{"id":5172,"date":"2024-05-29T08:44:45","date_gmt":"2024-05-29T06:44:45","guid":{"rendered":"https:\/\/www.uni.lu\/lcsb-en\/?post_type=research-projects&#038;p=5172"},"modified":"2025-02-05T07:59:27","modified_gmt":"2025-02-05T06:59:27","slug":"background","status":"publish","type":"research-projects","link":"https:\/\/www.uni.lu\/lcsb-en\/research-projects\/fastcov\/background\/","title":{"rendered":"Background"},"content":{"rendered":"<div class=\"section py-0 static\">\n<section class=\"py-0 wp-block-unilux-blocks-free-section section\"><div class=\"container xl:max-w-screen-xl\"><!-- SecondaryNavigationMirror --><div class=\"js-secondary-nav--sticky wp-block-unilux-blocks-secondary-navigation\" id=\"7acdcaa9-7010-4cf2-9e61-9e57c92d2e0d\">\n    <nav id=\"secondary-navigation\" role=\"navigation\" aria-label=\"Secondary menu\" class=\"secondary-nav\">\n        <button class=\"secondary-nav__button btn btn-solid--primary w-full\" aria-expanded=\"false\" aria-controls=\"secondary-navigation__list\" title=\"The selected page is Overview\" type=\"button\">\n            <span class=\"btn__name mr-auto\">Overview<\/span>\n            <svg aria-hidden=\"true\" focusable=\"false\" class=\"icon icon-outline icon--xs\">\n                <use xlink:href=\"https:\/\/www.uni.lu\/wp-content\/themes\/unilux-theme\/assets\/images\/icons\/icons-outline.svg#icon--arrow-down\" \/>\n            <\/svg>\n        <\/button>\n\n        <ul id=\"secondary-navigation__list\" class=\"secondary-nav__list\">\n            <li class=\"secondary-nav__item\">\n    <a href=\"https:\/\/www.uni.lu\/lcsb-en\/research-projects\/fastcov\/\" target=\"\" rel=\"noreferrer noopener\" class=\"secondary-nav__link \">\n        <svg aria-hidden=\"true\" focusable=\"false\" class=\"icon icon-outline icon--xs\">\n            <use xlink:href=\"https:\/\/www.uni.lu\/wp-content\/themes\/unilux-theme\/assets\/images\/icons\/icons-outline.svg#icon--arrow-right\" \/>\n        <\/svg>\n        <span class=\"secondary-nav__name\">Overview<\/span>\n    <\/a>\n<\/li>\n<li class=\"secondary-nav__item\">\n    <a href=\"https:\/\/www.uni.lu\/lcsb-en\/research-projects\/fastcov\/background\/\" target=\"\" rel=\"noreferrer noopener\" class=\"secondary-nav__link \">\n        <svg aria-hidden=\"true\" focusable=\"false\" class=\"icon icon-outline icon--xs\">\n            <use xlink:href=\"https:\/\/www.uni.lu\/wp-content\/themes\/unilux-theme\/assets\/images\/icons\/icons-outline.svg#icon--arrow-right\" \/>\n        <\/svg>\n        <span class=\"secondary-nav__name\">Background<\/span>\n    <\/a>\n<\/li>\n<li class=\"secondary-nav__item\">\n    <a href=\"https:\/\/www.uni.lu\/lcsb-en\/research-projects\/fastcov\/study-design\/\" target=\"\" rel=\"noreferrer noopener\" class=\"secondary-nav__link \">\n        <svg aria-hidden=\"true\" focusable=\"false\" class=\"icon icon-outline icon--xs\">\n            <use xlink:href=\"https:\/\/www.uni.lu\/wp-content\/themes\/unilux-theme\/assets\/images\/icons\/icons-outline.svg#icon--arrow-right\" \/>\n        <\/svg>\n        <span class=\"secondary-nav__name\">Study design<\/span>\n    <\/a>\n<\/li>\n<li class=\"secondary-nav__item\">\n    <a href=\"https:\/\/www.uni.lu\/lcsb-en\/research-projects\/fastcov\/partners\/\" target=\"\" rel=\"noreferrer noopener\" class=\"secondary-nav__link \">\n        <svg aria-hidden=\"true\" focusable=\"false\" class=\"icon icon-outline icon--xs\">\n            <use xlink:href=\"https:\/\/www.uni.lu\/wp-content\/themes\/unilux-theme\/assets\/images\/icons\/icons-outline.svg#icon--arrow-right\" \/>\n        <\/svg>\n        <span class=\"secondary-nav__name\">Partners<\/span>\n    <\/a>\n<\/li>\n<li class=\"secondary-nav__item\">\n    <a href=\"https:\/\/www.uni.lu\/lcsb-en\/research-projects\/fastcov\/contact\/\" target=\"\" rel=\"noreferrer noopener\" class=\"secondary-nav__link \">\n        <svg aria-hidden=\"true\" focusable=\"false\" class=\"icon icon-outline icon--xs\">\n            <use xlink:href=\"https:\/\/www.uni.lu\/wp-content\/themes\/unilux-theme\/assets\/images\/icons\/icons-outline.svg#icon--arrow-right\" \/>\n        <\/svg>\n        <span class=\"secondary-nav__name\">Contact<\/span>\n    <\/a>\n<\/li>\n        <\/ul>\n    <\/nav>\n<\/div>\n<!