ArticleLiterature Review

Intermittent fasting interventions for the treatment of overweight and obesity in adults aged 18 years and over: A systematic review protocol.

November 2015
The JBI Database of Systematic Reviews and Implementation Reports 13(10):60

DOI:10.11124/jbisrir-2015-2363

Authors:

Louisa J Ells

Leeds Beckett University

Victoria J. McGowan

Newcastle University

Show all 6 authorsHide

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)? INCLUSION CRITERIA Types of participants This review will consider studies that include free-living (not hospitalized) male and female adults aged 18 years and over (adults of any age will be included; however age will be considered as a potential moderator) who are overweight or obese (i.e. have a Body Mass Index greater than or equal to 25 or 30). Participants will be excluded if they have secondary or syndromic forms of obesity or are diabetic, undergoing bariatric surgery, pregnant or breast feeding, and taking medication associated with weight loss (e.g. orlistat, metformin) or weight gain (e.g. steroids, antipsychotics). Types of intervention(s)/phenomena of interest This review will consider studies that evaluate intermittent fasting interventions (defined as consumption of 800* kcal or less on at least one day, but no more than six days in a calendar week) that follow participants for at least 12 calendar weeks from the start of the intervention. *as there is no accepted formal definition of “fasting” - the NICE upper limit for a very low calorie diet will be used in this review. Types of comparators Interventions will be compared to control (no intervention) or usual care (which is likely to consist of advice to continuously follow a reduced calorie diet, which is usually around 25% of recommended energy intake).

Obesidade e jejum intermitente como intervenção dietética em cães: Revisão

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Aug 2022

A obesidade é o excesso de gordura corporal que resulta no comprometimento da saúde e do bem-estar do animal. É uma afecção de grande preocupação, pois vem afetando cada vez mais a população canina. O tratamento é baseado no manejo dietético e na realização de exercícios físicos, e a conscientização dos tutores é imprescindível para o sucesso desta abordagem terapêutica. A dieta do cão obeso necessita ser balanceada de acordo com a fisiologia de cada organismo, onde os nutrientes essenciais são equilibrados e gerenciados por um nutrólogo veterinário, que inclui fibras, proteínas, carboidratos, lipídeos, umidade do alimento e rotina de exercícios físicos no planejamento nutricional. O jejum intermitente (JI) é uma abordagem recentemente experimentada e que já possui vários benefícios observados em diversos estudos. A implantação do JI como intervenção dietética em cães pode ser utilizada com a orientação de um profissional, trazendo resultados promissores na redução de peso saudável dos animais. O objetivo deste trabalho foi realizar uma revisão bibliográfica sobre a obesidade e sobre a dieta ideal utilizada em cães que possuem essa doença, além de defender o jejum intermitente como uma intervenção terapêutica atual.

Phytochemicals

Chapter

Jul 2022

Phytochemicals are naturally found in plants and have disease-preventing functions. They have an important role in preventing chronic diseases. They act as synergistic agents allowing nutrients to be used more effectively by the body. The beneficial medicinal effect can be used as therapeutic agents against many communicable and non-communicable diseases. In general, these compounds are defined as chemicals produced by vegetable organisms. From the above-mentioned viewpoint, these molecules are not essential nutrients. However, their importance should be considered from the viewpoint of nutritional significance and public health at least, even if there is limited evidence that certain molecules (or groups) have a specific action without synergy with other compounds found in ‘healthy’ foods such as fruits, pulses, whole grains, nuts, and certain vegetable products. The complexity of this matter needs some type of acceptable classification concerning phytochemicals before discussing their benefits. Two options are discussed in this chapter, based on biosynthetic pathways, structural features and solubility in water, or based mainly on the structural features of each class.

Food Safety and Quality Control in Food Industry

Chapter

Jul 2022

Food safety and quality control ensure the food is safe for human consumption. Proper food supply chain management benefits both the manufacturers and consumers. Quality assurance and quality control processes are implemented to supply safe food and beverage products to the consumer. National regulatory guidelines of each country monitor the activities of food business operators, like the United States Food and Drug Administration, the European Food Safety Authority, China Food and Drug Administration, and the Food Safety and Standards Authority of India. Food manufacturers are required to meet the given standards of quality and food safety and need to get certified to ensure the defence mechanism against many foodborne diseases. These arguments are debated for decades. On the other side, what about the perception of quality control and effectiveness? In fact, the difference between real-time checks and the evidence of already carried out checks should be evaluated. This chapter discusses this problem—and the possible solution on behalf of the final recipients—in detail.

Nutrition Education and Diet Counselling

Chapter

Jul 2022

Nutrition education is an essential component in improving dietary habits and food choices and nutritional status of a population. The basic aim of this book has been to give a heterogeneous and complete overview of the complexity of nutritional education, mainly from the viewpoint of research chemists and technologists in the first part of the work. However, the final objective—in the Indian subcontinent and worldwide—should be the education of normal consumers with reference to available dietary models and related pros/cons. Nutrition education should be considered as a possible collection of experiences that can be taught and consequently learned by all possible food consumers with the aim of ameliorating physical well-being in terms of mobility, vision, hearing, mental ability, etc. Learners should be able to adopt nutrition-related ‘protocols’, which can be considered real co-medicinal therapies. These guidelines should not only promote physical activity, even if this feature is one of the needed pillars in the ambit of human well-being. On the other side, a correct dietary style is needed if the following aims––adequate management of body weight, physical activity day-by-day, food safety bases, and the management of alcoholic beverages have to be obtained. In this ambit, diet counselling is extremely useful as a needed co-therapy, in India and abroad. The problem is that individualized diet counselling and self-management training—are extremely difficult activities both for the healthcare professional and the patient him/herself. Diet counselling has to be really ameliorated by means of a multidisciplinary strategy.

Food Additives

Chapter

Jul 2022

Food additives can be defined as chemical substances deliberately added to foods directly or indirectly in known and regulated quantities for the purposes of assisting in the processing of foods, preservation, and improving flavour, texture, and/or appearance of foods. These compounds have important roles in the production of processed products. At present, there is a great demand for convenience and ready-to-serve food products. Consequently, food additives are essential to prevent rancidity and durability performances of foods. Additives play a key role in maintaining food qualities and characteristics that consumers demand, keeping food safe, wholesome, and appealing from farm to fork. This brief introduction should be discussed not only from the technological viewpoint, but also from the viewpoint of public health and food safety. Simplified discrimination of food additives may be offered in this chapter depending on their intended/declared function (food preservation; sensorial enhancement; technological functions; sweetness amelioration).

