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Wohlgemuth KJ, Conner MJ, Tinsley GM, Palmer TB, Mota JA. Strategies for Improving Firefighter Health On-Shift: A Review. J Funct Morphol Kinesiol 2024; 9:105. [PMID: 38921641 PMCID: PMC11204757 DOI: 10.3390/jfmk9020105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
The fire service suffers from high rates of cardiovascular disease and poor overall health, and firefighters often suffer fatal and non-fatal injuries while on the job. Most fatal injuries result from sudden cardiac death, while non-fatal injuries are to the musculoskeletal system. Previous works suggest a mechanistic link between several health and performance variables and injury risk. In addition, studies have suggested physical activity and nutrition can improve overall health and occupational performance. This review offers practical applications for exercise via feasible training modalities as well as nutritional recommendations that can positively impact performance on the job. Time-efficient training modalities like high-intensity interval training and feasible modalities such as resistance training offer numerous benefits for firefighters. Also, modifying and supplementing the diet and can be advantageous for health and body composition in the fire service. Firefighters have various schedules, making it difficult for planned exercise and eating while on shift. The practical training and nutritional aspects discussed in this review can be implemented on-shift to improve the overall health and performance in firefighters.
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Affiliation(s)
- Kealey J. Wohlgemuth
- Neuromuscular and Occupational Performance Laboratory, Texas Tech University, Lubbock, TX 79409, USA;
| | | | - Grant M. Tinsley
- Energy Balance and Body Composition Laboratory, Texas Tech University, Lubbock, TX 79409, USA;
| | - Ty B. Palmer
- Muscular Assessment Laboratory, Texas Tech University, Lubbock, TX 79409, USA;
| | - Jacob A. Mota
- Neuromuscular and Occupational Performance Laboratory, Texas Tech University, Lubbock, TX 79409, USA;
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Ahmed K, Abdu Y, Khasawneh S, Shukri A, Adam E, Mustafa S, Affas M, Mohamed Ibrahim MI, Al Zayed A, Yassin MA. The effect of intermittent fasting on the clinical and hematological parameters of patients with sickle cell disease: A preliminary study. Front Med (Lausanne) 2023; 10:1097466. [PMID: 36895718 PMCID: PMC9989014 DOI: 10.3389/fmed.2023.1097466] [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: 11/13/2022] [Accepted: 02/01/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction Sickle cell disease is a genetic disorder that frequently presents with vaso-occlusive crisis (VOC). Most patients with sickle cell disease in Qatar are Muslims; hence, they practice intermittent fasting during the holy month of Ramadan. However, there is a paucity of literature describing the effect of intermittent fasting on the occurrence of severe VOC. As a result, there is a lack of guidelines or standardized protocols that can help physicians advise patients with sickle cell disease who wish to practice intermittent fasting. Therefore, this study's aim was to investigate the effect of intermittent fasting on the clinical and hematological parameters of individuals with sickle cell disease. Methods We conducted a retrospective study for 52 Muslim patients with sickle cell disease in Qatar aged ≥18 years who were confirmed to be fasting during the holy month of Ramadan during any of the years 2019-2021. The difference in the occurrence of severe VOC, hemolytic crisis, and other clinical, hematological, and metabolic parameters were studied one month before, during, and one month after the intermittent fasting of Ramadan using the patient's medical records. Mean (sd), median (IQR), and frequency (%) described the data. One-way with repeated measures ANOVA with a Greenhouse-Geisser correction and Friedman tests (*) were used at alpha level 0.05. Results The study participants' (mean±sd) age was (31.1±9.2) years, 51.9% were males, and 48.1% were females. Roughly seventy percent of the participants were of Arab ethnicity, while the rest were either African or Asian. Most of the patients were homozygotes (SS) (90.4%). The median number of severe VOC (P = 0.7) and hemolytic crisis (P = 0.5) was not found to be significantly different before, during, or after Ramadan. Significant differences, however, were found in platelet count (P = 0.003), reticulocyte count (P < 0.001), and creatinine level (P = 0.038) with intermittent fasting. Discussion In this preliminary study, intermittent fasting does not seem to influence the rate of occurrence of severe vaso-occlusive crisis or hemolytic crisis in patients with sickle cell disease; however, it was found to be associated with differences in platelet count, reticulocytes count, and creatinine level. The statistical and clinical significance of these findings needs to be confirmed in studies with a larger sample size.
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Affiliation(s)
- Khalid Ahmed
- Department of Hematology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Yasamin Abdu
- Department of Community Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Sief Khasawneh
- Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Ahmed Shukri
- Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Ehab Adam
- Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Salma Mustafa
- Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Mohammad Affas
- Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | | | | | - Mohamed A Yassin
- Department of Hematology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
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Hajek P, Przulj D, Pesola F, McRobbie H, Peerbux S, Phillips-Waller A, Bisal N, Myers Smith K. A randomised controlled trial of the 5:2 diet. PLoS One 2021; 16:e0258853. [PMID: 34788298 PMCID: PMC8598045 DOI: 10.1371/journal.pone.0258853] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/05/2021] [Indexed: 01/02/2023] Open
Abstract
Objective The 5:2 diet is a popular intermittent energy restriction method of weight management that awaits further evaluation. We compared the effects of one-off 5:2 instructions with the effects of one-off standard multicomponent weight-management advice; and also examined whether additional behavioural support enhances 5:2 adherence and efficacy compared to one-off instructions. Methods Three hundred adults with obesity were randomised to receive a Standard Brief Advice (SBA) covering diet and physical activity (N = 100); 5:2 self-help instructions (5:2SH) (N = 100); or 5:2SH plus six once-weekly group support sessions (N = 100). Participants were followed up for one year. Results Adherence to 5:2SH was initially high (74% at 6 weeks), but it declined over time (31% at 6 months and 22% at one year). 5:2SH and SBA achieved similar weight-loss at six months (-1.8kg (SD = 3.5) vs -1.7kg (SD = 4.4); b = 0.23, 95%CI:-0.79–1.27, p = 0.7) and at one year (-1.9kg (SD = 4.9) vs -1.8kg (SD = 5.7), b = 0.20, 95%CI:-1.21–1.60, p = 0.79), with 18% vs 15% participants losing ≥5% of their body weight with 5:2SH and SBA, respectively at one year (RR = 0.83, 95%CI:0.44–1.54, p = 0.55). Both interventions received positive ratings, but 5:2SH ratings were significantly higher. 5:2SH had no negative effect on fat and fiber intake and physical activity compared to SBA. Compared to 5:2SH, 5:2G generated a greater weight loss at 6 weeks (-2.3kg vs -1.5kg; b = 0.74, 95%CI:1.37–0.11, p = 0.02), but by one year, the difference was no longer significant (-2.6kg vs -1.9kg, p = 0.37; ≥5% body weight loss 28% vs 18%, p = 0.10). Conclusions Simple 5:2 advice and multicomponent weight management advice generated similar modest results. The 5:2 diet did not undermine other health behaviours, and it received more favourable ratings. Adding initial group support enhanced 5:2 adherence and effects, but the impact diminished over time. Health professionals who provide brief weight management advice may consider including the 5:2 advice as an option. Trial registration ISRCTN registry (ISRCTN79408248).
