazha cholagogues herbs (officinal fee or charge number 2
number 3) to 500 ml. After that, locally heated area of the liver within 60 minutes.
3-4 hours is enema.
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