Mulijono D
Volume6-Issue11
Dates: Received: 2025-08-29 | Accepted: 2025-11-11 | Published: 2025-11-12
Pages: 1682-1690
Abstract
The escalating burden of chronic Non-Communicable Diseases (NCDs)-including Cardiovascular Disease (CVD), Type 2 Diabetes Mellitus (T2DM), obesity, hypertension, and cancer-highlights the failure of symptom-based medicine to address root causes. Lifestyle medicine now stands as a transformative alternative, with two proven interventions-Whole-Food Plant-Based Diets (WFPBD) and Intermittent Fasting (IF)-showing powerful metabolic and anti-inflammatory benefits.
When combined, WFPBD and IF yield synergistic physiological effects, enhancing insulin sensitivity, lipid regulation, autophagy, and inflammation control while promoting sustainable weight loss and cellular repair. This integration addresses both the quality and timing of nutrition, targeting the molecular roots of chronic disease.
At Bethsaida Hospital (Indonesia), under the leadership of Prof. Dasaad Mulijono, this combined WFPBD+IF protocol has been implemented for nearly seven years in thousands of patients with advanced cardiometabolic disorders. The program demonstrated measurable success, including the reversal of Coronary Artery Disease (CAD), remission of T2DM & hypertension, reduction in medication use, normalisation of lipid and inflammatory markers, improved renal function, and sustained weight loss.
This low-cost, scalable, and clinically validated model demonstrates that integrating nutrition and fasting offers a replicable blueprint for global metabolic restoration and long-term disease reversal.
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DOI: 10.37871/jbres2221
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© 2025 Mulijono D, et al. Distributed under Creative Commons CC-BY 4.0
How to cite this article
Mulijono D. Combining Whole Food Plant-Based Diet and Intermittent Fasting: A Synergistic Strategy to Combat Chronic Diseases. J Biomed Res Environ Sci. 2025 Nov 11; 6(11): 1682-1690. doi: 10.37871/ jbres2221, Article ID: JBRES2221, Available at: https://www.jelsciences.com/articles/jbres2221.pdf
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References
- Ouyang F, Cheng X, Zhou W, He J, Xiao S. Increased Mortality Trends in Patients With Chronic Non-communicable Diseases and Comorbid Hypertension in the United States, 2000-2019. Front Public Health. 2022 Jul 11;10:753861. doi: 10.3389/fpubh.2022.753861. PMID: 35899158; PMCID: PMC9309719.
- Piovani D, Nikolopoulos GK, Bonovas S. Non-Communicable Diseases: The Invisible Epidemic. J Clin Med. 2022 Oct 8;11(19):5939. doi: 10.3390/jcm11195939. PMID: 36233805; PMCID: PMC9572583.
- Taheri Soodejani M. Non-communicable diseases in the world over the past century: a secondary data analysis. Front Public Health. 2024 Oct 3;12:1436236. doi: 10.3389/fpubh.2024.1436236. PMID: 39421825; PMCID: PMC11484412.
- Di Cesare M, Perel P, Taylor S, Kabudula C, Bixby H, Gaziano TA, McGhie DV, Mwangi J, Pervan B, Narula J, Pineiro D, Pinto FJ. The Heart of the World. Glob Heart. 2024 Jan 25;19(1):11. doi: 10.5334/gh.1288. PMID: 38273998; PMCID: PMC10809869.
- Chong B, Jayabaskaran J, Jauhari SM, Chan SP, Goh R, Kueh MTW, Li H, Chin YH, Kong G, Anand VV, Wang JW, Muthiah M, Jain V, Mehta A, Lim SL, Foo R, Figtree GA, Nicholls SJ, Mamas MA, Januzzi JL, Chew NWS, Richards AM, Chan MY. Global burden of cardiovascular diseases: projections from 2025 to 2050. Eur J Prev Cardiol. 2025 Aug 25;32(11):1001-1015. doi: 10.1093/eurjpc/zwae281. PMID: 39270739.
