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Aims: Extended fasting–postprandial switch intermitting time has been shown to affect Alzheimer's disease (AD). Few studies have investigated the cerebral perfusion response to fasting–postprandial metabolic switching (FMS) in AD patients. We aimed to evaluate the cerebral perfusion response to FMS in AD patients. Methods: In total, 30 AD patients, 32 mild cognitive impairment (MCI) patients, and 30 healthy control individuals (HCs) were included in the quantification of cerebral perfusion via cerebral blood flow (CBF). The cerebral perfusion response to FMS was defined as the difference (ΔCBF) between fasting and postprandial CBF. Results: Patients with AD had a regional negative ΔCBF in the anterior temporal lobe, part of the occipital lobe and the parietal lobe under FMS stimulation, whereas HCs had no significant ΔCBF. The AD patients had lower ΔCBF values in the right anterior temporal lobe than the MCI patients and HCs. ΔCBF in the anterior temporal lobe was negatively correlated with cognitive severity and cognitive reserve factors in AD patients. Conclusions: AD patients exhibited a poor ability to maintain cerebral perfusion homeostasis under FMS stimulation. The anterior temporal lobe is a distinct area that responds to FMS in AD patients and negatively correlates with cognitive function. [ABSTRACT FROM AUTHOR]

Obesity is advancing at an accelerated pace, and yet its treatment is still an emerging field. Although studies have demonstrated the role of the microbiota in the pathogenesis of obesity, this is the first study to show the effects of intermittent fasting (IF), combined or not with exercise, and high-intensity interval training (HIIT) on the gut microbiota composition in women with obesity. Our hypothesis is that IF combined with HIIT can promote the remodeling of the composition and function of the gut microbiota. Thirty-six women with obesity, aged between 18 and 40 yr, participated in the study. They were randomly divided into three groups: 1) IF associated with HIIT group [IF + exercise group (EX), n = 15]; 2) HIIT group (EX, n = 11); and 3) IF group (IF, n = 10). Interventions took place over 8 wk, and all assessments were performed preintervention and postintervention. The HIIT circuit was performed 3 times/wk, for 25 min/session. The IF protocol was a 5:2 (2 times/wk). Multiplex analysis of inflammatory cytokines, sequencing of the 16S rRNA gene, and gas chromatography to measure fecal concentrations of short-chain fatty acids (SCFAs) were performed. This study was registered on ClinicalTrials.gov (NCT05237154). Exercise increased fecal acetate concentrations (P = 0.04), but no changes were observed in the composition and functional profile of the microbiota. The interventions did not change the composition of the microbiota, but exercise may play a modulatory role in the production of acetate. This investigation provides clinical insights into the use of IF and HIIT for women with obesity. NEW & NOTEWORTHY: This is the first investigation about alternate-day fasting combined with HITT on the gut microbiota of obese women. The study contributes to the advancement of human science involving IF and HIIT, popular strategies for managing obesity. Previous evidence has explored IF in modulating the microbiota in animal models or specific populations and clinical conditions. Despite the subtle outcomes, this study has relevance and originality in the field of gut microbiota knowledge. [ABSTRACT FROM AUTHOR]

This non-randomized controlled trial aimed to compare the effect of the 5:2 diet on insulin levels as a primary outcome and markers of insulin secretion (connecting peptide (C-peptide) and insulin-like growth factor binding protein-1 (IGFBP-1)) and sensitivity (Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)), as well as body composition as secondary outcomes in overweight/obese individuals with and without type 2 diabetes (T2D). Ninety-seven participants (62% women), 35 with T2D and 62 BMI- and waist-matched controls without T2D, followed the 5:2 diet (two days per week of fasting) for six months with a 12-month follow-up. At six months, there was no loss to follow-up in the T2D group, whereas four controls discontinued this study. Overall, 82% attended the 12-month follow-up. After the intervention, insulin levels decreased in the control group and glucose decreased in the T2D group, while C-peptide, HOMA-IR, waist circumference, BMI, trunk, and total fat% decreased in both groups. Furthermore, low IGFBP-1, indicating hyperinsulinemia, improved in the T2D group. The changes in fasting glucose and waist measurement were significantly more improved in the T2D group than in the controls. Persistent positive effects were observed at the 12-month follow-up. The 5:2 diet for six months was feasible and efficient to reduce markers of insulin secretion and resistance and therefore holds promise as management of overweight/obesity in subjects with and without T2D. [ABSTRACT FROM AUTHOR]

Objective: Predisposing factors of Peyronie’s disease remain controversial. We know that obesity has extremely negative effects on erectile tissue. Therefore, in our study, we aimed to examine the relationship between Peyronie’s disease and the body shape index (ABSI), which is a new parameter for the evaluation of visceral adiposity. Materials and Methods: In this study, 55 healthy volunteers (group-1) and 50 Peyronie’s disease patients (group-2). Age, comorbidities, waist circumference (WC), height, body mass index (BMI), testosterone, fasting glucose, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, International Index of Erectile Function (IIEF), and ABSI scores of all patients were analyzed. In addition, plaque sizes, duration of symptoms, and curvature degrees of patients in group 2 were calculated. Results: The mean ages of group 1 and group 2 were 57.02±8.34 years and 56.02±10.65 years, respectively (p>0.05). Fasting glucose, WC, BMI, and ABSI values were significantly higher in group 2 (p=0.031, p<0.001, p=0.026 and p<0.001). LDL and HDLvalues were similar between both groups (p>0.05). The IIEF score was observed to be lower in group 2 (p<0.001). In terms of ABSI values, the discrimination power of Peyronie’s disease was strong. The cut-off value for the ABSI score was 0.08. For this cut-off point, classification success was determined as 88.0% sensitivity and 80.0% selectivity. Conclusion: ABSI can be a reliable independent risk factor for Peyronie’s disease and a predictor of visceral adiposity. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To compare the percent weight change and metabolic outcomes among diabetic participants with obesity on intermittent fasting (IF) 16:8, IF 14:10, or normal controlled diets. Materials and Methods: A randomized controlled trial was conducted to randomize participants into three groups. Each group followed IF 16:8, IF 14:10, according to the protocol 3 days/week for 3 months or a control group. Results: A total of 99 participants completed the study. The percentage weight change from baseline was −4.02% (95% CI, −4.40 to −3.64) in IF 16:8, −3.15% (95% CI, −3.41 to −2.89) in IF 14:10, and −0.55% (95% CI, −1.05 to −0.05) in the control group. The percentage weight loss from baseline was significantly more in both IF groups (P < 0.001, both) when compared with the control group. Weight loss was significantly more in the IF 16:8 group than in that of the IF 14:10 group (P < 0.001). Metabolic outcomes (decrease in FBS and HbA1C, and improvement in lipid profiles) were significantly improved from baseline in both IF groups in comparison with the control group. Conclusions: Either IF 16:8 or 14:10 had a benefit in the percentage weight change, glucose and lipid profiles in obese diabetic patients compared with the control group when consumed for 3 days a week for 3 months. [ABSTRACT FROM AUTHOR]

Organisms subjected to periodic nutrient limitation early in life exhibit improvements in aspects of survival, including resistance to some environmental stressors. Recent findings indicate that forms of periodic fasting, such as intermittent fasting and time‐restricted feeding, can improve starvation resistance. However, it remains unclear to what extent this survival improvement persists across different genetic backgrounds. In this study, we examine fasting‐induced starvation resistance across a broad survey of wild‐derived lineages and document genetic variation within this trait. We adopt a standard dietary intervention and show improvement in starvation resistance within a common laboratory lineage, replicating previous results. Next, we examine fasting‐induced starvation resistance across isofemale lines collected across latitudes and in different seasons, and among inbred lines derived from flies collected on different continents. We discover genetic variation of fasting‐induced starvation resistance and show that fasting improved starvation resistance as often as it worsened starvation resistance. Fasted flies generally showed reduced fat concentration, and their starvation survival varied with sex, season of collection and geographic origin. While specific lineages common to the laboratory can show a specific fasting‐induced phenotype, we show that this result is not consistent across genetic backgrounds, reinforcing the idea that phenotypes observed in historic laboratory strains may not be conserved across a species. [ABSTRACT FROM AUTHOR]

Obesity compromises metabolic flexibility and increases specific immune responses. Fasting forces metabolic flexibility and alters glucose, fatty acids, glycerol, and amino acids to maintain blood glucose and energy balance. Intermittent fasting (IF) lowers inflammation and opposes metabolic dysfunction during obesity. IF can improve glucose metabolism independent of changes in obesity. Gut microbiota composition altered by IF triggers changes in immunity and metabolism. Intermittent fasting (IF) modifies cell- and tissue-specific immunometabolic responses that dictate metabolic flexibility and inflammation during obesity and type 2 diabetes (T2D). Fasting forces periods of metabolic flexibility and necessitates increased use of different substrates. IF can lower metabolic inflammation and improve glucose metabolism without lowering obesity and can influence time-dependent, compartmentalized changes in immunity. Liver, adipose tissue, skeletal muscle, and immune cells communicate to relay metabolic and immune signals during fasting. Here we review the connections between metabolic and immune cells to explain the divergent effects of IF compared with classic caloric restriction (CR) strategies. We also explore how the immunometabolism of metabolic diseases dictates certain IF outcomes, where the gut microbiota triggers changes in immunity and metabolism during fasting. [ABSTRACT FROM AUTHOR]

