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Mena-Hernández DR, Jiménez-Domínguez G, Méndez JD, Olvera-Hernández V, Martínez-López MC, Guzmán-Priego CG, Reyes-López Z, Ramos-García M, Juárez-Rojop IE, Zavaleta-Toledo SS, Ble-Castillo JL. Effect of Early Time-Restricted Eating on Metabolic Markers and Body Composition in Individuals with Overweight or Obesity. Nutrients 2024; 16:2187. [PMID: 39064630 PMCID: PMC11279456 DOI: 10.3390/nu16142187] [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: 06/19/2024] [Revised: 07/07/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
This study aimed to evaluate the effect of early time-restricted eating (eTRE) on metabolic markers and body composition in individuals with overweight or obesity. Seventeen subjects completed a randomized, crossover, and controlled clinical trial. Twelve women and five men participated, with a mean age of 25.8 ± 10.0 years and a BMI of 32.0 ± 6.3 kg/m2. The eTRE intervention included 16 h of fasting (3:00 pm to 7:00 am) and 8 h of ad libitum eating (7:00 am to 03:00 pm) (16:8). The trial included four weeks of interventions followed by a four-week washout period. Body weight, waist and hip circumferences, and body composition measurements were taken. Additionally, a venous blood sample was collected for biochemical determinations. In a before-after analysis, eTRE induced a reduction in BW and BMI in women but this was not significant when compared to the control group. eTRE did not modify any other anthropometric measurements, fasting biochemical parameters, glycemic and insulinemic responses, blood pressure, or subjective appetite. In conclusion, eTRE did not induce beneficial effects on the glycemic and lipid metabolisms, body composition, subjective appetite, or blood pressure. These findings may be attributed to the special characteristics of the population and the short intervention period.
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Affiliation(s)
- Dalila Rubí Mena-Hernández
- Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico
| | - Guadalupe Jiménez-Domínguez
- Departamento de Medicina Interna, Hospital General de Zona No. 46, Instituto Mexicano del Seguro Social (IMSS), Villahermosa 86060, Mexico
| | - José D. Méndez
- Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México 06703, Mexico
| | - Viridiana Olvera-Hernández
- Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico
| | - Mirian C. Martínez-López
- Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico
| | - Crystell G. Guzmán-Priego
- Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico
| | - Zeniff Reyes-López
- Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico
| | - Meztli Ramos-García
- Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico
| | - Isela E. Juárez-Rojop
- Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico
| | - Selene S. Zavaleta-Toledo
- Departamento de Medicina Interna, Hospital General de Zona No. 46, Instituto Mexicano del Seguro Social (IMSS), Villahermosa 86060, Mexico
| | - Jorge L. Ble-Castillo
- Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico
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2
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Bakhsh JA, Vidmar AP, Salvy SJ. Intermittent Fasting in Youth: A Scoping Review. RESEARCH SQUARE 2024:rs.3.rs-4524102. [PMID: 39011109 PMCID: PMC11247931 DOI: 10.21203/rs.3.rs-4524102/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
Intermittent fasting (IF) focuses on the timing of eating rather than diet quality or energy intake, with evidence supporting its effects on weight loss and cardiometabolic outcomes in adults. However, there is limited evidence for its efficacy in adolescents and emerging adults. To address this, a scoping review examined IF regimens in individuals aged 10 to 25, focusing on methodology, intervention parameters, outcomes, adherence, feasibility, and efficacy. The review included 39 studies with 731 participants aged 15 to 25. Methodologies varied, with 18 studies on time-restricted eating and others requiring caloric restriction. Primary outcomes included cardiometabolic risk factors (11/29), body composition (9/29), anthropometric measurements (8/29), and feasibility (2/29). Most studies reported significant weight loss. This review underscores IF's potential in treating obesity in this age group but highlights the need for rigorous studies with standardized frameworks for feasibility to ensure comparability and determine IF's practicality in this age group.