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Affiliation(s)
- Peter Hajek
- Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Dunja Przulj
- Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Francesca Pesola
- Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Hayden McRobbie
- Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Sarrah Peerbux
- Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Anna Phillips-Waller
- Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Natalie Bisal
- Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Katie Myers Smith
- Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- * E-mail:
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Martínez-Rodríguez A, Rubio-Arias JA, García-De Frutos JM, Vicente-Martínez M, Gunnarsson TP. Effect of High-Intensity Interval Training and Intermittent Fasting on Body Composition and Physical Performance in Active Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126431. [PMID: 34198554 PMCID: PMC8296247 DOI: 10.3390/ijerph18126431] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/03/2021] [Accepted: 06/09/2021] [Indexed: 01/25/2023]
Abstract
Nutritional strategies may have an effect on body composition and physical performance. Intermittent fasting (IF) is an eating pattern that cycles between periods of eating and fasting in specified time periods. Moreover, it is a common strategy among members of the athlete population that are looking for weight loss. However, this strategy may negatively affect physical performance, as compared to other weight loss strategies. The main purpose of this research was to use a cross-over design to study the effects of HIIT, with or without intermittent fasting, on muscular and anaerobic performance in 14 active women (27 ± 6 y). To assess performance, body composition (anthropometry), hand-grip strength, and counter-movement jump (CMJ) height was measured, and a 30 s Wingate test was completed assessed. HIIT + IF reduced fat mass (1 kg, p < 0.05, d = 1.1; 1.5%, p < 0.01, d = 1.0) and increased CMJ height (6.2 cm, p < 0.001, d = 1.8). In addition, the change in CMJ height in HIIT + IF was higher over HIIT (5.2 cm, p < 0.001, d = 1.9). In conclusion, intermittent fasting could be a nutritional strategy to decrease fat mass and increase jumping performance. However, longer duration programs would be necessary to determine whether other parameters of muscle performance could be positively affected by IF.
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Affiliation(s)
- Alejandro Martínez-Rodríguez
- Department of Analytical Chemistry, Nutrition and Food Sciences, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL Foundation), 03010 Alicante, Spain
- Correspondence:
| | - Jacobo A. Rubio-Arias
- Department of Education, Faculty of Education Sciences, University of Almería, 04120 Almería, Spain;
| | | | - Manuel Vicente-Martínez
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain;
| | - Thomas P. Gunnarsson
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 2100 Copenhagen Ø, Denmark;
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Nowosad K, Sujka M. Effect of Various Types of Intermittent Fasting (IF) on Weight Loss and Improvement of Diabetic Parameters in Human. Curr Nutr Rep 2021; 10:146-154. [PMID: 33826120 PMCID: PMC8102292 DOI: 10.1007/s13668-021-00353-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE OF REVIEW A number of recent studies have suggested that intermittent fasting is as effective as traditional calorie restriction (CR) for weight loss and for cardioprotection. However, it is still unclear whether IF improves diabetes risk indicators as does CR. This review provides an overview of various patterns of intermittent fasting and shows the effect of intermittent fasting on human anthropometric such as excess body weight and biochemical parameters for example high glucose and fasting insulin, which are risk factors for diabetes. RECENT FINDINGS There is a growing body of evidence pointing to the benefits of intermittent fasting for glucose and insulin homeostasis, but this should be confirmed by further studies in population groups with (or at high risk) type II diabetes and insulin resistance. Long-term studies are also needed that could reveal potential negative health effects that some studies report. Eleven studies in overweight/obese adult people that included changes in weight, body composition, and diabetic parameters (fasting glucose, fasting insulin, HbA1c concentration, and HOMA-IR index) were published between 2012 and 2020. Seven studies concerning the effects of alternate day fasting (ADF) on weight loss and diabetic parameters were analyzed. All of them have shown the effects of ADF on weight loss and slight improvement in diabetic parameters. For time-restricted feeding (TRF), a significant improvement in the HOMA-IR index was observed in 2 studies. One study saw an increase in fasting glucose. An analysis of 2 studies using a complete alternate day fasting (CADF) was performed. One study showed decrease in fasting glucose and insulin, and in one a decrease in glycosylated hemoglobin (HbA1c) was observed. CONCLUSION Different types of intermittent fasting reduce body weight and reduce diabetes parameters such as fasting glucose, fasting insulin, HOMA-IR index, and glycated hemoglobin (HbA1c).
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Affiliation(s)
- Karolina Nowosad
- Department of Analysis and Evaluation of Food Quality, University of Life Sciences in Lublin, Skromna 8, 20-704, Lublin, Poland
| | - Monika Sujka
- Department of Analysis and Evaluation of Food Quality, University of Life Sciences in Lublin, Skromna 8, 20-704, Lublin, Poland.
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Yassin MA, Ghasoub RS, Aldapt MB, Abdulla MA, Chandra P, Shwaylia HM, Nashwan AJ, Kassem NA, Akiki SJ. Effects of Intermittent Fasting on Response to Tyrosine Kinase Inhibitors (TKIs) in Patients With Chronic Myeloid Leukemia: An Outcome of European LeukemiaNet Project. Cancer Control 2021; 28:10732748211009256. [PMID: 33874754 PMCID: PMC8204644 DOI: 10.1177/10732748211009256] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The overall survival of patients with Chronic Myeloid Leukemia (CML) treated by
using tyrosine kinase inhibitors (TKIs) is very close to that of the healthy
population. However, little is known about the effect of specific measures such
as intermittent fasting, especially during Ramadan period. A 3-year
retrospective study was conducted to evaluate the effect of fasting on patients
with CML receiving TKIs by evaluating certain clinical, hematological, and
molecular parameters. A total of 49 patients were eligible, with a median age of
46 years (range: 22-86), of these 36 (73.5%) were males and 13 (26.5%) were
females. Twenty-seven (55%) patients are Middle Eastern, while 16 (32.7%) from
the Indian subcontinent, and 6 (12.3%) Africans. Imatinib was the most common
TKI; used in 25 patients (51%). The mean White blood cells (WBCs), neutrophils,
and BCR-ABL were found to be reduced after fasting compared to before and during
with statistical difference. The use of TKIs while fasting did not result in
significant changes in hematological nor BCR-ABL levels in our study. Patients
who wish to practice intermittent fasting may be reassured in this regard, yet
physicians can adopt the safe trial approach, where they allow the patients to
fast, but with instructions such as when to break fasting.