Given its nonnegligible role in metabolic homeostasis, adipose tissue has been the target for treating metabolic disorders such as obesity, diabetes and cardiovascular diseases. Besides its lipolytic function, adipose thermogenesis has gained increased interest due to the irreplaceable contribution to dissipating energy to restore equilibrium, and its therapeutic effects have been testified in various animal models. In this review, we will brief about the canonical cold-stimulated adipose thermogenic mechanisms, elucidate on the exercise- and intermittent fasting-induced adipose thermogenic mechanisms, with a focus on the similarities and disparities among these signaling pathways, in an effort to uncover the overlapped and specific targets that may yield potent therapeutic efficacy synergistically in improving metabolic health. • Adipose thermogenic mechanisms induced by cold exposure, exercise and intermittent fasting share similar signaling pathways. • Certain adipose thermogenic mechanisms induced by exercise are distinctive. • Adipose thermogenesis has been applied in treatment for various diseases. • Similarities and disparities in adipose thermogenic mechanisms shed new light on treating diseases. [ABSTRACT FROM AUTHOR]

between dietary and consumed energy is vital for preventing chronic illnesses and increasing life expectancy. Intermittent fasting (IF), a dietary approach typically implemented through time restrictions, exerts positive effects on the immune system and shows promising outcomes in managing various diseases. Objectives. To evaluate the effectiveness of IF on the immune system with a wide cytokine panel. Materials and methods. A total of 21 volunteers with body mass index (BMI) between 25 and 30 were included in the study. Fasting was applied for 16 h in a day to the volunteers, and they were free to consume food for the rest of the day. The weight, BMI, interleukin (IL)-1β, interferon (IFN)-α2, IFN-γ, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23, and IL-33 values were measured using flow cytometry and compared before and after 21 days follow-up. Results. The mean age of study participants was 37.76 ±8.06 years and weight loss of the volunteers was 3.35 percentile compared to the values obtained before fasting. The pro-inflammatory cytokines decreased, while anti-inflammatory cytokines increased after fasting; there was a significant difference in TNF-α, MCP-1, IL-6, IL-8, and IL-33 values. Also, IL-1β, IL-8 and IL-12p70 had moderately positive, IL-33 had strongly negative, and IL-10 had moderately negative correlation with the BMI change over time. Conclusions. Intermittent fasting has positive effects on obesity-induced inflammation and promotes decrease in proinflammatory cytokines and increase in IL-33 values, which is known to have a protective effect on fat-associated inflammatio [ABSTRACT FROM AUTHOR]

Background: Exercise and dietary interventions are essential for maintaining weight and reducing fat accumulation. With the growing popularity of various dietary strategies, evidence suggests that combining exercise with dietary interventions offers greater benefits than either approach alone. Consequently, this combined strategy has become a preferred method for many individuals aiming to maintain health. Calorie restriction, 5/2 intermittent fasting, time-restricted feeding, and the ketogenic diet are among the most popular dietary interventions today. Aerobic exercise, resistance training, and mixed exercise are the most widely practiced forms of physical activity. Exploring the best combinations of these approaches to determine which yields the most effective results is both meaningful and valuable. Despite this trend, a comparative analysis of the effects of different exercise and diet combinations is lacking. This study uses network meta-analysis to evaluate the impact of various combined interventions on body composition and to compare their efficacy. Methods: We systematically reviewed literature from database inception through May 2024, searching PubMed, Web of Science, Embase, and the Cochrane Library. The study was registered in PROSPERO under the title: "Effects of Exercise Combined with Different Dietary Interventions on Body Composition: A Systematic Review and Network Meta-Analysis" (identifier: CRD42024542184). Studies were meticulously selected based on specific inclusion and exclusion criteria (The included studies must be randomized controlled trials involving healthy adults aged 18 to 65 years. Articles were rigorously screened according to the specified inclusion and exclusion criteria.), and their risk of bias was assessed using the Cochrane risk of bias tool. Data were aggregated and analyzed using network meta-analysis, with intervention efficacy ranked by Surface Under the Cumulative Ranking (SUCRA) curves. Results: The network meta-analysis included 78 randomized controlled trials with 5219 participants, comparing the effects of four combined interventions: exercise with calorie restriction (CR+EX), exercise with time-restricted eating (TRF+EX), exercise with 5/2 intermittent fasting (5/2F+EX), and exercise with a ketogenic diet (KD+EX) on body composition. Intervention efficacy ranking was as follows: (1) Weight Reduction: CR+EX > KD+EX > TRF+EX > 5/2F+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 2.94 (−3.64, 9.52); 2.37 (−0.40, 5.15); 1.80 (−1.75, 5.34)). (2) BMI: CR+EX > KD+EX > 5/2F+EX > TRF+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 1.95 (−0.49, 4.39); 2.20 (1.08, 3.32); 1.23 (−0.26, 2.71)). (3) Body Fat Percentage: CR+EX > 5/2F+EX > TRF+EX > KD+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 2.66 (−1.56, 6.89); 2.84 (0.56, 5.13); 3.14 (0.52, 5.75).). (4) Lean Body Mass in Male: CR+EX > TRF+EX > KD+EX (Relative to CR+EX, the effect sizes of TRF+EX and KD+EX are −1.60 (−6.98, 3.78); −2.76 (−7.93, 2.40)). (5) Lean Body Mass in Female: TRF+EX > CR+EX > 5/2F+EX > KD+EX (Relative to TRF+EX, the effect sizes of CR+EX, 5/2F+EX and KD+EX are −0.52 (−2.58, 1.55); −1.83 (−4.71, 1.04); −2.46 (−5.69,0.76).). Conclusion: Calorie restriction combined with exercise emerged as the most effective strategy for reducing weight and fat percentage while maintaining lean body mass. For women, combining exercise with time-restricted eating proved optimal for preserving muscle mass. While combining exercise with a ketogenic diet effectively reduces weight, it is comparatively less effective at decreasing fat percentage and preserving lean body mass. Hence, the ketogenic diet combined with exercise is considered suboptimal. [ABSTRACT FROM AUTHOR]

As the population ages, promoting healthy aging through targeted interventions becomes increasingly crucial. Growing evidence suggests that dietary interventions can significantly impact this process by modulating fundamental molecular pathways. This review focuses on the potential of targeted dietary strategies in promoting healthy aging and the mechanisms by which specific nutrients and dietary patterns influence key pathways involved in cellular repair, inflammation, and metabolic regulation. Caloric restriction, intermittent fasting, the Mediterranean diet, as well as the ketogenic diet showed promising effects on promoting healthy aging, possibly by modulating mTORC1 AMPK, an insulin signaling pathway. By understanding the intricate interplay between diet and molecular pathways, we can develop personalized dietary strategies that not only prevent age-related diseases, but also promote overall health and well-being throughout the aging process. [ABSTRACT FROM AUTHOR]

This study examined the effects of time restricted eating (TRE) on sex hormones in males and females, versus daily calorie restriction (CR). Adults with obesity (n = 90) were randomized to 1 of 3 groups for 12-months: 8-h TRE (eating only between 12:00 to 8:00 pm, with no calorie counting); CR (25% energy restriction daily); or control. Body weight decreased (P < 0.01) in the TRE and CR groups, relative to controls, in males, premenopausal females, and postmenopausal females, by month 12. Total testosterone, dehydroepiandrosterone (DHEA), and sex hormone binding globulin (SHBG) levels did not change over time, or between groups, in males, premenopausal females, and postmenopausal females. Estradiol, estrone, and progesterone were only measured in postmenopausal females, and remained unchanged. These findings suggest that TRE produces significant weight loss but does not impact circulating sex hormone levels in males and females with obesity over 12 months, relative to CR and controls. [ABSTRACT FROM AUTHOR]

Abstract Background Intermittent fasting (IF) holds promise for enhancing metabolic health. However, the optimum IF forms and their superiority over continuous energy restriction (CER) remain unclear due to disconnected findings. Methods We systematically searched PubMed, Embase, and the Cochrane databases for meta-analyses of randomized controlled trials (RCTs) investigating the association between IF and metabolic health outcomes. Subsequently, we performed an umbrella review and network meta-analysis (NMA) to evaluate the efficacy of different forms of IF (time-restricted eating (TRE), alternate-day fasting (ADF), and 5:2 diet (regular eating for 5 days and energy restriction for 2 days per week)) compared to CER and usual diets on metabolic health outcomes. To assess the certainty of both direct and indirect estimates, we employed the Confidence in Network Meta-Analysis (CINeMA) approach. Additionally, we calculated the surface under the cumulative ranking curve (SUCRA) for each dietary strategy to determine their ranking in terms of metabolic health benefits. Results Ten of the best and non-redundant meta-analysis studies, involving 153 original studies and 9846 participants, were included. When considering direct evidence only, all IF forms significantly reduced body weight compared to usual diets. In NMA incorporating indirect evidence, all IF regimens also significantly reduced body weight compared to usual diets. In the SUCRA of NMA, IF ranked higher than usual diets or CER in 85.4% and 56.1% of the outcomes, respectively. ADF had the highest overall ranking for improving metabolic health (ranked first: 64.3%, ranked second: 14.3%). Conclusions Overall, all IF forms demonstrate potentials to improve metabolic health, with ADF appearing to produce better outcomes across investigated outcomes. Further high-quality trials are warranted to confirm the (relative) efficacy of IF on metabolic health. Trial registration PROSPERO (record no: CRD42022302690).