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Affiliation(s)
- Jomanah A Bakhsh
- Department of Population and Public Health Sciences, University of Southern California
| | - Alaina P Vidmar
- Children's Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism
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Jospe MR, Liao Y, Giles ED, Hudson BI, Slingerland JM, Schembre SM. A low-glucose eating pattern is associated with improvements in glycemic variability among women at risk for postmenopausal breast cancer: an exploratory analysis. Front Nutr 2024; 11:1301427. [PMID: 38660060 PMCID: PMC11039850 DOI: 10.3389/fnut.2024.1301427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/22/2024] [Indexed: 04/26/2024] Open
Abstract
Background High glycemic variability (GV) is a biomarker of cancer risk, even in the absence of diabetes. The emerging concept of chrononutrition suggests that modifying meal timing can favorably impact metabolic risk factors linked to diet-related chronic disease, including breast cancer. Here, we examined the potential of eating when glucose levels are near personalized fasting thresholds (low-glucose eating, LGE), a novel form of timed-eating, to reduce GV in women without diabetes, who are at risk for postmenopausal breast cancer. Methods In this exploratory analysis of our 16-week weight loss randomized controlled trial, we included 17 non-Hispanic, white, postmenopausal women (average age = 60.7 ± 5.8 years, BMI = 34.5 ± 6.1 kg/m2, HbA1c = 5.7 ± 0.3%). Participants were those who, as part of the parent study, provided 3-7 days of blinded, continuous glucose monitoring data and image-assisted, timestamped food records at weeks 0 and 16. Pearson's correlation and multivariate regression were used to assess associations between LGE and GV, controlling for concurrent weight changes. Results Increases in LGE were associated with multiple unfavorable measures of GV including reductions in CGM glucose mean, CONGA, LI, J-Index, HBGI, ADDR, and time spent in a severe GV pattern (r = -0.81 to -0.49; ps < 0.044) and with increases in favorable measures of GV including M-value and LBGI (r = 0.59, 0.62; ps < 0.013). These associations remained significant after adjusting for weight changes. Conclusion Low-glucose eating is associated with improvements in glycemic variability, independent of concurrent weight reductions, suggesting it may be beneficial for GV-related disease prevention. Further research in a larger, more diverse sample with poor metabolic health is warranted.Clinical trial registration: ClinicalTrials.gov, NCT03546972.
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Affiliation(s)
- Michelle R. Jospe
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
| | - Yue Liao
- Department of Kinesiology at the College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Erin D. Giles
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
| | - Barry I. Hudson
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
| | - Joyce M. Slingerland
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
| | - Susan M. Schembre
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
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Chimatapu SN, Mittelman SD, Habib M, Osuna-Garcia A, Vidmar AP. Wearable Devices Beyond Activity Trackers in Youth With Obesity: Summary of Options. Child Obes 2024; 20:208-218. [PMID: 37023409 PMCID: PMC10979694 DOI: 10.1089/chi.2023.0005] [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] [Indexed: 04/08/2023]
Abstract
Background: Current treatment protocols to prevent and treat pediatric obesity focus on prescriptive lifestyle interventions. However, treatment outcomes are modest due to poor adherence and heterogeneity in responses. Wearable technologies offer a unique solution as they provide real-time biofeedback that could improve adherence to and sustainability of lifestyle interventions. To date, all reviews on wearable devices in pediatric obesity cohorts have only explored biofeedback from physical activity trackers. Hence, we conducted a scoping review to (1) catalog other biofeedback wearable devices available in this cohort, (2) document various metrics collected from these devices, and (3) assess safety and adherence to these devices. Methods: This scoping review was conducted adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Fifteen eligible studies examined the use of biofeedback wearable devices beyond activity trackers in pediatric cohorts, with an emphasis on feasibility of these devices. Results: Included studies varied in sample sizes (15-203) and in ages 6-21 years. Wearable devices are being used to capture various metrics of multicomponent weight loss interventions to provide more insights about glycemic variability, cardiometabolic function, sleep, nutrition, and body fat percentage. High safety and adherence rates were reported among these devices. Conclusions: Available evidence suggests that wearable devices have several applications aside from activity tracking, which could modify health behaviors through real-time biofeedback. Overall, these devices appear to be safe and feasible so as to be employed in various settings in the pediatric age group to prevent and treat obesity.
