Practice Applications Topics of Professional Interest| Volume 115, ISSUE 8, P1203-1212, August 2015

Intermittent Fasting and Human Metabolic Health

Published:April 06, 2015DOI:https://doi.org/10.1016/j.jand.2015.02.018
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      Periods of voluntary abstinence from food and drink (ie, intermittent fasting) has been practiced since earliest antiquity by peoples around the globe. Books on ethnology and religion describe a remarkable variety of fasting forms and practices.
      • Brongers H.A.
      Instruction and Interpretation: Studies in Hebrew Language, Palestinian Archaeology and Biblical Exegesis.
      Renewed interest in fasting regimens is evidenced by a plethora of popular press publications and diet recommendations. For example, in 2013, Mosley and Spencer
      • Mosley M.
      • Spencer M.
      The FastDiet: Lose Weight, Stay Healthy, and Live Longer with the Simple Secret of Intermittent Fasting.
      published a best-selling book titled The Fast Diet, which touts the benefits of restricting energy intake severely for 2 days a week while eating normally the rest of the week. Dozens of books promote various fasting dietary patterns and the web offers hundreds of fasting-related sites. However, scientific evidence for the health benefits of intermittent fasting in human beings is often extrapolated from animal studies, based on observational data on religious fasting (particularly Ramadan), or derived from experimental studies with modest sample sizes.
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      References

