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Batitucci G, Almeida OG, De Martinis ECP, Solar I, Cintra DE, de Freitas EC. Intermittent fasting and high-intensity interval training do not alter gut microbiota composition in adult women with obesity. Am J Physiol Endocrinol Metab 2024; 327:E241-E257. [PMID: 38922577 DOI: 10.1152/ajpendo.00310.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 06/06/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024]
Abstract
Obesity is advancing at an accelerated pace, and yet its treatment is still an emerging field. Although studies have demonstrated the role of the microbiota in the pathogenesis of obesity, this is the first study to show the effects of intermittent fasting (IF), combined or not with exercise, and high-intensity interval training (HIIT) on the gut microbiota composition in women with obesity. Our hypothesis is that IF combined with HIIT can promote the remodeling of the composition and function of the gut microbiota. Thirty-six women with obesity, aged between 18 and 40 yr, participated in the study. They were randomly divided into three groups: 1) IF associated with HIIT group [IF + exercise group (EX), n = 15]; 2) HIIT group (EX, n = 11); and 3) IF group (IF, n = 10). Interventions took place over 8 wk, and all assessments were performed preintervention and postintervention. The HIIT circuit was performed 3 times/wk, for 25 min/session. The IF protocol was a 5:2 (2 times/wk). Multiplex analysis of inflammatory cytokines, sequencing of the 16S rRNA gene, and gas chromatography to measure fecal concentrations of short-chain fatty acids (SCFAs) were performed. This study was registered on ClinicalTrials.gov (NCT05237154). Exercise increased fecal acetate concentrations (P = 0.04), but no changes were observed in the composition and functional profile of the microbiota. The interventions did not change the composition of the microbiota, but exercise may play a modulatory role in the production of acetate. This investigation provides clinical insights into the use of IF and HIIT for women with obesity.NEW & NOTEWORTHY This is the first investigation about alternate-day fasting combined with HITT on the gut microbiota of obese women. The study contributes to the advancement of human science involving IF and HIIT, popular strategies for managing obesity. Previous evidence has explored IF in modulating the microbiota in animal models or specific populations and clinical conditions. Despite the subtle outcomes, this study has relevance and originality in the field of gut microbiota knowledge.
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Affiliation(s)
- Gabriela Batitucci
- Department of Food and Nutrition, School of Pharmaceutical Sciences of Araraquara, State University of Sao Paulo, Araraquara, Brazil
| | - Otávio G Almeida
- Ribeirão Preto School of Pharmaceutical Sciences, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Elaine C P De Martinis
- Ribeirão Preto School of Pharmaceutical Sciences, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Isabela Solar
- Faculty of Applied Sciences, University of Campinas, Limeira, Brazil
| | - Dennys E Cintra
- Nutritional Genomics Laboratory and Nutrigenomics and Lipids Center, Faculty of Applied Sciences, University of Campinas, Limeira, Brazil
| | - Ellen Cristini de Freitas
- Department of Food and Nutrition, School of Pharmaceutical Sciences of Araraquara, State University of Sao Paulo, Araraquara, Brazil
- Laboratory of Exercise Physiology and Metabolism, School of Physical Education and Sports of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
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Dietvorst C, Kroon J, Slebe R, Serlie MJ, Berk KA, Rutters F. Challenges in Providing an Overview of Results of Intermittent Fasting Interventions on Diabetes Parameters. Comment on Silva et al. Effects of Intermittent Fasting on Regulation of Metabolic Homeostasis: A Systematic Review and Meta-Analysis in Health and Metabolic-Related Disorders. J. Clin. Med. 2023, 12, 3699. J Clin Med 2024; 13:4091. [PMID: 39064131 PMCID: PMC11278055 DOI: 10.3390/jcm13144091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024] Open
Abstract
We hereby comment on the systematic review "Effects of Intermittent Fasting on Regulation of Metabolic Homeostasis: A Systematic Review and Meta-Analysis in Health and Metabolic-Related Disorders" by Silva et al [...].
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Affiliation(s)
- Carmen Dietvorst
- Department of Internal Medicine, Division of Dietetics, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands; (C.D.)
| | - Jur Kroon
- Department of Endocrinology and Metabolism and Amsterdam Gastroenterology Metabolism Endocrinology Institute, Amsterdam University Medical Center, 1081 BT Amsterdam, The Netherlands; (J.K.)
| | - Romy Slebe
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre, 1105 AZ Amsterdam, The Netherlands
| | - Mireille J. Serlie
- Department of Endocrinology and Metabolism and Amsterdam Gastroenterology Metabolism Endocrinology Institute, Amsterdam University Medical Center, 1081 BT Amsterdam, The Netherlands; (J.K.)
- Section of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA
| | - Kirsten A. Berk
- Department of Internal Medicine, Division of Dietetics, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands; (C.D.)
| | - Femke Rutters
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre, 1105 AZ Amsterdam, The Netherlands
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Sun ML, Yao W, Wang XY, Gao S, Varady KA, Forslund SK, Zhang M, Shi ZY, Cao F, Zou BJ, Sun MH, Liu KX, Bao Q, Xu J, Qin X, Xiao Q, Wu L, Zhao YH, Zhang DY, Wu QJ, Gong TT. Intermittent fasting and health outcomes: an umbrella review of systematic reviews and meta-analyses of randomised controlled trials. EClinicalMedicine 2024; 70:102519. [PMID: 38500840 PMCID: PMC10945168 DOI: 10.1016/j.eclinm.2024.102519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/20/2024] Open
Abstract
Background Benefits of Intermittent fasting (IF) on health-related outcomes have been found in a range of randomised controlled trials (RCTs). Our umbrella review aimed to systematically analyze and synthesize the available causal evidence on IF and its impact on specific health-related outcomes while evaluating its evidence quality. Methods We comprehensively searched the PubMed, Embase, Web of Science, and Cochrane databases (from inception up to 8 January 2024) to identify related systematic reviews and meta-analyses of RCTs investigating the association between IF and human health outcomes. We recalculated the effect sizes for each meta-analysis as mean difference (MD) or standardized mean difference (SMD) with corresponding 95% confidence intervals (CIs). Subgroup analyses were performed for populations based on three specific status: diabetes, overweight or obesity, and metabolic syndrome. The quality of systematic reviews was evaluated using A Measurement Tool to Assess Systematic Reviews (AMSTAR), and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. This study is registered with PROSPERO (CRD42023382004). Findings A total of 351 associations from 23 meta-analyses with 34 health outcomes were included in the study. A wide range of outcomes were investigated, including anthropometric measures (n = 155), lipid profiles (n = 83), glycemic profiles (n = 57), circulatory system index (n = 41), appetite (n = 9), and others (n = 6). Twenty-one (91%) meta-analyses with 346 associations were rated as high confidence according to the AMSTAR criteria. The summary effects estimates were significant at p < 0.05 in 103 associations, of which 10 (10%) were supported by high certainty of evidence according to GRADE. Specifically, compared with non-intervention diet in adults with overweight or obesity, IF reduced waist circumference (WC) (MD = -1.02 cm; 95% CI: -1.99 to -0.06; p = 0.038), fat mass (MD = -0.72 kg; 95% CI: -1.32 to -0.12; p = 0.019), fasting insulin (SMD = -0.21; 95% CI: -0.40 to -0.02; p = 0.030), low-density lipoprotein cholesterol (LDL-C) (SMD = -0.20; 95% CI: -0.38 to -0.02; p = 0.027), total cholesterol (TC) (SMD = -0.29; 95% CI: -0.48 to -0.10; p = 0.003), and triacylglycerols (TG) (SMD = -0.23; 95% CI: -0.39 to -0.06; p = 0.007), but increased fat free mass (FFM) (MD = 0.98 kg; 95% CI: 0.18-1.78; p = 0.016). Of note, compared with the non-intervention diet, modified alternate-day fasting (MADF) reduced fat mass (MD = -0.70 kg; 95% CI: -1.38 to -0.02; p = 0.044). In people with overweight or obesity, and type 2 diabetes, IF increases high-density lipoprotein cholesterol (HDL-C) levels compared to continuous energy restriction (CER) (MD = 0.03 mmol/L; 95% CI: 0.01-0.05; p = 0.010). However, IF was less effective at reducing systolic blood pressure (SBP) than a CER diet in adults with overweight or obesity (SMD = 0.21; 95% CI: 0.05-0.36; p = 0.008). Interpretation Our findings suggest that IF may have beneficial effects on a range of health outcomes for adults with overweight or obesity, compared to CER or non-intervention diet. Specifically, IF may decreased WC, fat mass, LDL-C, TG, TC, fasting insulin, and SBP, while increasing HDL-C and FFM. Notably, it is worth noting that the SBP lowering effect of IF appears to be weaker than that of CER. Funding This work was supported by the National Key Research and Development Program of China (Q-JW), the Natural Science Foundation of China (Q-JW and T-TG), Outstanding Scientific Fund of Shengjing Hospital of China Medical University (Q-JW), and 345 Talent Project of Shengjing Hospital of China Medical University (T-TG).