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Affiliation(s)
- Sri Nikhita Chimatapu
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Steven D. Mittelman
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Manal Habib
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Antonia Osuna-Garcia
- Department of Health and Life Sciences Librarian, Nursing, Biomedical Library, University of California Los Angeles, Los Angeles, CA, USA
| | - Alaina P. Vidmar
- Center for Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
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Townley J, Northstone K, Hinton EC, Hamilton-Shield J, Searle A, Leary S. Daily Duration of Eating for Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:993. [PMID: 38613026 PMCID: PMC11013214 DOI: 10.3390/nu16070993] [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: 02/23/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Time-limited eating is a dietary intervention whereby eating is limited to a specific window of time during the day. The usual eating windows of adults, and how these can be manipulated for dietary interventions, is well documented. However, there is a paucity of data on eating windows of young people, the manipulation of which may be a useful intervention for reducing obesity. This paper reviewed the existing literature on the eating windows of children and adolescents, aged 5-18 years, plus clock times of first and last intakes and variations by subgroup. Two databases (Medline and Embase) were searched for eligible papers published between February 2013 and February 2023, with forward searching of the citation network of included studies on Web of Science. Articles were screened, and data extracted, in duplicate by two independent reviewers. Ten studies were included, with both observational and experimental designs. Narrative synthesis showed large variations in eating windows with average values ranging from 9.7 h to 16.4 h. Meta-analysis, of five studies, showed a pooled mean daily eating window of 11.3 h (95% CI 11.0, 11.7). Large variations in eating windows exist across different study populations; however, the pooled data suggest that it may be possible to design time-limited eating interventions in paediatric populations aimed at reducing eating windows. Further high-quality research, investigating eating windows and subsequent associations with health outcomes, is needed.
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Affiliation(s)
- Jill Townley
- Bristol Dental School, University of Bristol, Dorothy Hodgkin Building, Whitson Street, Bristol BS1 3NY, UK
| | - Kate Northstone
- Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK;
| | - Elanor C. Hinton
- NIHR Bristol Biomedical Research Centre, Diet and Physical Activity Theme, Faculty of Health Sciences, University of Bristol, Education and Research Centre, Upper Maudlin Street, Bristol BS1 3NU, UK; (E.C.H.); (J.H.-S.); (A.S.)
| | - Julian Hamilton-Shield
- NIHR Bristol Biomedical Research Centre, Diet and Physical Activity Theme, Faculty of Health Sciences, University of Bristol, Education and Research Centre, Upper Maudlin Street, Bristol BS1 3NU, UK; (E.C.H.); (J.H.-S.); (A.S.)
| | - Aidan Searle
- NIHR Bristol Biomedical Research Centre, Diet and Physical Activity Theme, Faculty of Health Sciences, University of Bristol, Education and Research Centre, Upper Maudlin Street, Bristol BS1 3NU, UK; (E.C.H.); (J.H.-S.); (A.S.)
| | - Sam Leary
- Bristol Dental School, University of Bristol, 1 Trinity Walk, Bristol BS2 0PT, UK;
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Fernández-Rodríguez R, Garrido-Miguel M, Bizzozero-Peroni B, Díaz-Goñi V, Rodríguez-Gutiérrez E, Guzmán-Pavón MJ, Meseguer-Henarejos AB, Torres-Costoso A. Time-Restricted Eating and Bone Health: A Systematic Review with Meta-Analysis. Nutrients 2024; 16:876. [PMID: 38542787 PMCID: PMC10974430 DOI: 10.3390/nu16060876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/05/2024] Open
Abstract
Time-restricted eating (TRE) has emerged as a dietary strategy that restricts food consumption to a specific time window and is commonly applied to facilitate weight loss. The benefits of TRE on adipose tissue have been evidenced in human trials and animal models; however, its impact on bone tissue remains unclear. To systematically synthesize and examine the evidence on the impact of TRE on bone health (bone mineral content (BMC), bone mineral density (BMD), and bone turnover factors), PubMed, Scopus, Cochrane CENTRAL, and Web of Science databases were systematically explored from inception to 1 October 2023 searching for randomized controlled trials (RCTs) aimed at determining the effects of TRE on bone health in adults (≥18 years). The Cochrane Handbook and the PRISMA recommendations were followed. A total of seven RCTs involving 313 participants (19 to 68 years) were included, with an average length of 10.5 weeks (range: 4 to 24 weeks). Despite the significant weight loss reported in five out of seven studies when compared to the control, our meta-analysis showed no significant difference in BMD (g/cm2) between groups (MD = -0.009, 95% CI: -0.026 to 0.009, p = 0.328; I2 = 0%). BMC and bone turnover markers between TRE interventions and control conditions were not meta-analyzed because of scarcity of studies (less than five). Despite its short-term benefits on cardiometabolic health, TRE did not show detrimental effects on bone health outcomes compared to those in the control group. Nevertheless, caution should be taken when interpreting our results due to the scarcity of RCTs adequately powered to assess changes in bone outcomes.