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Affiliation(s)
- Mohamed A Yassin
- Hematology Section, Medical Oncology, National Center for Cancer Care and Research (NCCCR), 36977Hamad Medical Corporation (HMC), Doha, Qatar.,College of Medicine, Qatar University (QU), Doha, Qatar
| | - Rola S Ghasoub
- Department of Pharmacy, National Center for Cancer Care and Research (NCCCR), 36977Hamad Medical Corporation (HMC), Doha, Qatar
| | - Mahmood B Aldapt
- Hematology Section, Medical Oncology, National Center for Cancer Care and Research (NCCCR), 36977Hamad Medical Corporation (HMC), Doha, Qatar
| | - Mohammad A Abdulla
- Hematology Section, Medical Oncology, National Center for Cancer Care and Research (NCCCR), 36977Hamad Medical Corporation (HMC), Doha, Qatar
| | - Prem Chandra
- Medical Research Center, 36977Hamad Medical Corporation (HMC), Doha, Qatar
| | - Hawraa M Shwaylia
- Hematology Section, Medical Oncology, National Center for Cancer Care and Research (NCCCR), 36977Hamad Medical Corporation (HMC), Doha, Qatar
| | - Abdulqadir J Nashwan
- Department of Nursing, Hazm Mebaireek General Hospital (HMGH), 36977Hamad Medical Corporation (HMC), Doha, Qatar
| | | | - Susanna J Akiki
- Diagnostic Genomic Division, 36977Hamad Medical Corporation (HMC), Doha, Qatar
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Daas MC, de Roos NM. Intermittent fasting contributes to aligned circadian rhythms through interactions with the gut microbiome. Benef Microbes 2021; 12:147-161. [PMID: 33530881 DOI: 10.3920/bm2020.0149] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The timing of food consumption is considered to be an important modulator of circadian rhythms, regulating a wide range of physiological processes which are vital to human health. The exact mechanisms underlying this relationship are not fully understood, but likely involve alterations in the structure and functioning of the gut microbiome. Therefore, this narrative review aims to clarify these mechanisms by focusing on intermittent fasting as a dietary strategy of food timing. A literature search identified 4 clinical and 18 preclinical studies that examined either (1) the impact of intermittent fasting on the gut microbiome, or (2) whether circadian rhythms of the host are subject to changes in the bacterial populations in the gut. Results reveal that intermittent fasting directly influences the gut microbiome by amplifying diurnal fluctuations in bacterial abundance and metabolic activity. This in turn leads to fluctuations in the levels of microbial components (lipopolysaccharide) and metabolites (short-chain fatty acids, bile acids, and tryptophan derivates) that act as signalling molecules to the peripheral and central clocks of the host. Binding of these substrates to pattern-recognition receptors on the surface of intestinal epithelial cells in an oscillating manner leads to fluctuations in the expression of circadian genes and their transcription factors involved in various metabolic processes. Intermittent fasting thus contributes to circadian rhythmicity in the host and could hold promising implications for the treatment and prevention of diseases associated with disordered circadian rhythms, such as obesity and metabolic syndrome. Future intervention studies are needed to find more evidence on this relationship in humans, as well as to clarify the optimal fasting regimen for balanced circadian rhythms.
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Affiliation(s)
- M C Daas
- Division of Human Nutrition and Health, Department of Agrotechnology and Food Sciences, Wageningen University, P.O. Box 17, 6700 AA, Wageningen, the Netherlands
| | - N M de Roos
- Division of Human Nutrition and Health, Department of Agrotechnology and Food Sciences, Wageningen University, P.O. Box 17, 6700 AA, Wageningen, the Netherlands
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8
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The Effects of Islamic Fasting on Blood Biochemical Parameters in Morbidly Obese Patients Undergone Bariatric Surgery. Indian J Surg 2020. [DOI: 10.1007/s12262-020-02231-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Harris L, Hamilton S, Azevedo LB, Olajide J, De Brún C, Waller G, Whittaker V, Sharp T, Lean M, Hankey C, Ells L. Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2019; 16:507-547. [PMID: 29419624 DOI: 10.11124/jbisrir-2016-003248] [Citation(s) in RCA: 153] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To examine the effectiveness of intermittent energy restriction in the treatment for overweight and obesity in adults, when compared to usual care treatment or no treatment. INTRODUCTION Intermittent energy restriction encompasses dietary approaches including intermittent fasting, alternate day fasting, and fasting for two days per week. Despite the recent popularity of intermittent energy restriction and associated weight loss claims, the supporting evidence base is limited. INCLUSION CRITERIA This review included overweight or obese (BMI ≥25 kg/m) adults (≥18 years). Intermittent energy restriction was defined as consumption of ≤800 kcal on at least one day, but no more than six days per week. Intermittent energy restriction interventions were compared to no treatment (ad libitum diet) or usual care (continuous energy restriction ∼25% of recommended energy intake). Included interventions had a minimum duration of 12 weeks from baseline to post outcome measurements. The types of studies included were randomized and pseudo-randomized controlled trials. The primary outcome of this review was change in body weight. Secondary outcomes included: i) anthropometric outcomes (change in BMI, waist circumference, fat mass, fat free mass); ii) cardio-metabolic outcomes (change in blood glucose and insulin, lipoprotein profiles and blood pressure); and iii) lifestyle outcomes: diet, physical activity, quality of life and adverse events. METHODS A systematic search was conducted from database inception to November 2015. The following electronic databases were searched: MEDLINE, Embase, CINAHL, Cochrane Library, ClinicalTrials.gov, ISRCTN registry, and anzctr.org.au for English language published studies, protocols and trials. Two independent reviewers evaluated the methodological quality of included studies using the standardized critical appraisal instruments from the Joanna Briggs Institute. Data were extracted from papers included in the review by two independent reviewers using the standardized data extraction tool from the Joanna Briggs Institute. Effect sizes were expressed as weighted mean differences and their 95% confidence intervals were calculated for meta-analyses. RESULTS Six studies were included in this review. The intermittent energy restriction regimens varied across studies and included alternate day fasting, fasting for two days, and up to four days per week. The duration of studies ranged from three to 12 months. Four studies included continuous energy restriction as a comparator intervention and two studies included a no treatment control intervention. Meta-analyses showed that intermittent energy restriction was more effective than no treatment for weight loss (-4.14 kg; 95% CI -6.30 kg to -1.99 kg; p ≤ 0.001). Although both treatment interventions achieved similar changes in body weight (approximately 7 kg), the pooled estimate for studies that investigated the effect of intermittent energy restriction in comparison to continuous energy restriction revealed no significant difference in weight loss (-1.03 kg; 95% CI -2.46 kg to 0.40 kg; p = 0.156). CONCLUSIONS Intermittent energy restriction may be an effective strategy for the treatment of overweight and obesity. Intermittent energy restriction was comparable to continuous energy restriction for short term weight loss in overweight and obese adults. Intermittent energy restriction was shown to be more effective than no treatment, however, this should be interpreted cautiously due to the small number of studies and future research is warranted to confirm the findings of this review.