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Affiliation(s)
- Ming-Li Sun
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei Yao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao-Ying Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Krista A. Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Sofia K. Forslund
- Experimental and Clinical Research Center, A Cooperation of Charité-Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Max Delbruck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Miao Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zan-Yu Shi
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fan Cao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bing-Jie Zou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ming-Hui Sun
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ke-Xin Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi Bao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jin Xu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xue Qin
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qian Xiao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lang Wu
- Cancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - De-Yu Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of Advanced Reproductive Medicine and Fertility (China Medical University), National Health Commission, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Nussbaumer H, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Dietary Recommendations for Persons with Type 2 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2024; 132:182-215. [PMID: 38286422 DOI: 10.1055/a-2166-6772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Affiliation(s)
- Thomas Skurk
- ZIEL Institute for Food & Health, Technical University of Munich, Freising, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition, Faculty of Agriculture and Nutritional Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | | | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
- German Center for Diabetes Research (DZD), Munich, Germany
| | - Winfried Keuthage
- Specialist Practice for Diabetes and Nutritional Medicine, Münster, Germany
| | - Peter Kronsbein
- Faculty of Nutrition and Food Sciences, Niederrhein University of Applied Sciences, Mönchengladbach Campus, Mönchengladbach, Germany
| | - Karsten Müssig
- Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | | | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Astrid Tombek
- Diabetes Centre Bad Mergentheim, Bad Mergentheim, Germany
| | - Katharina S Weber
- Institute for Epidemiology, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany
- Vivantes Humboldt Hospital, Berlin, Germany
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5
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Yao K, Su H, Cui K, Gao Y, Xu D, Wang Q, Ha Z, Zhang T, Chen S, Liu T. Effectiveness of an intermittent fasting diet versus regular diet on fat loss in overweight and obese middle-aged and elderly people without metabolic disease: a systematic review and meta-analysis of randomized controlled trials. J Nutr Health Aging 2024; 28:100165. [PMID: 38308923 DOI: 10.1016/j.jnha.2024.100165] [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: 08/28/2023] [Accepted: 12/31/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVE As the number of adults aged over 40 with obesity increases dramatically, intermittent fasting interventions (IF) may help them to lose fat and weight. This systematic review investigated the most recent research on the effects of intermittent fasting and a regular diet on body composition and lipids in adults aged over 40 with obesity without the metabolic disease. DATA SOURCES Randomized controlled trials (RCTs) on IF on adults aged over 40 with obesity were retrieved from PubMed, Web of Science, EBSCO, China Knowledge Network (CNKI), VIP database, Wanfang database with the experimental group using IF and the control group using a regular diet. Revman was used for meta-analysis. Effect sizes are expressed as weighted mean differences (WMD) and 95% confidence intervals (CI). STUDY SELECTION A total of 9 articles of randomised controlled trials that met the requirements were screened for inclusion. Studies typically lasted 2-6 weeks. The experimental population was aged 42-66 years, with a BMI range of 25.7-35 kg/m2. SYNTHESIS A total of 9 RCTs were included. meta-analysis showed that body weight (MD: -2.05 kg; 95% CI (-3.84, -0.27); p = 0.02), BMI (MD: -0.73 kg/m2; 95% CI (-1.05, -0.41); p < 0.001), fat mass (MD: -2.14 kg; 95% CI (-3.81, 0.47); p = 0.01), and TG (MD = -0.32 mmol/L, 95% CI (-0.50, -0.15, p < 0.001) were significantly lower in the experimental group than in the control group. No significant reduction in lean body mass (MD: -0.31 kg; 95% CI (-0.96, 0.34); p = 0.35). CONCLUSION IF had a reduction in body weight, BMI, fat mass, and TG in adults aged over 40 with obesity without metabolic disease compared to RD, and IF did not cause a significant decrease in lean body mass, which suggests healthy and effective fat loss. However, more long-term and high-quality trials are needed to reach definitive conclusions.
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Affiliation(s)
- Ke Yao
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Hao Su
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China.
| | - Kaiyin Cui
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Ye Gao
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Dengyun Xu
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Qian Wang
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Zhitong Ha
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Teng Zhang
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Shuning Chen
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Tao Liu
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
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6
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Lange MG, Coffey AA, Coleman PC, Barber TM, Van Rens T, Oyebode O, Abbott S, Hanson P. Metabolic changes with intermittent fasting. J Hum Nutr Diet 2024; 37:256-269. [PMID: 37786321 PMCID: PMC10953463 DOI: 10.1111/jhn.13253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/29/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND The prevalence of obesity is rising globally and effective strategies to treat obesity are needed. Intermittent fasting, a dietary intervention for weight management, has received growing interest from the general public, as well as healthcare professionals, as a form of lifestyle intervention. METHODS We executed a rapid review using PUBMED database to identify systematic reviews that examined the impact of intermittent fasting on metabolic indices, published between 2011 and 2022. RESULTS Intermittent fasting leads to weight loss of a similar magnitude to continuous energy restriction. Most of the evidence shows that intermittent fasting leads to greater fat loss as measured by fat mass (kg) or body fat percentage compared to an ad libitum diet, but fat loss attained during intermittent fasting is not significantly different to continuous energy restriction, although recent evidence shows intermittent fasting to be superior. There is mixed evidence for the impact of intermittent fasting on insulin resistance, fasting glucose and lipid profile. Some studies focused on populations of Muslim people, which showed that Ramadan fasting may lead to weight loss and improvement of metabolic parameters during fasting, although the effects are reversed when fasting is finished. CONCLUSIONS Intermittent fasting is more effective than an ad libitum dietary intake, and equally or more effective as continuous energy restriction, for weight management. However, there is inconclusive evidence on whether intermittent fasting has a clinically beneficial effect on glucose and lipid metabolism.