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Affiliation(s)
- Rubén Fernández-Rodríguez
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
| | - Miriam Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 16002 Cuenca, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, 02006 Albacete, Spain
| | - Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
- Instituto Superior de Educación Física, Universidad de la República, Rivera 40000, Uruguay
| | - Valentina Díaz-Goñi
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
| | - Eva Rodríguez-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 16002 Cuenca, Spain
| | - María José Guzmán-Pavón
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, 45071 Toledo, Spain;
| | | | - Ana Torres-Costoso
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, 45071 Toledo, Spain;
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Tszyan M. Prevention of obesity and carbohydrate metabolism disorders in the population at an industrial facility. PRZEGLAD GASTROENTEROLOGICZNY 2024; 19:33-45. [PMID: 38571534 PMCID: PMC10985765 DOI: 10.5114/pg.2024.136246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/22/2022] [Indexed: 04/05/2024]
Abstract
Introduction One of the urgent tasks of modern healthcare is the development of measures aimed at preventing obesity in the able-bodied population, including in the Republic of Kazakhstan, which would reduce economic losses and increase the coefficient of life expectancy in the population. Aim To identify measures for the early prevention of excess weight, obesity, and carbohydrate metabolism disorders in the able-bodied population at an industrial facility in Kazakhstan. Material and methods The study involved 662 people (574 men and 88 women) aged 19 to 64 years. The subjects were divided into 2 groups: the main group - persons with obesity (242 people) and the control group - relatively healthy persons (422 people). The diagnosis of obesity was made based on the medical history of a patient, external examination, and physical, laboratory, and instrumental assessment. Results Three main factors influencing the development of obesity have been identified: a significant level of inactivity; serum glucose; the presence of comorbidities. Other factors (gender and age, smoking) do not have a significant effect on the increase in the body mass index of persons working at an industrial facility. Conclusions Accordingly, a priority in the prevention of obesity is a healthy lifestyle, involving regular physical activity and a healthy balanced diet.
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Affiliation(s)
- Maxim Tszyan
- Department of Public Health and Social Sciences, Kazakhstan Medical University “Higher School of Public Health”, Almaty, Republic of Kazakhstan
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Jayakumar A, Gillett ES, Wee CP, Kim A, Vidmar AP. Impact of 8-hour time-limited eating on sleep in adolescents with obesity. J Clin Sleep Med 2023; 19:1941-1949. [PMID: 37477160 PMCID: PMC10620649 DOI: 10.5664/jcsm.10734] [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: 05/18/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023]
Abstract
STUDY OBJECTIVES The relationship between time-limited eating (TLE) and sleep quality is a topic of growing interest in the field of chronobiology. Data in adult cohorts shows that TLE may improve sleep quality, but this has not been evaluated in adolescents. The aim of this secondary analysis was to (1) examine the impact of 8-hour TLE on sleep parameters in youth with obesity and (2) explore if there was any association between sleep patterns and glycemic profiles. METHODS Adolescents with obesity were randomized into one of three groups: 8-hour TLE (participants self-selected their eating window) + real-time continuous glucose monitor, 8-hour TLE + blinded continuous glucose monitor, or a prolonged eating window. In the primary analysis, it was found that participants in the real-time continuous glucose monitor group + 8-hour TLE group did not access their continuous glucose monitor data and thus for this analysis the two TLE groups were combined and only completers who had available Pittsburgh Sleep Quality Index (PSQI) data at all three time points were included. Participants completed the PSQI at baseline, week 4, and week 12. Mixed-effects generalized linear regression models were utilized to examine the change in PSQI score and assess association between glycemic variability and PSQI total score overtime by intervention arm. RESULTS The median PSQI total score for the TLE groups (n = 27) was 6 at week 0 (interquartile range = 5 to 10) and 5 at week 12 (interquartile range = 2 to 7). There was no significant difference in the change in total PSQI score or sleep latency between TLE and control over the study period (P > .05). There was no association between PSQI score and change in weight or glycemic profile between groups (all P values > 0.05). CONCLUSIONS These results suggest that in adolescents with obesity, an 8-hour TLE approach did not negatively impact sleep quality or efficiency when compared to a prolonged eating window. The potential effects of TLE on sleep should be further investigated in larger randomized trials. CITATION Jayakumr A, Gillett ES, Wee CP, Kim A, Vidmar AP. Impact of 8-hour time-limited eating on sleep in adolescents with obesity. J Clin Sleep Med. 2023;19(11):1941-1949.