Antioxidants and Nutritional Significance

Chapter

Jul 2022

This chapter concerns a general introduction to the category of natural and synthetic antioxidants. The current situation in the food and beverage industries and the market is showing many interesting challenges for food technologists. Several points of discussion should be considered, including the historical, technological, and nutritional diversification of food and beverage products, the nature of food products as the association between contained food and container, the study of food-related risks, prevention methods, and correlated scandals. Actually, there are no modern food or beverage products without chemical substances. Consequently, the use of chemical compounds has to be considered a natural feature of modern edible products, also in conjunction with the need to extend shelf life (the First Parisi’s Law of Food Degradation assigns limited durability for each food and beverage product), and in spite of the demand for ‘natural’ foods or ‘clean labels’. In this ambit, the action of (preferably) natural antioxidants or synthetic compounds concerns essentially the delay of cell damage in the human body, contrasting ‘oxidative stress’. These molecules could be also useful for therapeutic approaches in the medical sector with the possibility of direct supplementation by means of non-food applications. Consequently, the use of natural antioxidants should not be considered at present as a single approach for food production, in the Indian subcontinent and worldwide.

Food Preservation

Chapter

Jul 2022

Food preservation can be defined as the science that deals with the process of prevention of decay or spoilage of food and helps it to be stored in a fit condition for future use. It helps to increase the shelf life of food thus increasing the food supply. It can be saved by means of proper food preservation methods during scarcity, stabilizing food prices, and increasing the availability by minimizing wastage. Food preservation has enabled the food industry to produce a wide range of foodstuffs of good and uniform quality at reasonable prices. At present, the main challenges for the modern industry of foods and beverages are innovation, sustainability, and safety. The innovation aims at maintaining technological processes at the highest possible level. On the other side, food safety should be considered as an ideal macro-container including innovation and process sustainability. Unfortunately, difficulties are occurring with a notable frequency at present when speaking of food regulatory compliance. This chapter would give some useful advice and information concerning modern technologies and food quality and safety.

Trends in Food Chemistry, Nutrition and Technology in Indian Sub-Continent

Book

Jul 2022

Chapter

Jul 2022

In India, the prevalence of obesity is rapidly increasing due to many factors such as globalization, urbanization, sedentary lifestyle, and dietary patterns. The consequences are immense as it results in type-2 diabetes, cardiovascular disease, liver illness, arthritis, cancer, and many other associated complications. Diet counselling and optimum dietary modifications help in the management of obesity. Dietary management includes restriction of calories, carbohydrates, fats, and protein enabling weight loss in a slow and steady phase. This chapter has the aim of highlighting different diets and methods to reduce obesity: from calories-restricted diets, such as the ‘Atkins diet’ (very low-calorie diet, intermittent energy restriction…) to no-sugar and carbohydrates-restricted (low-carb) diets such as the ketogenic model, to fats-restricted and protein-restricted approaches… and other ‘questionable’ diets. What about the pros and cons of similar extreme diets?

Health Benefits of Non-nutrients. Dietary Fibre and Water

Chapter

Jul 2022

Foods (and beverages above all) are generally water-dissolved solutions. This is a normal condition and also a pre-requisite for all edible products in human history, also meaning that dehydration treatments may be considered as one of the many tracts of anthropic activities and civilization in general. The simple production of more or less dehydrated cheeses should easily demonstrate this fact. In addition, the addition of water in certain products has to be mentioned from two opposite viewpoints: the regulatory and the technological perspectives. However, water is also essential for life, and the same thing can be affirmed with reference to other non-nutrients of vegetable origin (phytochemicals). In the ambit of phytochemistry, the class of ‘dietary fibres’ has been also mentioned because of their role as health promoters in the human diet, their contrasting importance against certain health disorders, high or low water solubility, and finally, their resistance—when observable—to human-produced digesting enzymes. Each of these points has to be examined with connection to the role of water in the human diet and foods/beverages in general. Consequently, the significance of water and also dietary fibres should be discussed: the research should investigate the use and consequences of water and dietary fibres present in the industry. This chapter would give a brief overview of this matter.

A Proposed Application for Controlling Overweight and Obesity within the Framework of the Internet of Things

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Dec 2021

Currently, overweight and obesity are two problems for global health that affect people’s quality of life. The Internet of Things (IoT) has raised the possibility of digital interaction taken to another level. This paper proposes design requirements to develop a mobile application that contributes to the control of overweight or obesity under the IoT approach, focusing on some approaches that currently exist in home-oriented health with the help of existing mobile applications. The idea of this concept is the presence of the environment of various interconnected things or objects with sensors, networking, and processing technologies integrating and working together to provide an environment in which smart services are taken to the end users. The IoT allows monitoring people in real time and analyzing information provided by mobile applications and smart devices (wearables) they have, through techniques of artificial intelligence that allow the identification of variables criticism and the generation of medical recommendations. The medical assistance model will change from the existing hospital-centric model that we commonly know to a totally home-centred health one, in which there will be less work intensity and operational cost. The home health service allows the use of IoT technology, very often called Internet of Healthcare Things (IoHT).

Short-term intermittent energy restriction interventions for weight management: a systematic review and meta-analysis: Daily Intermittent Energy Restriction

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Oct 2017

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.

INTERMITTENT FASTING: PHYSIOLOGICAL BENEFIT

Article

Aug 2022

Intermittent fasting is a type of Popular Dietary Pattern of Practice which is based on Timed Periods of Fasting. Two Different Regimens are alternative day fasting and time Restricted eating. Eventhough there are no large randomized control trials Examining the Relationship between Intermittent fasting and CVS outcome, Current Studies suggest the Diet Restriction is quite helpful for health.

FİTOKİMYASALLAR VE HAŞLAMA YÖNTEMİNİN ÇEŞİTLİ SEBZELERDEKİ FİTOKİMYASALLARA ETKİSİ

Conference Paper

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May 2021

Fitokimyasallar, bitkiler tarafından çeşitli kimyasal yollarla üretilen besleyici olmayan kimyasal bileşiklerdir. Sağlık üzerine birçok yararlı etkileri olan fitokimyasallar polifenoller, terpenoidler, organosülfürler, fitosteroller olmak üzere dört başlık altında incelenebilir. Polifenoller kendi içinde 5 ana başlığa daha ayrılır: Basit fenolik asitler, stilbenler, kurkuminoidler, lignanlar ve flavonoidler. Terpenoidlerin arasında karotenoidler (laykopen, lutein ve karoten) ve sesquiterpenler bulunur. Organasülfür bileşikler arasında allil sülfit, allisin ve alliksin bulunur. Bu bileşikler sarımsak, soğan, pırasa gibi sebzelerde bol miktarda bulunmaktadır. Son olarak kolesterol benzeri yapıda olan ve kalp sağlığı ile ilgili önemli etkileri olduğu düşünülen fitostreroller arasında kampestrol, stigmasterol ve sitosterol bulunur. Birçok hastalığın önlenmesi veya tedavisinde etkili olan fitokimyasallar sebzelerde yoğun olarak bulunur. Genel olarak sebzeler pişirilerek tüketilmektedir. Toplumda sebzelerin çiğ olarak tüketilmesinin daha doğru olduğu kanısı olsa da pişirme ile aktif olan biyoaktif bileşikler nedeniyle pişirmenin olumlu yanları da vardır. Pişirmenin sebzeler üzerinde tek bir etkisi yoktur. Bunun sebebi sebze türlerinin farklı olması olduğu gibi pişirme süresi, sıcaklık gibi etkilerden kaynaklanıyor olabilir. Pişirme yöntemlerinden biri olan haşlama yöntemi pişirme yöntemleri arasında beslenme ve diyetetik uzmanları tarafından en çok önerilen yöntemlerden biridir. Son zamanlarda haşlama suyuna geçen vitamin ve mineraller nedeniyle haşlamanın sağlıklı olarak değerlendirilmesi sorgulanmaktadır. Bu nedenle bu çalışmada fitokimyasalları kategorize etmek ve fitokimyasalların yoğun olarak bulunduğu çeşitli sebzelerde haşlama yöntemi ile fitokimyasalların değişimini incelemek amaçlanmıştır.