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Affiliation(s)
- Leanne Harris
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sharon Hamilton
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Liane B Azevedo
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Joan Olajide
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Caroline De Brún
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Gillian Waller
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Vicki Whittaker
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Tracey Sharp
- Independent Public Health Consultant, United Kingdom
| | - Mike Lean
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Catherine Hankey
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Louisa Ells
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
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Muhammad HFL, Pratama SA, Hartono MN. The differential response to intermittent fasting diet versus low calorie diet with exercise based on -866 G/A UCP2 gene variation in adults with overweight/obesity. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2019. [DOI: 10.3233/mnm-190331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Harry Freitag Luglio Muhammad
- Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Yogyakarta, Indonesia
| | - Satwika Arya Pratama
- Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Yogyakarta, Indonesia
| | - Maya Nurfitriani Hartono
- Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Yogyakarta, Indonesia
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11
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Faris MAIE, Jahrami HA, Obaideen AA, Madkour MI. Impact of diurnal intermittent fasting during Ramadan on inflammatory and oxidative stress markers in healthy people: Systematic review and meta-analysis. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2019. [DOI: 10.1016/j.jnim.2018.11.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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12
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Potter C, Griggs RL, Brunstrom JM, Rogers PJ. Breaking the fast: Meal patterns and beliefs about healthy eating style are associated with adherence to intermittent fasting diets. Appetite 2018; 133:32-39. [PMID: 30339785 DOI: 10.1016/j.appet.2018.10.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/12/2018] [Accepted: 10/16/2018] [Indexed: 12/28/2022]
Abstract
Many believe that eating three meals each day is healthy and that skipping meals can be detrimental. What remains unclear is whether this belief undermines attempts to restrict energy intake by skipping meals. In an online survey, participants (N = 312) with experience of intermittent fasting (IF) reported their beliefs about healthy meal and snack frequency, as well as their non-fasting-dasy and fasting-day eating patterns. They also reported their level of concern with fasting-day meal patterns and their concern to generate fullness when selecting foods. Individuals currently following an IF diet (Current-IF dieters) and those who had previously attempted an IF diet but were non-adherent (Former-IF dieters) took part. Former-IF dieters were more likely to believe that it is healthy to eat three meals a day, punctuated by several snacks. On fasting-days, Former-IF dieters were also more likely to eat breakfast, a mid-morning snack, lunch, and a mid-afternoon snack whereas Current-IF dieters tended to save their eating for dinner and a late evening snack. Former-IF dieters were also more likely to be concerned about the negative consequences of missing a meal, to eat in anticipation of future hunger, and to prioritise fullness over taste when selecting foods. These findings reveal how beliefs about a healthy eating style can play an important role in shaping dietary patterns. Interventions aimed at modifying beliefs about healthy meal patterns may promote IF diet adherence.
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Affiliation(s)
- Christina Potter
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, UK.
| | - Rebecca L Griggs
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, UK
| | - Jeffrey M Brunstrom
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK
| | - Peter J Rogers
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK
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13
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Ahn JH, Noh Y, Shin BN, Kim SS, Park JH, Lee TK, Song M, Kim H, Lee JC, Yong JH, Kang IJ, Lee YL, Won MH, Kim JD. Intermittent fasting increases SOD2 and catalase immunoreactivities in the hippocampus but does not protect from neuronal death following transient ischemia in gerbils. Mol Med Rep 2018; 18:4802-4812. [PMID: 30272360 PMCID: PMC6236287 DOI: 10.3892/mmr.2018.9503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/11/2018] [Indexed: 12/17/2022] Open
Abstract
Intermittent fasting has been shown to have neuroprotective effects against transient focal cerebral ischemic insults. However, the effects of intermittent fasting on transient global ischemic insult has not been studied much yet. The present study examined effects of intermittent fasting on endogenous antioxidant enzyme expression levels in the hippocampus and investigated whether the fasting protects neurons 5 days after 5 min of transient global cerebral ischemia. Gerbils were randomly subjected to either ad libitum or alternate-day intermittent fasting for two months and assigned to sham surgery or transient ischemia. Changes of antioxidant enzymes were examined using immunohistochemistry for cytoplasmic superoxide dismutase 1 (SOD1), mitochondrial (SOD2), catalase (CAT), and glutathione peroxidase (GPX). The effects of intermittent fasting on ischemia-induced antioxidant changes, neuronal damage/degeneration and glial activation were examined. The weight of fasting gerbils was not different from that of control gerbils. In controls, SOD1 and GPX immunoreactivities were strong in pyramidal neurons of filed cornu ammonis 1 (CA1). Transient ischemia in controls significantly decreased expressions of SOD1 and GPX in CA1 pyramidal neurons. Intermittent fasting resulted in increased expressions of SOD2 and CAT, not of SOD1 and GPX, in CA1 pyramidal neurons. Nevertheless, CA1 pyramidal neurons were not protected in gerbils subjected to fasting after transient ischemia, and inhibition of glial-cell activation was not observed in the gerbils. In summary, intermittent fasting for two months increased SOD2 and CAT immunoreactivities in hippocampal CA1 pyramidal neurons. However, fasting did not protect the CA1 pyramidal neurons from transient cerebral ischemia. The results of the present study indicate that intermittent fasting may increase certain antioxidants, but not protect neurons from transient global ischemic insult.