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Affiliation(s)
- Archana Jayakumar
- Division of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Emily S. Gillett
- Division of Pediatric Pulmonology and Sleep Medicine, Children’s Hospital Los Angeles, Los Angeles, California
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Choo Phei Wee
- Southern California Clinical and Translational Science Institute, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Ahlee Kim
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
- Center for Endocrinology, Diabetes and Metabolism, Diabetes & Obesity Program, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Alaina P. Vidmar
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
- Center for Endocrinology, Diabetes and Metabolism, Diabetes & Obesity Program, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
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Silva AI, Direito M, Pinto-Ribeiro F, Ludovico P, Sampaio-Marques B. 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:jcm12113699. [PMID: 37297894 DOI: 10.3390/jcm12113699] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023] Open
Abstract
Intermittent fasting (IF) is an emerging dietetic intervention that has been associated with improved metabolic parameters. Nowadays, the most common IF protocols are Alternate-Day Fasting (ADF) and Time-Restricted Fasting (TRF), but in this review and meta-analysis we have also considered Religious Fasting (RF), which is similar to TRF but against the circadian rhythm. The available studies usually include the analysis of a single specific IF protocol on different metabolic outcomes. Herein, we decided to go further and to conduct a systematic review and meta-analysis on the advantages of different IF protocols for metabolic homeostasis in individuals with different metabolic status, such as with obesity, diabetes mellitus type 2 (T2D) and metabolic syndrome (MetS). Systematic searches (PubMed, Scopus, Trip Database, Web of Knowledge and Embase, published before June 2022) of original articles in peer-review scientific journals focusing on IF and body composition outcomes were performed. Sixty-four reports met the eligibility criteria for the qualitative analysis and forty-seven for the quantitative analysis. Herein, we showed that ADF protocols promoted the major beneficial effects in the improvement of dysregulated metabolic conditions in comparison with TRF and RF protocols. Furthermore, obese and MetS individuals are the most benefited with the introduction of these interventions, through the improvement of adiposity, lipid homeostasis and blood pressure. For T2D individuals, IF impact was more limited, but associated with their major metabolic dysfunctions-insulin homeostasis. Importantly, through the integrated analysis of distinct metabolic-related diseases, we showed that IF seems to differently impact metabolic homeostasis depending on an individual's basal health status and type of metabolic disease.