Medical and Therapeutic Applications of Ketosis: An Overview

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Jan 2020

Michael Paden Smith

A prioritization regimen of the acupuncture treatment for simple obesity: Protocol for systematic review and network meta-analysis

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Oct 2019

Background: Patients with simple obesity suffer from poor quality of life, as well as high risk of hypertension, diabetes, cardiovascular, and cerebrovascular accidents. Lots of Clinical trials suggested that acupuncture is beneficial for simple obesity, and it aims to gather solid evidence in order to provide reliable reference in establishing guidelines for acupuncture treatment of simple obesity in this study. Methods: Relevant databases including Cochrane Library, PubMed, Cochrane Central Register of Controlled Trials, Medline University Resource Center, Chinese Biomedical Literature Service System, and China National Knowledge Infrastructure will be retrieved from January 1950 to November 2018. Two authors will screen studies independently according to the inclusion and exclusion criteria and extract the data in a form of sheet. Quality evaluations and bias risk assessments will be performed for the methodology of included studies. Dichotomous data will be analyzed using odds ratio (OR), and continuous data using mean differences. Network meta-analysis will be conducted by using Stata 14.0. The Development and Evaluation approach will be used to rate the certainty of the evidence of estimates derived from meta-analysis. The primary outcome is body mass index (BMI), and the secondary outcomes are triglycerides, total cholesterol, low-density lipoprotein-cholesterol, effective rate, adverse effects, and recurrence rate. Trial registration number is CRD42019117387. Results: Based on current evidence, this review will rank the efficacy and safety of the various acupuncture regimen in decreasing BMI, triglycerides, total cholesterol of patients with simple obesity, and to summarize a prioritization regimen. Conclusion: This evidence may be useful for clinicians, patients, and guideline-makers to select the optimum proposal of acupuncture for the simple obesity treatment.

Intermittent Fasting in Cardiovascular Disorders—An Overview

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Mar 2019

Intermittent fasting is a form of time restricted eating (typically 16 h fasting and 8 h eating), which has gained popularity in recent years and shows promise as a possible new paradigm in the approach to weight loss and the reduction of inflammation, and has many potential long term health benefits. In this review, the authors will incorporate many aspects of fasting, mainly focusing on its effects on the cardiovascular system, involving atherosclerosis progression, benefits for diabetes mellitus type 2, lowering of blood pressure, and exploring other cardiovascular risk factors (such as lipid profile and inflammation).

Evaluation of the effects of intermittent fasting on clinical and laboratory parameters in metabolic syndrome

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Mar 2025

Aim: Metabolic syndrome is associated with serious conditions, including obesity, type 2 diabetes mellitus, hypertension, and cardiovascular disorders. We aimed to study the effects of intermittent fasting on metabolic syndrome. Methods: Patients with metabolic syndrome were enrolled in the study. Before the intervention, anthropometric measurements (body weight, body mass index [BMI], waist and hip circumferences) and laboratory parameters (fasting blood glucose, glycated hemoglobin [HbA1c], fasting insulin) were recorded. All participants were instructed to fast for 14-16 hours per day for three months, consuming two meals during the remaining 8-10 hours. After three months, anthropometric measurements were taken again, and laboratory parameters were reassessed. Data collected before the intervention and at the third month of intermittent fasting were compared. Results: Twenty patients with metabolic syndrome completed the study protocol (7 men and 13 women). The mean age of the participants was 56±12 years. There was a statistically significant reduction in weight (from 94.4±16.7 kg to 89.1±15.9 kg), BMI (from 34.9±5.6 kg/m² to 33±5.5 kg/m²), waist circumference (from 113±13 cm to 105±11.3 cm), and hip circumference (from 118±11 cm to 113±10.4 cm) (p-values: <0.001, <0.001, <0.001, and 0.001, respectively). Moreover, fasting blood glucose (p=0.024), fasting insulin (p=0.001), and HbA1c (p=0.008) levels significantly decreased after three months of intermittent fasting. Conclusion: Intermittent fasting should be considered a nutritional strategy to reduce BMI, waist circumference, and body weight and to improve metabolic parameters.

Understanding the Epidemiology of Obesity and Related Conditions: A Global Perspective

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Jan 2025

Obesity, a complex and multifactorial condition, has reached epidemic proportions globally, posing a significant threat to public health. This paper reviews the global epidemiology of obesity and associated comorbidities, exploring key trends, drivers, and implications for healthcare systems. We examine the distribution of obesity across different regions, age groups, and socioeconomic strata, analyzing factors such as dietary changes, physical inactivity, genetic predisposition, and socioeconomic inequalities. The paper delves into the growing burden of obesity-related conditions, including type 2 diabetes, cardiovascular diseases, and certain types of cancer, emphasizing their impact on morbidity, mortality, and healthcare expenditures. We discuss the challenges of obesity management, highlighting the need for multifaceted interventions that address individual behaviors, environmental factors, and social determinants of health. Finally, we explore promising research directions for understanding the complex interplay of factors influencing obesity prevalence and for developing effective strategies for prevention and management.

Effects of Intermittent Fasting and Sex on Blood Glucose, Free Fatty Acids, and Lipid Profile in Wistar Rats

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Jun 2024

Intermittent fasting (IF) has been reported to improve metabolic health through its effect on glucose and lipid profile. However, there is limited information on the effects of Intermittent Fasting on free fatty acids and sex related differences. This study was designed to investigate the effects of Intermittent Fasting (IF) on blood glucose, free fatty acids, lipid profile in both male and female Wistar rats and sex related differences. Twenty Wistar rats of both sexes weighing between 170-200g were used in the study. The animals were grouped into four (4) groups (n=5) per group. Groups 1 and 11 were male and female control groups respectively fed ad libitum with feed and water while groups 111 and 1V were male and female intermittent fasting groups fasted for 16 hours and fed for 8 hours for 28 days respectively. They had free access to water for 24 hours. At the end of 28 days fasting, blood glucose, free fatty acids and lipid profile were determined. The results of the study showed that intermittent fasting was associated with a significant increase in free fatty acids in female rats (p< 0.05) but a non- significant increase in male rats. In both female and male rats, intermittent fasting was associated with a significant decrease (p< 0.05) ins blood glucose, total cholesterol, and low-density lipoprotein, but a non-significant decrease in triglyceride compared with control groups in both male and female rats. In conclusion, Intermittent fasting may help to improve blood glucose and maintain a balanced lipid profile in both males and females. However, Intermittent fasting may also raise the level of free fatty acids and the effect might be more pronounced in females.