Abstract Background Type 2 diabetes mellitus (T2DM) is a globally prevalent chronic condition. Individuals with T2DM are at increased risk of developing complications associated with both macrovascular and microvascular pathologies. These comorbidities reduce patient quality of life and increase mortality. Dietary restriction is a principal therapeutic approach for managing T2DM. This study assessed the effects of various dietary regimens on body weight and metabolic profiles in T2DM patients, aiming to determine the most beneficial interventions for enhancing clinical outcomes and overall well-being. Methods We conducted a literature search in PubMed, Embase, and Web of Science from 2003 to April 15, 2024. The risk of bias was assessed via the Revised Cochrane risk-of-bias tool for randomized trials (RoB2). The certainty of the evidence was appraised via the confidence in network meta-analysis (CINeMA) framework. Intermittent fasting (IF) was directly compared with continuous energy restriction (CER) via Review Manager 5.4. Network meta-analysis was statistically assessed via R Studio 4.3.3 and STATA 14.0. Results Eighteen studies involving 1,658 participants were included. The network meta-analysis indicated that intermittent energy restriction, the twice-per-week fasting, time-restricted eating, fasting-mimicking diets (FMD), and CER interventions were more effective than conventional diets. Direct comparisons revealed that IF was as effective as CER for reducing glycated haemoglobin A1c, body weight, and body mass index. The results of the cumulative ranking analysis demonstrated that FMD had the greatest combined intervention effect, followed by TRE in terms of overall effectiveness. Conclusions Both IF and CER exert positive influences on weight control and metabolic profile enhancement in individuals with T2DM, with FMD as part of IF demonstrating the greatest impact. To substantiate these findings, more rigorous randomized controlled trials that directly compare the effects of the different IF regimens with one another and with the CER regimen are needed.

Xiaoyu Liu, Pengyun Du, Jianing Xu, Wei Wang, Chenggang Zhang School of Life Sciences, Beijing University of Chinese Medicine, Beijing, People’s Republic of ChinaCorrespondence: Chenggang Zhang, School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China, Email jxs@bucm.edu.cnPurpose: This study aims to assess the therapeutic potential of combining Shen-Ling-Bai-Zhu-San (SLBZS) or prebiotics with intermittent fasting (IF) in type 2 diabetes mellitus (T2DM) mice and to investigate the synergistic effects and underlying mechanisms.Methods: Type 2 diabetic mouse models were induced using high-fat diet (HFD) and streptozotocin (STZ), followed by IF treatment. Mice were then grouped for combined therapy with different doses of SLBZS and prebiotics. Fasting blood glucose (FBG) levels, body weight variations, and oral glucose tolerance tests were assessed to elucidate metabolic alterations. The hepatic and renal parameters were evaluated to determine systemic changes in T2DM mice, while the insulin levels were quantified by ELISA to assess glucose homeostasis. Gut microbiota alterations were examined via 16S rRNA sequencing. Alterations of the genes in relevant signaling pathways were analyzed using RT-qPCR.Results: IF improved FBG, body weight, insulin levels, and other diabetes indicators. Combined IF with SLBZS or prebiotics yielded similar effects. Furthermore, it ameliorated dyslipidemia and mitigated hepatic and renal parameters in T2DM mice. Pancreatic tissue histopathology showed islet cell restoration post-intervention. IF therapy reduced the abnormally elevated GSK-3β gene expression and increased the abnormally reduced GLUT2 genes. Further analysis indicated that the combination of IF with prebiotics and high doses of SLBZS upregulated the expression of the INSR and IRS1 genes. Gut microbiota analysis revealed restored diversity and structure, with notable changes in specific bacterial families. At the family level, the contents of Akkermansiaceae and Bifidobacteriaceae were restored. Phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt2) analysis suggested metabolic pathway alterations.Conclusion: IF improved type 2 diabetic symptoms, with combined SLBZS and prebiotics showing similar effects. IF with high concentration of SLBZS and prebiotics doses upregulated the INSR and IRS1 genes and had superior effects on gut microbiota compared to IF alone.Keywords: [type 2 diabetes mellitus, intermittent fasting, prebiotics, Shen-Ling-Bai-Zhu-San]

Abstract There is a need to investigate the effect of lifestyle modifications on cardiometabolic health-related issues that occur during menopause. The aim of this study was to compare the effect of resistance and endurance circuit training program alone (exercise group, n = 34) with the effect of time-restricted eating (16:8) combined with a training program (combination group, n = 28) on cardiometabolic health in 62 menopausal women (aged 51.3 ± 4.69 years). Testing was conducted before and after a 12-week period and included an assessment of body composition, glycemic control, lipid panel, blood pressure, and anthropometric measurements. Decreases in body mass index and systolic blood pressure were significantly greater in the combination group than in the exercise group (F(1,60) = 4.482, p = 0.038, η2 = 0.07; F(1,57) = 5.215, p = 0.026, η2 = 0.08, respectively, indicating moderate effects). There were significant decreases in fat mass (p = 0.001, r = 0.654), glucose level (p = 0.017, r = 0.459), insulin level (p = 0.013, r = 0.467), homeostatic model assessment for insulin resistance (p = 0.009, r = 0.499), waist circumference (p = 0.002, r = 0.596), and waist-to-height ratio (p = 0.003, r = 0.588) (indicating moderate effect) in the combination group, while there were no significant changes in the exercise group. There were no changes in lipid panel indicators in either group. This is the first study to investigate the effect of time-restricted eating combined with exercise in menopausal women. The results of the study provide evidence that the combination of time-restricted eating and exercise leads to a greater body mass index reduction than exercise alone in menopausal women. Trial registration: ClinicalTrials.gov, NCT06138015 registered 18 November 2023—Retrospectively registered, https://clinicaltrials.gov/study/NCT06138015 .

Obesity, a prevalent and multifactorial disease, is linked to a range of metabolic abnormalities, including insulin resistance, dyslipidemia, and chronic inflammation. These imbalances not only contribute to cardiometabolic diseases but also play a significant role in cancer pathogenesis. The rising prevalence of obesity underscores the need to investigate dietary strategies for effective weight management for individuals with overweight or obesity and cancer. This European Society for the Study of Obesity (EASO) position statement aimed to summarize current evidence on the role of obesity in cancer and to provide insights on the major nutritional interventions, including the Mediterranean diet (MedDiet), the ketogenic diet (KD), and the intermittent fasting (IF), that should be adopted to manage individuals with overweight or obesity and cancer. The MedDiet, characterized by high consumption of plant-based foods and moderate intake of olive oil, fish, and nuts, has been associated with a reduced cancer risk. The KD and the IF are emerging dietary interventions with potential benefits for weight loss and metabolic health. KD, by inducing ketosis, and IF, through periodic fasting cycles, may offer anticancer effects by modifying tumor metabolism and improving insulin sensitivity. Despite the promising results, current evidence on these dietary approaches in cancer management in individuals with overweight or obesity is limited and inconsistent, with challenges including variability in adherence and the need for personalized dietary plans.

To investigate the effect of intermittent fasting (IF) combined with exercise on browning of white adipose tissue (WAT), we randomly divided male C57BL/6 mice aged 5–6 weeks into six groups: control (Con), exercise (Ex), alternate-day fasting (ADF), alternate-day fasting combined with exercise (ADFEx), time-restricted feeding (TRF), and time-restricted feeding combined with exercise (TRFEx). After the six-week experimental period, blood lipid levels of mice were tested. Next, Western blot was used to detect the expression levels of phosphorylated adenosine monophosphate activated protein kinase (p-AMPK), peroxisome proliferator-activated receptor gamma (PPARγ), peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α), uncoupling protein 1 (UCP1), active fibronectin type III domain containing protein 5 (FNDC5) and PR domain-containing 16 (PRDM16) in the bilateral inguinal white adipose tissue (in-WAT), perirenal adipose tissue (pe-WAT), epididymal adipose tissue (ep-WAT), interscapular brown adipose tissue (BAT), and left hindlimb skeletal muscle of mice. The effect of IF combined with exercise on protein expression in WAT browning-related signaling pathways in mice was analyzed, and the degrees of browning in different adipose tissues were compared. The results showed that the level of total cholesterol (TC) in each experimental group was significantly lower than that of the Con group. The levels of triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) in the TRF and TRFEx groups were significantly lower than those in the Con group (P < 0.05). The relative expression levels of p-AMPK, PPARγ, PGC-1α, UCP1, FNDC5 and PRDM16 in different adipose tissues and skeletal muscle increased to different extents in the ADF, ADFEx, TRF and TRFEx groups compared with the Con group; the relative expression levels of p-AMPK, PPARγ, PGC-1α and UCP1 in BAT, in-WAT and pe-WAT increased significantly in the TRFEx group compared with the Con group. These results suggested that the combination of IF and exercise promoted the browning of WAT, and the mechanism might be related to the activation of the PPARγ/PGC-1α/UCP1 signaling pathway. TRFEx was most effective among all treatments.

