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Ye YF, Zhang MX, Lin Z, Tang L. Is Intermittent Fasting Better Than Continuous Energy Restriction for Adults with Overweight and Obesity? Diabetes Metab Syndr Obes 2022; 15:2813-2826. [PMID: 36134390 PMCID: PMC9484493 DOI: 10.2147/dmso.s376409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022] Open
Abstract
As a popular weight management intervention, intermittent fasting (IF) has been widely applied to the treatment of overweight and obesity in adults. This review describes the different forms and implementation protocols of IF and their effects on body weight, body composition, cardiometabolic risk factors and other diseases. The existing evidence suggests that IF is as effective as continuous energy restriction and may be a feasible and effective approach to weight loss.
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Affiliation(s)
- Ya-Fei Ye
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, People’s Republic of China
- Health Management Centre, Taizhou Hospital, Zhejiang University, Linhai, 317000, People’s Republic of China
| | - Mei-Xian Zhang
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317000, People’s Republic of China
| | - Zhi Lin
- Operating Rooms, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317000, People’s Republic of China
| | - Leiwen Tang
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, People’s Republic of China
- Correspondence: Leiwen Tang, Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 East Qingchun Road, Hangzhou, 310016, People’s Republic of China, Tel/Fax +86-571-86006438, Email
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Ardissino M, Vincent M, Hines O, Amin R, Eichhorn C, Tang AR, Collins P, Moussa O, Purkayastha S. Long-term cardiovascular outcomes after orlistat therapy in patients with obesity: a nationwide, propensity-score matched cohort study. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2021; 8:179-186. [PMID: 33991094 DOI: 10.1093/ehjcvp/pvaa133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 08/25/2020] [Indexed: 11/14/2022]
Abstract
AIMS The rising prevalence of obesity and its associated comorbidities represent a growing public health issue; in particular, obesity is known to be a major risk factor for cardiovascular disease. Despite the evidence behind the efficacy of orlistat in achieving weight loss in patients with obesity, no study thus far has quantified its long-term effect on cardiovascular outcomes. The purpose of this study is to explore long-term cardiovascular outcomes after orlistat therapy. METHODS AND RESULTS A propensity-score matched cohort study was conducted on the nation-wide electronic primary and integrated secondary healthcare records of the Clinical Practice Research Datalink (CPRD). The 36 876 patients with obesity in the CPRD database who had completed a course of orlistat during follow-up were matched on a 1:1 basis with equal numbers of controls who had not taken orlistat. Patients were followed up for a median of 6 years for the occurrence of the primary composite endpoint of major adverse cardiovascular events (fatal or non-fatal myocardial infarction or ischaemic stroke), and a number of secondary endpoints including primary endpoint components individually, the occurrence of new-onset heart failure, coronary revascularization, new chronic kidney disease stage III+ (CKD3+), and all-cause mortality. During the median study follow-up of 6 years, the occurrence of major adverse cardiovascular events was lower in the orlistat cohort [hazard ratio (HR) 0.74; 95% confidence interval (CI) 0.66-0.83, P < 0.001]. Patients who took orlistat experienced lower rates of myocardial infarction (HR 0.77; 95% CI 0.66-0.88, P < 0.001) and ischaemic stroke (HR 0.68; 95% CI 0.56 to -0.84, P < 0.001) as well as new-onset heart failure (HR 0.79; 95% CI 0.67-0.94, P = 0.007). There was no differences in revascularization rates (HR 1.12; 95% CI 0.91-1.38, P = 0.27), but a lower rate of both CKD3+ development (HR 0.78; 95% CI 0.73-0.83, P < 0.001) and mortality (HR 0.39, 95% CI 0.36 to -0.41, P < 0.001) was observed. CONCLUSION In this nation-wide, propensity-score matched study, orlistat was associated with lower rates of overall major adverse cardiovascular events, new-onset heart failure, renal failure, and mortality. This study adds to current evidence on the known improvements in cardiovascular risk factor profiles of orlistat treatment by suggesting a potential role in primary prevention.
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Affiliation(s)
- Maddalena Ardissino
- Department of Medicine, Imperial College London, Exhibition Road, London SW7 2AZ, UK
| | - Matthew Vincent
- Department of Medicine, Imperial College London, Exhibition Road, London SW7 2AZ, UK
| | - Oliver Hines
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Ravi Amin
- Department of Medicine, Imperial College London, Exhibition Road, London SW7 2AZ, UK
| | - Christian Eichhorn
- Department of Medicine, Imperial College London, Exhibition Road, London SW7 2AZ, UK.,Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Alice R Tang
- Department of Medicine, Imperial College London, Exhibition Road, London SW7 2AZ, UK
| | - Peter Collins
- Department of Medicine, Imperial College London, Exhibition Road, London SW7 2AZ, UK.,Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, Sydney Street, London SW3 6NP, UK
| | - Osama Moussa
- Division of Surgery and Cancer, Imperial College London, Praed Street, London W2 1NY, UK
| | - Sanjay Purkayastha
- Department of Medicine, Imperial College London, Exhibition Road, London SW7 2AZ, UK.,Division of Surgery and Cancer, Imperial College London, Praed Street, London W2 1NY, UK.,Imperial Weight Centre, Imperial College Healthcare NHS trust, Praed Street, London W2 1NY, UK
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Petersen KS, Clifton PM, Lister N, Keogh JB. Reply to: "Effect of weight loss induced by energy restriction on measures of arterial compliance: A systematic review and meta-analysis". Atherosclerosis 2016; 252:203-204. [PMID: 27477185 DOI: 10.1016/j.atherosclerosis.2016.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 07/06/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Kristina S Petersen
- School of Pharmacy and Medical Science, University of South Australia, GPO Box 2471, Adelaide, South Australia 5000, Australia; The George Institute for Global Health, University of Sydney, P.O. Box M201, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia
| | - Peter M Clifton
- School of Pharmacy and Medical Science, University of South Australia, GPO Box 2471, Adelaide, South Australia 5000, Australia
| | - Natalie Lister
- School of Pharmacy and Medical Science, University of South Australia, GPO Box 2471, Adelaide, South Australia 5000, Australia
| | - Jennifer B Keogh
- School of Pharmacy and Medical Science, University of South Australia, GPO Box 2471, Adelaide, South Australia 5000, Australia.
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