- Gaidai O, Cao Y, Loginov S. Global Cardiovascular Diseases Death Rate Prediction. Curr Probl Cardiol. 2023 May;48(5):101622. doi: 10.1016/j.cpcardiol.2023.101622. Epub 2023 Jan 29. PMID: 36724816.
- Niebuur J, Vonk JM, Du Y, de Bock GH, Lunter G, Krabbe PFM, Alizadeh BZ, Snieder H, Smidt N, Boezen M, Corpeleijn E. Lifestyle factors related to prevalent chronic disease multimorbidity: A population-based cross-sectional study. PLoS One. 2023 Jul 24;18(7):e0287263. doi: 10.1371/journal.pone.0287263. PMID: 37486939; PMCID: PMC10365307.
- Oster H, Chaves I. Effects of Healthy Lifestyles on Chronic Diseases: Diet, Sleep and Exercise. Nutrients. 2023 Oct 31;15(21):4627. doi: 10.3390/nu15214627. PMID: 37960280; PMCID: PMC10650398.
- Du Y, de Bock GH, Vonk JM, Pham AT, van der Ende MY, Snieder H, Smidt N, Krabbe PFM, Alizadeh BZ, Lunter G, Corpeleijn E. Lifestyle factors and incident multimorbidity related to chronic disease: a population-based cohort study. Eur J Ageing. 2024 Nov 28;21(1):37. doi: 10.1007/s10433-024-00833-x. PMID: 39609306; PMCID: PMC11604909.
- Hacker K. The Burden of Chronic Disease. Mayo Clin Proc Innov Qual Outcomes. 2024 Jan 20;8(1):112-119. doi: 10.1016/j.mayocpiqo.2023.08.005. Erratum in: Mayo Clin Proc Innov Qual Outcomes. 2024 Dec 13;9(1):100588. doi: 10.1016/j.mayocpiqo.2024.11.005. PMID: 38304166; PMCID: PMC10830426.
- Vasim I, Majeed CN, DeBoer MD. Intermittent Fasting and Metabolic Health. Nutrients. 2022 Jan 31;14(3):631. doi: 10.3390/nu14030631. PMID: 35276989; PMCID: PMC8839325.
- Song DK, Kim YW. Beneficial effects of intermittent fasting: a narrative review. J Yeungnam Med Sci. 2023 Jan;40(1):4-11. doi: 10.12701/jyms.2022.00010. Epub 2022 Apr 4. PMID: 35368155; PMCID: PMC9946909.
- Reddy BL, Reddy VS, Saier MH Jr. Health Benefits of Intermittent Fasting. Microb Physiol. 2024;34(1):142-152. doi: 10.1159/000540068. Epub 2024 Jul 2. PMID: 38955141; PMCID: PMC11262566.
- Esquivel MK. Nutrition Benefits and Considerations for Whole Foods Plant-Based Eating Patterns. Am J Lifestyle Med. 2022 Apr 22;16(3):284-290. doi: 10.1177/15598276221075992. PMID: 35706588; PMCID: PMC9189583.
- Key TJ, Papier K, Tong TYN. Plant-based diets and long-term health: findings from the EPIC-Oxford study. Proc Nutr Soc. 2022 May;81(2):190-198. doi: 10.1017/S0029665121003748. Epub 2021 Oct 27. PMID: 35934687; PMCID: PMC7613518.
- Herpich C, Müller-Werdan U, Norman K. Role of plant-based diets in promoting health and longevity. Maturitas. 2022 Nov;165:47-51. doi: 10.1016/j.maturitas.2022.07.003. Epub 2022 Jul 22. PMID: 35914402.
- Bansal S, Connolly M, Harder T. Impact of a Whole-Foods, Plant-Based Nutrition Intervention on Patients Living with Chronic Disease in an Underserved Community. Am J Lifestyle Med. 2021 Jun 6;16(3):382-389. doi: 10.1177/15598276211018159. PMID: 35706591; PMCID: PMC9189580.
- Kahleova H, Levin S, Barnard ND. Vegetarian Dietary Patterns and Cardiovascular Disease. Prog Cardiovasc Dis. 2018 May-Jun;61(1):54-61. doi: 10.1016/j.pcad.2018.05.002. Epub 2018 May 22. PMID: 29800598.