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Affiliation(s)
- Ji Hyeon Ahn
- Department of Biomedical Science and Research Institute for Bioscience and Biotechnology, Hallym University, Chuncheon, Gangwon 24252, Republic of Korea
| | - Yoohun Noh
- Famenity Company, Gwacheon, Geyonggi 13837, Republic of Korea
| | - Bich Na Shin
- Danchunok Company, Chuncheon, Gangwon 24210, Republic of Korea
| | - Sung-Su Kim
- Famenity Company, Gwacheon, Geyonggi 13837, Republic of Korea
| | - Joon Ha Park
- Department of Biomedical Science and Research Institute for Bioscience and Biotechnology, Hallym University, Chuncheon, Gangwon 24252, Republic of Korea
| | - Tae-Kyeong Lee
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon 24341, Republic of Korea
| | - Minah Song
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon 24341, Republic of Korea
| | - Hyunjung Kim
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon 24341, Republic of Korea
| | - Jae-Chul Lee
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon 24341, Republic of Korea
| | - Jun-Hwan Yong
- Department of Occupational Therapy, Dongnam Health University, Suwon, Gyeonggi 16238, Republic of Korea
| | - Il Jun Kang
- Department of Food Science and Nutrition, Hallym University, Chuncheon, Gangwon 24252, Republic of Korea
| | - Yun Lyul Lee
- Department of Physiology and Institute of Neurodegeneration and Neuroregeneration, College of Medicine, Hallym University, Chuncheon, Gangwon 24252, Republic of Korea
| | - Moo-Ho Won
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon 24341, Republic of Korea
| | - Jong Dai Kim
- Division of Food Biotechnology, School of Biotechnology, Kangwon National University, Chuncheon, Gangwon 24341, Republic of Korea
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Intermittent living; the use of ancient challenges as a vaccine against the deleterious effects of modern life - A hypothesis. Med Hypotheses 2018; 120:28-42. [PMID: 30220336 DOI: 10.1016/j.mehy.2018.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/25/2018] [Accepted: 08/04/2018] [Indexed: 12/19/2022]
Abstract
Chronic non-communicable diseases (CNCD) are the leading cause of mortality in developed countries. They ensue from the sum of modern anthropogenic risk factors, including high calorie nutrition, malnutrition, sedentary lifestyle, social stress, environmental toxins, politics and economic factors. Many of these factors are beyond the span of control of individuals, suggesting that CNCD are inevitable. However, various studies, ours included, show that the use of intermittent challenges with hormetic effects improve subjective and objective wellbeing of individuals with CNCD, while having favourable effects on immunological, metabolic and behavioural indices. Intermittent cold, heat, fasting and hypoxia, together with phytochemicals in multiple food products, have widespread influence on many pathways related with overall health. Until recently, most of the employed challenges with hormetic effects belonged to the usual transient live experiences of our ancestors. Our hypothesis; we conclude that, whereas the total inflammatory load of multi-metabolic and psychological risk factors causes low grade inflammation and aging, the use of intermittent challenges, united in a 7-10 days lasting hormetic intervention, might serve as a vaccine against the deleterious effects of chronic low grade inflammation and it's metabolic and (premature) aging consequences.
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Muhammad HFL, Latifah FN, Susilowati R. The yo-yo effect of Ramadan fasting on overweight/obese individuals in Indonesian: A prospective study. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2018. [DOI: 10.3233/mnm-17188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Ramadan fasting has been associated with a significant body weight, fat mass and waist-hip circumference reduction. However, this is mostly followed by weight regain in 2 weeks after the fasting is stopped. Currently there is no explanation on how this rebound phenomena occurred. OBJECTIVE: The aim of this study was to examine the role of lifestyle and hormonal background on weight regain after Ramadan fasting in overweight individuals. METHODS: This was an observational study with prospective cohort design. Subjects were overweight/obese men and women adults with age between 21 and 56 years old. Body weight, percent fat, fat free mass and hip-waist circumference were measured before (week 0), 28 days after Ramadan fasting (week 4) and 2 weeks after the end of Ramadan (week 6). In addition, data on lifestyle factors such as dietary intake and physical activity were collected in those time points. Leptin was measured before and at the end of Ramadan fasting period. RESULTS: Body weight was significantly reduced at the end of Ramadan (week 4, p < 0,0001) and increased after Ramadan (week 6, p < 0,0001). Leptin was significantly reduced after Ramadan (p = 0,018) and we found that leptin level at the end of Ramadan was associated with percent body weight reduction (p = 0,011). CONCLUSION: We conducted a study to understand Ramadan fasting yo-yo effect in overweight and obese individuals and this study showed that dietary factor prior to the fasting has a significant impact on overweight/obese individual.
