PURPOSE: People may be unable to obtain anything edible for days under some circumstances, but they must maintain their calmness and cognition to navigate solutions. Our aim was to study changes in subjective sensations and cognition in healthy adults during a 10-day complete fasting experiment. METHODS: Thirteen healthy male volunteers voluntarily participated in the 22-day experiment comprising 4 phases: 3 days of baseline consumption, 10 days of complete fasting (only water ad libitum), 4 days of calorie restriction, and a 5-day recovery period. The volunteers' subjective sensations, cognitive performance, and serum energy substances were measured at 6 time points. RESULTS: Across the 6 time points, the trajectories of subjective sensations in response to fasting were "U"- or " intersection "-shaped curves instead of progressive discomfort or mood enhancement. A significant fasting time effect was found on depression-dejection (baseline: 16.85 +/- 2.88; highest score on the third day of completing fasting: 17.69 +/- 3.97, P = 0.04) and self-rated anxiety (baseline: 26.23 +/- 4.75; highest score on the sixth day of completing fasting: 30.85 +/- 5.58, P = 0.01), and the change curves were consistent with the inflection point of the energy substrates shifting from serum glucose to ketone. In addition, basic cognitive functions appeared to be unaffected during the 10-day fast. CONCLUSIONS: Our study showed strong influences on the sensations from the third to sixth days of the prolonged fasting period but no significant effects on basic cognitive abilities associated with the energy substance switch. These findings could contribute to the development and understanding of survival strategies in food-shortage emergencies or of intermittent fasting programmes.
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