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Affiliation(s)
- Maria G. Lange
- Warwick Medical SchoolUniversity of WarwickCoventryUK
- Warwickshire Institute for the Study of Diabetes Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | | | | | - Thomas M. Barber
- Warwick Medical SchoolUniversity of WarwickCoventryUK
- Warwickshire Institute for the Study of Diabetes Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | | | - Oyinlola Oyebode
- Wolfson Institute of Population HealthQueen Mary University of LondonLondonUK
| | - Sally Abbott
- Department of DieteticsUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
- Research Centre for Intelligent HealthcareCoventry UniversityCoventryUK
| | - Petra Hanson
- Warwick Medical SchoolUniversity of WarwickCoventryUK
- Warwickshire Institute for the Study of Diabetes Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
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7
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Schroor MM, Joris PJ, Plat J, Mensink RP. Effects of Intermittent Energy Restriction Compared with Those of Continuous Energy Restriction on Body Composition and Cardiometabolic Risk Markers - A Systematic Review and Meta-Analysis of Randomized Controlled Trials in Adults. Adv Nutr 2024; 15:100130. [PMID: 37827491 PMCID: PMC10831889 DOI: 10.1016/j.advnut.2023.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/21/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023] Open
Abstract
The interest in intermittent energy restriction (IER) diets as a weight-loss approach is increasing. Different IER protocols exist, including time-restricted eating (TRE), alternate-day fasting (ADF), and the 5:2 diet. This meta-analysis compared the effects of these IER diets with continuous energy restriction (CER) on anthropometrics and cardiometabolic risk markers in healthy adults. Twenty-eight trials were identified that studied TRE (k = 7), ADF (k = 10), or the 5:2 diet (k = 11) for 2-52 wk. Energy intakes between intervention groups within a study were comparable (17 trials), lower in IER (5 trials), or not reported (6 trials). Weighted mean differences (WMDs) were calculated using fixed- or random-effects models. Changes in body weight [WMD: -0.42 kg; 95% confidence interval (CI): -0.96 to 0.13; P = 0.132] and fat mass (FM) (WMD: -0.31 kg; 95% CI: -0.98 to 0.36; P = 0.362) were comparable when results of the 3 IER diets were combined and compared with those of CER. All IER diets combined reduced fat-free mass (WMD: -0.20 kg; 95% CI: -0.39 to -0.01; P = 0.044) and waist circumference (WMD: -0.91 cm; 95% CI: -1.76 to -0.06; P = 0.036) more than CER. Effects on body mass index [BMI (kg/m2)], glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), serum lipid and lipoprotein concentrations, and blood pressure did not differ. Further, TRE reduced body weight, FM, and fat-free mass more than CER, whereas ADF improved HOMA-IR more. BMI was reduced less in the 5:2 diet compared with CER. In conclusion, the 3 IER diets combined did not lead to superior improvements in anthropometrics and cardiometabolic risk markers compared with CER diets. Slightly greater reductions were, however, observed in fat-free mass and waist circumference. To what extent differences in energy intakes between groups within studies may have influenced these outcomes should be addressed in future studies.
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Affiliation(s)
- Maite M Schroor
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
| | - Peter J Joris
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Jogchum Plat
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Ronald P Mensink
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
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8
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Abstract
Overweight and obesity are an important public health problem that affects a significant part of the world population and increases the risk of many metabolic diseases. Weight loss is the primary goal in obesity treatment, and many different dietary interventions are tried for this purpose. Intermittent fasting is a diet that has become popular in recent years with the weight loss it provides and includes periods of fasting and feeding. In addition to providing weight loss, intermittent fasting also has positive effects on important risk factors such as glucoregulatory parameters, blood lipids, and oxidative stress. Intermittent fasting appears to be an effective and safe way to achieve weight loss in obesity. It could also have therapeutic effects on obesity-related diseases. The aim of this review was to bring together up-to-date information on the effects of intermittent fasting on obesity and various obesity-related diseases, mechanisms of action, possible benefits and harms, and potential uses.
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Affiliation(s)
- Caner Özyildirim
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Türkiye -
| | - Asli Uçar
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Türkiye
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9
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Maki KC, Kirkpatrick CF, Allison DB, Gadde KM. Pharmacotherapy for obesity: recent evolution and implications for cardiovascular risk reduction. Expert Rev Endocrinol Metab 2023; 18:307-319. [PMID: 37199542 DOI: 10.1080/17446651.2023.2209176] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Obesity is highly prevalent in the U.S. and is associated with an increased risk of major adverse cardiovascular events (MACE). Modalities for the management of obesity include lifestyle intervention, pharmacotherapy, and bariatric surgery. AREAS COVERED This review describes the evidence on the effects of weight loss therapies on MACE risk. Lifestyle interventions and older antiobesity pharmacotherapies have been associated with <12% body weight reduction and no clear benefit to reduce MACE risk. Bariatric surgery is associated with substantial weight reduction (20-30%) and markedly lower subsequent risk for MACE. Newer antiobesity pharmacotherapies, particularly semaglutide and tirzepatide, have shown greater efficacy for weight reduction compared with older medications and are being evaluated in cardiovascular outcomes trials. EXPERT OPINION Current practice for cardiovascular risk reduction in patients with obesity is lifestyle intervention for weight loss, combined with the treatment of obesity-related cardiometabolic risk factors individually. The use of medications to treat obesity is relatively rare. In part, this reflects concerns about long-term safety and weight loss effectiveness, possible provider bias, as well as lack of clear evidence of MACE risk reduction. If ongoing outcomes trials demonstrate the efficacy of newer agents in reducing MACE risk, this will likely lead to expanded use in obesity management.
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Affiliation(s)
- Kevin C Maki
- Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
- Midwest Biomedical Research, Addison, IL, USA
| | - Carol F Kirkpatrick
- Midwest Biomedical Research, Addison, IL, USA
- Idaho State University, Pocatello, ID, USA
| | - David B Allison
- Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
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10
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Li Z, Wu X, Gao H, Xiang T, Zhou J, Zou Z, Tong L, Yan B, Zhang C, Wang L, Wang W, Yang T, Li F, Ma H, Zhao X, Mi N, Yu Z, Li H, Zeng Q, Li Y. Intermittent energy restriction changes the regional homogeneity of the obese human brain. Front Neurosci 2023; 17:1201169. [PMID: 37600013 PMCID: PMC10434787 DOI: 10.3389/fnins.2023.1201169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
Background Intermittent energy restriction (IER) is an effective weight loss strategy. However, the accompanying changes in spontaneous neural activity are unclear, and the relationship among anthropometric measurements, biochemical indicators, and adipokines remains ambiguous. Methods Thirty-five obese adults were recruited and received a 2-month IER intervention. Data were collected from anthropometric measurements, blood samples, and resting-state functional magnetic resonance imaging at four time points. The regional homogeneity (ReHo) method was used to explore the effects of the IER intervention. The relationships between the ReHo values of altered brain regions and changes in anthropometric measurements, biochemical indicators, and adipokines (leptin and adiponectin) were analyzed. Results Results showed that IER significantly improved anthropometric measurements, biochemical indicators, and adipokine levels in the successful weight loss group. The IER intervention for weight loss was associated with a significant increase in ReHo in the bilateral lingual gyrus, left calcarine, and left postcentral gyrus and a significant decrease in the right middle temporal gyrus and right cerebellum (VIII). Follow-up analyses showed that the increase in ReHo values in the right LG had a significant positive correlation with a reduction in Three-factor Eating Questionnaire (TFEQ)-disinhibition and a significant negative correlation with an increase in TFEQ-cognitive control. Furthermore, the increase in ReHo values in the left calcarine had a significant positive correlation with the reduction in TFEQ-disinhibition. However, no significant difference in ReHo was observed in the failed weight loss group. Conclusion Our study provides objective evidence that the IER intervention reshaped the ReHo of some brain regions in obese individuals, accompanied with improved anthropometric measurements, biochemical indicators, and adipokines. These results illustrated that the IER intervention for weight loss may act by decreasing the motivational drive to eat, reducing reward responses to food cues, and repairing damaged food-related self-control processes. These findings enhance our understanding of the neurobiological basis of IER for weight loss in obesity.