Abstract Background Randomized controlled trials have confirmed the effectiveness of four prevalent caloric restriction regimens in reducing obesity-related health risks. However, there is no consensus on the optimal regimen for weight management in adults. Methods We systematically searched PubMed, Embase, Web of Science, and Cochrane CENTRAL up to January 15, 2024, for randomized controlled trials (RCT) involving adults, evaluating the weight-loss effects of alternate day fasting (ADF), short-term fasting (STF), time-restricted eating (TRE), and continuous energy restriction (CER). The primary outcome was body weight, with secondary outcomes including BMI, fat mass, lean mass, waist circumference, fasting glucose, HOMA-IR, and adverse events. Bayesian network meta-analysis was conducted, ranking regimens using the surface under the cumulative ranking curve and the probability of being the best. Study quality was assessed using the Confidence in Network Meta-Analysis tool. Results Data from 47 RCTs (representing 3363 participants) were included. ADF showed the most significant body weight loss (Mean difference (MD): -3.42; 95% Confidence interval (CI): -4.28 to -2.55), followed by TRE (MD: -2.25; 95% CI: -2.92 to -1.59). STF (MD: -1.87; 95% CI: -3.32 to -0.56) and CER (MD: -1.59; 95% CI: -2.42 to -0.79) rank third and fourth, respectively. STF lead to decline in lean mass (MD: -1.26; 95% CI: -2.16, -0.47). TRE showed benefits on fasting glucose (MD: -2.98; 95% CI: -4.7, -1.26). Subgroup analysis revealed all four caloric restriction regimens likely lead to modest weight loss after 1–3 months, with ADF ranked highest, but by 4–6 months, varying degrees of weight regain occur, particularly with CER, while interventions lasting 7–12 months may result in effective weight loss, with TRE potentially ranking first during both the 4–6 months and 7–12 months periods. ADF showing fewer and shorter-lasting physical symptoms. Conclusion All four included regiments were effective in reducing body weight, with ADF likely having the most significant impact. Each regimen likely leads to modest weight loss after 1–3 months, followed by weight regain by 4–6 months. However, interventions lasting 7–12 months achieve greater weight loss overall. Trial registration PROSPERO: CRD42022382478.

Abstract Background Cardiovascular disease represents a significant risk factor for mortality in individuals with type 2 diabetes mellitus (T2DM). High-density lipoprotein (HDL) is believed to play a crucial role in maintaining cardiovascular health through its multifaceted atheroprotective effects and its capacity to enhance glycemic control. The impact of dietary interventions and intermittent fasting (IF) on HDL functionality remains uncertain. The objective of this study was to assess the effects of dietary interventions and IF as a strategy to safely improve glycemic control and reduce body weight on functional parameters of HDL in individuals with T2DM. Methods Before the 12-week intervention, all participants (n = 41) of the INTERFAST-2 study were standardized to a uniform basal insulin regimen and randomized to an IF or non-IF group. Additionally, all participants were advised to adhere to dietary recommendations that promoted healthy eating patterns. The IF group (n = 19) followed an alternate-day fasting routine, reducing their calorie intake by 75% on fasting days. The participants’ glucose levels were continuously monitored. Other parameters were measured following the intervention: Lipoprotein composition and subclass distribution were measured by nuclear magnetic resonance spectroscopy. HDL cholesterol efflux capacity, paraoxonase 1 (PON1) activity, lecithin cholesterol acyltransferase (LCAT) activity, and cholesterol ester transfer protein (CETP) activity were assessed using cell-based assays and commercially available kits. Apolipoprotein M (apoM) levels were determined by ELISA. Results Following the 12-week intervention, the IF regimen significantly elevated serum apoM levels (p = 0.0144), whereas no increase was observed in the non-IF group (p = 0.9801). ApoM levels correlated with weight loss and fasting glucose levels in the IF group. Both groups exhibited a robust enhancement in HDL cholesterol efflux capacity (p

ABSTRACT Aims/Introduction To compare the percent weight change and metabolic outcomes among diabetic participants with obesity on intermittent fasting (IF) 16:8, IF 14:10, or normal controlled diets. Materials and Methods A randomized controlled trial was conducted to randomize participants into three groups. Each group followed IF 16:8, IF 14:10, according to the protocol 3 days/week for 3 months or a control group. Results A total of 99 participants completed the study. The percentage weight change from baseline was −4.02% (95% CI, −4.40 to −3.64) in IF 16:8, −3.15% (95% CI, −3.41 to −2.89) in IF 14:10, and −0.55% (95% CI, −1.05 to −0.05) in the control group. The percentage weight loss from baseline was significantly more in both IF groups (P

Context Different intermittent fasting (IF) protocols have been proven to be efficient in improving cardiometabolic markers, but further research is needed to examine whether or not combining IF regimens plus physical exercise is superior to control diets (ie, nonfasting eating) plus physical exercise in this setting. Objective The aim of this study was to determine whether or not combining IF plus exercise interventions is more favorable than a control diet plus exercise for improving cardiometabolic health outcomes. Data Source PubMed, Scopus, and Web of Science were comprehensively searched until April 2023. Data Extraction Electronic databases were searched for clinical trials that determined the effect of IF plus exercise vs a control diet plus exercise on body weight, lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides, and total cholesterol), and systolic and diastolic blood pressure (SBP and DBP, respectively). Analyses were conducted for IF plus exercise vs a nonfasting diet plus exercise to calculate weighted mean differences (WMDs). Data Analysis The meta-analysis included a total of 14 studies, with a total sample of 360 adults with or without obesity. The duration ranged from 4 to 52 weeks. IF plus exercise decreased body weight (WMD = –1.83 kg; P = 0.001), LDL (WMD = –5.35 mg/dL; P = 0.03), and SBP (WMD = –2.99 mm Hg; P = 0.003) significantly more than a control diet plus exercise. HDL (WMD = 1.57 mg/dL; P = 0.4) and total cholesterol (WMD = –2.24 mg/dL; P = 0.3) did not change significantly for IF plus exercise vs a control diet plus exercise, but there was a trend for reducing triglycerides (WMD = –13.13 mg/dL; P = 0.07) and DBP (WMD = 2.13 mm Hg; P = 0.05), which shows clinical magnitude. Conclusion IF plus exercise improved some cardiometabolic outcomes (body weight, blood pressure, and lipid profile) compared with a control diet plus exercise. Systematic Review Registration PROSPERO registration no. CRD42023423878. [ABSTRACT FROM AUTHOR]

Summary: Objective: The purpose of this study is to utilize network meta‐analysis (NMA) to synthesize relevant randomized controlled trials (RCTs) and evaluate the most effective intermittent fasting (IF) combined with exercise interventions for weight loss. Methods: This study searched five databases up until April 2024, obtaining RCTs that investigated the effects of intermittent fasting (IF) combined with exercise. The quality of the literature was assessed using the Cochrane tool, followed by a random‐effects statistical analysis of each intervention. Eventually, a NMA was conducted to compare the effectiveness of each intervention on weight loss, thereby determining their combined effectiveness on reducing weight. Results: A total of nine trials, comparing 12 interventions involving 570 participants, were included. All interventions significantly reduced body weight (BW) and fat mass (FM) compared to the control (CON) group. In terms of BW reduction, the alternate‐day fasting + moderate‐intensity continuous training (ADF + MICT) intervention had the highest surface under the cumulative ranking curve average (SUCRA) score 88.1(MD: −4.44,95% CI −5.95, −2.92). Furthermore, for improving FM, the ADF + MICT intervention also had the highest SUCRA score 92.7(MD: −3.65,95% CI −5.05, −2.25), making it the optimal intervention for improving FM. Conclusion: The NMA results indicate that all interventions are effective in reducing weight. Among them, ADF + MICT is the most effective strategy for reducing BW, and it is also the best approach for improving FM. [ABSTRACT FROM AUTHOR]

Food intake and energy expenditure are sensed and processed by multiple brain centres to uphold energy homeostasis. Evidence from the past decade points to the brain vasculature as a new critical player in regulating energy balance that functions in close association with the local neuronal networks. Nutritional imbalances alter many properties of the neurovascular system (such as neurovascular coupling and blood–brain barrier permeability), thus suggesting a bidirectional link between the nutritional milieu and neurovascular health. Increasing numbers of people are consuming a Western diet (comprising ultra-processed food with high-fat and high-sugar content) and have a sedentary lifestyle, with these factors contributing to the current obesity epidemic. Emerging pharmacological interventions (for example, glucagon-like peptide 1 receptor agonists) successfully trigger weight loss. However, whether these approaches can reverse the detrimental effects of long-term exposure to the Western diet (such as neurovascular uncoupling, neuroinflammation and blood–brain barrier disruption) and maintain stable body weight in the long-term needs to be clarified in addition to possible adverse effects. Lifestyle interventions revert the nutritional trigger for obesity and positively affect our overall health, including the cardiovascular system. This Perspective examines how lifestyle interventions affect the neurovascular system and neuronal networks. Nutritional imbalances (such as overnutrition in obesity) alter many properties of the neurovascular system, including neurovascular coupling and blood–brain barrier permeability. This Perspective examines how lifestyle interventions targeting weight loss, including intermittent fasting, caloric restriction and physical activity, affect the neurovascular system and neuronal networks. [ABSTRACT FROM AUTHOR]

