[Fasting: the Switch of Life-report on the 18th International Congress of the Medical Association for Fasting and Nutrition (ÄGHE)]

The international congress of the German Medical Association for Fasting and Nutrition (ÄGHE e. V.) was held in cooperation with the Maria Buchinger Foundation for the 18th time in June 2019 in Überlingen at Lake Constance. The congress offers a platform for physicians, fasting therapists, and all interested parties to exchange the latest scientific findings in fasting research. "Fasting: the Switch of Life" was the title of the congress, where well-known national and international fasting researchers spoke about health effects of fasting therapies, the indications and contraindications of fasting, and the latest biological, genetic, and neuroscientific findings related to it, such as protein diets and integrative fasting therapies. The religious and spiritual dimension of fasting were also considered in addition to the health-related aspects. Apart from the lectures and case reports, the aim of the congress was to discuss the current developments and challenges in fasting therapy with the participants.

Physicians' attitudes and views regarding religious fasting during pregnancy and review of the literature

Many patients worldwide seek medical advice regarding safety of fasting during pregnancy. This issue lacks high quality evidence, which makes giving medical advice challenging. To aid decision making on this subject we performed an internet mediated survey to determine the expert opinion on this issue. The survey was answered by one hundred and eight obstetricians and gynecologists (OB/GYN). The questions were aimed at the content of the medical advice given to pregnant patients on Ramadan (for Muslim patients) and Yom Kippur (for Jewish patients) fasts. For both fasts, most physicians recommended against fasting on the second or third trimester, while fasting on the first trimester was controversial. Differences were found between medical advices provided by physicians according to their demographical characteristics. Regarding Ramadan fast, senior specialists were more lenient about fasting than younger specialists (62% and 35%, respectively, p = 0.01). As to Yom Kippur fast, religious and traditional physicians were more likely to permit fasting compared to their secular colleagues (53% and 25%, respectively, p = 0.01). Additionally, a comprehensive literature review was conducted revealing possible adverse maternal and fetal outcomes of fasting; however the risk for long term clinical complications is yet to be defined.