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Affiliation(s)
- Zhonglin Li
- Department of Radiology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Xiaoling Wu
- Department of Nuclear Medicine, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Hui Gao
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Tianyuan Xiang
- Health Mangement Institute, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jing Zhou
- Department of Nephrology, Henan Provincial Clinical Research Center for Kidney Disease, Henan Provincial Key Laboratory of Kidney Disease and Immunology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, China
| | - Zhi Zou
- Department of Radiology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Li Tong
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Bin Yan
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Chi Zhang
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Linyuan Wang
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Wen Wang
- Department of Nutrition, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Tingting Yang
- Department of Nutrition, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Fengyun Li
- Department of Health Management, Henan Key Laboratory of Chronic Disease Management, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Huimin Ma
- Department of Health Management, Henan Key Laboratory of Chronic Disease Management, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Xiaojuan Zhao
- Department of Health Management, Henan Key Laboratory of Chronic Disease Management, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Na Mi
- Department of Health Management, Henan Key Laboratory of Chronic Disease Management, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Ziya Yu
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Hao Li
- Department of Oral Health Management, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Qiang Zeng
- Health Mangement Institute, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yongli Li
- Department of Health Management, Henan Key Laboratory of Chronic Disease Management, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
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11
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Wang H, Song W, Yuan W, Zhou Q, Sadiq FA, Zhao J, Wu W, Lu W. Modulating the Human Gut Microbiota through Hypocaloric Balanced Diets: An Effective Approach for Managing Obesity. Nutrients 2023; 15:3101. [PMID: 37513521 PMCID: PMC10383620 DOI: 10.3390/nu15143101] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
This study aimed to investigate the effects of a hypocaloric balanced diet (HBD) on anthropometric measures and gut microbiota of 43 people with obesity. Fecal samples were collected from the study subjects at weeks 0 and 12, and a detailed analysis of gut microbiota was performed using 16S rRNA gene sequencing. By comparing anthropometric measures and microbiota changes in subjects before and after the HBD intervention, we revealed the potential effects of HBD on weight loss and gut microbiota. Our results indicated that the HBD resulted in a significant decrease in body mass index (BMI), and most of the physiological indicators were decreased to a greater degree in the effective HBD group (EHBD, weight loss ≥ 5%) than in the ineffective HBD group (IHBD, weight loss < 5%). The HBD intervention also modified the gut microbiota of the subjects with obesity. Specifically, Blautia, Lachnoclostridium, Terrisporobacter, Ruminococcus (R. torques, R. gnavus), and Pseudomonas were significantly reduced. In addition, we employed machine learning models, such as XGBRF and GB models, to rank the importance of various features and identified the top 10 key bacterial genera involved. Gut microbiota co-occurrence networks showed the dominance of healthier microbiota following successful weight loss. These results suggested that the HBD intervention enhanced weight loss, which may be related to diet-induced changes in the gut microbiota.
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Affiliation(s)
- Hongchao Wang
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Wenyan Song
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Weiwei Yuan
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Qunyan Zhou
- Department of Nutriology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - Faizan Ahmed Sadiq
- Technology and Food Science Unit, Flanders Research Institute for Agriculture, Fisheries and Food (ILVO), 9090 Melle, Belgium
| | - Jianxin Zhao
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Wenjun Wu
- Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - Wenwei Lu
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
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12
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Klammer C, Schindler K, Bugl R, Plazek D, Vötter M, Kirchner T, Martino C, Klammer-Martin J, Brix J, Dämon S, Hoppichler F, Kautzky-Willer A, Kruschitz R, Toplak H, Clodi M, Ludvik B. [Nutrition for diabetic patients (Update 2023)]. Wien Klin Wochenschr 2023; 135:62-77. [PMID: 37101026 PMCID: PMC10133079 DOI: 10.1007/s00508-023-02170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 04/28/2023]
Abstract
All patients with diabetes require individual and personalized nutritional consultation with professionals. The patient's needs should be the primary focus of the dietary therapy, taking their lifestyle and the type of diabetes into consideration. With the recommendations to the patient's diet, there need to be specific metabolic goals to reduce the disease's progression and to avoid long term health effects. Therefore, practical guidelines such as portion size and meal planning tips should be the main focus.According to the latest national and international standards, patients suffering from diabetes should have access to nutrition consulting and nutritional training. During consultation they can be supported on- how to manage their health condition and choosing food and beverage to improve their health.These practical recommendations sum up the latest literature on nutritional aspects of diabetes treatment.
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Affiliation(s)
- Carmen Klammer
- Abteilung für Innere Medizin, Konventhospital der Barmherzigen Brüder Linz, Linz, Österreich
- ICMR - Institute of Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz, Altenberger Straße 69, 4040, Linz, Österreich
| | - Karin Schindler
- Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz, Wien, Österreich
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Rita Bugl
- Wiener Gesundheitsverband Klinik Ottakring, Wien, Österreich
| | | | | | - Tanja Kirchner
- Österreichische Gesundheitskasse Mein Peterhof Baden, Baden, Österreich
| | - Claudia Martino
- Österreichische Gesundheitskasse Mein Gesundheitszentrum Floridsdorf, Wien, Österreich
| | | | - Johanna Brix
- Medizinische Abteilung mit Diabetologie, Endokrinologie und Nephrologie, Klinik Landstraße, Wien, Österreich
| | - Sabine Dämon
- Special Institute for Preventive Cardiology and Nutrition, SIPCAN - Initiative für ein gesundes Leben, Elsbethen/Salzburg, Österreich
| | - Friedrich Hoppichler
- Special Institute for Preventive Cardiology and Nutrition, SIPCAN - Initiative für ein gesundes Leben, Elsbethen/Salzburg, Österreich
- Abteilung für Innere Medizin, Krankenhaus der Barmherzigen Brüder Salzburg, Salzburg, Österreich
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Renate Kruschitz
- Abteilung für Innere Medizin, Krankenhaus der Elisabethinen, Klagenfurt, Österreich
| | - Hermann Toplak
- Klinische Abteilung für Endokrinologie und Diabetologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich
| | - Martin Clodi
- Abteilung für Innere Medizin, Konventhospital der Barmherzigen Brüder Linz, Linz, Österreich.
- ICMR - Institute of Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz, Altenberger Straße 69, 4040, Linz, Österreich.
| | - Bernhard Ludvik
- Medizinische Abteilung mit Diabetologie, Endokrinologie und Nephrologie, Klinik Landstraße, Wien, Österreich
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13
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Cook F, Langdon-Daly J, Serpell L. Compliance of participants undergoing a '5-2' intermittent fasting diet and impact on body weight. Clin Nutr ESPEN 2022; 52:257-261. [PMID: 36513463 DOI: 10.1016/j.clnesp.2022.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/26/2022] [Accepted: 08/08/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Intermittent fasting (IF) has grown in popularity as a weight loss tool, where caloric intake is fully/partially restricted on a recurring basis. This study aimed to assess compliance with IF fast-day calorie restriction and whether 5-2 IF leads to reduced overall energy intake, weight loss and compensatory increased energy intake on non-fast days. METHOD Participants completed diet diaries at baseline and 28 days post 5-2 IF in a repeated measures within-subjects design. 5-2 IF required restricted energy intake to 500 kcal/day (women), 650 kcal/day (men) on two 'fast' days/week whilst eating ad-libitum on other days. RESULTS 52 participants were included (n = 42 female; age 44 ± 11.2yrs). Median weight loss after 28 days 5-2 IF was statistically significant (1.8 [-2 - 7.3 IQR = 2.2]kg; 2.8 [-2.7-11.2 IQR = 2.5]% p < 0.001). There was a significant reduction in total energy intake during 5-2 IF compared with pre-diet (median 1288.0 [IQR 423.8]kcal and median 1751.5 [IQR 505.3]kcal respectively, p < 0.001). Carbohydrate, protein and fat consumption proportionately reduced during 5-2 IF. Participants had significantly higher energy intake (p < 0.001) on non-fast days that followed a fast day (1928.4 ± 711.9 kcal) compared to non-fast days not following a fast day (1316.2 ± 310.0 kcal). 55.8% complied with fast day calorie restrictions. CONCLUSION 5-2 IF was associated with significantly reduced energy intake, and weight loss over a 28-day period. Compliance rate was lower than most previous studies. Participants had significantly higher energy intake on non-fast days following fast days suggesting fasting may lead to over-compensation. Further research should investigate strategies to improve compliance and long-term sustainability of IF diets.