Open-label placebos reduce weight in obesity: a randomized controlled trial

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Sep 2024

Obesity is a major public health problem worldwide. Different approaches are known to face this problem, for example, dieting, surgery, or drug interventions. It has also been shown that placebos may help to reduce weight and hunger feelings, but the use of placebos is linked to problems with respect to the patient-healthcare-provider relationship. However, recent studies demonstrated that even placebos without deception (open-label placebos) affect symptoms such as pain, anxiety, or emotional distress. Here we aimed to examine whether an open-label placebo may help to lose weight in obesity. Our study included fifty-seven overweight and obese patients who aimed to lose weight using a combination of diet and sports. Patients were randomly divided into two groups. Participants in the open-label placebo group received two placebos each day. A treatment-as-usual group received no pills. Primary outcome included changes of body weight. Secondary outcomes were change of eating behavior and self-management abilities. After 4 weeks we found that participants in the open-label placebo condition lost more weight than the treatment-as-usual group. Furthermore, OLP treatment affected eating behavior. No effects for self-management abilities were found. Although further research is necessary, open-label placebos might help individuals to lose weight.

Invited Editorial: Pre‑packaged Food: A Universal Appraisal Regarding Cardiometabolic Syndrome Health Implication

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Measures Adopted for Weight Reduction among Obese and Overweight Individuals

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Overweight and obesity are termed as excessive or abnormal fat accumulation which eventually leads to major life-threatening problems. The up strike is due to demographic transition, modernization, and industrialization. Irregular physical activity, high-calorie diet, and unhealthy lifestyle are the major reasons for obesity. The management of obesity or overweight comprises diet restrictions, by increasing physical activity, certain weight-loss program, and medical management that is by certain drugs that had a great challenge in reduction of weight. The article tried to discuss various weight reduction strategies adopted by obese and overweight individuals. The search strategy includes using the words "weight reduction strategies," "obese," and "overweight." The platforms which the authors searched include PubMed, Google Scholar, and Scopus.

9: Non-pharmacological Management of Hypertension

Chapter

Sep 2022

Hypertension contributes to high rates of mortality and morbidity in both developing and developed countries.Predisposing factors such as sedentary lifestyles, unhealthy dietary habits and physical inactivity are associated with its growing prevalence over the years. Modernized lifestyles play important roles in the growing prevalence of uncontrolled hypertension, particularly in developing countries. Poor medication adherence, reduced drug effectiveness, drug unaffordability or unavailability, and side/adverse effects of medications are additional important obstacles in the ability to control the disease, therefore, the use of non-pharmacologic interventions are now being explored.

Comparison of the Effects of Intermittent Energy Restriction and Continuous Energy Restriction among Adults with Overweight or Obesity: An Overview of Systematic Reviews and Meta-Analyses

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Full-text available

May 2022

There is considerable heterogeneity across the evidence regarding the effects of intermittent energy restriction and continuous energy restriction among adults with overweight or obesity which presents difficulties for healthcare decision-makers and individuals. This overview of systematic reviews aimed to evaluate and synthesize the existing evidence regarding the comparison of the two interventions. We conducted a search strategy in eight databases from the databases’ inception to December 2021. The quality of 12 systematic reviews was assessed with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE). One review was rated as high quality, 1 as moderate, 4 as low, and 6 as critically low. A meta-analysis of the original studies was conducted for comparison of primary intermittent energy restriction protocols with continuous energy restriction. Intermittent energy restriction did not seem to be more effective in weight loss compared with continuous energy restriction. The advantages of intermittent energy restriction in reducing BMI and waist circumference and improvement of body composition were not determined due to insufficient evidence. The evidence quality of systematic reviews and original trials remains to be improved in future studies.

Pengaruh Alternate Day Fasting terhadap Berat Badan, Glukosa Darah, dan Fungsi Hati pada Tikus Putih Galur Sprague Dawley

Article

Full-text available

Oct 2020

Obesity is a global epidemic problem that can increase the risk of metabolic syndrome and insulin resistance. Modification of diet and moderate exercise can control metabolism. Alternate Day Fasting is one of the intermittent fasting diet modifications where the day alternates between normal and fasting diets. When fasting can consume food substances 20-25% of total energy. Aim this research objective was to determine the effect of the Alternate Day Fasting diet on body weight, blood glucose, and liver function. This research is an experimental study on male Sprague Dawley rats aged 2-3 months, weighing 150-250 grams, and no anatomical abnormalities, which are divided into 2 groups, namely control (n = 10) and Alternate Day Fasting (n = 10). The Alternate Day Fasting can reduce body weight (mean = 197.5) compared to controls (mean = 253.6). There was no difference in blood glucose (Mann Whitney; p> 0.05), Serum Glutamic Oxaloacetate Transaminase (Mann Whitney; p> 0.05), Serum Glutamic Pyruvic Transaminase (Mann Whitney; p> 0.05) between the control group and the Alternate Day Fasting diet. In conclusion Alternate Day Fasting Diet can lose weight, but does not cause a decrease in blood glucose, and does not result in an increase in Serum Glutamic Oxaloacetic Transaminase and Serum Glutamic Pyruvic Transaminase. PENDAHULUAN Berdasarkan laporan WHO (2016) obesitas telah terjadi pada lebih dari 650 juta orang di dunia. 1 Selain menyebabkan gangguan cardiovaskler, obesitas juga berperan dalam resistensi insulin. Apabila terjadi penumpukan lipid pada hati dan otot diakibatkan obesitas, hal ini mempengaruhi kerja insulin pada organ tersebut yang mengakibatkan terjadinya resistensi insulin. 2 Banyak hal yang dilakukan untuk menurunkan risiko penyakit obesitas, salah satunya yakni modifikasi diet. Salah satu bentuk modifikasi diet yakni diet puasa intermiten. 3 Menurut American Heart Association (AHA), diet puasa intermiten dapat menurunkan berat badan, risiko penyakit metabolik, dan mengurangi resistensi insulin. Akan tetapi, belum ada penelitian mengenai efek jangka panjang dari diet puasa intermiten. 4 Beberapa penelitian membuktikan bahwa diet puasa intermiten dapat menurunkan berat badan 2,5% hingga 9,9%. 5

Pengaruh Alternate Day Fasting terhadap Berat Badan, Glukosa Darah, dan Fungsi Hati pada Tikus Putih Galur Sprague Dawley

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The Metabolic Impact and Beneficial Effects of Different Energy Restriction Protocols in Rats: An Alternative Health Plan