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Affiliation(s)
- Ana Inês Silva
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4806-909 Guimarães, Portugal
| | - Manuel Direito
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4806-909 Guimarães, Portugal
| | - Filipa Pinto-Ribeiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4806-909 Guimarães, Portugal
| | - Paula Ludovico
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4806-909 Guimarães, Portugal
| | - Belém Sampaio-Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4806-909 Guimarães, Portugal
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Noakes TD, Prins PJ, Volek JS, D’Agostino DP, Koutnik AP. Low carbohydrate high fat ketogenic diets on the exercise crossover point and glucose homeostasis. Front Physiol 2023; 14:1150265. [PMID: 37057184 PMCID: PMC10086139 DOI: 10.3389/fphys.2023.1150265] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
In exercise science, the crossover effect denotes that fat oxidation is the primary fuel at rest and during low-intensity exercise with a shift towards an increased reliance on carbohydrate oxidation at moderate to high exercise intensities. This model makes four predictions: First, >50% of energy comes from carbohydrate oxidation at ≥60% of maximum oxygen consumption (VO2max), termed the crossover point. Second, each individual has a maximum fat oxidation capacity (FATMAX) at an exercise intensity lower than the crossover point. FATMAX values are typically 0.3–0.6 g/min. Third, fat oxidation is minimized during exercise ≥85%VO2max, making carbohydrates the predominant energetic substrate during high-intensity exercise, especially at >85%VO2max. Fourth, high-carbohydrate low-fat (HCLF) diets will produce superior exercise performances via maximizing pre-exercise storage of this predominant exercise substrate. In a series of recent publications evaluating the metabolic and performance effects of low-carbohydrate high-fat (LCHF/ketogenic) diet adaptations during exercise of different intensities, we provide findings that challenge this model and these four predictions. First, we show that adaptation to the LCHF diet shifts the crossover point to a higher %VO2max (>80%VO2max) than previously reported. Second, substantially higher FATMAX values (>1.5 g/min) can be measured in athletes adapted to the LCHF diet. Third, endurance athletes exercising at >85%VO2max, whilst performing 6 × 800 m running intervals, measured the highest rates of fat oxidation yet reported in humans. Peak fat oxidation rates measured at 86.4 ± 6.2%VO2max were 1.58 ± 0.33 g/min with 30% of subjects achieving >1.85 g/min. These studies challenge the prevailing doctrine that carbohydrates are the predominant oxidized fuel during high-intensity exercise. We recently found that 30% of middle-aged competitive athletes presented with pre-diabetic glycemic values while on an HCLF diet, which was reversed on LCHF. We speculate that these rapid changes between diet, insulin, glucose homeostasis, and fat oxidation might be linked by diet-induced changes in mitochondrial function and insulin action. Together, we demonstrate evidence that challenges the current crossover concept and demonstrate evidence that a LCHF diet may also reverse features of pre-diabetes and future metabolic disease risk, demonstrating the impact of dietary choice has extended beyond physical performance even in athletic populations.
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Affiliation(s)
- T. D. Noakes
- Department of Medical and Wellness Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - P. J. Prins
- Department of Exercise Science, Grove City College, Grove City, PA, United States
| | - J. S. Volek
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - D. P. D’Agostino
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, United States
- Human Healthspan, Resilience and Performance, Institute of Human and Machine Cognition, Pensacola, FL, United States
| | - A. P. Koutnik
- Human Healthspan, Resilience and Performance, Institute of Human and Machine Cognition, Pensacola, FL, United States
- *Correspondence: A. P. Koutnik,
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11
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Effectiveness of Non-Contact Dietary Coaching in Adults with Diabetes or Prediabetes Using a Continuous Glucose Monitoring Device: A Randomized Controlled Trial. Healthcare (Basel) 2023; 11:healthcare11020252. [PMID: 36673620 PMCID: PMC9859545 DOI: 10.3390/healthcare11020252] [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: 12/18/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
We aimed to evaluate the effectiveness of dietary coaching and continuous glucose monitoring (CGM) in patients with diabetes or prediabetes to improve their behavioral skills and health outcomes. A randomized controlled study with pre- and post-testing was conducted. Data were collected between November 2020 and April 2021. Forty-five patients with diabetes or prediabetes who used a CGM device were enrolled and analyzed. Dietary education, individual coaching and group coaching were provided to participants in the experimental group for 4 weeks. After the intervention, the thigh circumference in men significantly differed between the two groups (z = -2.02, p = 0.044). For women, participants in the experimental group showed greater improvement in eating self-efficacy compared with those in the control group (z = -2.66, p = 0.008). Insomnia was negatively related to the change in eating self-efficacy (r = -0.35, p = 0.018) and increase in thigh circumference (r = -0.35, p = 0.017). Even if used within a short intervention period, non-contact dietary coaching programs can help enhance behavioral skills, such as eating self-efficacy and health outcomes, such as thigh circumference. Moreover, the changed variables can indirectly improve other health outcomes in patients with diabetes or prediabetes.
