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Bakhsh JA, Vidmar AP, Salvy SJ. Intermittent Fasting in Youth: A Scoping Review. RESEARCH SQUARE 2024:rs.3.rs-4524102. [PMID: 39011109 PMCID: PMC11247931 DOI: 10.21203/rs.3.rs-4524102/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
Intermittent fasting (IF) focuses on the timing of eating rather than diet quality or energy intake, with evidence supporting its effects on weight loss and cardiometabolic outcomes in adults. However, there is limited evidence for its efficacy in adolescents and emerging adults. To address this, a scoping review examined IF regimens in individuals aged 10 to 25, focusing on methodology, intervention parameters, outcomes, adherence, feasibility, and efficacy. The review included 39 studies with 731 participants aged 15 to 25. Methodologies varied, with 18 studies on time-restricted eating and others requiring caloric restriction. Primary outcomes included cardiometabolic risk factors (11/29), body composition (9/29), anthropometric measurements (8/29), and feasibility (2/29). Most studies reported significant weight loss. This review underscores IF's potential in treating obesity in this age group but highlights the need for rigorous studies with standardized frameworks for feasibility to ensure comparability and determine IF's practicality in this age group.
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Affiliation(s)
- Jomanah A Bakhsh
- Department of Population and Public Health Sciences, University of Southern California
| | - Alaina P Vidmar
- Children's Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism
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2
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Clayton DJ, Varley I, Papageorgiou M. Intermittent fasting and bone health: a bone of contention? Br J Nutr 2023; 130:1487-1499. [PMID: 36876592 PMCID: PMC10551474 DOI: 10.1017/s0007114523000545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/23/2023] [Accepted: 02/24/2023] [Indexed: 03/07/2023]
Abstract
Intermittent fasting (IF) is a promising strategy for weight loss and improving metabolic health, but its effects on bone health are less clear. This review aims to summarise and critically evaluate the preclinical and clinical evidence on IF regimens (the 5:2 diet, alternate-day fasting (ADF) and time-restricted eating (TRE)/time-restricted feeding and bone health outcomes. Animal studies have utilised IF alongside other dietary practices known to elicit detrimental effects on bone health and/or in models mimicking specific conditions; thus, findings from these studies are difficult to apply to humans. While limited in scope, observational studies suggest a link between some IF practices (e.g. breakfast omission) and compromised bone health, although lack of control for confounding factors makes these data difficult to interpret. Interventional studies suggest that TRE regimens practised up to 6 months do not adversely affect bone outcomes and may even slightly protect against bone loss during modest weight loss (< 5 % of baseline body weight). Most studies on ADF have shown no adverse effects on bone outcomes, while no studies on the ‘5–2’ diet have reported bone outcomes. Available interventional studies are limited by their short duration, small and diverse population samples, assessment of total body bone mass exclusively (by dual-energy X-ray absorptiometry) and inadequate control of factors that may affect bone outcomes, making the interpretation of existing data challenging. Further research is required to better characterise bone responses to various IF approaches using well-controlled protocols of sufficient duration, adequately powered to assess changes in bone outcomes and designed to include clinically relevant bone assessments.
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Affiliation(s)
- David J. Clayton
- Musculoskeletal Research Group, Nottingham Trent University, Clifton Campus, Nottingham, UK
| | - Ian Varley
- Musculoskeletal Research Group, Nottingham Trent University, Clifton Campus, Nottingham, UK
| | - Maria Papageorgiou
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
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3
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High stability of blood parameters during mouse lifespan: sex-specific effects of every-other-day fasting. Biogerontology 2022; 23:559-570. [PMID: 35915171 DOI: 10.1007/s10522-022-09982-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/19/2022] [Indexed: 11/02/2022]
Abstract
Every-other-day fasting (EODF) is one type of caloric restriction that is proposed to have significant health benefits, including slowing aging-related processes. The present study evaluated multiple parameters of blood homeostasis comparing mice of different ages and mice on different diet regimes: ad libitum (AL) versus EODF. Hematological and classical biochemical parameters of blood were measured in young (6-month), middle-aged (12-month) and old (18-month) C57BL/6J mice of both sexes subjected either to EODF, or AL feeding. Middle-aged AL males showed a decrease in erythrocyte and total leucocyte counts and an increase in plasma alkaline phosphatase activity, whereas old animals showed a decrease in relative levels of lymphocytes and an increase in relative levels of neutrophils, a decrease in plasma lactate and an increase in total cholesterol levels, compared to young mice. AL-fed females demonstrated higher stability of blood parameters during aging than males did. The EODF regimen did not significantly affect hematological parameters in females but prevented a decline in total leukocyte count with age in males. In both sexes, EODF partially prevented age-associated changes in levels of plasma lactate and cholesterol and activity of alkaline phosphatase. Thus, during normal aging, mice showed a sex-dependent maintenance of blood homeostasis which was not significantly affected by EODF.
