Fasting During Chemotherapy and Hematologic, Metabolic, and Quality of Life Outcomes: A Systematic Review and Meta-Analysis
7 affiliations
- 1Division of Prevention Science and Community Health, Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- 2Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- 3Sylvester Comprehensive Cancer Center, Division of Medical Oncology, University of Miami, Miami, FL 33136, USA
- 4VCU Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, VA 23298, USA
- 5Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
- 6Department of Psychology and Medicine, Division of Medical Oncology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- 7School of Education and Human Development, University of Miami, Miami, FL 33136, USA
Abstract
Background/Objectives: Fasting has been proposed as a non-pharmacologic method of reducing chemotherapy toxicity. However, its effects across outcome domains have not been well-quantified. Methods: In line with PRISMA 2020 guidelines (PROSPERO: CRD420261296778), we searched PubMed, Embase, Web of Science, and CENTRAL from January 2015 through April 2026 for randomized or prospective comparative trials evaluating fasting during chemotherapy. Risk of bias was assessed using RoB 2 and criteria aligned with ROBINS-I. Standardized mean differences (Hedges’ g) and risk ratios (RRs) were pooled using three-level random-effects models. Results: Seven publications reporting six trials (268 participants) were included. The pooled estimate did not reach statistical significance (g = 0.21, 95% CI: −0.02–0.43, p = 0.064). Hematologic parameters (g = 0.11, 95% CI: −0.23–0.45) and quality of life (QoL) and patient-reported outcomes from one trial (g = 0.32, 95% CI: −0.03–0.66) did not differ significantly between groups. Adverse events also did not differ significantly (RR = 0.86, 95% CI: 0.55–1.36). Conclusions: Across six small trials, fasting during chemotherapy did not significantly affect hematologic parameters, QoL, or adverse events. However, it is worth nothing that point estimates generally favored fasting. Hence, a small benefit can neither be confirmed nor ruled out at this time. Adequately powered trials assessing patient-important outcomes and incorporating nutritional monitoring are needed before fasting can be recommended or ruled out.
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BibTeX
@article{rolle2026fasting,
title = {{Fasting During Chemotherapy and Hematologic, Metabolic, and Quality of Life Outcomes: A Systematic Review and Meta-Analysis}},
author = {LaShae D. Rolle and Harleen Kaur and Cameron G. Jacobsen and Melanie E. Stone and Dominique Thomas and Kate M. Bonilla and Loren Yavelberg and Jaime Rafael Merchan and Soyeon Ahn and Tracy E. Crane},
journal = {Nutrients},
year = {2026},
month = nov,
doi = {10.3390/nu18213681},
url = {https://www.mdpi.com/2072-6643/18/21/3681},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Fasting During Chemotherapy and Hematologic, Metabolic, and Quality of Life Outcomes: A Systematic Review and Meta-Analysis
AU - LaShae D. Rolle
AU - Harleen Kaur
AU - Cameron G. Jacobsen
AU - Melanie E. Stone
AU - Dominique Thomas
AU - Kate M. Bonilla
AU - Loren Yavelberg
AU - Jaime Rafael Merchan
AU - Soyeon Ahn
AU - Tracy E. Crane
PY - 2026
DA - 2026/11/06
JO - Nutrients
DO - 10.3390/nu18213681
UR - https://www.mdpi.com/2072-6643/18/21/3681
AB - Background/Objectives: Fasting has been proposed as a non-pharmacologic method of reducing chemotherapy toxicity. However, its effects across outcome domains have not been well-quantified. Methods: In line with PRISMA 2020 guidelines (PROSPERO: CRD420261296778), we searched PubMed, Embase, Web of Science, and CENTRAL from January 2015 through April 2026 for randomized or prospective comparative trials evaluating fasting during chemotherapy. Risk of bias was assessed using RoB 2 and criteria aligned with ROBINS-I. Standardized mean differences (Hedges’ g) and risk ratios (RRs) were pooled using three-level random-effects models. Results: Seven publications reporting six trials (268 participants) were included. The pooled estimate did not reach statistical significance (g = 0.21, 95% CI: −0.02–0.43, p = 0.064). Hematologic parameters (g = 0.11, 95% CI: −0.23–0.45) and quality of life (QoL) and patient-reported outcomes from one trial (g = 0.32, 95% CI: −0.03–0.66) did not differ significantly between groups. Adverse events also did not differ significantly (RR = 0.86, 95% CI: 0.55–1.36). Conclusions: Across six small trials, fasting during chemotherapy did not significantly affect hematologic parameters, QoL, or adverse events. However, it is worth nothing that point estimates generally favored fasting. Hence, a small benefit can neither be confirmed nor ruled out at this time. Adequately powered trials assessing patient-important outcomes and incorporating nutritional monitoring are needed before fasting can be recommended or ruled out.
SN - 2072-6643
ER -