-- end SecondaryNavigationMirror -->\n\n<div class=\"wp-block-unilux-blocks-spacer is-spacer-size-sm\"><\/div>\n\n\n<p>Shortly after the start of the COVID-19 pandemic in 2020, it became clear that some people experienced lingering effects beyond the acute phase of the initial SARS-CoV-2 infection. This condition is now known as long COVID syndrome and refers to a range of symptoms that persist for weeks or months after the initial infection has resolved. Common symptoms include fatigue, shortness of breath, brain fog, joint pain and chest pain.<\/p>\n\n\n\n<p>Below you will find more information about long COVID syndrome, its impact on health and society, current treatment approaches and the FastCoV study team&#8217;s previous experience in nutritional clinical trials.<\/p>\n\n\n<div class=\"wp-block-unilux-blocks-spacer is-spacer-size-sm\"><\/div>\n\n\n<div class=\"wp-block-unilux-blocks-accordion accordion accordion--theme accordion-standard\" data-reference=\"dd3d6f8c-eda2-41cc-a056-97b0b437a2ec\" data-accordion-type=\"standard\"><div class=\"accordion__item  wp-block-unilux-blocks-accordion-item\">\n    <h3 class=\"accordion__header\"\n        >\n        <button\n            type=\"button\"\n            id=\"accordion-labelledby-2b4490e1-aafe-41d7-bdd1-0d623d66082d\"\n            class=\"accordion__button collapsed\"\n            aria-expanded=\"false\"\n            aria-controls=\"accordion-panel-2b4490e1-aafe-41d7-bdd1-0d623d66082d\"\n            data-bs-toggle=\"collapse\"\n            data-bs-target=\"#accordion-panel-2b4490e1-aafe-41d7-bdd1-0d623d66082d\"\n        >\n            <span class=\"accordion__title\">\n                                Long COVID syndrome and its impact on health and society            <\/span>\n\n            <svg aria-hidden=\"true\" focusable=\"false\" class=\"icon icon-outline icon--arrow-down \"><use xlink:href=\"https:\/\/www.uni.lu\/wp-content\/themes\/unilux-theme\/assets\/images\/icons\/icons-outline.svg#icon--arrow-down\"><\/use><\/svg>        <\/button>\n    <\/h3>\n    <div id=\"accordion-panel-2b4490e1-aafe-41d7-bdd1-0d623d66082d\"\n        class=\"accordion__collapse collapse\"\n        aria-labelledby=\"accordion-labelledby-2b4490e1-aafe-41d7-bdd1-0d623d66082d\"\n        data-bs-parent=\"[data-reference=&quot;dd3d6f8c-eda2-41cc-a056-97b0b437a2ec&quot;]\"\n    >\n        <div class=\"accordion__body \">\n            \n<div class=\"wp-block-columns is-layout-flex wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<p>Long COVID syndrome is a highly variable condition that occurs as a post-acute complication of SARS-CoV-2 infection in up to 10% of cases. According to the World Health Organization, long COVID syndrome is defined as symptoms that occur at least 3 months after initial infection, persist for at least 2 months, and cannot be attributed to an alternative diagnosis.<\/p>\n\n\n<div class=\"wp-block-unilux-blocks-spacer is-spacer-size-sm\"><\/div>\n\n\n<p>The duration, characteristics and severity of symptoms are highly variable, ranging from fatigue, shortness of breath, pain, depression\/anxiety to cognitive impairment, often referred to as &#8216;brain fog&#8217;. They often affect daily activities, income and quality of life of those affected. The underlying causes of long COVID syndrome are still under investigation.