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Affiliation(s)
- Florence Cook
- Division of Medicine, University College London, London, WC1E 6BT, UK; Department of Nutrition & Dietetics, University College London Hospital NHS Foundation Trust, London, NW1 2PG, UK.
| | - Jasmin Langdon-Daly
- Division of Psychology & Language Sciences, University College London, London, WC1E 6BT, UK
| | - Lucy Serpell
- Division of Psychology & Language Sciences, University College London, London, WC1E 6BT, UK
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14
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Does Timing Matter? A Narrative Review of Intermittent Fasting Variants and Their Effects on Bodyweight and Body Composition. Nutrients 2022; 14:nu14235022. [PMID: 36501050 PMCID: PMC9736182 DOI: 10.3390/nu14235022] [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: 10/21/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
The practice of fasting recently has been purported to have clinical benefits, particularly as an intervention against obesity and its related pathologies. Although a number of different temporal dietary restriction strategies have been employed in practice, they are generally classified under the umbrella term "intermittent fasting" (IF). IF can be stratified into two main categories: (1) intra-weekly fasting (alternate-day fasting/ADF, twice-weekly fasting/TWF) and (2) intra-daily fasting (early time-restricted eating/eTRE and delayed time-restricted eating/dTRE). A growing body of evidence indicates that IF is a viable alternative to daily caloric restriction (DCR), showing effectiveness as a weight loss intervention. This paper narratively reviews the literature on the effects of various commonly used IF strategies on body weight and body composition when compared to traditional DCR approaches, and draws conclusions for their practical application. A specific focus is provided as to the use of IF in combination with regimented exercise programs and the associated effects on fat mass and lean mass.
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15
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Alternate day fasting on subjective feelings of appetite and body weight for adults with overweight or obesity: a systematic review. J Nutr Sci 2022; 11:e94. [PMID: 36405095 PMCID: PMC9641525 DOI: 10.1017/jns.2022.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/08/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Alternate day fasting (ADF) with consumption of calories up to 25 % of the daily energy intake on fast days is one of the most used intermittent fasting regimens and promoted as a promising, alternative approach for treating obesity. Feelings of appetite are critical for adherence to dietary approaches, and therefore the success of dietary interventions. This systematic review aimed to assess the effects of a minimum of 8 weeks of ADF on subjective feelings of appetite and body weight for adults with overweight and obesity. We conducted the review in accordance with the Cochrane guidelines, including systematic searches in four databases. Because of the high level of clinical and methodological heterogeneity, a narrative approach was used to synthesise the results. Eight studies with a total of 456 participants met the eligibility criteria: three randomised controlled trials and five uncontrolled before-after studies. Seven of the studies had high risk of bias. Feelings of appetite were assessed by hunger in eight studies, fullness in seven studies, satisfaction in four studies and desire to eat in one study. All the studies assessed weight loss. The certainty of the evidence was rated low or very low for all outcomes, thus no firm conclusions can be drawn about the potential benefits of ADF on subjective feelings of appetite and body weight. Despite the high interest in ADF, good quality evidence is still needed to determine its effectiveness and if offered in clinical practice, ADF should be offered cautiously while concomitantly evaluated.
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16
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Li X, Nian B, Li R, Cao X, Liu Y, Liu Y, Xu YJ. Fasting and metabolic syndrome: A systematic review and Meta-analyses. Crit Rev Food Sci Nutr 2022; 64:1836-1844. [PMID: 36069291 DOI: 10.1080/10408398.2022.2119362] [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] [Indexed: 11/03/2022]
Abstract
Objective: Fasting is considered to be a food structure that can improve body health. Several randomized clinical trials (RCTs) have investigated the effects of fasting in patients with metabolic syndrome (MS). In this review, we performed a meta-analysis to assess the effects of fasting on patients with MS. Methods: Following PRISMA guidelines, a systematic literature search was conducted in PubMed, Embase, and Cochrane Central updated to September 2021. The quality evaluation and heterogeneity detection of the included research literature were carried out by Revman and Stata software through a random-effects model. Results: A total of 268 subjects were included. The pooled results revealed that fasting significantly reduced body weight (WMD: -2.48 kg, 95% CI: -3.22, -1.74), BMI (WMD = -2.72 cm; 95%CI: -4.04, -1.40 cm), body fat percent (WMD: -1.57%, 95%CI: -2.47, -0.68), insulin level (WMD: -2.45 mmol/L; 95%CI: -4.40, -0.49 mmol/L) and HOMA-IR (WMD:-0.65 mmol/L; 95%CI: -0.90, -0.41 mmol/L) in patients with MS, whereas had no effect on glucose, blood pressure and lipids profile. Conclusions: Our findings provide insights into the effect of fasting on the anthropometric outcomes, insulin resistance, and gut microbiota in MS.
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Affiliation(s)
- Xue Li
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, National Engineering Research Center for Functional Food, National Engineering Laboratory for Cereal Fermentation Technology, Collaborative Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, Jiangsu, China
| | - Binbin Nian
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, National Engineering Research Center for Functional Food, National Engineering Laboratory for Cereal Fermentation Technology, Collaborative Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, Jiangsu, China
| | - Ruizhi Li
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, National Engineering Research Center for Functional Food, National Engineering Laboratory for Cereal Fermentation Technology, Collaborative Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, Jiangsu, China
| | - Xinyu Cao
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, National Engineering Research Center for Functional Food, National Engineering Laboratory for Cereal Fermentation Technology, Collaborative Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, Jiangsu, China
| | - Yanjun Liu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, National Engineering Research Center for Functional Food, National Engineering Laboratory for Cereal Fermentation Technology, Collaborative Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, Jiangsu, China
| | - Yuanfa Liu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, National Engineering Research Center for Functional Food, National Engineering Laboratory for Cereal Fermentation Technology, Collaborative Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, Jiangsu, China
| | - Yong-Jiang Xu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, National Engineering Research Center for Functional Food, National Engineering Laboratory for Cereal Fermentation Technology, Collaborative Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, Jiangsu, China
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Saha A, Hamilton-Reeves J, DiGiovanni J. White adipose tissue-derived factors and prostate cancer progression: mechanisms and targets for interventions. Cancer Metastasis Rev 2022; 41:649-671. [PMID: 35927363 PMCID: PMC9474694 DOI: 10.1007/s10555-022-10056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/27/2022] [Indexed: 12/01/2022]
Abstract
Obesity represents an important risk factor for prostate cancer, driving more aggressive disease, chemoresistance, and increased mortality. White adipose tissue (WAT) overgrowth in obesity is central to the mechanisms that lead to these clinical observations. Adipose stromal cells (ASCs), the progenitors to mature adipocytes and other cell types in WAT, play a vital role in driving PCa aggressiveness. ASCs produce numerous factors, especially chemokines, including the chemokine CXCL12, which is involved in driving EMT and chemoresistance in PCa. A greater understanding of the impact of WAT in obesity-induced progression of PCa and the underlying mechanisms has begun to provide opportunities for developing interventional strategies for preventing or offsetting these critical events. These include weight loss regimens, therapeutic targeting of ASCs, use of calorie restriction mimetic compounds, and combinations of compounds as well as specific receptor targeting strategies.
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Affiliation(s)
- Achinto Saha
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX, 78723, USA
- Center for Molecular Carcinogenesis and Toxicology, The University of Texas at Austin, Austin, TX, 78723, USA
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, 78723, USA
| | - Jill Hamilton-Reeves
- Departments of Urology and Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - John DiGiovanni
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX, 78723, USA.
- Center for Molecular Carcinogenesis and Toxicology, The University of Texas at Austin, Austin, TX, 78723, USA.
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, 78723, USA.
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Dell Pediatric Research Institute, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA.
