Khoroshilov Igor Evgenievich

Doctor of Medical Sciences. Gastroenterologist, nutritionist.

Graduated with honors and a gold medal from the Military Medical Academy in Leningrad in 1988. Worked as a military doctor in Germanyfor 3 years. After defending a Ph.D. thesis on the subject of therapeutic fasting, Dr. Khoroshilov worked at the nutrition research laboratory of the Military Medical Academy in St. Petersburg.Igor Khoroshilov organized and headed the Department of Nutritional Scienceand Clinical Nutrition at the I.I.Mechnikov Medical Academy in St. Petersburg (2005-2012).

He proposed and began training medical nutritionists. He treats patients with obesity and various forms of malnutrition, cachexia, sarcopenia and anorexia. Author of 447 publishedworks, 30 books and 8 doctors’ manuals, including: Therapeutic Fasting in the Clinical Treatmentof Internal Diseases (1995), Therapeutic Fasting in Treatment of Internal Diseases (1998, 1999), and Guidelines for Parenteral and Enteral Nutrition,edited by I.E. Khoroshilov (2000), Clinical Nutrition(2009), DietologyGuide, 2nd, 3rd, 4th ed. (2006, 2008, 2012), Nutritional Support in Gastroenterology(2012), Nutrition Science in Gastroenterology(2013), Enteral and Parenteral Nutrition: National Leadership(2014), Clinical Nutrition and Nutritional Support(2018).

Member of the Russian Society for Parenteral and Enteral Nutrition and the European Society for Clinical Nutrition and Metabolism (ESPEN). Certified European Clinical Nutrition Teacher (since 2009, Nice, France). Academician of the International Academy of Sciences on Ecology and Safety of Man and Nature (MANEB, since 2006).He has made more than 300 reports at Russian and international conferences, i.e.,in Munich (2001), Berlin (2002), Lucerne (2002), Cannes (2003), Lisbon (2004), Brussels (2005), Rome (2005), Berlin (2006), Istanbul (2006), Prague (2007), Hamburg (2008), Florence (2008), Vienna (2009), Barcelona (2010), Gothenburg (2011), Barcelona (2012), Huberlingen (2013), Leipzig (2013), Geneva (2014), Warsaw (2015), Paris (2015), Berlin (2016), Rome (2017), Krakow (2019).Member of the editorial board and editorial review boardsof Russian journals Clinical Nutrition, Nutrition,Clinical Nutrition and Metabolism, University Therapeutic Journal.

Clinical and hygienic aspects of absolute (dry) fasting.
Abstract of a Thesis of a Candidate’s Degree in Medical Sciences

The 11-page abstract gives a brief description of the study by Igor Khoroshilov Clinical and hygienic aspects of absolute (dry) fasting (1994). His work was commissioned by one of the military departments, which was interested in the problem of human survival in the absence of food and drink. Igor Khoroshilov studied the condition of a group of volunteers who conducted a 3-day dry fast in a pressure chamber, which served to create a controlled external environment. Before and after fasting, the members of the group evaluated the state of the cardiovascular, digestive, urinary systems, investigated the state of protein, carbohydrate, lipid and water-mineral metabolism, studied changes in the neurohumoral regulation of the body. Based on the data, the researchers concluded that none of the bodily systems suffer from a 3-day dry fast.

QUESTION: Should I take electrolytes during wet fasting? If so, is it true for everyone, or only under specific conditions?
What is your opinion on this?

ANSWER: There is no loss of water or electrolytes from the body during therapeutic wet fasting under ordinary temperature conditions (not in extreme heat). Therefore, there is no need for additional electrolytes, moreover, they may even be harmful.
Salt (sodium chloride) intake may lead to so-called “hungry” edema, which is why it is forbidden not only during fasting, but also for one month after the fast. Potassium and calcium intake during fasting may cause gastric erosion and ulcers.
Sometimes, potassium preparations are administered intravenously, i.e., in case of heart rhythm irregularities during fasting; calcium and magnesium are used if muscle cramps occur, but this is extremely rare. In general, during fasting, it is
sufficient to consume regular boiled (non-distilled) water without added vitamins and minerals.

QUESTION: There is a widespread belief online about the benefits of baking soda. In particular, its intake is recommended to ‘cleanse the blood vessels.’ It is also recommended for preparing for dry fasting. The benefits of baking soda usually aren’t scientifically referenced. In your opinion, is soda useful for fasting and why?

ANSWER: Ketonic acids are formed in the body during fasting, against the background of decomposition and oxidation of adipose tissue, and a shift in acid-base balance may also occur. This is the so-called “acidotic shift” described by German scientists Schenck and Mayer in 1938. Sometimes this process causes a headache, or nausea and vomiting. That’s why alkaline mineral water intake is recommended during fasting. During severe ketoacidosis, drinking baking soda solution or its intravenous administration may be recommended.

QUESTION: Some of our readers encounter kidney problems after conducting dry fasting independently. In one case, a person conducted a 5-day dry fast, after which these problems (pains) appeared. In another case, the pain appeared after a weekly 48-hour dry fasting over a period of 2 months. In your opinion, what can cause such problems and can they be avoided?

ANSWER: During dry fasting, or more precisely, absolute fasting, the body experiences a deficiency of fluid, a decrease in urine volume and an increase in its density. If there are kidney stones or salts in the urine, a renal colic can be triggered. Therefore, this fasting method is not recommended for people with kidney problems. In general, dry fasting is most indicated for patients with pronounced obesity, edema, and we believe that its duration should not exceed 2-3 days. Fasting can be subsequently continued with limited water intake – 10 ml per 1 kg of body weight per day.

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