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Using Dietary Macronutrient Patterns to Predict Sarcopenic Obesity in Older Adults: A Representative Korean Nationwide Population-Based Study

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Older adults with sarcopenic obesity (SO) are at increased risk of adverse health outcomes. It has not been identified which pattern of macronutrient intake is appropriate in relation to SO. We aimed to compare the patterns of macronutrient intake for predicting SO in older adults. Data from a total of 3828 older adults who participated in the 2008–2011 Korea National Health and Nutrition Examination Survey were analyzed. The one-day 24 h dietary recall method was used to assess macronutrient intake. SO was defined by a combination of body mass index (BMI) ≥ 25 kg/m2 and BMI adjusted-appendicular skeletal muscle mass <0.789 for men and <0.512 for women. Weighted logistic regression analysis revealed the odds ratio (95% confidence interval) for SO of total calorie intake per 100 increments and carbohydrate (CHO) intake (g/kg/day) per 1 increment to be 0.95 (0.91–0.99) and 0.83 (0.74–0.94), respectively, after adjusting for confounding variables in women. The predictive power for SO of CHO intake (g/kg/day) was higher compared with the other patterns of macronutrient intake both in men and women. In conclusion, total calorie intake and CHO intake (g/kg/day) are inversely related to SO in women. CHO intake (g/kg/day) could be the best index for determining SO.

Gut Microbiota-A positive contributor in the process of intermittent fasting-mediated obesity control

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Full-text available

Oct 2021

Historically, intermittent fasting (IF) has been considered as an effective strategy for controlling the weight of athletes before competition. Along with excellent insight into its application in various spaces by numerous studies, increasing IF-mediated positive effects have been reported, including anti-aging, neuroprotection, especially obesity control. Recently, the gut microbiota has been considered as an essential manipulator for host energy metabolism and its structure has been reported to be sensitive to dietary structure and habits, indicating that there is a potential and strong association between IF and gut microbiota. In this paper, we focused on the crosstalk between these symbionts and energy metabolism during IF which hold the promise to optimize host energy metabolism at various physical positions, including adipose tissue, liver and intestines, and further improve milieu internal homeostasis. Moreover, this paper also discussed the positive function of a potentially recommendatory strain (Akkermansia muciniphila) based on the observational data for IF-mediated alternated pattern of gut microbiota and a hopefully regulatory pathway (circadian rhythm) for gut microbiota in IF-involved improvement on host energy metabolism. Finally, this review addressed the limitation and perspective originating from these studies, such as the association with tissue-specific bio-clock and single strain research, which may continuously reveal novel viewpoints and mechanisms to understand the energy metabolism and develop new strategies for treating obesity, diabetes, and metabolic disorders.

Effects of intermittent fasting on liver physiology and metabolism in mice

Article

Full-text available

Jul 2021

A broad spectrum of health benefits from intermittent fasting have been reported in studies on animal models and human subjects. However, the underlying mechanisms of these beneficial effects remain largely elusive. The present study aimed to explore the effects and potential mode of action of intermittent fasting in mouse models with a focus on the liver. C57BL/6 mice were subjected to intermittent fasting or ad libitum feeding as controls. It was determined that 12 h of daily intermittent fasting for 30 days significantly reduced the cumulative food intake compared with that in mice with ad libitum feeding. Fasting resulted in a significantly reduced liver mass but only had a minimal effect on bodyweight. The effects on the liver by 30 days of fasting were not reversed by subsequent ad libitum refeeding for 30 days. Among the measured blood biochemical parameters, the levels of blood glucose were decreased, while the levels of alkaline phosphatase were increased in fasting mice. Of note, targeted metabolic profiling revealed global elevation of metabolites in the livers of fasting mice. These metabolic molecules included adenosine triphosphate, nicotinamide adenine dinucleotide phosphate (NADP), reduced NADP and succinate, which are essentially involved in the citric acid cycle and oxidative phosphorylation. Thus, it was concluded that daily 12 h of intermittent fasting for one month significantly reduced the liver weight of mice, which is associated with enhanced liver metabolism.

Loss of iRhom2 accelerates fat gain and insulin resistance in diet-induced obesity despite reduced adipose tissue inflammation

Article

Mar 2020
METABOLISM

Background Low-grade inflammation and metabolic dysregulation are common comorbidities of obesity, both of which are associated with alterations in iRhom2-regulated pro-inflammatory cytokine and epidermal growth factor receptor (EGFR) ligand signaling. Objective Our objective was to determine the role of iRhom2 in the regulation of low-grade inflammation and metabolic dysregulation in a murine model of diet-induced obesity. Methods Wild type (WT) and iRhom2-deficient mice were fed normal chow (NC) or a high-fat diet (HFD) starting at 5 weeks of age for up to 33 weeks. Body composition, glucose and insulin tolerance, feeding behavior, and indirect calorimetry were measured at defined time points. Adipose tissue cytokine expression and inflammatory lesions known as crown-like structures (CLS) were analyzed at the end-point of the study. Results iRhom2-deficient mice show accelerated fat gain on a HFD, accompanied by insulin resistance. Indirect calorimetry did not demonstrate changes in energy expenditure or food intake, but locomotor activity was significantly reduced in HFD iRhom2-deficient mice. Interestingly, CLS, macrophage infiltration, and TNF production were decreased in adipose tissue from HFD iRhom2-deficient mice, but circulating cytokines were unchanged. In inguinal and perigonadal fat, the EGFR ligand amphiregulin was markedly induced in HFD controls but completely prevented in iRhom2-deficient mice, suggesting a potentially dominant role of EGFR-dependent mechanisms over TNF in the modulation of insulin sensitivity. Conclusions This study elucidates a novel role for iRhom2 as an immuno-metabolic regulator that affects adipose tissue inflammation independent of insulin resistance.

Anti‑obesity effects of a mixed extract containing Platycodon grandiflorum, Apium graveolens and green tea in high‑fat‑diet‑induced obese mice

Article

Feb 2020

The anti-obesity effect of a combination of extracts made of Platycodongrandiflorum (PGE), Apium graveolens (AGE) and green tea (GTE) extracts was investigated in a high-fat diet-induced obese C57BL/6N mouse model. Body weight, epididymal adipose tissue weight, liver weight, adipocytes size and serum lipid profile, insulin, leptin and glucose levels were investigated. Additionally, hepatic steatosis, injury and oxidative burden were evaluated in the present study. The current study demonstrated that the PGE, AGE, and GTE (PAG) mixture were most effective in preventing obesity and its associated complications compared with the single extracts used alone. This was evidenced by the PAG's prevention of weight gain, reduction of adipocyte size, beneficial effects in serum lipid profile, levels of insulin, leptin and glucose, and the prevention of liver injury by reducing fat accumulation in the liver, decreased GOT and GPT enzymes and the upregulation of liver antioxidant enzymes. These results suggested that PAG may provide insights into functional food ingredients for use in the prevention of obesity.