Introduction: Fasting denotes abstinence from food or drink or both for well-being, ritualistic, and spiritual purposes. This study was conducted to explore the effect of Navratras fasting on anthropometric parameters, biochemical factors, and pro-inflammatory biomarkers. Materials and Methods: This study was a short-term longitudinal follow-up study conducted during Navratras (Oct 2020) in a residential medical college campus in western Maharashtra. Assessment of the participants based on anthropometry, biochemical, and pro-inflammatory markers was done at three-time points 7 days before the start of intermittent fasting (T1) (before the start of Navratras), at the end of intermittent fasting (the last day of the festival) (T2) (during Navratras), and 1 week after completion of intermittent fasting (T3) (after the end of Navratras). Results: A total of 50 subjects participated in the study, and the mean age of study participants was 33.6 ± 10 years. There was a significant reduction in body weight (P = 0.001), waist circumference (P = 0.001), and hip circumference (P ≤ 0.05) during the intermittent fasting period (T2). Significantly lower levels of total cholesterol (P < 0.01) and low density lipoprotein (LDL) (P < 0.01) were observed in the T2 and T3 time points of sampling. However, a significant increase in TNF-alpha, IL-1, IL-6, and IL-8 levels was observed during the T2 phase (P < 0.001). Conclusion: The current exploratory study evaluating the importance of intermittent fasting during Navratras showed a significant reduction in certain anthropometric as well as biochemical parameters. It is recommended that intermittent fasting may be considered by individuals who are overweight and need to improve overall health. However, it is important that like any other weight-loss program, intermittent fasting should also be undertaken under medical supervision.

Abstract Background and purpose Time-restricted feeding (TRF) is a dietary pattern that alternates between periods of fasting and feeding, which has gained significant attention in recent years. The 16/8 approach consists of fasting for 16 h and feeding for an 8-h window, while the 12/12 method consists of fasting for 12 h and a 12-h feeding window. Limited research exists comparing the effects of these methods coupled with physical activity (PA). The aim of this investigation was to examine the acute effects between conditions of varying TRF durations (12 and 16 h) and PA intensities on the fat oxidation rate (FOR). It was hypothesized that i) the TRF16 conditions would exhibit higher FORmax and that PA would enhance these effects, and ii) High Intensity Interval Training (HIIT) would result in greater effects on FORmax compared to Low-Moderate Intensity Steady State Continuous Training (MICT) PA. Methods and results Eighteen young adults (age: 23 ± 2.0 yrs., body mass index: 23.5 ± 2.8 kg·m−2) were recruited and participated in the supervised intervention. The discrete component open circuit spirometry system was used to measure oxygen consumption (VO2), and Frayne’s equation was used to determine the FOR plus FORmax. ANOVA was used to determine pre/post-intervention differences in FORmax. The FORmax for the TRF16 + HIIT intervention was significantly higher than the TRF12 (mean difference = 0.099 g·min-1, p = 0.011, 95% CI 0.017 to 0.180) and TRF16 fast alone (mean difference = 0.093 g·min-1, p = 0.002, 95% CI 0.027 to 0.159). The FORmax for TRF12 + HIIT intervention was significantly higher than the TRF12 fast alone (mean difference = 0.070 g·min−1, p = 0.023, 95% CI 0.007 to 0.134). The TRF16 + HIIT intervention was also significantly higher than the TRF12 fast alone (mean difference = 0.099 g·min−1, p = 0.011, 95% CI 0.017 to 0.180). Conclusion This study contributes to the ever-growing body of literature on the acute effects of TRF and PA on young adult males and females. The findings suggest that the TRF16 + HIIT PA intervention results in the highest FORmax. Trial registration Retrospective Registration ISRCTN # 10076373 (October 6, 2023).

Abstract Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases, and it is characterized by a series of fatty liver diseases that can lead to severe liver disease. Although no therapeutic drug has been approved as an effective therapy for NAFLD to date, dietary changes and physical activity are thought to be the cornerstone of NAFLD management. For this reason, some articles are available to analyze the studies done so far using various modifications of intermittent fasting (IF) among animals and patients with NAFLD. Data from preclinical and clinical trials suggested that IF positively impacts inflammatory and metabolic markers in both animals and humans. Inflammation and oxidative stress are the major risk factors involved in the pathogenesis of NAFLD. IF has been shown to have positive benefits in alleviating metabolic disorders, promoting the browning of white tissue, resetting circadian rhythm, and activating autophagy of cells. This review is intended to provide a detailed synopsis of the protocols, potential mechanisms of action, and supporting evidence for IF in NAFLD. We will highlight what is currently known about IF approaches in NAFLD treatments in clinical populations with mechanism insight from animal studies, and the safety concerns in certain patient groups. Graphical Abstract The protocols of intermittent fasting (IF) are various. Data from trials suggested that IF positively impacts both humans and animals. IF has been shown to have potential treatments for nonalcoholic fatty liver disease.

Abstract Background Time-restricted eating (TRE) has been shown to be associated with improvements in some aspects of the metabolic syndrome. Nevertheless, only a few studies have addressed the effect of TRE on pulse wave velocity (PWV). We thus propose a randomized controlled trial to compare the effects of TRE with standard dietary advice on PWV and thereby present the protocol. Methods Forty-eight participants will be assigned to either TRE or control groups using simple randomization. The TRE group will consume their meals during a 10-h period and experience 14 h of fasting. They will also be advised to consume their last meal no later than 20:00. Both groups will receive standard dietary advice. The participants will be followed for 6 weeks. The primary outcome will be changes in PWV. Laboratory measurements, including lipid profile, liver enzyme tests, fasting blood glucose (FBG), insulin concentrations, and insulin resistance, as well as anthropometric data, blood pressure, basal metabolic rate, appetite status, physical activity level, sleep quality, cognitive function, quality of life, and calorie intake, will be evaluated throughout the study. Discussion The outcomes of this study will allow a comparison of the effects of TRE and standard dietary recommendations on PWV and other cardiometabolic factors in individuals with metabolic syndrome (MetS). Trial registration Iranian Registry of Clinical Trials; code: IRCT20201230049889N1; registered on August 14, 2022. The registration of the trial is accessible at: https://www.IRCT.ir/trial/64485?revision=281341 .

Background Time-restricted feeding (TRF), devoid of calorie restriction, is acknowledged for promoting metabolic health and mitigating various chronic metabolic diseases. While TRF exhibits widespread benefits across multiple tissues, there is limited exploration into its impact on kidney function. In this study, our aim was to investigate the potential ameliorative effects of TRF on kidney damage in a mouse model of cisplatin-induced acute kidney injury (AKI). Methods Cisplatin-induced AKI was induced through intraperitoneal injection of cisplatin into C57BL/6 male mice. Mice undergoing TRF were provided unrestricted access to standard chow daily but were confined to an 8-hour feeding window during the dark cycle for 2 weeks before cisplatin injection. The mice were categorized into four groups: control, TRF, cisplatin, and TRF + cisplatin. Results The tubular damage score and serum creatinine levels were significantly lower in the TRF + cisplatin group compared to the cisplatin group. The TRF + cisplatin group exhibited reduced expression of phosphorylated nuclear factor kappa B, inflammatory cytokines, and F4/80-positive macrophages compared to the cisplatin group. Furthermore, oxidative stress markers for DNA, protein, and lipid were markedly decreased in the TRF + cisplatin group compared to the cisplatin group. TUNEL-positive tubular cells, cleaved caspase-3 expression, and the Bax/Bcl-2 ratio in the TRF + cisplatin group were lower than those in the cisplatin group. Conclusion TRF, without calorie restriction, effectively mitigated kidney damage by suppressing inflammatory reactions, oxidative stress, and tubular apoptosis in a mouse model of cisplatin-induced AKI. TRF holds promise as a novel dietary intervention for preventing cisplatin-induced AKI.