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Intermittent Fasting: Potential Bridge of Obesity and Diabetes to Health? Nutrients 2022; 14:nu14050981. [PMID: 35267959 PMCID: PMC8912812 DOI: 10.3390/nu14050981] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 12/12/2022] Open
Abstract
Obesity has been an escalating worldwide health problem for decades, and it is likely a risk factor of prediabetes and diabetes. Correlated with obesity, the number of diabetic patients is also remarkable. A modest weight loss (5–10%) is critical to alleviate the risk of any other metabolic disease. Reduced energy intake has been an essential factor for weight loss reduction. As a new behavior intervention to lose weight, intermittent fasting (IF) attracts considerable attention and has become a popular strategy among young people. IF is a diet pattern that cycles between periods of fasting and eating on a regular schedule, involving various types, mainly Intermittent Energy Restriction and Time-Restricted Fasting. Accumulating evidence shows that short-term IF has a greatly positive effect in animal studies and contributes favorable benefits in human trials as well. Nevertheless, as an emerging, diverse, and relatively premature behavior intervention, there are still limited studies considering patients with obesity and type 2 diabetes mellitus. It is also a controversial intervention for the treatment of metabolic disease and cancer. The risks and challenges appear consequently. Additionally, whether intermittent fasting can be applied to long-term clinical treatment, and whether it has side effects during the long-term period or not, demands more large-scale and long-term experiments.
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Joaquim L, Faria A, Loureiro H, Matafome P. Benefits, mechanisms, and risks of intermittent fasting in metabolic syndrome and type 2 diabetes. J Physiol Biochem 2022; 78:295-305. [PMID: 34985730 DOI: 10.1007/s13105-021-00839-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/18/2021] [Indexed: 10/19/2022]
Abstract
One of the emergent nutritional strategies for improving multiple features of cardiometabolic diseases is the practice of intermittent fasting (IF), which consists of alternating periods of eating and fasting. IF can reduce circulating glucose and insulin levels, fat mass, and the risk of developing age-related pathologies. IF appears to upregulate evolution-conserved adaptive cellular responses, such as stress-response pathways, autophagy, and mitochondrial function. IF was also observed to modulate the circadian rhythms of hormones like insulin or leptin, among others, which levels change in conditions of food abundance and deficit. However, some contradictory results regarding the duration of the interventions and the anterior metabolic status of the participants suggest that more and longer studies are needed in order to draw conclusions. This review summarizes the current knowledge regarding the role of IF in the modulation of mechanisms involved in type 2 diabetes, as well as the risks.
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Affiliation(s)
- Lisandra Joaquim
- Instituto Politécnico de Coimbra, Coimbra Health School (ESTeSC), Coimbra, Portugal
| | - Ana Faria
- Instituto Politécnico de Coimbra, Coimbra Health School (ESTeSC), Coimbra, Portugal
| | - Helena Loureiro
- Instituto Politécnico de Coimbra, Coimbra Health School (ESTeSC), Coimbra, Portugal
| | - Paulo Matafome
- Instituto Politécnico de Coimbra, Coimbra Health School (ESTeSC), Coimbra, Portugal.
- Institute of Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Subunit 1, 1st floor, Azinhaga de Santa Comba, Celas, 3000-354, Coimbra, Portugal.
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.
- Clinical Academic Center, Coimbra, Portugal.
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Teong XT, Heilbronn LK. Evidence gaps and potential roles of intermittent fasting in the prevention of chronic diseases. Exp Gerontol 2021; 153:111506. [PMID: 34352288 DOI: 10.1016/j.exger.2021.111506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/05/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Moderate calorie restriction (CR) has long been recognized to reduce the risk of chronic diseases that are associated with obesity and aging. Intermittent fasting (IF) has recently emerged as a viable alternative to daily CR to reduce risk markers of chronic diseases, such as type 2 diabetes and cardiovascular diseases. The majority of trials have shown that IF provides similar metabolic and weight benefits to CR, although a few suggest that IF maybe superior to CR. The type of fasting protocol that is employed varies widely and could underpin the divergence in study outcomes. This review will discuss the findings of currently available IF versus CR trials, the protocol differences that exist between studies, as well as the gaps that still exist in the field, and finally will highlight upcoming studies that will further our understanding of the metabolic effectiveness of IF diets for metabolic health.
