Evaluating a 20-Day Preoperative Fasting Program to Influence Gut Microbiome and Immune Response Before Hip Replacement Surgery

What this Trial Is About

This research evaluates whether a structured 20-day preoperative fasting program affects inflammation and gut microbiome diversity in adults undergoing elective primary total hip arthroplasty THA. The study focuses on reducing plasma IL-8, a proinflammatory marker, and increasing gut microbial alpha-diversity compared to standard care. It also considers effects on other immune markers, metabolic measures, patient-reported outcomes, and postoperative complications. Participants are randomly assigned to either a fasting group or a standard care group. The fasting intervention includes alternating 5-day cycles of the Buchinger Fastenbox, a low-carbohydrate vegetable broth diet, and intermittent fasting, self-administered at home with study supervision. The control group receives usual preoperative care without fasting or supplements. Both groups undergo continuous glucose monitoring and regular weight, waist circumference, and blood pressure measurements before surgery. During the study, stool and blood samples are collected before fasting begins, just before surgery, and at several points after surgery to analyze immune cells, cytokines, and gut microbiome changes. Participants complete questionnaires on diet, infection symptoms, and joint health. Follow-up occurs up to six months post-surgery to assess recovery, complications, and metabolic outcomes. The study aims to enroll 130 adults aged 18 to 75 years.

Preoperative Fasting and the Gut Microbiome Before Hip Replacement