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18
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Keenan S, Cooke MB, Chen WS, Wu S, Belski R. The Effects of Intermittent Fasting and Continuous Energy Restriction with Exercise on Cardiometabolic Biomarkers, Dietary Compliance, and Perceived Hunger and Mood: Secondary Outcomes of a Randomised, Controlled Trial. Nutrients 2022; 14:3071. [PMID: 35893925 PMCID: PMC9370806 DOI: 10.3390/nu14153071] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Excess weight in the form of adiposity plays a key role in the pathogenesis of cardiometabolic diseases. Lifestyle modifications that incorporate continuous energy restriction (CER) are effective at inducing weight loss and reductions in adiposity; however, prescribing daily CER results in poor long-term adherence. Over the past decade, intermittent fasting (IF) has emerged as a promising alternative to CER that may promote increased compliance and/or improvements in cardiometabolic health parameters independent of weight loss. (2) Methods: This paper presents a secondary analysis of data from a 12-week intervention investigating the effects of a twice-weekly fast (5:2 IF; IFT group) and CER (CERT group) when combined with resistance exercise in 34 healthy participants (17 males and 17 females, mean BMI: 27.0 kg/m2, mean age: 23.9 years). Specifically, changes in cardiometabolic blood markers and ratings of hunger, mood, energy and compliance within and between groups were analysed. Dietary prescriptions were hypoenergetic and matched for energy and protein intake. (3) Results: Both dietary groups experienced reductions in total cholesterol (TC; mean reduction, 7.8%; p < 0.001), low-density lipoprotein cholesterol (LDL-C; mean reduction, 11.1%; p < 0.001) and high-density lipoprotein cholesterol (mean reduction 2.6%, p = 0.049) over the 12 weeks. Reductions in TC and LDL-C were greater in the IFT group after adjustment for baseline levels and change in weight. No significant changes in markers of glucose regulation were observed. Both groups maintained high levels of dietary compliance (~80%) and reported low levels of hunger over the course of the intervention period. (4) Conclusions: Secondary data analysis revealed that when combined with resistance training, both dietary patterns improved blood lipids, with greater reductions observed in the IFT group. High levels of compliance and low reported levels of hunger throughout the intervention period suggest both diets are well tolerated in the short-to-medium term.
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Affiliation(s)
- Stephen Keenan
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia; (M.B.C.); (W.S.C.); (S.W.); (R.B.)
| | - Matthew B. Cooke
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia; (M.B.C.); (W.S.C.); (S.W.); (R.B.)
| | - Won Sun Chen
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia; (M.B.C.); (W.S.C.); (S.W.); (R.B.)
| | - Sam Wu
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia; (M.B.C.); (W.S.C.); (S.W.); (R.B.)
| | - Regina Belski
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia; (M.B.C.); (W.S.C.); (S.W.); (R.B.)
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia
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19
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Wang J, Wang F, Chen H, Liu L, Zhang S, Luo W, Wang G, Hu X. Comparison of the Effects of Intermittent Energy Restriction and Continuous Energy Restriction among Adults with Overweight or Obesity: An Overview of Systematic Reviews and Meta-Analyses. Nutrients 2022; 14:nu14112315. [PMID: 35684119 PMCID: PMC9183159 DOI: 10.3390/nu14112315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/28/2022] [Accepted: 05/29/2022] [Indexed: 02/05/2023] Open
Abstract
There is considerable heterogeneity across the evidence regarding the effects of intermittent energy restriction and continuous energy restriction among adults with overweight or obesity which presents difficulties for healthcare decision-makers and individuals. This overview of systematic reviews aimed to evaluate and synthesize the existing evidence regarding the comparison of the two interventions. We conducted a search strategy in eight databases from the databases’ inception to December 2021. The quality of 12 systematic reviews was assessed with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE). One review was rated as high quality, 1 as moderate, 4 as low, and 6 as critically low. A meta-analysis of the original studies was conducted for comparison of primary intermittent energy restriction protocols with continuous energy restriction. Intermittent energy restriction did not seem to be more effective in weight loss compared with continuous energy restriction. The advantages of intermittent energy restriction in reducing BMI and waist circumference and improvement of body composition were not determined due to insufficient evidence. The evidence quality of systematic reviews and original trials remains to be improved in future studies.
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Affiliation(s)
| | | | | | | | | | | | - Guan Wang
- Correspondence: (G.W.); (X.H.); Tel.: +86-028-85421373 (X.H.); Fax: +86-028-85582944 (X.H.)
| | - Xiuying Hu
- Correspondence: (G.W.); (X.H.); Tel.: +86-028-85421373 (X.H.); Fax: +86-028-85582944 (X.H.)
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20
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Dietary recommendations for persons with type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes 2022; 130:S151-S184. [PMID: 35359013 DOI: 10.1055/a-1624-5095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Thomas Skurk
- ZIEL Institute for Food & Health, Technical University of Munich, Freising, Germany.,Else Kröner-Fresenius-Center for Nutritional Medicine, Technical University of Munich, Freising, Germany
| | - Anja Bosy-Westphal
- Institute for Human Nutrition, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany.,Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.,German Center for Diabetes Research (DZD), Munich, Germany
| | - Winfried Keuthage
- Focus Practice for Diabetes and Nutritional Medicine, Münster, Germany
| | - Peter Kronsbein
- Department of Ecotrophology, Niederrhein University of Applied Sciences, Mönchengladbach Campus, Germany
| | - Karsten Müssig
- Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | | | - Katharina S Weber
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany.,Vivantes Humboldt Hospital, Berlin, Germany
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21
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Röhling M, Kempf K, Banzer W, Braumann KM, Führer-Sakel D, Halle M, McCarthy D, Martin S, Scholze J, Toplak H, Berg A, Predel HG. A High-Protein and Low-Glycemic Formula Diet Improves Blood Pressure and Other Hemodynamic Parameters in High-Risk Individuals. Nutrients 2022; 14:nu14071443. [PMID: 35406053 PMCID: PMC9003071 DOI: 10.3390/nu14071443] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 02/04/2023] Open
Abstract
Low-caloric formula diets can improve hemodynamic parameters of patients with type 2 diabetes. We, therefore, hypothesized that persons with overweight or obesity can benefit from a high-protein, low-glycemic but moderate-caloric formula diet. This post-hoc analysis of the Almased Concept against Overweight and Obesity and Related Health Risk- (ACOORH) trial investigated the impact of a lifestyle intervention combined with a formula diet (INT, n = 308) compared to a control group with lifestyle intervention alone (CON, n = 155) on hemodynamic parameters (systolic and diastolic blood pressure (SBP, DBP), resting heart rate (HR), and pulse wave velocity (PWV)) in high-risk individuals with prehypertension or hypertension. INT replaced meals during the first 6 months (1 week: 3 meals/day; 2−4 weeks: 2 meals/day; 5−26 weeks: 1 meal/day). Study duration was 12 months. From the starting cohort, 304 (68.3%, INT: n = 216; CON: n = 101) participants had a complete dataset. Compared to CON, INT significantly reduced more SBP (−7.3 mmHg 95% CI [−9.2; −5.3] vs. −3.3 mmHg [−5.9; −0.8], p < 0.049) and DBP (−3.7 mmHg [−4.9; −2.5] vs. −1.4 mmHg [−3.1; 0.2], p < 0.028) after 12 months. Compared to CON, INT showed a pronounced reduction in resting HR and PWV after 6 months but both lost significance after 12 months. Changes in SBP, DBP, and PWV were significantly associated positively with changes in body weight and fat mass (all p < 0.05) and resting HR correlated positively with fasting insulin (p < 0.001) after 12 months. Combining a lifestyle intervention with a high-protein and low-glycemic formula diet improves hemodynamic parameters to a greater extent than lifestyle intervention alone in high-risk individuals with overweight and obesity.
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Affiliation(s)
- Martin Röhling
- West-German Center of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany; (K.K.); (S.M.)
- Correspondence: ; Tel.: +49-(0)211-56-60-360-66
| | - Kerstin Kempf
- West-German Center of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany; (K.K.); (S.M.)
| | - Winfried Banzer
- Department of Sports Medicine, Institute for Sports and Sport Science, University of Frankfurt, 60487 Frankfurt, Germany;
| | - Klaus Michael Braumann
- Department of Sports and Movement Medicine, Faculty of Psychology and Human Movement Sciences, University of Hamburg, 20148 Hamburg, Germany;
| | - Dagmar Führer-Sakel
- Diabetes and Metabolism and Division of Laboratory Research, Department of Endocrinology, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany;
| | - Martin Halle
- Department of Prevention, Rehabilitation and Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich (TUM), 80992 Munich, Germany;
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - David McCarthy
- Public Health Nutrition Research Group, London Metropolitan University, London N7 8DB, UK;
| | - Stephan Martin
- West-German Center of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany; (K.K.); (S.M.)