Effects of Intermittent Energy Restriction Combined with a Mediterranean Diet on Reducing Visceral Adiposity: A Randomized Active Comparator Pilot Study

Article

Full-text available

Jun 2019

Intermittent energy restriction combined with a Mediterranean diet (IER+MED) has shown promise to reduce body fat and insulin resistance. In the Multiethnic Cohort Adiposity Phenotype Study, Japanese Americans had the highest visceral adipose tissue (VAT) when adjusting for total adiposity. We conducted this pilot study to demonstrate feasibility and explore efficacy of following IER+MED for 12 weeks to reduce VAT among East Asians in Hawaii. Sixty volunteers (aged 35–55, BMI 25–40 kg/m2, VAT ≥ 90 cm2 for men and ≥ 80 cm2 for women) were randomized to IER+MED (two consecutive days with 70% energy restriction and 5 days euenergetic MED) or an active comparator (euenergetic Dietary Approaches to Stop Hypertension (DASH) diet). Participants and clinic staff (except dietitians) were blinded to group assignments. IER+MED had significantly larger reductions in DXA-measured VAT and total fat mass (−22.6 ± 3.6 cm2 and −3.3 ± 0.4 kg, respectively) vs. DASH (−10.7 ± 3.5 cm2 and −1.6 ± 0.4 kg) (p = 0.02 and p = 0.005). However, after adjusting for total fat mass, change in VAT was not statistically different between groups; whereas, improvement in alanine transaminase remained significantly greater for IER+MED vs. DASH (−16.2 ± 3.8 U/L vs. −4.0 ± 3.6 U/L, respectively, p = 0.02). Attrition rate was 10%, and participants adhered well to study prescriptions with no reported major adverse effect. Results demonstrate IER+MED is acceptable, lowers visceral and total adiposity among East Asian Americans, and may improve liver function more effectively than a healthful diet pattern. ClinicalTrials.gov Identifier: NCT03639350.

Energy Metabolism and Intermittent Fasting: The Ramadan Perspective

Article

Full-text available

May 2019

Intermittent fasting (IF) has been gaining popularity as a means of losing weight. The Ramadan fast (RF) is a form of IF practiced by millions of adult Muslims globally for a whole lunar month every year. It entails a major shift from normal eating patterns to exclusive nocturnal eating. RF is a state of intermittent liver glycogen depletion and repletion. The earlier (morning) part of the fasting day is marked by dominance of carbohydrate as the main fuel, but lipid becomes more important towards the afternoon and as the time for breaking the fast at sunset (iftar) gets closer. The practice of observing Ramadan fasting is accompanied by changes in sleeping and activity patterns, as well as circadian rhythms of hormones including cortisol, insulin, leptin, ghrelin, growth hormone, prolactin, sex hormones, and adiponectin. Few studies have investigated energy expenditure in the context of RF including resting metabolic rate (RMR) and total energy expenditure (TEE) and found no significant changes with RF. Changes in activity and sleeping patterns however do occur and are different from non-Ramadan days. Weight changes in the context of Ramadan fast are variable and typically modest with wise inter-individual variation. As well as its direct relevance to many religious observers, understanding intermittent fasting may have implications on weight loss strategies with even broader potential implications. This review examines current knowledge on different aspects of energy balance in RF, as a common model to learn from and also map out strategies for healthier outcomes in such settings.

The effects of Ramadan fasting on activity and energy expenditure

Article

Full-text available

Jan 2018

Background Fasting during the month of Ramadan entails abstinence from eating and drinking between dawn and sunset and a major shift in meal times and patterns with associated changes in several hormones and circadian rhythms; whether there are accompanying changes in energy metabolism is unclear. Objective We have investigated the impact of Ramadan fasting on resting metabolic rate (RMR), activity, and total energy expenditure (TEE). Design Healthy nonobese volunteers (n = 29; 16 women) fasting during Ramadan were recruited. RMR was measured with the use of indirect calorimetry. In subgroups of participants, activity (n = 11; 5 women) and TEE (n = 10; 5 women) in free-living conditions were measured with the use of accelerometers and the doubly labeled water technique, respectively. Body composition was measured with the use of bioelectrical impedance. Measurements were repeated after a wash-out period of between 1 and 2 mo after Ramadan. Nonparametric tests were used for comparative statistics. Results Ramadan fasting did not result in any change in RMR (mean ± SD: 1365.7 ± 230.2 compared with 1362.9 ± 273.6 kcal/d for Ramadan and post-Ramadan respectively, P = 0.713, n = 29). However, controlling for the effects of age, sex, and body weight, RMR was higher in the first week of Ramadan than in subsequent weeks. During Ramadan, the total number of steps walked were significantly lower (n = 11, P = 0.001), while overall sleeping time was reduced and different sleeping patterns were seen. TEE did not differ significantly between Ramadan and post-Ramadan (mean ± SD: 2224.1 ± 433.7 compared with 2121.0 ± 718.5 kcal/d for Ramadan and post-Ramadan, P = 0.7695, n = 10). Conclusions Ramadan fasting is associated with reduced activity and sleeping time, but no significant change in RMR or TEE. Reported weight changes with Ramadan in other studies are more likely to be due to differences in food intake. This trial is registered at clinicaltrials.gov as NCT02696421.

INTERMITTENT FASTING FACTS AND MYTHS: METABOLIC BENEFITS OF INTERMITTENT FASTING

Article

Full-text available

May 2022

Fasting is an age-old practice, often done for religious reasons, but fasting for weight loss is still capturing the public imagination. Intermittent fasting is a form of time restricted eating (typically 16 h fasting and 8 h eating), which has gained popularity over the last few years and shows potential as a possible new paradigm in the approach to weight loss and the reduction of inflammation, and has many potential long term health benefits. It also has positive as well as negative impact on the metabolic activities. In this review article authors had collected the evidences form various articles that describe the myths and facts regarding the intermittent fasting (IF). There were potential researches that analyses intermittent fasting (IF), calorie-restricted (CR) diets is beneficial for weight loss, cardiovascular diseases, cancer, cognitive, Type 2 diabetes and reduce the oxidative stress. Similarly, there are some facts and myths that are related to IF and CR which is worth knowing. The heterogeneity in the current evidence limits comparison of IF to other weight-loss strategies. Longer-term research is needed to understand the sustainable role IF can play in weight loss.

What are the benefits of fasting and of Ramadan?

Article

Oct 2024

There has been increased popularity of fasting as a lifestyle choice and a way of losing weight. Overall, fasting results in significant health benefits. Fasting during Ramadan (i.e. religious fasting) leads to additional benefits. Keywords: Fasting, Ramadan

Health Benefits of Exercise and Fasting

Chapter

Aug 2021

Health Benefits of Exercise and Fasting

Chapter

Full-text available

Dec 2020

Effectiveness of Ramadan diurnal intermittent fasting and concurrent training in the management of obesity: is the combination worth the weight?