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Affiliation(s)
| | - Fatikhat Nur Latifah
- Undergraduate School of Nutrition and Health, Faculty of Medicine, Universitas Gadjah Mada, Indonesia
| | - Rina Susilowati
- Department of Histology and Cell Biology, Faculty of Medicine, Universitas Gadjah Mada, Indonesia
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Jane L, Atkinson G, Jaime V, Hamilton S, Waller G, Harrison S. Intermittent fasting interventions for the treatment of overweight and obesity in adults aged 18 years and over: a systematic review protocol. ACTA ACUST UNITED AC 2018; 13:60-8. [PMID: 26571283 DOI: 10.11124/jbisrir-2015-2363] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE Are intermittent fasting interventions an effective treatment for overweight and obesity in adults, when compared to usual care treatment (continuous daily energy restriction - reduced calorie diet) or no treatment (ad libitum diet)? BACKGROUND Overweight and obesity (classified as Body Mass Index [BMI] of greater than or equal to 25 and 30 respectively) is a global public health concern, with more than 1.9 billion adults worldwide being overweight in 2014 (over 600 million of whom are obese), and resulting in more deaths than underweight. A raised BMI in adulthood is associated with an increased risk of developing a number of chronic diseases which include diabetes, cardiovascular disease, muscular skeletal disorders and some cancers. In addition to this substantial impact on individual health and well being, there are also significant wider costs, for example, in England the annual direct cost to the national health service for treating overweight, obesity and associated morbidity is estimated at over £5 billion pounds, with costs to the wider economy estimated at £27 billion. Therefore effective weight management is essential.As overweight and obesity results from an accumulation of excess body fat arising from an energy imbalance - consuming more energy (kcal) than is expended - the majority of weight management approaches center around behaviors to address this imbalance, i.e. reducing energy intake through caloric restriction and increasing energy expenditure through physical activity. However, the aetiology of overweight and obesity is highly complex, involving an interplay of biological, psychological, societal and environmental drivers. Consequently, effective weight management is challenging, and whilst there exists a plethora of available weight loss programs, not all are comprehensively evaluated and compared, and many weight loss attempts result in weight regain and poor long term results. It is therefore vitally important to review the effectiveness of all new approaches to support an evidence-based approach to weight management.Intermittent fasting (IF), also known as alternate day fasting (ADF), periodic fasting or intermittent energy restriction (IER) is a relatively new dietary approach to weight management that involves interspersing normal daily caloric intake with a short period of severe calorie restriction/fasting. In terms of the possible underlying biological benefits of intermittent fasting, there is some evidence, predominantly from animal studies, to demonstrate beneficial effects on weight loss and cardio-metabolic risk factors. Whilst the underpinning mechanistic evidence is limited, there is some evidence to suggest that the benefits may be explained mechanistically through fat utilization and nutritional stress. However current National Institute for Health and Care Excellence (NICE) guidance on the treatment of adult obesity does not recommend the routine use of very low calorie diets (VLCD) (defined as a hypocaloric diet of 800 or less kcal/day) for the treatment of adult obesity. The National Institute for Health and Care Excellence states that this approach should only be recommended if there is a clinical rationale for rapid weight loss and must be nutritionally complete, part of a multi-component weight management strategy, including ongoing support, and should be undertaken for a maximum of 12 weeks (followed continuously or intermittently). Furthermore, the British Dietetic Association raises concerns that rapid weight loss associated with fasting may largely be due to loss of water and glycogen rather than fat, and may result in fatigue, dizziness and low energy levels. Essentially IF involves the intermittent use of a VLCD, and there remain questions about the side effects of this approach, whether there is an optimal fasting pattern or calorie limit, and how sustainable it is for long term weight management.Intermittent fasting has recently gained much popularity following significant media attention. In the UK this dietary approach reached mainstream after a BBC Horizon documentary aired in August 2012, featured an IF approach called the 5:2 diet, which involves five days of regular eating patterns interchanged with two days of fasting (max 500kcal for women and 600kcal for men). However other IF patterns are used such as alternate day fasting. Despite the recent popularity of intermittent fasting and associated weight loss claims, the supporting evidence base in humans remains small and there is only one published systematic review examining the health benefits of this approach. However the aim of this review was to examine the impact of this intervention on wider health benefits (not specifically as a treatment approach for overweight and obesity), and did not provide a comprehensive methodology or meta-analysis of RCT data. This proposed review will hence address these gaps in the evidence base.
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Affiliation(s)
- Louisa Jane
- 1Health and Social Care Institute, Teesside University, United Kingdom2Teesside Centre for Evidence-based Practice: an Affiliate centre of The Joanna Briggs Institute
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Harris L, McGarty A, Hutchison L, Ells L, Hankey C. Short-term intermittent energy restriction interventions for weight management: a systematic review and meta-analysis. Obes Rev 2018; 19:1-13. [PMID: 28975722 DOI: 10.1111/obr.12593] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/22/2017] [Accepted: 07/03/2017] [Indexed: 11/30/2022]
Abstract
This systematic review synthesized the available evidence on the effect of short-term periods of intermittent energy restriction (weekly intermittent energy restriction; ≥7-d energy restriction) in comparison with usual care (daily continuous energy restriction), in the treatment of overweight and obesity in adults. Six electronic databases were searched from inception to October 2016. Only randomized controlled trials of interventions (≥12 weeks) in adults with overweight and obesity were included. Five studies were included in this review. Weekly intermittent energy restriction periods ranged from an energy intake between 1757 and 6276 kJ/d-1 . The mean duration of the interventions was 26 (range 14 to 48) weeks. Meta-analysis demonstrated no significant difference in weight loss between weekly intermittent energy restriction and continuous energy restriction post-intervention (weighted mean difference: -1.36 [-3.23, 0.51], p = 0.15) and at follow-up (weighted mean difference: -0.82 [-3.76, 2.11], p = 0.58). Both interventions achieved comparable weight loss of >5 kg and therefore were associated with clinical benefits to health. The findings support the use of weekly intermittent energy restriction as an alternative option for the treatment of obesity. Currently, there is insufficient evidence to support the long-term sustainable effects of weekly intermittent energy restriction on weight management.
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Affiliation(s)
- L Harris
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A McGarty
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Hutchison
- College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Ells
- Health and Social Care Institute, Teesside University, United Kingdom Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, Middlesbrough, UK
| | - C Hankey
- College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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18
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Alfaras I, Di Germanio C, Bernier M, Csiszar A, Ungvari Z, Lakatta EG, de Cabo R. Pharmacological Strategies to Retard Cardiovascular Aging. Circ Res 2017; 118:1626-42. [PMID: 27174954 DOI: 10.1161/circresaha.116.307475] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 04/08/2016] [Indexed: 01/10/2023]
Abstract
Aging is the major risk factor for cardiovascular diseases, which are the leading cause of death in the United States. Traditionally, the effort to prevent cardiovascular disease has been focused on addressing the conventional risk factors, including hypertension, hyperglycemia, hypercholesterolemia, and high circulating levels of triglycerides. However, recent preclinical studies have identified new approaches to combat cardiovascular disease. Calorie restriction has been reproducibly shown to prolong lifespan in various experimental model animals. This has led to the development of calorie restriction mimetics and other pharmacological interventions capable to delay age-related diseases. In this review, we will address the mechanistic effects of aging per se on the cardiovascular system and focus on the prolongevity benefits of various therapeutic strategies that support cardiovascular health.