Abstract Background There is little evidence to comprehensively summarize the adverse events (AEs) profile of intermittent fasting (IF) despite its widespread use in patients with overweight or obesity. Methods We searched the main electronic databases and registry websites to identify eligible randomized controlled trials (RCTs) comparing IF versus control groups. A direct meta-analysis using a fixed-effect model was conducted to pool the risk differences regarding common AEs and dropouts. Study quality was assessed by using the Jadad scale. Pre-specified subgroup and sensitivity analyses were conducted to explore potential heterogeneity. Results A total of 15 RCTs involving 1,365 adult individuals were included. Findings did not show a significant difference between IF and Control in risk rate of fatigue [0%, 95% confidence interval (CI), -1% to 2%; P = 0.61], headache [0%, 95%CI: -1% to 2%; P = 0.86] and dropout [1%, 95%CI: -2% to 4%; P = 0.51]. However, a numerically higher risk of dizziness was noted among the IF alone subgroup with non-early time restricted eating [3%, 95%CI: -0% to 6%; P = 0.08]. Conclusions This meta-analysis suggested that IF was not associated with a greater risk of AEs in adult patients affected by overweight or obesity. Additional large-scale RCTs stratified by key confounders and designed to evaluate the long-term effects of various IF regimens are needed to ascertain these AEs profile.

Intermittent fasting (IF) and calorie restriction (CR) were purported to have health benefits. This research aimed to determine the long-term effect of IF and CR on selected neurological parameters in mice. Swiss Webster male mice were divided into 3 groups: ad libitum feeding (AL), IF, and CR. Mice in each group received the treatment for 16 weeks. They were then tested for anhedonia, depression, aggressiveness, and social approach. They were also subjected to contextual fear conditioning tests to model PTSD. Compared to AL, sucrose intake in the IF group was lower, while the CR group showed higher intake (p

Intermittent fasting (IF), a dietary pattern alternating between eating and fasting periods within a 24-hour cycle, has garnered recognition for its potential to enhance both healthspan and lifespan in animal models and humans. It also shows promise in alleviating age-related diseases, including neurodegeneration. Vascular cognitive impairment (VCI) spans a severity range from mild cognitive deficits to severe cognitive deficits and loss of function in vascular dementia. Chronic cerebral hypoperfusion has emerged as a significant contributor to VCI, instigating vascular pathologies such as microbleeds, blood-brain barrier dysfunction, neuronal loss, and white matter lesions. Preclinical studies in rodents strongly suggest that IF has the potential to attenuate pathological mechanisms, including excitotoxicity, oxidative stress, inflammation, and cell death pathways in VCI models. Hence, this supports evaluating IF in clinical trials for both existing and at-risk VCI patients. This review compiles existing data supporting IF’s potential in treating VCI-related vascular and neuronal pathologies, emphasizing the mechanisms by which IF may mitigate these issues. Hence providing a comprehensive overview of the available data supporting IF’s potential in treating VCI by emphasizing the underlying mechanisms that make IF a promising intervention for VCI.

Abstract Background Glucose metabolism regulation is influenced by age and meal skipping, although research on their interplay with hyperglycemia remains limited. This study aims to explore the intricate relationship between meal-skipping patterns and hyperglycemia risk across distinct age groups in South Korean adults. Methods Utilizing data from the Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2013 to 2020, comprising 28,530 individuals aged 19 years and older, this study employed multivariable logistic regression models to examine the associations between meal-skipping patterns and the risk of hyperglycemia. Results Meal-skipping patterns were categorized into three groups: no skipping (NS), skipping breakfast (SB), and skipping dinner (SD). Age groups were defined as “young” (aged 19–44), “middle-aged” (aged 45–64), and “elderly” adults (over 65 years old). Among “young” adults, SB was associated with a 1.33-fold higher risk of hyperglycemia (OR = 1.33, 95% CI = 1.14–1.54) compared to NS. Conversely, in “elderly” adults, SD was linked to a 0.49-fold reduced risk (95% CI = 0.29–0.82) when compared to NS. Additionally, we observed that the Korean Health Eating Index (KHEI) scores, representing the quality of diet on a scale of 0 to 100, were consistently lower in SB compared to NS across all age groups. Intriguingly, specifically among the “elderly” group, this score was higher in SD compared to NS (p

Background: Gestational diabetes (GD) can threaten the health of both the mother and the foetus if it is not effectively managed. While there exists a growing body of research on self-management interventions for GD, there is a lack of reviewed studies regarding the various self-management interventions in Africa. The purpose of this review is to map the evidence of self-management interventions for GD in Africa. Methods: Searches for records were conducted in four major databases, including PubMed, PubMed Central, Science Direct and Journal Storage. Additional documents from Google and Google Scholar were also added. The guidelines for conducting scoping reviews by Arksey and O'Malley were followed. Results: The results revealed that intermittent fasting, education on diet, insulin injection, blood glucose monitoring, physical activities, lifestyle modification and foot care were the available self-management interventions for GD in Africa. Most of the reviewed studies reported intermittent fasting and patient education as effective self-management interventions for GD in Africa. The barriers identified in the reviewed studies were either patient-related or facility-related. Patient-related barriers included lack of awareness, and negative attitude, while facility-related barriers included lack of access to education on GD, especially, face-to-face educational interventions. Conclusion: It is crucial to consider the cultural and personal needs, as well as the educational level of women with gestational diabetes when creating an effective self-management intervention. Optimal results can be achieved for self-management of gestational diabetes by integrating multidisciplinary approaches. [ABSTRACT FROM AUTHOR]

Introduction: Maintaining metabolic balance relies on accumulating nutrients during feeding periods and their subsequent release during fasting. In obesity and metabolic disorders, strategies aimed at reducing food intake while simulating fasting have garnered significant attention for weight loss. Caloric restriction (CR) diets and intermittent fasting (IF) interventions have emerged as effective approaches to improving cardiometabolic health. Although the comparative metabolic benefits of CR versus IF remain inconclusive, this review focuses on various forms of IF, particularly time-restricted eating (TRE). Methods: This study employs a narrative review methodology, systematically collecting, synthesizing, and interpreting the existing literature on TRE and its metabolic effects. A comprehensive and unbiased search of relevant databases was conducted to identify pertinent studies, including pre-clinical animal studies and clinical trials in humans. Keywords such as "Obesity," "Intermittent Fasting," "Time-restricted eating," "Chronotype," and "Circadian rhythms" guided the search. The selected studies were critically appraised based on predefined inclusion and exclusion criteria, allowing for a thorough exploration and synthesis of current knowledge. Results: This article synthesizes pre-clinical and clinical studies on TRE and its metabolic effects, providing a comprehensive overview of the current knowledge and identifying gaps for future research. It explores the metabolic outcomes of recent clinical trials employing different TRE protocols in individuals with overweight, obesity, or type II diabetes, emphasizing the significance of individual chronotype, which is often overlooked in practice. In contrast to human studies, animal models underscore the role of the circadian clock in mitigating metabolic disturbances induced by obesity through time-restricted feeding (TRF) interventions. Consequently, we examine pre-clinical evidence supporting the interplay between the circadian clock and TRF interventions. Additionally, we provide insights into the role of the microbiota, which TRE can modulate and its influence on circadian rhythms. [ABSTRACT FROM AUTHOR]

Fasting can affect the body's inflammatory response, and this has been linked to potential health benefits, including improvements for people with rheumatic diseases. In this work, we evaluated, in vitro, how changes in nutrient availability alter the inflammatory response of macrophages. Macrophage-differentiated THP1 cells were cultured, deprived of FCS or subjected to cycles of FCS deprivation and restoration to mimic intermittent fasting. Changes in the macrophage phenotype, the cells' response to inflammatory stimuli and the level of mitochondrial alteration were assessed. The results indicate that while periods of serum starvation are associated with a decrease in IL1β and TNFα expression, consistent with an anti-inflammatory response, intermittent serum starvation cycles promote a pro-inflammatory phenotype. Rapid changes in reducing capacity and mitochondrial response were also observed. Of note, while some changes, such as the production of oxygen free radicals, were reversed with refeeding, others, such as a decrease in reducing capacity, were maintained and even increased. This study shows that different fasting protocols can have diverging effects and highlights that time-limited nutrient changes can significantly affect macrophage functions in cell cultures. These findings help elucidate some of the mechanisms by which specific fasting dietary interventions could help control inflammatory diseases. [ABSTRACT FROM AUTHOR]

The aim of this secondary analysis was to compare the effects of time-restricted eating (TRE) versus calorie restriction (CR) and controls on sleep in adults with type 2 diabetes (T2D). Adults with T2D (n = 75) were randomized to 1 of 3 interventions for 6 months: 8 h TRE (eating only between 12 and 8 pm daily); CR (25% energy restriction daily); or control. Our results show that TRE has no effect on sleep quality, duration, insomnia severity, or risk of obstructive sleep apnea, relative to CR and controls, in patients with T2D over 6 months. [ABSTRACT FROM AUTHOR]

Intermittent fasting has drawn significant interest in the clinical research community due to its potential to address metabolic complications such as obesity and type 2 diabetes mellitus. Various intermittent fasting regimens include alternate-day fasting (24 h of fasting followed by 24 h of eating), time-restricted fasting (fasting for 14 h and eating within a 10 h window), and the 5:2 diet (fasting for two days and eating normally for the other five days). Intermittent fasting is associated with a reduced risk of type 2 diabetes mellitus-related complications and can slow their progression. The increasing global prevalence of type 2 diabetes mellitus highlights the importance of early management. Since prediabetes is a precursor to type 2 diabetes mellitus, understanding its progression is essential. However, the long-term effects of intermittent fasting on prediabetes are not yet well understood. Therefore, this review aims to comprehensively compile existing knowledge on the therapeutic effects of intermittent fasting in managing type 2 diabetes mellitus and prediabetes. [ABSTRACT FROM AUTHOR]

