• Spyridon N Karras, Theocharis Koufakis, Andrea Petróczi, Dirk Folkerts, Maria Kypraiou, Hilda Mulrooney, Declan P Naughton, Angeliki Persynaki, Pantelis Zebekakis, Dimitrios Skoutas, and Kalliopi Kotsa.
• Division of Endocrinology and Metabolism, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece. Electronic address: Karraspiros@yahoo.gr.
• Nutrition. 2019 Mar 1; 59: 69-76.

ObjectivesChristian Orthodox fasting (COF), a periodical vegetarian subset of the Mediterranean diet, has been proven to exert beneficial effects on human health. Athonian fasting is a pescetarian COF variation, where red meat is strictly restricted throughout the year. Previous studies have examined the COF nutritional synthesis and health effects in general population fasters (GF) and Athonian monks (AM), separately. The aim of this study is to comparatively evaluate the characteristics and effects of this nutritional advocacy between the two populations.MethodsThe study included 43 male GFs (20-45 y of age) and 57 age-matched male AMs following COF. Dietary intake data were collected in both groups during a restrictive (RD) and a nonrestrictive (NRD) day. Nutritional, cardiometabolic, and anthropometric parameters were compared between the two cohorts.ResultsAM presented lower daily total caloric intake for both RD (1362.42 ± 84.52 versus 1575.47 ± 285.96 kcal, P < 0.001) and NRD (1571.55 ± 81.07 versus 2137.80 ± 470.84 kcal, P < 0.001) than GF.They also demonstrated lower body mass index (23.77 ± 3.91 versus 28.92 ± 4.50 kg/m2, P <0.001), body fat mass (14.57 ± 8.98 versus 24.61 ± 11.18 kg, P = 0.001), and homeostatic model assessment for insulin resistance values (0.98 ± 0.72 versus 2.67 ± 2.19 mmol/L, P < .001) than GF. Secondary hyperparathyroidism (parathyroid hormone concentrations: 116.08 ± 49.74 pg/mL), as a result of profound hypovitaminosis D [25(OH)D: 9.27 ± 5.81 ng/mL], was evident in the AM group.ConclusionsThe results of the present study highlight the unique characteristics of Athonian fasting and its value as a health-promoting diet. The effects of limitation of specific vitamins and minerals during fasting warrants further investigation.Copyright © 2019 Elsevier Ltd. All rights reserved.

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