<\/p>\n\n\n\n<p>Current hypotheses focus on:<\/p>\n\n\n\n<ul class=\"ulux-list\">\n<li class=\"ulux-list-item\">Dysfunction of the inflammatory\/immune response<\/li>\n\n\n\n<li class=\"ulux-list-item\">Blood vessel damage<\/li>\n\n\n\n<li class=\"ulux-list-item\">Cellular metabolic dysregulation<\/li>\n\n\n\n<li class=\"ulux-list-item\">Disruption to the digestive system and its microbiome.<\/li>\n<\/ul>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\"><figure class=\"wp-block-dev4-reusable-blocks-image  object-fit--cover\">\n    \n<img decoding=\"async\" class=\"wp-block-image unilux-custom-image-block\"\n                alt=\"Illustration of the effects of long COVID: persistent inflammation leading to tissue damage, mitochondrial dysfunction, gut dysbiosis and cognitive influence\"\n            src=\"https:\/\/www.uni.lu\/wp-content\/uploads\/sites\/6\/2024\/05\/EN-LongCoV-illustration.png\"\n                srcset=\"https:\/\/www.uni.lu\/wp-content\/uploads\/sites\/6\/2024\/05\/EN-LongCoV-illustration-190x300.png 190w, https:\/\/www.uni.lu\/wp-content\/uploads\/sites\/6\/2024\/05\/EN-LongCoV-illustration-649x1024.png 649w, https:\/\/www.uni.lu\/wp-content\/uploads\/sites\/6\/2024\/05\/EN-LongCoV-illustration-768x1211.png 768w, https:\/\/www.uni.lu\/wp-content\/uploads\/sites\/6\/2024\/05\/EN-LongCoV-illustration-974x1536.png 974w, https:\/\/www.uni.lu\/wp-content\/uploads\/sites\/6\/2024\/05\/EN-LongCoV-illustration.png 1075w\"\n                style=\"object-position: 14.00% 37.00%; font-family: &quot;object-fit: cover; object-position: 14.00% 37.00%;&quot;; aspect-ratio: 2\/3; object-fit: cover; width: 100%;\"\n        loading=\"lazy\"\n\/>    <\/figure><\/div>\n<\/div>\n\n<p>It is thought that the initial infection triggers an immune response that causes inflammation as part of the normal defense mechanism. In some cases, an exaggerated or dysregulated immune response results in persistent inflammation and organ damage. This process is common to other chronic diseases such as rheumatoid arthritis, diabetes and neurodegenerative diseases.<\/p>\n\n<p>More than 65 million people worldwide are currently affected by various forms of long COVID syndrome, with most patients between 36 and 50 years of age. Most cases involve non-hospitalised individuals who experience symptoms that disrupt their health and quality of life. In addition, long COVID syndrome has a social impact, particularly in the workplace, as many patients have to reduce or stop working due to the condition. This has socio-economic consequences, including increased sickness absence, reduced productivity, social isolation and increased emotional distress.<\/p>\n        <\/div>\n    <\/div>\n<\/div>\n\n<div class=\"accordion__item  wp-block-unilux-blocks-accordion-item\">\n    <h3 class=\"accordion__header\"\n        >\n        <button\n            type=\"button\"\n            id=\"accordion-labelledby-4cd0a760-95c4-4e6a-af7f-263510623918\"\n            class=\"accordion__button collapsed\"\n            aria-expanded=\"false\"\n            aria-controls=\"accordion-panel-4cd0a760-95c4-4e6a-af7f-263510623918\"\n            data-bs-toggle=\"collapse\"\n            data-bs-target=\"#accordion-panel-4cd0a760-95c4-4e6a-af7f-263510623918\"\n        >\n            <span class=\"accordion__title\">\n                                Current treatment approaches            <\/span>\n\n            <svg aria-hidden=\"true\" focusable=\"false\" class=\"icon icon-outline icon--arrow-down \"><use xlink:href=\"https:\/\/www.uni.lu\/wp-content\/themes\/unilux-theme\/assets\/images\/icons\/icons-outline.svg#icon--arrow-down\"><\/use><\/svg>        <\/button>\n    <\/h3>\n    <div id=\"accordion-panel-4cd0a760-95c4-4e6a-af7f-263510623918\"\n        class=\"accordion__collapse collapse\"\n        aria-labelledby=\"accordion-labelledby-4cd0a760-95c4-4e6a-af7f-263510623918\"\n        