- Esselstyn CB Jr, Gendy G, Doyle J, Golubic M, Roizen MF. A way to reverse CAD? J Fam Pract. 2014 Jul;63(7):356-364b. PMID: 25198208.
- Mehta P, Tawfeeq S, Padte S, Sunasra R, Desai H, Surani S, Kashyap R. Plant-based diet and its effect on coronary artery disease: A narrative review. World J Clin Cases. 2023 Jul 16;11(20):4752-4762. doi: 10.12998/wjcc.v11.i20.4752. PMID: 37583985; PMCID: PMC10424050.
- Ornish D, Scherwitz LW, Billings JH, Brown SE, Gould KL, Merritt TA, Sparler S, Armstrong WT, Ports TA, Kirkeeide RL, Hogeboom C, Brand RJ. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998 Dec 16;280(23):2001-7. doi: 10.1001/jama.280.23.2001. Erratum in: JAMA 1999 Apr 21;281(15):1380. PMID: 9863851.
- Satija A, Bhupathiraju SN, Spiegelman D, Chiuve SE, Manson JE, Willett W, Rexrode KM, Rimm EB, Hu FB. Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults. J Am Coll Cardiol. 2017 Jul 25;70(4):411-422. doi: 10.1016/j.jacc.2017.05.047. PMID: 28728684; PMCID: PMC5555375.
- Tuso P, Stoll SR, Li WW. A plant-based diet, atherogenesis, and coronary artery disease prevention. Perm J. 2015 Winter;19(1):62-7. doi: 10.7812/TPP/14-036. Epub 2014 Nov 24. PMID: 25431999; PMCID: PMC4315380.
- Peña-Jorquera H, Cid-Jofré V, Landaeta-Díaz L, Petermann-Rocha F, Martorell M, Zbinden-Foncea H, Ferrari G, Jorquera-Aguilera C, Cristi-Montero C. Plant-Based Nutrition: Exploring Health Benefits for Atherosclerosis, Chronic Diseases, and Metabolic Syndrome-A Comprehensive Review. Nutrients. 2023 Jul 21;15(14):3244. doi: 10.3390/nu15143244. PMID: 37513660; PMCID: PMC10386413.
- Babalola F, Adesuyi A, David F, Kolajo BA, Urhi A, Akinade O, Adedoyin AM, Alugba G, Arisoyin AE, Okereke OP, Unedu OR, Aladejare AO, Oboasekhi AA, Anugwom GO. A Comprehensive Review on the Effects of Vegetarian Diets on Coronary Heart Disease. Cureus. 2022 Oct 2;14(10):e29843. doi: 10.7759/cureus.29843. PMID: 36337779; PMCID: PMC9626375.
- Sikand G, Severson T. Top 10 dietary strategies for atherosclerotic cardiovascular risk reduction. Am J Prev Cardiol. 2020 Nov 19;4:100106. doi: 10.1016/j.ajpc.2020.100106. Erratum in: Am J Prev Cardiol. 2021 Mar 22;6:100174. doi: 10.1016/j.ajpc.2021.100174. PMID: 34327475; PMCID: PMC8315554.
- McMacken M, Shah S. A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol. 2017 May;14(5):342-354. doi: 10.11909/j.issn.1671-5411.2017.05.009. PMID: 28630614; PMCID: PMC5466941.
- Yang X, Li Y, Wang C, Mao Z, Chen Y, Ren P, Fan M, Cui S, Niu K, Gu R, Li L. Association of plant-based diet and type 2 diabetes mellitus in Chinese rural adults: The Henan Rural Cohort Study. J Diabetes Investig. 2021 Sep;12(9):1569-1576. doi: 10.1111/jdi.13522. Epub 2021 Mar 2. PMID: 33559976; PMCID: PMC8409831.
