Siddha fasting in obese acute decompensated heart failure may improve hospital outcomes through empowerment and natural ketosis

•Decompensated acute heart failure (AHF) hospitalizations are increasing in the obese with higher risk for complications and mortality.•Siddha fasting can be safely explored in AHF with potential to improve outcomes.•Natural ketosis and mental stress reduction may account for the fasting related imm...

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Published in:	Explore (New York, N.Y.) Vol. 18; no. 6; pp. 714 - 718
Main Authors:	Chockalingam, Anand, Kumar, Senthil, Ferrer, Mauricio Sendra, Gajagowni, Saivaroon, Isaac, Maxwell, Karuparthi, Poorna, Aggarwal, Kul, Shunmugam, Selva, Amuthan, Arul, Aggarwal, Arpit, Hans, Chetan P., Krishnaswamy, Kiruba, Dorairajan, Smrita, Liu, Zhenguo, Flaker, Greg
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-11-2022
Subjects:	Acute heart failure Cardiorenal syndrome Fasting Meditation Mindfulness EF Cardiorenal syndrome Fasting Meditation CRS Acute heart failure HUGE HFpEF Mindfulness AHF
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Summary:	•Decompensated acute heart failure (AHF) hospitalizations are increasing in the obese with higher risk for complications and mortality.•Siddha fasting can be safely explored in AHF with potential to improve outcomes.•Natural ketosis and mental stress reduction may account for the fasting related immediate clinical benefits. Morbid obesity (BMI > 35 kg/m2 with comorbid conditions) is present in 25 – 35% of acute decompensated heart failure (AHF) patients. Prevalence of HF increases with duration of morbid obesity from 30% at 15 years to over 90% at 30 years. There is a need to develop pragmatic therapies that address the unique physical and mental challenges faced by obese AHF patients. Siddha is 5,000 year old Tamil Medicine using yoga and mind-body methods towards higher consciousness. Hunger gratitude Experience (HUGE) is intuitive Siddha fasting method which may improve in-hospital AHF outcomes independent of weight reduction. We present 5 cases of morbidly obese patients with cardiorenal syndrome (CRS) that began intermittent fasting either during their AHF hospitalization or in the outpatient setting for refractory symptoms despite hospitalization. Initiation of fasting correlated with reduction of respiratory distress and edema as well as improvements in psychological wellbeing and functional capacity. Siddha fasting mediates hemodynamic and anti-inflammatory effects through natural ketosis and psychological benefits through empowerment in AHF. Potential role of fasting in reducing myocardial workload, coronary steal, angina, volume overload, and CRS needs further study in cardiac patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1550-8307 1878-7541
DOI:	10.1016/j.explore.2021.12.003