Intermittent religious fasting increases the risk of hypo- and hyperglycemia in individuals with diabetes, but its impact on those without diabetes has been poorly investigated. The aim of this preliminary study was to examine the effects of religious Bahá'í fasting (BF) on glycemic control and variability and compare these effects with time-restricted eating (TRE). In a three-arm randomized controlled trial, 16 subjects without diabetes were assigned to a BF, TRE, or control group. Continuous glucose monitoring and food intake documentation were conducted before and during the 19 days of the intervention, and the 24 h mean glucose and glycemic variability indices were assessed. The BF and TRE groups, but not the control group, markedly reduced the daily eating window while maintaining macronutrient composition. Only the BF group decreased caloric intake (−677.8 ± 357.6 kcal, p = 0.013), body weight (−1.92 ± 0.95 kg, p = 0.011), and BMI (−0.65 ± 0.28 kg, p = 0.006). Higher maximum glucose values were observed during BF in the within-group (+1.41 ± 1.04, p = 0.039) and between-group comparisons (BF vs. control: p = 0.010; TRE vs. BF: p = 0.022). However, there were no alterations of the 24 h mean glucose, intra- and inter-day glycemic variability indices in any group. The proportions of time above and below the range (70–180 mg/dL) remained unchanged. BF and TRE do not exhibit negative effects on glycemic control and variability in subjects without diabetes. [ABSTRACT FROM AUTHOR]

Background and purpose: Time-restricted feeding (TRF) is a dietary pattern that alternates between periods of fasting and feeding, which has gained significant attention in recent years. The 16/8 approach consists of fasting for 16 h and feeding for an 8-h window, while the 12/12 method consists of fasting for 12 h and a 12-h feeding window. Limited research exists comparing the effects of these methods coupled with physical activity (PA). The aim of this investigation was to examine the acute effects between conditions of varying TRF durations (12 and 16 h) and PA intensities on the fat oxidation rate (FOR). It was hypothesized that i) the TRF16 conditions would exhibit higher FORmax and that PA would enhance these effects, and ii) High Intensity Interval Training (HIIT) would result in greater effects on FORmax compared to Low-Moderate Intensity Steady State Continuous Training (MICT) PA. Methods and results: Eighteen young adults (age: 23 ± 2.0 yrs., body mass index: 23.5 ± 2.8 kg·m−2) were recruited and participated in the supervised intervention. The discrete component open circuit spirometry system was used to measure oxygen consumption (VO2), and Frayne's equation was used to determine the FOR plus FORmax. ANOVA was used to determine pre/post-intervention differences in FORmax. The FORmax for the TRF16 + HIIT intervention was significantly higher than the TRF12 (mean difference = 0.099 g·min-1, p = 0.011, 95% CI 0.017 to 0.180) and TRF16 fast alone (mean difference = 0.093 g·min-1, p = 0.002, 95% CI 0.027 to 0.159). The FORmax for TRF12 + HIIT intervention was significantly higher than the TRF12 fast alone (mean difference = 0.070 g·min−1, p = 0.023, 95% CI 0.007 to 0.134). The TRF16 + HIIT intervention was also significantly higher than the TRF12 fast alone (mean difference = 0.099 g·min−1, p = 0.011, 95% CI 0.017 to 0.180). Conclusion: This study contributes to the ever-growing body of literature on the acute effects of TRF and PA on young adult males and females. The findings suggest that the TRF16 + HIIT PA intervention results in the highest FORmax. Trial registration: Retrospective Registration ISRCTN # 10076373 (October 6, 2023). [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases, and it is characterized by a series of fatty liver diseases that can lead to severe liver disease. Although no therapeutic drug has been approved as an effective therapy for NAFLD to date, dietary changes and physical activity are thought to be the cornerstone of NAFLD management. For this reason, some articles are available to analyze the studies done so far using various modifications of intermittent fasting (IF) among animals and patients with NAFLD. Data from preclinical and clinical trials suggested that IF positively impacts inflammatory and metabolic markers in both animals and humans. Inflammation and oxidative stress are the major risk factors involved in the pathogenesis of NAFLD. IF has been shown to have positive benefits in alleviating metabolic disorders, promoting the browning of white tissue, resetting circadian rhythm, and activating autophagy of cells. This review is intended to provide a detailed synopsis of the protocols, potential mechanisms of action, and supporting evidence for IF in NAFLD. We will highlight what is currently known about IF approaches in NAFLD treatments in clinical populations with mechanism insight from animal studies, and the safety concerns in certain patient groups. The protocols of intermittent fasting (IF) are various. Data from trials suggested that IF positively impacts both humans and animals. IF has been shown to have potential treatments for nonalcoholic fatty liver disease. [ABSTRACT FROM AUTHOR]

The time of day that we eat is increasingly recognized as contributing as importantly to overall health as the amount or quality of the food we eat. The endogenous circadian clock has evolved to promote intake at optimal times when an organism is intended to be awake and active, but electric lights and abundant food allow eating around the clock with deleterious health outcomes. In this review, we highlight literature pertaining to the effects of food timing on health, beginning with animal models and then translation into human experiments. We emphasize the pitfalls and opportunities that technological advances bring in bettering understanding of eating behaviors and their association with health and disease. There is great promise for restricting the timing of food intake both in clinical interventions and in public health campaigns for improving health via nonpharmacological therapies. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the influence of combined intermittent fasting (IF) and high‐intensity interval training (HIIT) on morphology, caspase‐independent apoptosis signaling pathway, and myostatin expression in soleus and gastrocnemius (white portion) muscles from healthy rats. Sixty‐day‐old male Wistar rats (n = 60) were divided into four groups: control (C), IF, high‐intensity‐interval training (T), and high‐intensity‐interval training and intermittent fasting (T‐IF). The C and T groups received ad libitum chow daily; IF and T‐IF received the same standard chow every other day. Animals from T and T‐IF underwent a HIIT protocol five times a week for 12 weeks. IF reduced gastrocnemius mass and increased pro‐apoptotic proteins apoptosis‐inducing factor (AIF) and endonuclease G (EndoG) in soleus and cleaved‐to‐non‐cleaved PARP‐1 ratio and myostatin expression in gastrocnemius white portion. HIIT increased AIF and apoptosis repressor with caspase recruitment domain expression in soleus and cleaved‐to‐total PARP‐1 ratio in gastrocnemius muscle white portion. The combination of IF and HIIT reduced fiber cross‐sectional area in both muscles, increased EndoG and AIF expression, and decreased cleaved‐to‐non‐cleaved PARP‐1 ratio in gastrocnemius muscle white portion. Muscle responses to IF and HIIT are directly impacted by the muscle fiber type composition and are modulated, at least in part, by myostatin and caspase‐independent apoptosis signaling. [ABSTRACT FROM AUTHOR]

Idiopathic intracranial hypertension (IIH) is a disorder that primarily affects obese women of reproductive age. The exact pathogenesis of IIH is unknown though multiple etiologies have been proposed. We report a case of IIH triggered by first-time Ramadan intermittent fasting (RIF) in an 18-year-old woman. Our patient developed new onset headaches, diplopia, and pulsatile tinnitus with examination notable for bilateral papilledema and lumbar puncture revealing an elevated opening pressure. Her symptoms resolved after cessation of RIF, apart from persistent left sided tinnitus which later resolved with acetazolamide administration. This case report uniquely illustrates that RIF may provoke symptomatic IIH. We hypothesize that a decreased concentration of glucagon-like peptide-1 (GLP-1) induced by fasting results in decreased GLP-1 receptor activation in the choroid plexus, allowing for increased CSF secretion into the ventricles invoking increased intracranial pressure (ICP). This theoretical mechanism provides further insight as to the possible underlying pathophysiology of IIH. [ABSTRACT FROM AUTHOR]

Optimal nutrition is highly valuable for athletes aiming at maintaining or improving body composition and sports performance. When combined with structured exercise, time-restricted energy intake may represent an effective nonpharmacological approach to achieving these results. The aim of this study was to investigate the effects of 4 weeks of time-restricted eating (TRE) vs 4 weeks of habitual diet on aerobic capacity, body composition, and metabolic health in 18- to 30-year-old men accustomed to endurance running. This trial used a randomized-crossover study design. Participants completed graded exercise tests, body composition scans, and fasting blood samples before and after each intervention condition. Sixteen male physical education students were recruited and enrolled in the study from the Faculty of Human Kinetics—University of Lisbon in September 2020, in Lisbon, Portugal. One participant was excluded after 1 week because of a lack of adherence to the study protocol. Therefore, 15 participants completed the study and were involved in the final analysis. During the TRE condition, participants consumed two to three meals within an 8-hour eating window (between 1:00 and 9:00 pm). Only water, tea, and coffee (without caloric additives) were permitted to be consumed in the remaining 16 hours per 24-hour period. During the non-TRE condition, participants consumed their habitual diet without any timing restrictions. The order of the TRE intervention and the habitual diet condition was randomized and counterbalanced, and participants served as their own controls. The participants followed a structured training routine during each dietary condition. Body composition variables, indices of running aerobic capacity, and markers of metabolic health were assessed. One-way repeated-measures analysis of variance and covariance were performed to analyze differences between conditions and time with each intervention. Neither condition elicited observed changes in total body mass, fat mass, or fat-free mass between time points. Moreover, no significant changes were observed for markers of metabolic health. Significant improvements were obtained with both conditions for the first ventilatory threshold, maximum oxygen uptake (VO 2max), and velocity at VO 2max (P < 0.05). Four weeks of endurance running and TRE, compared with 4 weeks of endurance running and a habitual diet, in healthy trained 18- to 30-year-old male recreational runners did not result in observed differences in total body mass, fat mass, or fat-free mass. In addition, TRE did not offer any additional benefit for improving submaximal or peak exercise capacity in this population. [ABSTRACT FROM AUTHOR]

