Avoid Mistakes: How to Break a Fast Properly

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Short 1-3 day fasting always has a positive effect on the body. Fasting allows it to rest from the continuous digestion of food and helps prevent certain diseases. Short-term fasting is great for beginners, because it barely leaves room for mistakes. Prolonged fasting, which is carried out for therapeutic purposes, is more complicated. In this case, non-observance of certain rules can nullify the therapeutic effect, and even cause harm. One of these rules entails a strict adherence to a specific diet when ending a fast. This diet entails a very slow and gradual increase in the daily ration and the elimination of certain foods from it. There are two reasons to follow this diet.

The first and most apparent reason is that during abstinence from food, the digestive apparatus has a chance to rest and undergo significant changes. This is how the famous Soviet scientist, the founder of the modern Russian school of medical fasting, Yuri Nikolaev, describes this process:

“It is important to remember the main rule here: during dosed therapeutic fasting (especially medium and long-term), a change occurs in the gastrointestinal tract, similar to what happens during typhoid fever, the intestinal walls become more tender, cleaner, like those of a newborn baby. It would never occur to anyone to enter an operating room and throw a handful of dirt into a patient’s open wound. But something like this happens every time when, at the end of fasting, a person eats a plate of pasta with meatballs, thick meat broth, a piece of cake, etc.”

During the fast, the gastrointestinal tract adapts to almost complete rest, and reverse adaptation will take time. Depending on the duration of fasting, readjustment may take half to the full duration of a fast.

The second reason why a special diet is crucial in breaking a fast is less obvious. It follows from the experience of Russian doctors of the second half of the 20th century, who widely used fasting to treat patients in a clinical setting. In those years, doctors actively researched this method in order to find a non-drug way to treat severe chronic diseases, such as asthma, schizophrenia, stomach ulcers, hypertension and coronary heart disease. During the fast and the subsequent recovery period, the researchers meticulously recorded the patient’s health condition, metabolism, homeostasis, the sympathoadrenal system tone, examined the changes in the function of the adrenal cortex, thyroid gland and other endocrine glands. They determined that the recovery period has as much importance in attaining the therapeutic effect as fasting itself (A. Kokosov, S. Osinin). It is during the recovery period that tissue self-renewal takes place, their regenerative activity increases, restorative hematopoiesis processes intensify: the body is rejuvenated. The regenerative manifestations do not reach their maximum immediately, but after a certain latent period – approximately 10-20 days after the end of a fast (Yu. Nikolaev). These doctors’ experience suggests that adherence to an appropriate refeeding diet is required to maximize the therapeutic effect of fasting.

Thus, you should never act on a whim during the recovery period and focus on your own feeling of hunger. Otherwise, in the best-case scenario, you will not attain the desired result, and at worst, you will harm your body.

Emphasizing the importance of the recovery period, Yuri Nikolaev actually avoided the term “therapeutic fasting.” He preferred to call his method “unloading diet therapy” (abbreviated RDT in Russian), which included both parts: fasting (unloading) and diet.

Special diets for the recovery period, one of which is provided below, are not based on general considerations about proper nutrition. On the contrary, they are based on the experience of therapeutic fasting specialists observing the condition of patients who followed a particular refeeding diet in the end of fasting. Researchers have repeatedly observed a reversal of the therapeutic effect when the restorative nutrition regimen was violated.

There is no single “proper” diet to break a fast. Doctors have developed different diet options depending on the patient’s condition, concomitant diseases and the duration of abstinence from food. All of them are similar: gradual, based on milk and vegetables (for the first few days) and salt-free.

Below is a summary of recommendations for breaking a fast proposed by Yuri Nikolaev, who, being a psychiatrist, successfully applied the method of therapeutic fasting in patients with schizophrenia.