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Affiliation(s)
- Xiao Tong Teong
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia; Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Leonie K Heilbronn
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia; Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia.
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Allaf M, Elghazaly H, Mohamed OG, Fareen MFK, Zaman S, Salmasi AM, Tsilidis K, Dehghan A. Intermittent fasting for the prevention of cardiovascular disease. Cochrane Database Syst Rev 2021; 1:CD013496. [PMID: 33512717 PMCID: PMC8092432 DOI: 10.1002/14651858.cd013496.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death worldwide. Lifestyle changes are at the forefront of preventing the disease. This includes advice such as increasing physical activity and having a healthy balanced diet to reduce risk factors. Intermittent fasting (IF) is a popular dietary plan involving restricting caloric intake to certain days in the week such as alternate day fasting and periodic fasting, and restricting intake to a number of hours in a given day, otherwise known as time-restricted feeding. IF is being researched for its benefits and many randomised controlled trials have looked at its benefits in preventing CVD. OBJECTIVES To determine the role of IF in preventing and reducing the risk of CVD in people with or without prior documented CVD. SEARCH METHODS We conducted our search on 12 December 2019; we searched CENTRAL, MEDLINE and Embase. We also searched three trials registers and searched the reference lists of included papers. Systematic reviews were also viewed for additional studies. There was no language restriction applied. SELECTION CRITERIA We included randomised controlled trials comparing IF to ad libitum feeding (eating at any time with no specific caloric restriction) or continuous energy restriction (CER). Participants had to be over the age of 18 and included those with and without cardiometabolic risk factors. Intermittent fasting was categorised into alternate-day fasting, modified alternate-day fasting, periodic fasting and time-restricted feeding. DATA COLLECTION AND ANALYSIS Five review authors independently selected studies for inclusion and extraction. Primary outcomes included all-cause mortality, cardiovascular mortality, stroke, myocardial infarction, and heart failure. Secondary outcomes include the absolute change in body weight, and glucose. Furthermore, side effects such as headaches and changes to the quality of life were also noted. For continuous data, pooled mean differences (MD) (with 95% confidence intervals (CIs)) were calculated. We contacted trial authors to obtain missing data. We used GRADE to assess the certainty of the evidence. MAIN RESULTS: Our search yielded 39,165 records after the removal of duplicates. From this, 26 studies met our criteria, and 18 were included in the pooled analysis. The 18 studies included 1125 participants and observed outcomes ranging from four weeks to six months. No studies included data on all-cause mortality, cardiovascular mortality, stroke, myocardial infarction, and heart failure at any point during follow-up. Of quantitatively analysed data, seven studies compared IF with ab libitum feeding, eight studies compared IF with CER, and three studies compared IF with both ad libitum feeding and CER. Outcomes were reported at short term (≤ 3 months) and medium term (> 3 months to 12 months) follow-up. Body weight was reduced with IF compared to ad libitum feeding in the short term (MD -2.88 kg, 95% CI -3.96 to -1.80; 224 participants; 7 studies; low-certainty evidence). We are uncertain of the effect of IF when compared to CER in the short term (MD -0.88 kg, 95% CI -1.76 to 0.00; 719 participants; 10 studies; very low-certainty evidence) and there may be no effect in the medium term (MD -0.56 kg, 95% CI -1.68 to 0.56; 279 participants; 4 studies; low-certainty evidence). We are uncertain about the effect of IF on glucose when compared to ad libitum feeding in the short term (MD -0.03 mmol/L, 95% CI -0.26 to 0.19; 95 participants; 3 studies; very-low-certainty of evidence) and when compared to CER in the short term: MD -0.02 mmol/L, 95% CI -0.16 to 0.12; 582 participants; 9 studies; very low-certainty; medium term: MD 0.01, 95% CI -0.10 to 0.11; 279 participants; 4 studies; low-certainty evidence). The changes in body weight and glucose were not deemed to be clinically significant. Four studies reported data on side effects, with some participants complaining of mild headaches. One study reported on the quality of life using the RAND SF-36 score. There was a modest increase in the physical component summary score. AUTHORS' CONCLUSIONS Intermittent fasting was seen to be superior to ad libitum feeding in reducing weight. However, this was not clinically significant. There was no significant clinical difference between IF and CER in improving cardiometabolic risk factors to reduce the risk of CVD. Further research is needed to understand the safety and risk-benefit analysis of IF in specific patient groups (e.g. patients with diabetes or eating disorders) as well as the effect on longer-term outcomes such as all-cause mortality and myocardial infarction.