Article

Dec 2022

Background and aims: We investigated, in men with obesity, the efficacy of the combination of two strategies (Ramadan diurnal intermittent fasting 'RDIF' strategy vs RDIF plus concurrent training program 'RDIF-CT' strategy) known for their positive impact on body composition and then we explored the possible impact on metabolic and inflammatory biomarkers. Methods and results: Twenty obese men, age: 31.8 ± 7.05 years, BMI: 33.1 ± 4.2 kg m-2, performing regularly RDIF, were randomized into two groups: RDIF-CT (n = 10) and RDIF without training (RDIF-NCT) (n = 10). The RDIF-CT group participated in High intensity interval training (HIIT) program combined with resistance exercises for 4 weeks. Body composition, blood glucose, lipid profile, liver biomarkers and inflammation were assessed before and after 4-week RDIF. Both groups showed a significant decrease in weight, fat mass (FM), fat percentage (Fat%) and waist circumference (WC) and an improvement in blood glucose, lipid profile and inflammation. Fat free mass decreased significantly in RDIF-NCT (p < 0.05) while remaining unchanged in RDIF-CT. However, RDIF-CT induced greater improvements in body composition (i.e., weight, FM, Fat% and WC (p < 0.05, p < 0.01, p < 0.01 and p < 0.05; respectively)) as well as greater decrease in lipid biomarkers (i.e., TC, TG and LDL (p < 0.01 for all)), inflammation (i.e., CRP (p < 0.05)), and liver damage (i.e., ASAT, ALAT and Gamma-GT (p < 0.01, p < 0.05 and p < 0.001; respectively)) compared to RDIF-NCT group pre-post intervention. Conclusions: Our results suggest that a combination of RDIF and CT induces greater changes in body composition, lipid profile, inflammation and liver biomarkers compared to RDIF strategy alone. Clinical trial register: PACTR202203475387226.

Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD)

Article

Full-text available

Sep 2022
INT J MOL SCI

Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.

Important considerations for drugs, nutritional, and herbal supplements in pediatric solid organ transplant recipients

Article

Full-text available

Nov 2020
PEDIATR TRANSPLANT

Pediatric transplant recipients are on multiple prescription and non-prescription drugs. Many patients also use dietary, nutritional, and herbal supplements. This manuscript researched formulations of immunosuppressive drugs currently available and presents information on generic immunosuppressive drugs, commonly used non-prescription medications, dietary supplements, and herbal supplements. Immunosuppressive drugs are available in various formulations. Not all formulations are interchangeable. A number of FDA-approved generic formulations are available commercially in the United States. Generally generic formulations produce similar blood concentration vs time profiles compared to brand name products in adults and are considered to be bioequivalent. NSAID should be avoided in transplant patients due to potential drug interactions and increased risk associated with NSAID use; and appropriate doses of acetaminophen should be used for treatment of pain. Over-the-counter medications, such as guaifenesin and dextromethorphan, antihistamine medications, including diphenhydramine, loratadine, cetirizine, and fexofenadine, can be safely used in pediatric solid organ transplant population. Many safe and effective over-the-counter options exist for stool softening and as laxative. Diarrhea can lead to an increase in calcineurin inhibitor levels. Food can alter the absorption of immunosuppressive drugs. Several herbal products can alter immune status of the patients or alter the blood concentration of immunosuppressive drugs or may produce renal or hepatic toxicities and should be avoided in pediatric transplant recipients. It is important to educate pediatric transplant recipients and their families about not only immunosuppressive drug therapy but also about non-prescription drugs, dietary, and herbal supplement use.

Time-Limited Eating in Pediatric Patients with Obesity-A Case Series

Article

Full-text available

Jan 2020

Background: Time Limited Eating (TLE) is an effective strategy for management of obesity in adults, but there is a paucity of data that have examined its use in the clinical management of children with obesity. A TLE approach involves interspersing normal daily caloric intake with periods of prolonged calorie restriction several times per week. TLE may actually be more feasible, non-stigmatizing, flexible and effective in children, especially for adolescents, compared to alternatives like daily caloric or macronutrient restriction. This is because TLE removes the need for intensive counting of daily calorie intake or macronutrient content and focuses on a straightforward task of consuming food during a pre-specified time period. Also it avoids periods of extended caloric restriction which may interfere with growth and/or risk evoking development of eating behaviors. This case series describes four patients who trialed a TLE approach in a clinical weight management clinic and describes BMI reduction at 4 months. Case presentation: To date, 4 patients, ages 5-15, with varying underlying pathologies (i.e. Bardet Biedl Syndrome (BBS), previously healthy, craniopharyngioma and epilepsy) have tried a TLE type approach (16-hour fast/8-hour feed for 3-5 days per week) for 4 months and have demonstrated an average decrease in their BMI z-score compared to baseline of -0.24 SD. Patients and their families reported high degrees of satisfaction with this dietary approach. Conclusions: Families were very satisfied with the TLE intervention and reported it was feasible, flexible and sustainable to implement in a real life setting and associated with decreased zBMI. Further investigation is required to determine if this approach is effective in both the short and long term as a weight management technique.

A review of the molecular pathways mediating the improvement in diabetes mellitus following caloric restriction: YARIBEYGI et al.

Article

Nov 2018

Lifestyle modification is the cornerstone of diabetes prevention and treatment. Weight loss through caloric restriction (CR) is effective in improving glycemic control, though it is difficult for patients to follow in practice, and remains critical to achieve optimal glucose homeostasis. In this review, we look at what is known about the molecular pathways involved in CR‐induced insulin sensitivity and improved insulin resistance. Lifestyle modification is the cornerstone of diabetes prevention and treatment. Weight loss through caloric restriction (CR) is effective in improving glycemic control, though it is difficult for patients to follow in practice, and remains critical to achieve optimal glucose homeostasis. In this review, we look at what is known about the molecular pathways involved in CR‐induced insulin sensitivity and improved insulin resistance.

Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis

Article

Full-text available

Feb 2018

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.