data-bs-parent=\"[data-reference=&quot;dd3d6f8c-eda2-41cc-a056-97b0b437a2ec&quot;]\"\n    >\n        <div class=\"accordion__body \">\n            \n<p>Although the development of pharmacotherapies such as anti-inflammatory, antiviral, and immunomodulatory treatments appears promising, their efficacy in the treatment of long COVID syndrome has not yet been demonstrated and alternative therapeutic solutions are thus urgently needed. Although traditional pharmacotherapies may alleviate acute symptoms, they are often inadequate to address the complexity of diverse symptoms involving multiple organ systems with unclear underlying mechanisms and increased variability between individuals. To date, patient management involves personalised care plans tailored to each individual&#8217;s symptoms to improve quality of life. However, these symptomatic treatments usually do not target the underlying cause, highlighting the importance of research and development in this area.<\/p>\n\n<p>Recent research suggests that calorie restriction and fasting diets may reduce the inflammatory processes, one of the potential underlying causes of long COVID syndrome and medically supervised fasting has shown beneficial effects in other inflammatory syndromes. In addition, periodic fasting, where people regularly alternate between normal eating and fasting, promotes healthy microbial diversity in the gut. For example, one study showed that 13 out of 14 patients with chronic inflammatory bowel disease who fasted under medical supervision experienced an improvement in their symptoms.<\/p>\n\n<p>Therefore, we believe that the complex interplay between the immune response, metabolism, and gut microbiome in long COVID syndrome may be modulated by fasting. However, the lack of standard fasting protocols and limited objective assessment of protocol adherence by study participants pose difficulties in implementing such interventions and hamper the validity and reproducibility of their conclusions. This project aims to overcome these shortcomings and includes a pilot phase to assess feasibility.<\/p>\n        <\/div>\n    <\/div>\n<\/div>\n\n<div class=\"accordion__item  wp-block-unilux-blocks-accordion-item\">\n    <h3 class=\"accordion__header\"\n        >\n        <button\n            type=\"button\"\n            id=\"accordion-labelledby-5a47f1ba-92de-41c8-b36d-e913265799c1\"\n            class=\"accordion__button collapsed\"\n            aria-expanded=\"false\"\n            aria-controls=\"accordion-panel-5a47f1ba-92de-41c8-b36d-e913265799c1\"\n            data-bs-toggle=\"collapse\"\n            data-bs-target=\"#accordion-panel-5a47f1ba-92de-41c8-b36d-e913265799c1\"\n        >\n            <span class=\"accordion__title\">\n                                Previous expertise in nutritional clinical tials            <\/span>\n\n            <svg aria-hidden=\"true\" focusable=\"false\" class=\"icon icon-outline icon--arrow-down \"><use xlink:href=\"https:\/\/www.uni.lu\/wp-content\/themes\/unilux-theme\/assets\/images\/icons\/icons-outline.svg#icon--arrow-down\"><\/use><\/svg>        <\/button>\n    <\/h3>\n    <div id=\"accordion-panel-5a47f1ba-92de-41c8-b36d-e913265799c1\"\n        class=\"accordion__collapse collapse\"\n        aria-labelledby=\"accordion-labelledby-5a47f1ba-92de-41c8-b36d-e913265799c1\"\n        data-bs-parent=\"[data-reference=&quot;dd3d6f8c-eda2-41cc-a056-97b0b437a2ec&quot;]\"\n    >\n        <div class=\"accordion__body \">\n            \n<p>The FastCov study team consists of researchers from<a href=\"https:\/\/www.uni.lu\/lcsb-en\/research-projects\/fastcov\/partners\/\"> different Luxembourgish and German institutions.<\/a> Each group has extensive expertise in studying the impact of diet on various aspects of health and disease.