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Affiliation(s)
| | | | | | | | - Sadia Zaman
- School of Medicine, Imperial College London, London, UK
| | - Abdul-Majeed Salmasi
- Department of Cardiology, London North West University Healthcare NHS Trust, London, UK
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Abbas Dehghan
- School of Public Health, Imperial College London, London, UK
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Dorling JL, Martin CK, Redman LM. Calorie restriction for enhanced longevity: The role of novel dietary strategies in the present obesogenic environment. Ageing Res Rev 2020; 64:101038. [PMID: 32109603 DOI: 10.1016/j.arr.2020.101038] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/13/2020] [Accepted: 02/23/2020] [Indexed: 12/12/2022]
Abstract
Calorie restriction (CR) is a potent modulator of longevity in multiple species. A growing body of evidence shows that sustained periods of CR without malnutrition improves risk factors involved in the pathophysiology of type 2 diabetes, cardiovascular diseases, cancer, and neurological disorders in humans. Innovative dietary strategies such as intermittent fasting and protein restriction have recently emerged as alternative approaches that improve markers of aging. Some of these newer strategies might provide benefits for healthy aging with little to no CR and therefore, compared to traditional CR, may be easier to follow. Further to providing an update of CR studies in humans, the present narrative review appraises the influence of these contemporary dietary strategies on mechanisms posited to drive CR-induced longevity in humans, including those involving energy metabolism, oxidative damage, inflammation, glucose homeostasis, and functional changes in the neuroendocrine systems. The review also discusses the utilization of these diets for populations in the current obesogenic environment, and comments on whether current research can inform an optimal diet that attenuates aging, can be easily followed, and promises to improve longevity in humans.
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Affiliation(s)
- James L Dorling
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA, 70808, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA, 70808, USA
| | - Leanne M Redman
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA, 70808, USA.
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Fatahi S, Nazary-Vannani A, Sohouli MH, Mokhtari Z, Kord-Varkaneh H, Moodi V, Tan SC, Low TY, Zanghelini F, Shidfar F. The effect of fasting and energy restricting diets on markers of glucose and insulin controls: a systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2020; 61:3383-3394. [DOI: 10.1080/10408398.2020.1798350] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Somaye Fatahi
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Nazary-Vannani
- Students’ Scientific Research Center (SSRC), Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mohammad Hassan Sohouli
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Mokhtari
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition and dietetics, Faculty of Nutrition 12 Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Kord-Varkaneh
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vihan Moodi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Shing Cheng Tan
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Teck Yew Low
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Fernando Zanghelini
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle Upon Tyne, UK
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Severely restricting energy intake for 24 h does not affect markers of bone metabolism at rest or in response to re-feeding. Eur J Nutr 2020; 59:3527-3535. [PMID: 32016644 PMCID: PMC7669762 DOI: 10.1007/s00394-020-02186-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/17/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE Intermittent energy restriction commonly refers to ad libitum energy intake punctuated with 24 h periods of severe energy restriction. This can improve markers of metabolic health but the effects on bone metabolism are unknown. This study assessed how 24 h severe energy restriction and subsequent refeeding affected markers of bone turnover. METHODS In a randomised order, 16 lean men and women completed 2, 48 h trials over 3 days. On day 1, participants consumed a 24 h diet providing 100% [EB: 9.27 (1.43) MJ] or 25% [ER: 2.33 (0.34) MJ] of estimated energy requirements. On day 2, participants consumed a standardised breakfast (08:00), followed by an ad libitum lunch (12:00) and dinner (19:30). Participants then fasted overnight, returning on day 3. Plasma concentrations of C-terminal telopeptide of type I collagen (CTX), procollagen type 1 N-terminal propeptide (P1NP) and parathyroid hormone (PTH) were assessed as indices of bone metabolism after an overnight fast on days 1-3, and for 4 h after breakfast on day 2. RESULTS There were no differences between trials in fasting concentrations of CTX, P1NP or PTH on days 1-3 (P > 0.512). During both trials, consuming breakfast reduced CTX between 1 and 4 h (P < 0.001) and PTH between 1 and 2 h (P < 0.05), but did not affect P1NP (P = 0.773) Postprandial responses for CTX (P = 0.157), P1NP (P = 0.148) and PTH (P = 0.575) were not different between trials. Ad libitum energy intake on day 2 was greater on ER [12.62 (2.46) MJ] than EB [11.91 (2.49) MJ]. CONCLUSIONS Twenty-four hour severe energy restriction does not affect markers of bone metabolism.
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