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Affiliation(s)
- Irene Alfaras
- From the Experimental Gerontology Section, Translational Gerontology Branch (I.A., C.D.G., M.B., R.d.C.) and Laboratory of Cardiovascular Science (E.G.L.), National Institute on Aging, National Institutes of Health, Baltimore, MD; Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy (C.D.G.); and Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK (A.C., Z.U.)
| | - Clara Di Germanio
- From the Experimental Gerontology Section, Translational Gerontology Branch (I.A., C.D.G., M.B., R.d.C.) and Laboratory of Cardiovascular Science (E.G.L.), National Institute on Aging, National Institutes of Health, Baltimore, MD; Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy (C.D.G.); and Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK (A.C., Z.U.)
| | - Michel Bernier
- From the Experimental Gerontology Section, Translational Gerontology Branch (I.A., C.D.G., M.B., R.d.C.) and Laboratory of Cardiovascular Science (E.G.L.), National Institute on Aging, National Institutes of Health, Baltimore, MD; Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy (C.D.G.); and Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK (A.C., Z.U.)
| | - Anna Csiszar
- From the Experimental Gerontology Section, Translational Gerontology Branch (I.A., C.D.G., M.B., R.d.C.) and Laboratory of Cardiovascular Science (E.G.L.), National Institute on Aging, National Institutes of Health, Baltimore, MD; Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy (C.D.G.); and Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK (A.C., Z.U.)
| | - Zoltan Ungvari
- From the Experimental Gerontology Section, Translational Gerontology Branch (I.A., C.D.G., M.B., R.d.C.) and Laboratory of Cardiovascular Science (E.G.L.), National Institute on Aging, National Institutes of Health, Baltimore, MD; Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy (C.D.G.); and Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK (A.C., Z.U.)
| | - Edward G Lakatta
- From the Experimental Gerontology Section, Translational Gerontology Branch (I.A., C.D.G., M.B., R.d.C.) and Laboratory of Cardiovascular Science (E.G.L.), National Institute on Aging, National Institutes of Health, Baltimore, MD; Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy (C.D.G.); and Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK (A.C., Z.U.)
| | - Rafael de Cabo
- From the Experimental Gerontology Section, Translational Gerontology Branch (I.A., C.D.G., M.B., R.d.C.) and Laboratory of Cardiovascular Science (E.G.L.), National Institute on Aging, National Institutes of Health, Baltimore, MD; Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy (C.D.G.); and Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK (A.C., Z.U.).
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Chung H, Chou W, Sears DD, Patterson RE, Webster NJG, Ellies LG. Time-restricted feeding improves insulin resistance and hepatic steatosis in a mouse model of postmenopausal obesity. Metabolism 2016; 65:1743-1754. [PMID: 27832862 PMCID: PMC5123758 DOI: 10.1016/j.metabol.2016.09.006] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 09/07/2016] [Accepted: 09/12/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Menopause is associated with significant hormonal changes that result in increased total body fat and abdominal fat, amplifying the risk for metabolic syndrome and diseases such as diabetes, cardiovascular disease and cancer in postmenopausal women. Intermittent fasting regimens hold significant health benefit promise for obese humans, however, regimens that include extreme daytime calorie restriction or daytime fasting are generally associated with hunger and irritability, hampering long-term compliance and adoption in the clinical setting. Time-restricted feeding (TRF), a regimen allowing eating only during a specific period in the normal circadian feeding cycle, without calorie restriction, may increase compliance and provide a more clinically viable method for reducing the detrimental metabolic consequences associated with obesity. METHODS We tested TRF as an intervention in a mouse model of postmenopausal obesity. Metabolic parameters were measured using Clinical Laboratory Animal Monitoring System (CLAMS) and we carried out glucose tolerance tests. We also stained liver sections with oil red O to examine steatosis and measured gene expression related to gluconeogenesis. RESULTS Preexisting metabolic disease was significantly attenuated during 7 weeks of TRF. Despite having access to the same high fat diet (HFD) as ad libitum fed (ALF) mice, TRF mice experienced rapid weight loss followed by a delayed improvement in insulin resistance and a reduced severity of hepatic steatosis by having access to the HFD for only 8h during their normal nocturnal feeding period. The lower respiratory exchange ratio in the TRF group compared with the ALF group early in the dark phase suggested that fat was the predominant fuel source in the TRF group and correlated with gene expression analyses that suggested a switch from gluconeogenesis to ketogenesis. In addition, TRF mice were more physically active than ALF fed mice. CONCLUSIONS Our data support further analysis of TRF as a clinically viable form of intermittent fasting to improve metabolic health due to obesity.
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Affiliation(s)
- Heekyung Chung
- Department of Medicine, Division of Endocrinology and Metabolism, UC San Diego, La Jolla, CA 92093, USA
| | - Winjet Chou
- Department of Medicine, Division of Endocrinology and Metabolism, UC San Diego, La Jolla, CA 92093, USA
| | - Dorothy D Sears
- Department of Medicine, Division of Endocrinology and Metabolism, UC San Diego, La Jolla, CA 92093, USA; Moores Cancer Center, UC San Diego, La Jolla, CA 92093, USA; Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA 92093, USA
| | - Ruth E Patterson
- Moores Cancer Center, UC San Diego, La Jolla, CA 92093, USA; Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA 92093, USA
| | - Nicholas J G Webster
- Department of Medicine, Division of Endocrinology and Metabolism, UC San Diego, La Jolla, CA 92093, USA; Moores Cancer Center, UC San Diego, La Jolla, CA 92093, USA; VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Lesley G Ellies
- Moores Cancer Center, UC San Diego, La Jolla, CA 92093, USA; Department of Pathology, UC San Diego, La Jolla, CA 92093, USA.
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20
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Tinsley GM, La Bounty PM. Effects of intermittent fasting on body composition and clinical health markers in humans. Nutr Rev 2015; 73:661-74. [PMID: 26374764 DOI: 10.1093/nutrit/nuv041] [Citation(s) in RCA: 197] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Intermittent fasting is a broad term that encompasses a variety of programs that manipulate the timing of eating occasions by utilizing short-term fasts in order to improve body composition and overall health. This review examines studies conducted on intermittent fasting programs to determine if they are effective at improving body composition and clinical health markers associated with disease. Intermittent fasting protocols can be grouped into alternate-day fasting, whole-day fasting, and time-restricted feeding. Alternate-day fasting trials of 3 to 12 weeks in duration appear to be effective at reducing body weight (≈3%-7%), body fat (≈3-5.5 kg), total cholesterol (≈10%-21%), and triglycerides (≈14%-42%) in normal-weight, overweight, and obese humans. Whole-day fasting trials lasting 12 to 24 weeks also reduce body weight (≈3%-9%) and body fat, and favorably improve blood lipids (≈5%-20% reduction in total cholesterol and ≈17%-50% reduction in triglycerides). Research on time-restricted feeding is limited, and clear conclusions cannot be made at present. Future studies should examine long-term effects of intermittent fasting and the potential synergistic effects of combining intermittent fasting with exercise.