- Pollakova D, Andreadi A, Pacifici F, Della-Morte D, Lauro D, Tubili C. The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review. Nutrients. 2021 Jun 21;13(6):2123. doi: 10.3390/nu13062123. PMID: 34205679; PMCID: PMC8235036.
- Jardine MA, Kahleova H, Levin SM, Ali Z, Trapp CB, Barnard ND. Perspective: Plant-Based Eating Pattern for Type 2 Diabetes Prevention and Treatment: Efficacy, Mechanisms, and Practical Considerations. Adv Nutr. 2021 Dec 1;12(6):2045-2055. doi: 10.1093/advances/nmab063. PMID: 34113961; PMCID: PMC8634508.
- Ansari P, Khan JT, Chowdhury S, Reberio AD, Kumar S, Seidel V, Abdel-Wahab YHA, Flatt PR. Plant-Based Diets and Phytochemicals in the Management of Diabetes Mellitus and Prevention of Its Complications: A Review. Nutrients. 2024 Oct 30;16(21):3709. doi: 10.3390/nu16213709. PMID: 39519546; PMCID: PMC11547802.
- Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Green A, Ferdowsian H. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. Am J Clin Nutr. 2009 May;89(5):1588S-1596S. doi: 10.3945/ajcn.2009.26736H. Epub 2009 Apr 1. PMID: 19339401; PMCID: PMC2677007.
- Guest NS, Raj S, Landry MJ, Mangels AR, Pawlak R, Senkus KE, Handu D, Rozga M. Vegetarian and Vegan Dietary Patterns to Treat Adult Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2024 Oct;15(10):100294. doi: 10.1016/j.advnut.2024.100294. Epub 2024 Sep 30. Erratum in: Adv Nutr. 2025 Feb;16(2):100379. doi: 10.1016/j.advnut.2025.100379. PMID: 39415400; PMCID: PMC11540868.
- Panigrahi G, Goodwin SM, Staffier KL, Karlsen M. Remission of Type 2 Diabetes After Treatment With a High-Fiber, Low-Fat, Plant-Predominant Diet Intervention: A Case Series. Am J Lifestyle Med. 2023 Jun 15;17(6):839-846. doi: 10.1177/15598276231181574. PMID: 38511112; PMCID: PMC10948923.
- Hardt L, Mahamat-Saleh Y, Aune D, Schlesinger S. Plant-Based Diets and Cancer Prognosis: a Review of Recent Research. Curr Nutr Rep. 2022 Dec;11(4):695-716. doi: 10.1007/s13668-022-00440-1. Epub 2022 Sep 23. PMID: 36138327; PMCID: PMC9750928.
- Cheng E, Ou FS, Gatten C, Ma C, Venook AP, Lenz HJ, O'Reilly EM, Campbell PT, Kuang C, Caan BJ, Blanke CD, Ng K, Meyerhardt JA. Plant-based diet and survival among patients with metastatic colorectal cancer. J Natl Cancer Inst. 2025 Jan 1;117(1):169-179. doi: 10.1093/jnci/djae213. PMID: 39212617; PMCID: PMC11717424.
- Loeb S, Hua Q, Bauer SR, Kenfield SA, Morgans AK, Chan JM, Van Blarigan EL, Shreves AH, Mucci LA. Plant-based diet associated with better quality of life in prostate cancer survivors. Cancer. 2024 May 1;130(9):1618-1628. doi: 10.1002/cncr.35172. Epub 2024 Feb 13. PMID: 38348508; PMCID: PMC11009061.
- Madigan M, Karhu E. The role of plant-based nutrition in cancer prevention. J Unexplored Med Data. 2018;(3):9. doi: 10.20517/2572-8180.2018.05.
- Liu VN, Van Blarigan EL, Zhang L, Graff RE, Loeb S, Langlais CS, Cowan JE, Carroll PR, Chan JM, Kenfield SA. Plant-Based Diets and Disease Progression in Men With Prostate Cancer. JAMA Netw Open. 2024 May 1;7(5):e249053. doi: 10.1001/jamanetworkopen.2024.9053. PMID: 38691361; PMCID: PMC11063803.