Metabolic Effects of Intermittent Fasting

Article

Aug 2017

The objective of this review is to provide an overview of intermittent fasting regimens, summarize the evidence on the health benefits of intermittent fasting, and discuss physiological mechanisms by which intermittent fasting might lead to improved health outcomes. A MEDLINE search was performed using PubMed and the terms "intermittent fasting," "fasting," "time-restricted feeding," and "food timing." Modified fasting regimens appear to promote weight loss and may improve metabolic health. Several lines of evidence also support the hypothesis that eating patterns that reduce or eliminate nighttime eating and prolong nightly fasting intervals may result in sustained improvements in human health. Intermittent fasting regimens are hypothesized to influence metabolic regulation via effects on (a) circadian biology, (b) the gut microbiome, and (c) modifiable lifestyle behaviors, such as sleep. If proven to be efficacious, these eating regimens offer promising nonpharmacological approaches to improving health at the population level, with multiple public health benefits. Expected final online publication date for the Annual Review of Nutrition Volume 37 is August 21, 2017. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The Effects of Intermittent Energy Restriction on Indices of Cardiometabolic Health

Article

Full-text available

Mar 2014

Intermittent energy restriction (IER) has become the subject of considerable scientific interest as a potential dietary approach for weight-loss and improving cardiometabolic health. This approach involves intermittent periods of total or partial energy restriction (ER) alternated with non-restricted intake, and has been studied in rodent and human populations. This review aims to provide an overview of the IER literature to date, with a specific focus on its effects on cardiometabolic health indices in rodents and humans. Current evidence from studies in rodents and humans suggests that IER is capable of promoting weight-loss and/or favourably influencing an array of cardiometabolic health indices, with equal or greater efficacy than conventional continuous ER approaches. Putative mechanisms include the effects of IER on adipose tissue physiology, stress resistance and fat distribution within visceral and intra-hepatic sites. However, a large proportion of this mechanistic evidence is limited to indirect observations and/or has come from rodent studies requiring translation into humans. Furthermore, whilst there are some indications that total IER and the array of partial IER protocols which have been developed may elicit distinct biological effects, our knowledge around this is limited as only a small number of rodent studies have directly addressed this. Ultimately, whilst much remains to be learned about IER, including its mechanisms of action and long-term efficacy, the positive findings to date serve to highlight promising avenues for future research.

Intermittent fasting: A dietary intervention for prevention of diabetes and cardiovascular disease?

Article

Full-text available

Apr 2013

Intermittent fasting, in which individuals fast on consecutive or alternate days, has been reported to facilitate weight loss and improve cardiovascular risk. This review evaluates the various approaches to intermittent fasting and examines the advantages and limitations for use of this approach in the treatment of obesity and type 2 diabetes.

A Review of Evidence-Based Strategies to Treat Obesity in Adults

Article

Full-text available

Oct 2011
NUTR CLIN PRACT

Obesity, with its comorbidities, is a major public health problem. Population-based surveys estimate 2 of every 3 U.S. adults are overweight or obese. Despite billions of dollars spent annually on weight loss attempts, recidivism is high and long-term results are disappointing. In simplest terms, weight loss and maintenance depend on energy balance, and a combination of increased energy expenditure by exercise and decreased energy intake through caloric restriction is the mainstay of behavioral interventions. Many individuals successfully lose 5%-10% of body weight through behavioral approaches and thereby significantly improve health. Similar success occurs with some weight loss prescriptions, although evidence for successful weight loss with over-the-counter medications and supplements is weak. Commercial weight loss programs have helped many individuals achieve their goals, although few programs have been carefully evaluated and compared, limiting recommendations of one program over another. For the very obese, bariatric surgery is an option that leads to significant weight loss and improved health, although risks must be carefully weighed. Lifestyle changes, including regular physical activity, healthy food choices, and portion control, must be adopted, regardless of the weight loss approach, which requires ongoing support. Patients can best decide the appropriate approach working with a multidisciplinary team, including their health care provider and experts in nutrition, exercise, and behavioral intervention.

The Economic Burden of Ill Health due to Diet, Physical Inactivity, Smoking, Alcohol and Obesity in the UK: An Update to 2006–07 NHS Costs

Article

Full-text available

May 2011
J PUBLIC HEALTH-UK

Estimates of the economic cost of risk factors for chronic disease to the NHS provide evidence for prioritization of resources for prevention and public health. Previous comparable estimates of the economic costs of poor diet, physical inactivity, smoking, alcohol and overweight/obesity were based on economic data from 1992-93. Diseases associated with poor diet, physical inactivity, smoking, alcohol and overweight/obesity were identified. Risk factor-specific population attributable fractions for these diseases were applied to disease-specific estimates of the economic cost to the NHS in the UK in 2006-07. In 2006-07, poor diet-related ill health cost the NHS in the UK £5.8 billion. The cost of physical inactivity was £0.9 billion. Smoking cost was £3.3 billion, alcohol cost £3.3 billion, overweight and obesity cost £5.1 billion. The estimates of the economic cost of risk factors for chronic disease presented here are based on recent financial data and are directly comparable. They suggest that poor diet is a behavioural risk factor that has the highest impact on the budget of the NHS, followed by alcohol consumption, smoking and physical inactivity.

Health effects of intermittent fasting: Hormesis or harm? A systematic review

Article

Jul 2015
AM J CLIN NUTR

Intermittent fasting, alternate-day fasting, and other forms of periodic caloric desistance are gaining popularity in the lay press and among animal research scientists. Whether clinical evidence exists for or is strong enough to support the use of such dietary regimens as health interventions is unclear. This review sought to identify rigorous, clinically relevant research studies that provide high-quality evidence that therapeutic fasting regimens are clinically beneficial to humans. A systematic review of the published literature through January 2015 was performed by using sensitive search strategies to identify randomized controlled clinical trials that evaluated the effects of fasting on either clinically relevant surrogate outcomes (e.g., weight, cholesterol) or actual clinical event endpoints [e.g., diabetes, coronary artery disease (CAD)] and any other studies that evaluated the effects of fasting on clinical event outcomes. Three randomized controlled clinical trials of fasting in humans were identified, and the results were published in 5 articles, all of which evaluated the effects of fasting on surrogate outcomes. Improvements in weight and other risk-related outcomes were found in the 3 trials. Two observational clinical outcomes studies in humans were found in which fasting was associated with a lower prevalence of CAD or diabetes diagnosis. No randomized controlled trials of fasting for clinical outcomes were identified. Clinical research studies of fasting with robust designs and high levels of clinical evidence are sparse in the literature. Whereas the few randomized controlled trials and observational clinical outcomes studies support the existence of a health benefit from fasting, substantial further research in humans is needed before the use of fasting as a health intervention can be recommended. © 2015 American Society for Nutrition.

Tackling obesities: future choices. Foresight Programme of the Government Office for Science

Jan 2007

B Butland
S Jebb
P Kopelman
K Mcpherson
S Thomas
Mardell J Parry

Butland B, Jebb S, Kopelman P, McPherson K, Thomas S, Mardell J, Parry V. Tackling obesities: future choices. Foresight Programme of the Government Office for Science. 2007

Obesity: identification, assessment and management of overweight and obesity in children, young people and adults

Aug 2014

NICE. Obesity: identification, assessment and management of overweight and obesity in children, young people and adults. 2014 [Internet]. [Cited on August 28, 2015] Available from: http://www.nice.org.uk/guidance/cg189

Food fact sheets: detox diets

Aug 2014

British Dietetic Association. Food fact sheets: detox diets. 2014. [Internet]. [Cited on August 28, 2015] Available from: https://www.bda.uk.com/foodfacts/detoxdiets.pdf

Intermittent fasting interventions for the treatment of overweight and obesity in adults aged 18 years and over: A systematic review protocol.

Abstract

No full-text available

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