No trial has tested the effects of late time-restricted eating (lTRE) on glycemic control or body composition in adolescents with type 2 diabetes (T2D). The objective of the current study was to examine the feasibility, acceptability, and preliminary efficacy of lTRE compared with a prolonged eating window in adolescents with T2D. A 12-week, randomized, controlled, feasibility study of lTRE compared with control in adolescents with obesity and new-onset T2D was conducted. Eligible participants were 13 to 21 years of age with a diagnosis of T2D, on metformin monotherapy, recruited from Children's Hospital Los Angeles, between January 2021 and December of 2022. From 36 eligible participants, 27 were enrolled (75% recruitment rate; age, 16.5 ± 1.7 years; hemoglobin A1c [HbA1c], 6.6% ± 0.9%; 22/27 [81%] Hispanic, 17/27 [63%] female, 23/27 [85%] public insurance; all P -values > 0.05), and 23 of 27 completed the protocol. Participants wore a continuous glucose monitor (CGM) daily and were randomized to 1 of 2 meal-timing schedules for 12-weeks: (1) lTRE (eating all food between 12:00 pm and 20:00 pm without calorie counting or recommended daily caloric intake) or (2) Control (eating over a period of 12 or more hours per day). Study recruitment, retention, and adherence to intervention arms were captured to operationalize feasibility. Glucose control (HbA1c), weight loss (%BMI p95), total body fat mass on dual-energy X-ray absorptiometry, sleep, and dietary intake were explored as secondary outcomes. Analyses were based on the intention-to-treat population. Between-group differences in clinical outcomes were assessed using mixed-effects longitudinal regression models. Overall adherence to the 8-hour lTRE was 6.2 ± 1.1 d/wk, and control was 5.9 ± 0.9 d/wk. Participants assigned to lTRE indicated that limiting their eating window did not negatively affect their daily functioning, and no adverse events were reported. In this pilot study, lTRE led to a reduction in %BMI p95 (−3.4%; 95%confidence interval [CI], ‒6.1, ‒0.7, P = 0.02), HbA1c (−0.4%; 95%CI, ‒0.9, ‒0.01; P = 0.06), and alanine transaminase (ALT; –31.1 U/L; 95%CI, ‒60, ‒2; P = 0.05) within the group. There was no significant difference observed between lTRE and control across these measures (all P > 0.05). The lTRE group had a ‒271.4 (95% CI, ‒565.2, 5.2) kcal/day energy reduction compared with a +293.2 (95% CI, 30.4, 552.7) kcal/day increase in Control (P = 0.01). There were no significant changes observed in sleep or eating behaviors over the study period between groups. Recruitment and retention rates suggest a trial of lTRE in adolescents with T2D was feasible. lTRE was seen as acceptable by participants, and adherence was high. A revised intervention, building on the successful elements of this pilot alongside adapting implementations strategies to augment adherence and engagement, should therefore be considered. [ABSTRACT FROM AUTHOR]

Time-restricted eating (TRE), a type of intermittent fasting in which all daily calories are consumed within a window of ≤12 hours, is hypothesized to promote long-term weight management because of its relative simplicity. This study reports correlates of adherence among community-dwelling adults currently or formerly following a TRE dietary strategy. A 25-minute cross-sectional online survey was developed, including questions about TRE perceptions, behaviors, motivators and drivers, and demographics. The survey was administered in February 2021 via Prolific, an online platform for sample recruitment and survey dissemination. Eligibility criteria included US adult ages 18+ who currently or formerly (past 3 months) followed TRE (ie, consumed all daily calories within a window of ≤12 hours) for a minimum of 1 week. χ2 tests and analysis of covariance (ANCOVA; adjusting for sex and age) compared responses between current and former followers. Current followers (n = 296, mean [SD]: 34.2 ± 12.2y) were older than former followers (n = 295, mean [SD]: 31.1 ± 10.9 y) and practiced TRE for longer (median: 395 vs 90 days, P < 0.001). Current followers reported more success with meeting TRE goals (P ≤ 0.015), were less likely to report TRE concerns (P < 0.001), and more likely to report TRE satisfaction (P < 0.001). Four TRE motivators were more important among current (vs former) followers: weight maintenance, health (not weight), improved sleep, and preventing disease (P ≤ 0.017); weight loss was more important among former (vs current) followers (P = 0.003). Among adherence drivers, ability to work from home and the impact of COVID-19 were reported as more helpful for TRE adherence among current compared with former followers (P ≤ 0.028). TRE motivators and drivers differed between current and former followers; interventions tailored to individuals' preferences and circumstances may benefit TRE adherence. [ABSTRACT FROM AUTHOR]

Pre-exercise meal frequency is commonly believed to impact exercise performance, but little is known about its impact on resistance training. This study investigated the impact of breakfast consumption on afternoon resistance training performance in habitual breakfast consumers and nonconsumers. A randomized, crossover study was conducted in Lubbock, TX between November 2021 and May 2022. Thirty-nine resistance-trained male (n = 20) and female (n = 19) adults (mean ± SD age 23.0 ± 4.7 years) who habitually consumed (≥5 d/wk; n = 19) or did not consume (≥5 d/wk; n = 20) breakfast completed the study. After the establishment of 1-repetition maximums at the first visit, participants completed 2 additional visits, each of which included 4 sets of barbell back squat, bench press, and deadlift, using 80% of their 1-repetition maximum after either consuming breakfast and lunch or the same food at lunch only. Repetitions, along with average and peak average concentric velocity and power, were measured for all repetitions throughout each exercise session. Visual analog scales were used to assess feelings of fatigue, energy, focus, hunger, desire to eat, and fullness throughout each exercise session. Data were analyzed using linear mixed-effects models. No interactions or main effects involving condition or habitual breakfast consumption were observed for resistance training outcomes, although sex differences were noted. Male participants performed significantly fewer repetitions on sets 2, 3, and 4 (P <.014) for total repetitions, on sets 2 and 4 for barbell back squat (P <.023), and set 4 for deadlift (P =.006), with no observed differences between sexes for bench press repetitions. Male participants displayed reductions in average power across all sets and exercises except deadlift. These data suggest that alterations in pre-exercise meal frequency may not influence afternoon resistance training performance provided similar total nutritional intake is consumed. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa (HS) is a chronic condition that can overwhelm patients, and the effectiveness of supplementary dietary treatments remains uncertain. The primary aim of this review is to explore the connection between diet and HS progression. However, it is imperative to note that the evidence supporting a substantial role of the diet in HS remains weak. Dietary alterations alone should not be considered independent solutions for managing HS. Medical therapy continues to be indispensable for adequate treatment. Research indicates that the Mediterranean lifestyle and diet may provide cost‐effective and beneficial adjustments when combined with traditional therapies. Conversely, foods with a high glycemic index and dairy could worsen HS symptoms, conceivably through mechanisms linked to insulin resistance and inflammation. Zinc, known for its antioxidant properties, shows promise as an adjunct therapy. Moreover, evidence suggests a connection between vitamin D deficiency and HS severity, although the findings are inconclusive. Brewer's yeast‐free diet, B12 supplementation, intermittent fasting, and reducing the intake of refined sugar and dairy merit further investigation. In conclusion, this review highlights the need for additional research because of the lack of standardized reporting of clinical effects in the studies under scrutiny. A deeper exploration of the pathophysiology focusing on dietary modifications and their potential associations with HS severity is essential. Furthermore, it is crucial to recognize that patients' willingness to experiment with new diets makes them vulnerable to fraudulent interventions, highlighting the importance of evidence‐based dietary guidance. [ABSTRACT FROM AUTHOR]

This document provides a critique of a systematic review and meta-analysis on the effects of intermittent fasting on metabolic homeostasis. The authors express concerns about the limited inclusion of original studies in the review and highlight the need for a more comprehensive analysis. They also discuss the importance of considering different forms and definitions of intermittent fasting in future research. Additionally, the document includes a list of references to various scientific studies and systematic reviews on the effects of intermittent fasting and energy-restricted diets on health markers. It serves as a valuable resource for further exploration of the topic. [Extracted from the article]