- Campbell TM, Campbell EK, Culakova E, Blanchard LM, Wixom N, Guido JJ, Fetten J, Huston A, Shayne M, Janelsins MC, Mustian KM, Moore RG, Peppone LJ. A whole-food, plant-based randomized controlled trial in metastatic breast cancer: weight, cardiometabolic, and hormonal outcomes. Breast Cancer Res Treat. 2024 Jun;205(2):257-266. doi: 10.1007/s10549-024-07266-1. Epub 2024 Mar 6. PMID: 38446316; PMCID: PMC11101531.
- Najjar RS, Feresin RG. Plant-Based Diets in the Reduction of Body Fat: Physiological Effects and Biochemical Insights. Nutrients. 2019 Nov 8;11(11):2712. doi: 10.3390/nu11112712. PMID: 31717463; PMCID: PMC6893503.
- Greger M. A Whole Food Plant-Based Diet Is Effective for Weight Loss: The Evidence. Am J Lifestyle Med. 2020 Apr 3;14(5):500-510. doi: 10.1177/1559827620912400. PMID: 32922235; PMCID: PMC7444011.
- Ahmad SR. Plant-based diet for obesity treatment. Front Nutr. 2022 Sep 8;9:952553. doi: 10.3389/fnut.2022.952553. PMID: 36159462; PMCID: PMC9493195.
- Remde A, DeTurk SN, Almardini A, Steiner L, Wojda T. Plant-predominant eating patterns - how effective are they for treating obesity and related cardiometabolic health outcomes? - a systematic review. Nutr Rev. 2022 Apr 8;80(5):1094-1104. doi: 10.1093/nutrit/nuab060. PMID: 34498070.
- Bassin SR, Ferreira De Carvalho J, Gulati M. A Review of Plant-Based Diets for Obesity Management. Endocr Pract. 2024 Aug;30(8):779-789. doi: 10.1016/j.eprac.2024.04.020. Epub 2024 May 8. PMID: 38729570.
- Jakše B, Jakše B, Pinter S, Pajek J, Fidler Mis N. Whole-Food Plant-Based Lifestyle Program and Decreased Obesity. Am J Lifestyle Med. 2020 Aug 28;16(3):260-270. doi: 10.1177/1559827620949205. PMID: 35706599; PMCID: PMC9189574.
- Ivanova S, Delattre C, Karcheva-Bahchevanska D, Benbasat N, Nalbantova V, Ivanov K. Plant-Based Diet as a Strategy for Weight Control. Foods. 2021 Dec 8;10(12):3052. doi: 10.3390/foods10123052. PMID: 34945602; PMCID: PMC8701327.
- Campbell EK, Fidahusain M, Campbell Ii TM. Evaluation of an Eight-Week Whole-Food Plant-Based Lifestyle Modification Program. Nutrients. 2019 Sep 3;11(9):2068. doi: 10.3390/nu11092068. PMID: 31484341; PMCID: PMC6770132.
- Bolori P, Setaysh L, Rasaei N, Jarrahi F, Yekaninejad MS, Mirzaei K. Adherence to a healthy plant diet may reduce inflammatory factors in obese and overweight women-a cross-sectional study. Diabetes Metab Syndr. 2019 Jul-Aug;13(4):2795-2802. doi: 10.1016/j.dsx.2019.07.019. Epub 2019 Jul 26. PMID: 31405709.
- Chen Z, Schoufour JD, Rivadeneira F, Lamballais S, Ikram MA, Franco OH, Voortman T. Plant-based Diet and Adiposity Over Time in a Middle-aged and Elderly Population: The Rotterdam Study. Epidemiology. 2019 Mar;30(2):303-310. doi: 10.1097/EDE.0000000000000961. PMID: 30507650.
- Mazur-Włodarczyk K, Gruszecka-Kosowska A. Sustainable or Not? Insights on the Consumption of Animal Products in Poland. Int J Environ Res Public Health. 2022 Oct 11;19(20):13072. doi: 10.3390/ijerph192013072. PMID: 36293652; PMCID: PMC9603601.