<\/p>\n\n<p>The group at the <a href=\"https:\/\/www.uni.lu\/lcsb-en\/\">Luxembourg Centre for Systems Biomedicine<\/a> of the University of Luxembourg has recently studied the impact of diet on cognitive function in elderly people with age-related brain pathologies, analysing whether specific dietary interventions could offer neuronal protection. In addition, together with their colleagues from the <a href=\"https:\/\/www.uni.lu\/fstm-en\/research-departments\/department-of-life-sciences-and-medicine\/\">Department of Life Sciences and Medicine<\/a>, they have developed the protocol for the ExpoBiome study, a multi-centre clinical trial focusing on rheumatoid arthritis and Parkinson\u2019s disease patients in Berlin and Kassel, Germany. This study investigates the relationship between the gut microbiome, fasting, and immune status.<\/p>\n\n<p>The team at the <a href=\"https:\/\/www.charite.de\">Charit\u00e9 hospital in Berlin<\/a> contributed to the NutriFast study, which investigated the efficacy of therapeutic fasting and a plant-based diet in people with rheumatoid arthritis. Using dried blood spot metabolomics, the researchers were able to identify several metabolites that are upregulated during fasting exercise, indicating specific pathways involved in response to calorie restriction.<\/p>\n\n<p>Participation in the FastCoV study therefore puts you in the hands of an experienced team, who will guide you throughout the study, from an initial information session, through regular appointments during the fasting phase, to the gradual return to a normal diet and the follow-up.<\/p>\n        <\/div>\n    <\/div>\n<\/div>\n\n<div class=\"accordion__item  wp-block-unilux-blocks-accordion-item\">\n    <h3 class=\"accordion__header\"\n        >\n        <button\n            type=\"button\"\n            id=\"accordion-labelledby-635076d9-cbf4-4a4b-9fc4-96f0b9e49d25\"\n            class=\"accordion__button collapsed\"\n            aria-expanded=\"false\"\n            aria-controls=\"accordion-panel-635076d9-cbf4-4a4b-9fc4-96f0b9e49d25\"\n            data-bs-toggle=\"collapse\"\n            data-bs-target=\"#accordion-panel-635076d9-cbf4-4a4b-9fc4-96f0b9e49d25\"\n        >\n            <span class=\"accordion__title\">\n                                Key references            <\/span>\n\n            <svg aria-hidden=\"true\" focusable=\"false\" class=\"icon icon-outline icon--arrow-down \"><use xlink:href=\"https:\/\/www.uni.lu\/wp-content\/themes\/unilux-theme\/assets\/images\/icons\/icons-outline.svg#icon--arrow-down\"><\/use><\/svg>        <\/button>\n    <\/h3>\n    <div id=\"accordion-panel-635076d9-cbf4-4a4b-9fc4-96f0b9e49d25\"\n        class=\"accordion__collapse collapse\"\n        aria-labelledby=\"accordion-labelledby-635076d9-cbf4-4a4b-9fc4-96f0b9e49d25\"\n        data-bs-parent=\"[data-reference=&quot;dd3d6f8c-eda2-41cc-a056-97b0b437a2ec&quot;]\"\n    >\n        <div class=\"accordion__body \">\n            \n<p>1. A. V. Raveendran, R. Jayadevan, and S. Sashidharan, \u201cLong COVID: An overview,\u201d&nbsp;<em>Diabetes Metab. Syndr.<\/em>, vol. 15, no. 3, pp. 869\u2013875, 2021, doi: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33892403\/\" target=\"_blank\" rel=\"noreferrer noopener\">10.1016\/j.dsx.2021.04.007<\/a>.<\/p>\n\n<p id=\"references-10\">2. D. L. Sykes, L. Holdsworth, N. Jawad, P. Gunasekera, A. H. Morice, and M. G. Crooks, \u201cPost-COVID-19 Symptom Burden: What is Long-COVID and How Should We Manage It?,\u201d&nbsp;<em>Lung<\/em>, vol. 199, no. 2, pp. 113\u2013119, Apr. 2021, doi: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33569660\/\" target=\"_blank\" rel=\"noreferrer noopener\">10.1007\/s00408-021-00423-z<\/a>.<\/p>\n\n<p>3. L. Kohn&nbsp;<em>et al.<\/em>, \u201cLong COVID and return to work: a qualitative study,\u201d&nbsp;<em>Occup. Med. Oxf. Engl.