- Faculty of Medicine, Heinrich Heine University Düsseldorf, 40591 Düsseldorf, Germany
| | | | - Hermann Toplak
- Department of Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, 8010 Graz, Austria;
| | - Aloys Berg
- Faculty of Medicine, University of Freiburg, 79117 Freiburg, Germany;
| | - Hans-Georg Predel
- Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, 50933 Cologne, Germany;
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22
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Sowah SA, Milanese A, Schübel R, Wirbel J, Kartal E, Johnson TS, Hirche F, Grafetstätter M, Nonnenmacher T, Kirsten R, López-Nogueroles M, Lahoz A, Schwarz KV, Okun JG, Ulrich CM, Nattenmüller J, von Eckardstein A, Müller D, Stangl GI, Kaaks R, Kühn T, Zeller G. Calorie restriction improves metabolic state independently of gut microbiome composition: a randomized dietary intervention trial. Genome Med 2022; 14:30. [PMID: 35287713 PMCID: PMC8919571 DOI: 10.1186/s13073-022-01030-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 02/14/2022] [Indexed: 12/12/2022] Open
Abstract
Background The gut microbiota has been suggested to play a significant role in the development of overweight and obesity. However, the effects of calorie restriction on gut microbiota of overweight and obese adults, especially over longer durations, are largely unexplored. Methods Here, we longitudinally analyzed the effects of intermittent calorie restriction (ICR) operationalized as the 5:2 diet versus continuous calorie restriction (CCR) on fecal microbiota of 147 overweight or obese adults in a 50-week parallel-arm randomized controlled trial, the HELENA Trial. The primary outcome of the trial was the differential effects of ICR versus CCR on gene expression in subcutaneous adipose tissue. Changes in the gut microbiome, which are the focus of this publication, were defined as exploratory endpoint of the trial. The trial comprised a 12-week intervention period, a 12-week maintenance period, and a final follow-up period of 26 weeks. Results Both diets resulted in ~5% weight loss. However, except for Lactobacillales being enriched after ICR, post-intervention microbiome composition did not significantly differ between groups. Overall weight loss was associated with significant metabolic improvements, but not with changes in the gut microbiome. Nonetheless, the abundance of the Dorea genus at baseline was moderately predictive of subsequent weight loss (AUROC of 0.74 for distinguishing the highest versus lowest weight loss quartiles). Despite the lack of consistent intervention effects on microbiome composition, significant study group-independent co-variation between gut bacterial families and metabolic biomarkers, anthropometric measures, and dietary composition was detectable. Our analysis in particular revealed associations between insulin sensitivity (HOMA-IR) and Akkermansiaceae, Christensenellaceae, and Tanerellaceae. It also suggests the possibility of a beneficial modulation of the latter two intestinal taxa by a diet high in vegetables and fiber, and low in processed meat. Conclusions Overall, our results suggest that the gut microbiome remains stable and highly individual-specific under dietary calorie restriction. Trial registration The trial, including the present microbiome component, was prospectively registered at ClinicalTrials.govNCT02449148 on May 20, 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s13073-022-01030-0.
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Affiliation(s)
- Solomon A Sowah
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany.,Medical Faculty, Heidelberg University, Heidelberg, Germany.,European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany
| | - Alessio Milanese
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany
| | - Ruth Schübel
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Jakob Wirbel
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany
| | - Ece Kartal
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany.,Molecular Medicine Partnership Unit, Heidelberg, Germany
| | - Theron S Johnson
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Frank Hirche
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Mirja Grafetstätter
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Tobias Nonnenmacher
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Heidelberg, Germany
| | - Romy Kirsten
- Biobank of the National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Marina López-Nogueroles
- Analytical Unit, Biomarkers and Precision Medicine Unit, Health Research Institute Hospital La Fe, Valencia, Spain
| | - Agustín Lahoz
- Analytical Unit, Biomarkers and Precision Medicine Unit, Health Research Institute Hospital La Fe, Valencia, Spain
| | - Kathrin V Schwarz
- Department of General Paediatrics, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Dietmar-Hopp Metabolic Center, Heidelberg, Germany
| | - Jürgen G Okun
- Department of General Paediatrics, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Dietmar-Hopp Metabolic Center, Heidelberg, Germany
| | - Cornelia M Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Johanna Nattenmüller
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Heidelberg, Germany
| | | | - Daniel Müller
- Institute of Clinical Chemistry (IGFS), University Hospital Zurich, Zurich, Switzerland
| | - Gabriele I Stangl
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany. .,Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland, UK. .,Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg, Germany.
| | - Georg Zeller
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany.
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23
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McDiarmid S, Harvie M, Johnson R, Vyas A, Aglan A, Moran J, Ruane H, Hulme A, Sellers K, Issa BG. Manchester Intermittent versus Daily Diet App Study (MIDDAS): A pilot randomized controlled trial in patients with type 2 diabetes. Diabetes Obes Metab 2022; 24:432-441. [PMID: 34726317 DOI: 10.1111/dom.14592] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/20/2021] [Accepted: 10/31/2021] [Indexed: 11/27/2022]
Abstract
AIMS To test the feasibility and potential efficacy of remotely supported intermittent low-energy diets (ILEDs) and continuous low-energy diets (CLEDs) in people with type 2 diabetes (T2D) and the feasibility of a randomized controlled trial comparing the two approaches. MATERIALS AND METHODS Seventy-nine adults with overweight/obesity and T2D (≤8 years duration) were randomized 1:1 to CLED (8 weeks/56 days of daily Optifast 820 kcal (3430 kJ) diet) or isoenergetic ILED (2 days of Optifast and 5 days of a Mediterranean diet/week for 28 weeks). Weight maintenance/continued weight loss was undertaken for the remainder of the 52 weeks. Both groups received frequent telephone or the Oviva app support. Feasibility outcomes included study uptake, retention, app usage, dietary adherence, weight loss and change in glycated haemoglobin (HbA1c) at 52 weeks. RESULTS We enrolled 39 ILED and 40 CLED participants and 27 (69%) ILED and 30 CLED (75%) attended the 52-week follow-up. Eighty-nine per cent (70 of 79) started using the app and 86% (44 of 51) still used the app at 52 weeks. Intention-to-treat analysis at 52 weeks showed percentage weight loss was mean (95% confidence interval) -5.4% (-7.6, -3.1%) for ILED and -6.0% (-7.9, -4.0%) for CLED. HbA1c <48 mmol/mol was achieved in 42% of both groups. Mean (95% confidence interval) changes in the T2D medication effect score were 0.0008 (-0.3, 0.3) for ILED and -0.5 (-0.8, -0.3) for CLED. CONCLUSION The study shows the feasibility and potential efficacy of remotely delivered ILED and CLED programmes for weight loss and HbA1c reduction, and the feasibility of a randomized controlled trial comparing the two approaches.