Restorative diet for patients after a 10 to 25-day therapeutic water fast (according to Yu. Nikolaev)

Source: Methodical recommendations of the USSR Ministry of Health “Therapeutic fasting in treatment of neuropsychiatric diseases” Moscow 1979

Day 1: Fruit (apple, apricot, orange, grape) or vegetable (tomato, carrot) juices, diluted in half with boiled water, 1 liter of juice per day. One tablespoon is taken every 5-10 minutes. Gradually, both the amount of juice per intake and the intervals increase.

Day 2: Undiluted juices up to 1.5 liters per day; 200 ml every 2 hours.

Day 3: 500 ml of juice, 750 g of kefir and 500 g of apples (mashed and mixed with kefir). Food is taken 5 times a day every 3 hours (at 9-12-15-18-21 hours).

Day 4: 250 g of grated carrots + Day 3 ration. Carrots are mixed with grated apples and kefir as follows: 100 g apples, 50 g carrots and 100 g kefir.

Day 5: The amount of kefir is increased to 1 liter per day + 200 g beetroot salad (no salt) + 50g crackers. The amount of carrots is increased to 500 g per day.

Day 6: A switch to 4 meals per day. Each meal consists of carrots – 150 g, apples – 100 g, kefir – 250 g, honey – 1 teaspoon, beetroot salad – 100 g.

Day 7: Add 200 g of semi-liquid cereals (buckwheat, semolina, oatmeal) boiled in milk and 200 g of bread to Day 6 diet.

Days 8 and 9: Same as Day 7.

Day 10 and onwards: Add 200 g of vegetarian soup.

Day 11: Add 100 g of cottage cheese mixed with a small amount of sour cream.

Day 12: Add mashed potatoes with milk and 15-30 g of butter. Calorie content of the daily diet on day 1 of restorative nutrition is 395 kcal, day 2 – 790 kcal, day 3 – 966 kcal, day 4 – 1043 kcal, day 5 – 1377 kcal, day 6 – 1590 kcal, days 7, 8 and 9 – 2111 kcal, day 10 – 2245 kcal, day 11 – 2405 kcal, day 12 – about 2630 kcal; meanwhile, the daily amount of protein in the diet also gradually increases with restorative nutrition and amounts to 85-90 g on day 12.

This diet is compiled to maintain a balanced ratio of proteins, fats and carbohydrates and ensures a gradual transition to dietary nutrition. Fruit and vegetable juices, fresh fruits, vegetables and nuts can be added under the supervision of the attending physician with regard to the individual characteristics of the patients’ habitual diet.

For patients who have undergone a 10 to 12-day course of medical fasting, a restorative diet can be started with whole juices, and day 4 ration may be used starting on day 2.

Table salt should be excluded in the first half of the recovery period. Usually, meat, as well meat and fish products and mushrooms are not allowed. Patients should eat slowly and chew food thoroughly.

The hypo-natrium milk- and plant-based diet is followed for as long as the therapeutic fasting had lasted. Starting in the second week of nutrition, patients are prescribed multivitamin supplements in therapeutic doses. To consolidate the positive therapeutic results, in the absence of asthenic phenomena many patients are advised to adhere to this diet for 2-3 months. In addition to the high content of vitamins and mineral salts, the alkalinity has a positive impact. The transition to a mixed diet with the inclusion of meat and fish products should be gradual.

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Breaking a fast and refeeding with juices is not suitable for all fasting patients. It depends both on the patient’s concomitant illnesses and on individual intolerance. Pulmonologists A.Kokosov and S. Osinin (1980), who used the fasting method to treat patients with bronchial asthma, initially went through the recovery period using juices according to Yu.S. Nikolayev’s method. However, they gradually became convinced that fruit juices and fruits often cause allergic reactions (urticaria, difficulty breathing, an increased number of eosinophils) in most patients. After a prolonged investigation, the researchers settled on three alternative recovery options (cereal, whey, and carrot juice). The cereal version of restorative nutrition (for more details, see the book published in English by A. Kokosov, S. Osinin. Therapeutic Fasting in Bronchial Asthma Patients, Siberika 2020) is described below.

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