<\/em>, vol. 74, no. 1, pp. 29\u201336, Feb. 2024, doi: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36480262\/\" target=\"_blank\" rel=\"noreferrer noopener\">10.1093\/occmed\/kqac119<\/a>.<\/p>\n\n<p>4. M. S. Durstenfeld&nbsp;<em>et al.<\/em>, \u201cAssociation of nirmatrelvir for acute SARS-CoV-2 infection with subsequent Long COVID symptoms in an observational cohort study,\u201d&nbsp;<em>J. Med. Virol.<\/em>, vol. 96, no. 1, p. e29333, 2024, doi: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38175151\/\" target=\"_blank\" rel=\"noreferrer noopener\">10.1002\/jmv.29333<\/a>.<\/p>\n\n<p>5. X. Y. Loke, S. A. M. Imran, G. J. Tye, W. S. Wan Kamarul Zaman, and F. Nordin, \u201cImmunomodulation and Regenerative Capacity of MSCs for Long-COVID,\u201d&nbsp;<em>Int. J. Mol. Sci.<\/em>, vol. 22, no. 22, Art. no. 22, Jan. 2021, doi: <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8625432\/\" target=\"_blank\" rel=\"noreferrer noopener\">10.3390\/ijms222212421<\/a>.<\/p>\n\n<p>6. N. Nagata&nbsp;<em>et al.<\/em>, \u201cHuman Gut Microbiota and Its Metabolites Impact Immune Responses in COVID-19 and Its Complications,\u201d&nbsp;<em>Gastroenterology<\/em>, vol. 164, no. 2, pp. 272\u2013288, Feb. 2023, doi: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36155191\/\" target=\"_blank\" rel=\"noreferrer noopener\">10.1053\/j.gastro.2022.09.024<\/a>.<\/p>\n\n<p>7. F. Grundler, R. Mesnage, A. Cerrada, and F. Wilhelmi de Toledo, \u201cImprovements during long-term fasting in patients with long COVID \u2013 a case series and literature review,\u201d&nbsp;<em>Front. Nutr.<\/em>, vol. 10, p. 1195270, Nov. 2023, doi: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38024352\/\" target=\"_blank\" rel=\"noreferrer noopener\">10.3389\/fnut.2023.1195270<\/a>.<\/p>\n\n<p>8. B. Hansen, K. Roomp, H. Ebid and J.-G. Schneider. &#8220;Perspective: The Impact of Fasting and Caloric Restriction on Neurodegenerative Diseases in Human,&#8221; Adv Nutr. 2024 Apr;15(4):100197. doi: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38432589\/\" target=\"_blank\" rel=\"noreferrer noopener\">10.1016\/j.advnut.2024.100197<\/a>.<\/p>\n\n<p>9. B. Hansen&nbsp;<em>et al.<\/em>, \u201cProtocol for a multicentre cross-sectional, longitudinal ambulatory clinical trial in rheumatoid arthritis and Parkinson\u2019s disease patients analysing the relation between the gut microbiome, fasting and immune status in Germany (ExpoBiome),\u201d&nbsp;<em>BMJ Open<\/em>, vol. 13, no. 8, p. e071380, Aug. 2023, doi: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37597865\/\">10.1136\/bmjopen-2022-071380<\/a>.<\/p>\n\n<p>10.&nbsp;A. M. Hartmann&nbsp;<em>et al.<\/em>, \u201cPost Hoc Analysis of a Randomized Controlled Trial on Fasting and Plant-Based Diet in Rheumatoid Arthritis (NutriFast): Nutritional Supply and Impact on Dietary Behavior,\u201d&nbsp;<em>Nutrients<\/em>, vol. 15, no. 4, Art. no. 4, Jan. 2023, doi: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36839208\/\">10.3390\/nu15040851<\/a>.<\/p>\n        <\/div>\n    <\/div>\n<\/div><\/div>\n<\/div><\/section>\n<\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":63,"featured_media":0,"parent":5166,"menu_order":0,"template":"","meta":{"featured_image_focal_point":[],"show_featured_caption":false,"ulux_newsletter_groups":"","uluxPostTitle":"","uluxPrePostTitle":"","_trash_the_other_posts":false,"_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"rpp_rp_identifier":"5164","rpp_taxonomies_in_sync":true},"research-project-status":[271],"research-project-type":[385,384],"field-of-interest":[290],"organisation":[96,25,202,214],"authorship":[63],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v22.3 (Yoast SEO v22.3) - 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