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Affiliation(s)
- Grant M Tinsley
- Correspondence: G.M. Tinsley is with the Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA. P.M. LaBounty is with the Department of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, Texas, USA.
| | - Paul M La Bounty
- Correspondence: G.M. Tinsley is with the Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA. P.M. LaBounty is with the Department of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, Texas, USA
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21
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Taylor RW, Roy M, Jospe MR, Osborne HR, Meredith-Jones KJ, Williams SM, Brown RC. Determining how best to support overweight adults to adhere to lifestyle change: protocol for the SWIFT study. BMC Public Health 2015; 15:861. [PMID: 26341820 PMCID: PMC4560866 DOI: 10.1186/s12889-015-2205-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 09/02/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Physical activity plays a critical role in health, including for effective weight maintenance, but adherence to guidelines is often poor. Similarly, although debate continues over whether a "best" diet exists for weight control, meta-analyses suggest little difference in outcomes between diets differing markedly in macronutrient composition, particularly over the longer-term. Thus a more important question is how best to encourage adherence to appropriate lifestyle change. While brief support is effective, it has on-going cost implications. While self-monitoring (weight, diet, physical activity) is a cornerstone of effective weight management, little formal evaluation of the role that self-monitoring technology can play in enhancing adherence to change has occurred to date. People who eat in response to hunger have improved weight control, yet how best to train individuals to recognise when true physical hunger occurs and to limit consumption to those times, requires further study. METHODS/DESIGN SWIFT (Support strategies for Whole-food diets, Intermittent Fasting, and Training) is a two-year randomised controlled trial in 250 overweight (body mass index of 27 or greater) adults that will examine different ways of supporting people to make appropriate changes to diet and exercise habits for long-term weight control. Participants will be randomised to one of five intervention groups: control, brief support (monthly weigh-ins and meeting), app (use of MyFitnessPal with limited support), daily self-weighing (with brief monthly feedback), or hunger training (four-week programme which trains individuals to only eat when physically hungry) for 24 months. Outcome assessments include weight, waist circumference, body composition (dual-energy x-ray absorptiometry), inflammatory markers, blood lipids, adiponectin and ghrelin, blood pressure, diet (3-day diet records), physical activity (accelerometry) and aerobic fitness, and eating behaviour. SWIFT is powered to detect clinically important differences of 4 kg in body weight and 5 cm in waist circumference. Our pragmatic trial also allows participants to choose one of several dietary (Mediterranean, modified Paleo, intermittent fasting) and exercise (current recommendations, high-intensity interval training) approaches before being randomised to a support strategy. DISCUSSION SWIFT will compare four different ways of supporting overweight adults to lose weight while following a diet and exercise plan of their choice, an aspect we believe will enhance adherence and thus success with weight management. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12615000010594. Registered 8th January 2015.
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Affiliation(s)
- Rachael W Taylor
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Melyssa Roy
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Michelle R Jospe
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Hamish R Osborne
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Kim J Meredith-Jones
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Sheila M Williams
- Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Rachel C Brown
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
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22
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Ibrahim M, Abu Al Magd M, Annabi FA, Assaad-Khalil S, Ba-Essa EM, Fahdil I, Karadeniz S, Meriden T, Misha'l AA, Pozzilli P, Shera S, Thomas A, Bahijri S, Tuomilehto J, Yilmaz T, Umpierrez GE. Recommendations for management of diabetes during Ramadan: update 2015. BMJ Open Diabetes Res Care 2015; 3:e000108. [PMID: 26113983 PMCID: PMC4477152 DOI: 10.1136/bmjdrc-2015-000108] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 11/08/2022] Open
Abstract
Since the first ADA working group report on the recommendations for management of diabetes during Ramadan in 2005 and our update in 2010, we received many inquiries asking for regular updates on information regarding education, nutritional habits and new oral and injectable agents that may be useful for the management of patients with diabetes during Ramadan. Patients can be stratified into their risk of hypoglycemia and/or complications prior to the start of the fasting period of Ramadan. Those at high risk of hypoglycemia and with multiple diabetic complications should be advised against prolonged fasting. Even in the lower hypoglycemia risk group, adverse effects may still occur. In order to minimize adverse side effects during fasting in patients with diabetes and improve or maintain glucose control, education and discussion of glucose monitoring and treatment regimens should occur several weeks prior to Ramadan. Agents such as metformin, thiazolidinediones and dipeptidyl peptidase-4 inhibitors appear to be safe and do not need dose adjustment. Most sulfonylureas may not be used safely during Ramadan except with extreme caution; besides, older agents, such as chlorpropamide or glyburide, should not be used. Reduction of the dosage of sulfonylurea is needed depending on the degree of control prior to fasting. Misconceptions and local habits should be addressed and dealt with in any educational intervention and therapeutic planning with patients with diabetes. In this regard, efforts are still needed for controlled prospective studies in the field of efficacy and safety of the different interventions during the Ramadan Fast.
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Affiliation(s)
| | | | | | - Samir Assaad-Khalil
- Department of Internal Medicine, Unit of Diabetes & Metabolism, Alexandria Faculty of Medicine, Alexandria, Egypt
| | | | - Ibtihal Fahdil
- Eastern Mediterranean Office of the World Health Organization, Cairo, Egypt
| | | | - Terry Meriden
- Division of Endocrinology, University of IL, Chicago, Illinois, USA
| | | | - Paolo Pozzilli
- Department of Endocrinology and Metabolism, University Campus Bio Medico, Rome, Italy
| | - Samad Shera
- Diabetic Association of Pakistan, Karachi, Pakistan
| | | | - Suhad Bahijri
- Saudi Diabetes Group, King Abdul Aziz University, Jeddah, Saudi Arabia
| | | | - Temel Yilmaz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul University, Istanbul, Turkey
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Abstract
Excess calorie consumption is associated with metabolic disorders and increased incidence of morbidity. Restricting calorie content, either by daily calorie restriction or intermittent fasting periods, has multiple benefits including weight loss and improved body composition. Previous research has shown that restricting calories in this way can increase longevity and slow the ageing process in laboratory animals, although only sparse data exist in human populations. This review critically evaluates the benefits of these dietary interventions on age-related decline and longevity.
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Affiliation(s)
- James E Brown
- Aston Research Centre for Healthy Ageing & School of Life and Health Sciences, Aston University, Birmingham, UK
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