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Affiliation(s)
- Sarah McDiarmid
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK
- Department of Endocrinology and Diabetes, Manchester University NHS Foundation Trust, Manchester, UK
| | - Michelle Harvie
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
- Manchester Cancer Research Centre and NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - Rhona Johnson
- Department of Endocrinology and Diabetes, Manchester University NHS Foundation Trust, Manchester, UK
| | - Avni Vyas
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Azza Aglan
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Jacqui Moran
- Department of Endocrinology and Diabetes, Manchester University NHS Foundation Trust, Manchester, UK
| | - Helen Ruane
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Amanda Hulme
- Department of Endocrinology and Diabetes, Manchester University NHS Foundation Trust, Manchester, UK
| | - Katharine Sellers
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Basil G Issa
- Department of Endocrinology and Diabetes, Manchester University NHS Foundation Trust, Manchester, UK
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24
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Harvie M, French DP, Pegington M, Cooper G, Howell A, McDiarmid S, Lombardelli C, Donnelly L, Ruane H, Sellers K, Barrett E, Armitage CJ, Evans DG. Testing a breast cancer prevention and a multiple disease prevention weight loss programme amongst women within the UK NHS breast screening programme-a randomised feasibility study. Pilot Feasibility Stud 2021; 7:220. [PMID: 34930478 PMCID: PMC8690875 DOI: 10.1186/s40814-021-00947-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 11/04/2021] [Indexed: 12/03/2022] Open
Abstract
Background Excess weight and unhealthy behaviours (e.g. sedentariness, high alcohol) are common amongst women including those attending breast screening. These factors increase the risk of breast cancer and other diseases. We tested the feasibility and acceptability of a weight loss/behaviour change programme framed to reduce breast cancer risk (breast cancer prevention programme, BCPP) compared to one framed to reduce risk of breast cancer, cardiovascular disease (CVD) and diabetes (T2D) (multiple disease prevention programme, MDPP). Methods Women aged 47-73 years with overweight or obesity (n = 1356) in the NHS Breast Screening Programme (NHSBSP) were randomised (1:2) to be invited to join a BCPP or a MDPP. The BCPP included personalised information on breast cancer risk and a web and phone weight loss/behaviour change intervention. The MDPP also included an NHS Health Check (lipids, blood pressure, HbA1c and personalised feedback for risk of CVD [QRISK2] and T2D [QDiabetes and HbA1c]). Primary outcomes were uptake and retention and other feasibility outcomes which include intervention fidelity and prevalence of high CVD and T2D risk. Secondary outcomes included change in weight. Results The BCPP and MDPP had comparable rates of uptake: 45/508 (9%) vs. 81/848 (10%) and 12-month retention; 33/45 (73%) vs. 53/81 (65%). Both programmes had a high fidelity of delivery with receipt of mean (95% CI) 90 (88-98% of scheduled calls, 91 (86-95%) of scheduled e-mails and 89 (76-102) website entries per woman over the 12-month period. The MDPP identified 15% of women with a previously unknown 10-year CVD QRISK2 of ≥ 10% and 56% with 10-year Qdiabetes risk of ≥ 10%. Both groups experienced good comparable weight loss: BCPP 26/45 (58%) and MDPP 46/81 (57%) with greater than 5% weight loss at 12 months using baseline observation carried forward imputation. Conclusions Both programmes appeared feasible. The MDPP identified previously unknown CVD and T2D risk factors but does not appear to increase engagement with behaviour change beyond a standard BCPP amongst women attending breast screening. A future definitive effectiveness trial of BCPP is supported by acceptable uptake and retention, and good weight loss. Trial registration ISRCTN91372184, registered 28 September 2014. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00947-4.
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Affiliation(s)
- Michelle Harvie
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK. .,Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie, University of Manchester, 555 Wilmslow Rd., Manchester, M20 4GJ, UK.
| | - David P French
- Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie, University of Manchester, 555 Wilmslow Rd., Manchester, M20 4GJ, UK.,Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Coupland Street, Manchester, M13 9PL, UK
| | - Mary Pegington
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK.,Division of Cancer Sciences, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Grace Cooper
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
| | - Anthony Howell
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK.,Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie, University of Manchester, 555 Wilmslow Rd., Manchester, M20 4GJ, UK.,Division of Cancer Sciences, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK.,Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Rd., Manchester, M20 4BX, UK
| | - Sarah McDiarmid
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
| | - Cheryl Lombardelli
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
| | - Louise Donnelly
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
| | - Helen Ruane
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
| | - Katharine Sellers
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
| | - Emma Barrett
- Department of Medical Statistics, Education and Research Centre, Manchester University NHS Foundation Trust, M23 9LT, Manchester, UK
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Coupland Street, Manchester, M13 9PL, UK
| | - D Gareth Evans
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK.,Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie, University of Manchester, 555 Wilmslow Rd., Manchester, M20 4GJ, UK.,Genomic Medicine, Division of Evolution and Genomic Sciences, The University of Manchester, St Mary's Hospital, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
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25
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Empfehlungen zur Ernährung von Personen mit Typ-2-Diabetes mellitus. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1543-1293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Thomas Skurk
- ZIEL- Institute for Food & Health, Technische Universität München, Freising
- Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, Technische Universität München, Freising
| | - Anja Bosy-Westphal
- Institut für Humanernährung, Agrar- und Ernährungswissenschaftliche Fakultät, Christian-Albrechts-Universität zu Kiel, Kiel
| | | | - Stefan Kabisch
- Abt. Endokrinologie, Diabetes und Ernährungsmedizin, Charité Universitätsmedizin Berlin, Berlin
- Deutsche Zentrum für Diabetesforschung (DZD), München
| | | | - Peter Kronsbein
- Fachbereich Oecotrophologie, Hochschule Niederrhein, Campus Mönchengladbach
| | - Karsten Müssig
- Klinik für Innere Medizin und Gastroenterologie, Niels-Stensen-Kliniken, Franziskus-Hospital Harderberg, Georgsmarienhütte
| | - Andreas F. H. Pfeiffer
- Abt. Endokrinologie, Diabetes und Ernährungsmedizin, Charité Universitätsmedizin Berlin, Berlin
| | - Marie-Christine Simon
- Institut für Ernährungs- und Lebensmittelwissenschaften, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
| | | | - Katharina S. Weber
- Institut für Epidemiologie, Christian-Albrechts-Universität zu Kiel, Kiel
| | - Diana Rubin
- Vivantes Klinikum Spandau, Berlin
- Vivantes Humboldt Klinikum, Berlin
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26
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Cui Y, Cai T, Zhou Z, Mu Y, Lu Y, Gao Z, Wu J, Zhang Y. Health Effects of Alternate-Day Fasting in Adults: A Systematic Review and Meta-Analysis. Front Nutr 2020; 7:586036. [PMID: 33330587 PMCID: PMC7732631 DOI: 10.3389/fnut.2020.586036] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Alternate-day fasting (ADF) method is becoming more and more popular among adults. This meta-analysis aims to evaluate the effects of ADF on adults. Methods: Randomized controlled trials (RCTs) of ADF were searched using PubMed (1988 to March 2020), EMBASE (1995 to March 2020), and the Cochrane Controlled Trials Register. A systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. The datum was calculated by RevMan version 5.3.0. The original references for relating articles were also reviewed. Results: Seven randomized controlled trials involving 269 participants (152 in the ADF group and 117 in the control group) were studied. In this meta-analysis, compared with the control group, the ADF group showed statistically significant reductions in weight (p < 0.00001) and body mass index (p < 0.00001). Besides, the ADF group showed significant differences in terms of total cholesterol (p = 0.001), low-density lipoprotein (p = 0.01), triglycerides (p = 0.02), fat mass (p = 0.002), lean mass (p = 0.002), systolic blood pressure (p = 0.003), diastolic blood pressure (p = 0.007), and total calorie intake (p = 0.007). At the same time, the analysis demonstrated that the ADF group had a same effect compared with control group in aspects of high-density lipoprotein (p = 0.27), homeostasis model assessment-insulin resistance (p = 0.55), and fasting blood sugar (p = 0.09). Conclusions: This meta-analysis suggests that ADF is a viable diet strategy for weight loss, and it has a substantial improvement in risk indicators for diseases in obese or normal people.
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Affiliation(s)
- Yuanshan Cui
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.,Department of Urology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Tong Cai
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.,Binzhou Medical University, Yantai, China
| | - Zhongbao Zhou
- Department of Urology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Yingmei Mu
- Department of Allergy, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Youyi Lu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Zhenli Gao
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Jitao Wu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yong Zhang
- Department of Urology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
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