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12
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Cooper DJ, Zarabi S, Farrand B, Becker A, Roslin M. Continuous glucose monitoring reveals similar glycemic variability in individuals with obesity despite increased HOMA-IR. Front Nutr 2022; 9:1070187. [PMID: 36570168 PMCID: PMC9769456 DOI: 10.3389/fnut.2022.1070187] [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: 10/14/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
Background/aims Continuous glucose monitoring is a well-tolerated and versatile tool for management of diabetes and metabolic disease. While its use appears to be feasible to monitor glycemic profiles in diabetics, there is a paucity of data in individuals with obesity and normal glucose tolerance. The aim of this study is to investigate glucose fluctuations and insulin resistance patterns in normoglycemic participants with obesity vs. without obesity and contextualize these results against leading models for obesity. Materials and methods We designed a prospective, observational pilot study of two cohorts including 14 normoglycemic participants with obesity and 14 normoglycemic participants without obesity. Participants were monitored with continuous glucose monitoring (CGM) for five consecutive days. Insulin resistance levels were measured and glucometric data were extracted from CGM for all participants. Results Fasting serum insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were significantly higher in the group with obesity (P < 0.05). While the group with obesity had a higher mean blood glucose (MBG), mean amplitude of glycemic excursions (MAGE), and continuous overall glycemic action-1 h (CONGA-1), these differences were not significant. On univariate linear regression, insulin resistance (HOMA-IR) was associated with body mass index (BMI), waist circumference (WC), cohort with obesity, cohort consuming a high glycemic diet, hemoglobin A1c (HbA1c), and fasting insulin levels. WC and fasting insulin levels remained predictors of HOMA-IR in our multivariable model. Conclusion While there is much excitement surrounding the use of commercial CGM products in obesity management, our results suggest that fasting insulin and HOMA-IR values may be more clinically useful than CGM data alone.
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Affiliation(s)
- Dylan J. Cooper
- Department of Surgery, Northwell Health-Lenox Hill Hospital, New York, NY, United States,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, United States,*Correspondence: Dylan J. Cooper,
| | - Sharon Zarabi
- Department of Surgery, Northwell Health-Lenox Hill Hospital, New York, NY, United States
| | - Brianna Farrand
- Northern Westchester Hospital, Mount Kisco, NY, United States
| | - Amanda Becker
- Northern Westchester Hospital, Mount Kisco, NY, United States
| | - Mitchell Roslin
- Department of Surgery, Northwell Health-Lenox Hill Hospital, New York, NY, United States,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, United States,Northern Westchester Hospital, Mount Kisco, NY, United States
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13
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Vidmar AP, Cáceres NA, Schneider-Worthington CR, Shirazipour C, Buman MP, de la Haye K, Salvy SJ. Integration of Time-Based Recommendations with Current Pediatric Health Behavior Guidelines: Implications for Obesity Prevention and Treatment in Youth. Curr Obes Rep 2022; 11:236-253. [PMID: 36348216 PMCID: PMC9742346 DOI: 10.1007/s13679-022-00491-z] [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] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW Youth-onset obesity is associated with negative health outcomes across the lifespan including cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, dyslipidemias, asthma, and several cancers. Pediatric health guidelines have traditionally focused on the quality and quantity of dietary intake, physical activity, and sleep. RECENT FINDINGS Emerging evidence suggests that the timing (time of day when behavior occurs) and composition (proportion of time spent allocated to behavior) of food intake, movement (i.e., physical activity, sedentary time), and sleep may independently predict health trajectories and disease risks. Several theoretically driven interventions and conceptual frameworks feature behavior timing and composition (e.g., 24 h movement continuum, circadian science and chronobiology, intermittent fasting regimens, structured day hypothesis). These literatures are, however, disparate, with little crosstalk across disciplines. In this review, we examine dietary, sleep, and movement guidelines and recommendations for youths ages 0-18 in the context of theoretical models and empirical findings in support of time-based approaches. The review aims to inform a unifying framework of health behaviors and guide future research on the integration of time-based recommendations into current quantity and quality-based health guidelines for children and adolescents.
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Affiliation(s)
- Alaina P Vidmar
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA, 90027, USA.
| | - Nenette A Cáceres
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | | | - Celina Shirazipour
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Tempe, USA
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sarah-Jeanne Salvy
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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