- National Research Council (US) Board on Agriculture and Renewable Resources. Fat Content and Composition of Animal Products: Proceedings of a Symposium Washington, D.C. December 12-13, 1974. Washington (DC): National Academies Press (US); 1976. PMID: 25032409.
- Najjar RS. The Impacts of Animal-Based Diets in Cardiovascular Disease Development: A Cellular and Physiological Overview. J Cardiovasc Dev Dis. 2023 Jun 30;10(7):282. doi: 10.3390/jcdd10070282. PMID: 37504538; PMCID: PMC10380617.
- Masood W, Annamaraju P, Khan Suheb MZ, Uppaluri KR. Ketogenic Diet. 2023 Jun 16. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29763005.
- Chen S, Su X, Feng Y, Li R, Liao M, Fan L, Liu J, Chen S, Zhang S, Cai J, Zhu S, Niu J, Ye Y, Lo K, Zeng F. Ketogenic Diet and Multiple Health Outcomes: An Umbrella Review of Meta-Analysis. Nutrients. 2023 Sep 27;15(19):4161. doi: 10.3390/nu15194161. PMID: 37836444; PMCID: PMC10574428.
- Crosby L, Davis B, Joshi S, Jardine M, Paul J, Neola M, Barnard ND. Ketogenic Diets and Chronic Disease: Weighing the Benefits Against the Risks. Front Nutr. 2021 Jul 16;8:702802. doi: 10.3389/fnut.2021.702802. PMID: 34336911; PMCID: PMC8322232.
- Jiang Y, Sonu I, Garcia P, Fernandez-Becker NQ, Kamal AN, Zikos TA, Singh S, Neshatian L, Triadafilopoulos G, Goodman SN, Clarke JO. The Impact of Intermittent Fasting on Patients With Suspected Gastroesophageal Reflux Disease. J Clin Gastroenterol. 2023 Nov-Dec 01;57(10):1001-1006. doi: 10.1097/MCG.0000000000001788. Epub 2022 Nov 1. PMID: 36730832.
- Kocakusak A. Does Ramadan fasting contribute to the increase of peptic ulcer perforations? Eur Rev Med Pharmacol Sci. 2017 Jan;21(1):150-154. PMID: 28121343.
- Ojo TK, Joshua OO, Ogedegbe OJ, Oluwole O, Ademidun A, Jesuyajolu D. Role of Intermittent Fasting in the Management of Prediabetes and Type 2 Diabetes Mellitus. Cureus. 2022 Sep 5;14(9):e28800. doi: 10.7759/cureus.28800. PMID: 36225474; PMCID: PMC9534344.
- Corley BT, Carroll RW, Hall RM, Weatherall M, Parry-Strong A, Krebs JD. Intermittent fasting in Type 2 diabetes mellitus and the risk of hypoglycaemia: a randomized controlled trial. Diabet Med. 2018 May;35(5):588-594. doi: 10.1111/dme.13595. Epub 2018 Feb 27. PMID: 29405359.
- Obermayer A, Tripolt NJ, Pferschy PN, Kojzar H, Aziz F, Müller A, Schauer M, Oulhaj A, Aberer F, Sourij C, Habisch H, Madl T, Pieber T, Obermayer-Pietsch B, Stadlbauer V, Sourij H. Efficacy and Safety of Intermittent Fasting in People With Insulin-Treated Type 2 Diabetes (INTERFAST-2)-A Randomized Controlled Trial. Diabetes Care. 2023 Feb 1;46(2):463-468. doi: 10.2337/dc22-1622. PMID: 36508320; PMCID: PMC9887629.
- Chen L, Tian FY, Hu XH, Wu JW, Xu WD, Huang Q. Intermittent fasting in type 2 diabetes: from fundamental science to clinical applications. Eur Rev Med Pharmacol Sci. 2023 Jan;27(1):333-351. doi: 10.26355/eurrev_202301_30880. PMID: 36647882.






























