        • Brongers H.A.
        Instruction and Interpretation: Studies in Hebrew Language, Palestinian Archaeology and Biblical Exegesis.
        Brill Academic Publications, Brussels, Belgium1997
        • Mosley M.
        • Spencer M.
        The FastDiet: Lose Weight, Stay Healthy, and Live Longer with the Simple Secret of Intermittent Fasting.
        Atria Books, La Jolla, CA2013
        • Varady K.A.
        • Hellerstein M.K.
        Alternate-day fasting and chronic disease prevention: A review of human and animal trials.
        Am J Clin Nutr. 2007; 86: 7-13
        • Rothschild J.
        • Hoddy K.K.
        • Jambazian P.
        • Varady K.A.
        Time-restricted feeding and risk of metabolic disease: A review of human and animal studies.
        Nutr Rev. 2014; 72: 308-318
        • Halberg N.
        • Henriksen M.
        • Soderhamn N.
        • et al.
        Effect of intermittent fasting and refeeding on insulin action in healthy men.
        J Appl Physiol. 2005; 99: 2128-2136
        • Heilbronn L.K.
        • Smith S.R.
        • Martin C.K.
        • Anton S.D.
        • Ravussin E.
        Alternate-day fasting in nonobese subjects: Effects on body weight, body composition, and energy metabolism.
        Am J Clin Nutr. 2005; 81: 69-73
        • Horne B.D.
        • Muhlestein J.B.
        • Lappe D.L.
        • et al.
        Randomized cross-over trial of short-term water-only fasting: Metabolic and cardiovascular consequences.
        Nutr Metab Cardiovasc Dis. 2013; 23: 1050-1057
        • Varady K.A.
        • Roohk D.J.
        • McEvoy-Hein B.K.
        • Gaylinn B.D.
        • Thorner M.O.
        • Hellerstein M.K.
        Modified alternate-day fasting regimens reduce cell proliferation rates to a similar extent as daily calorie restriction in mice.
        FASEB J. 2008; 22: 2090-2096
        • Varady K.A.
        • Roohk D.J.
        • Hellerstein M.K.
        Dose effects of modified alternate-day fasting regimens on in vivo cell proliferation and plasma insulin-like growth factor-1 in mice.
        J Appl Physiol. 2007; 103: 547-551
        • Varady K.A.
        • Roohk D.J.
        • Loe Y.C.
        • McEvoy-Hein B.K.
        • Hellerstein M.K.
        Effects of modified alternate-day fasting regimens on adipocyte size, triglyceride metabolism, and plasma adiponectin levels in mice.
        J Lipid Res. 2007; 48: 2212-2219
        • Varady K.A.
        • Hudak C.S.
        • Hellerstein M.K.
        Modified alternate-day fasting and cardioprotection: Relation to adipose tissue dynamics and dietary fat intake.
        Metabolism. 2009; 58: 803-811
        • Williams K.V.
        • Mullen M.L.
        • Kelley D.E.
        • Wing R.R.
        The effect of short periods of caloric restriction on weight loss and glycemic control in type 2 diabetes.
        Diabetes Care. 1998; 21: 2-8
        • Johnson J.B.
        • Summer W.
        • Cutler R.G.
        • et al.
        Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma.
        Free Radic Biol Med. 2007; 42: 665-674
        • Varady K.A.
        • Bhutani S.
        • Church E.C.
        • Klempel M.C.
        Short-term modified alternate-day fasting: A novel dietary strategy for weight loss and cardioprotection in obese adults.
        Am J Clin Nutr. 2009; 90: 1138-1143
        • Harvie M.N.
        • Pegington M.
        • Mattson M.P.
        • et al.
        The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: A randomized trial in young overweight women.
        Int J Obes Suppl. 2011; 35: 714-727
        • Bhutani S.
        • Klempel M.C.
        • Kroeger C.M.
        • Trepanowski J.F.
        • Varady K.A.
        Alternate day fasting and endurance exercise combine to reduce body weight and favorably alter plasma lipids in obese humans.
        Obesity. 2013; 2: 1370-1379
        • Eshghinia S.
        • Mohammadzadeh F.
        The effects of modified alternate-day fasting diet on weight loss and CAD risk factors in overweight and obese women.
        J Diabetes Metab Disord. 2013; 12: 4
        • Harvie M.N.
        • Wright C.
        • Pegington M.
        • et al.
        The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women.
        Br J Nutr. 2013; 110: 1534-1547
        • Varady K.A.
        • Bhutani S.
        • Klempel M.C.
        • et al.
        Alternate day fasting for weight loss in normal weight and overweight subjects: A randomized controlled trial.
        Nutr J. 2013; 12: 146
        • Varady K.A.
        Intermittent versus daily calorie restriction: Which diet regimen is more effective for weight loss?.
        Obes Rev. 2011; 12: e593-601
        • Barnosky A.R.
        • Hoddy K.K.
        • Unterman T.G.
        • Varady K.A.
        Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: A review of human findings.
        Transl Res. 2014; 164: 302-311
        • Hatori M.
        • Vollmers C.
        • Zarrinpar A.
        • et al.
        Time-restricted feeding without reducing caloric intake prevents metabolic diseases in mice fed a high-fat diet.
        Cell Metab. 2012; 15: 848-860
        • LeCheminant J.D.
        • Christenson E.
        • Bailey B.W.
        • Tucker L.A.
        Restricting night-time eating reduces daily energy intake in healthy young men: A short-term cross-over study.
        Br J Nutr. 2013; 110: 2108-2113
        • Carlson O.
        • Martin B.
        • Stote K.S.
        • et al.
        Impact of reduced meal frequency without caloric restriction on glucose regulation in healthy, normal-weight middle-aged men and women.
        Metab Clin Exp. 2007; 56: 1729-1734
        • Stote K.S.
        • Baer D.J.
        • Spears K.
        • et al.
        A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults.
        Am J Clin Nutr. 2007; 85: 981-988
        • Sadeghirad B.
        • Motaghipisheh S.
        • Kolahdooz F.
        • Zahedi M.J.
        • Haghdoost A.A.
        Islamic fasting and weight loss: A systematic review and meta-analysis.
        Public Health Nutr. 2014; 17: 3396-3406
        • Kul S.
        • Savas E.
        • Ozturk Z.A.
        • Karadag G.
        Does Ramadan fasting alter body weight and blood lipids and fasting blood glucose in a healthy population? A meta-analysis.
        J Relig Health. 2013; 16: 1217-1222
        • Aksungar F.B.
        • Topkaya A.E.
        • Akyildiz M.
        Interleukin-6, C-reactive protein and biochemical parameters during prolonged intermittent fasting.
        Ann Nutr Metab. 2007; 51: 88-95
        • Faris M.A.
        • Kacimi S.
        • Al-Kurd R.A.
        • et al.
        Intermittent fasting during Ramadan attenuates proinflammatory cytokines and immune cells in healthy subjects.
        Nutr Res. 2012; 32: 947-955
        • Horne B.D.
        • May H.T.
        • Anderson J.L.
        • et al.
        Usefulness of routine periodic fasting to lower risk of coronary artery disease in patients undergoing coronary angiography.
        Am J Cardiol. 2008; 102: 814-819
        • Fraser G.E.
        • Shavlik D.J.
        Ten years of life: Is it a matter of choice?.
        Arch Intern Med. 2001; 161: 1645-1652
        • Kelly C.J.
        A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults.
        Am J Clin Nutr. 2007; 86: 1254-1255
        • Longo V.D.
        • Mattson M.P.
        Fasting: Molecular mechanisms and clinical applications.
        Cell Metab. 2014; 19: 181-192
        • Panda S.
        • Hogenesch J.B.
        • Kay S.A.
        Circadian rhythms from flies to human.
        Nature. 2002; 417: 329-335
        • Froy O.
        • Miskin R.
        Effect of feeding regimens on circadian rhythms: Implications for aging and longevity.
        Aging. 2010; 2: 7-27
        • Challet E.
        Circadian clocks, food intake, and metabolism.
        Prog Mol Biol Transl Sci. 2013; 119: 105-135
        • Scheer F.A.
        • Hilton M.F.
        • Mantzoros C.S.
        • Shea S.A.
        Adverse metabolic and cardiovascular consequences of circadian misalignment.
        Proc Natl Acad Sci USA. 2009; 106: 4453-4458
        • Eckel-Mahan K.L.
        • Patel V.R.
        • de Mateo S.
        • et al.
        Reprogramming of the circadian clock by nutritional challenge.
        Cell. 2013; 155: 1464-1478
        • Sensi S.
        • Pace Palitti V.
        • Guagnano M.T.
        Chronobiology in endocrinology.
        Ann Ist Super Sanita. 1993; 29: 613-631
        • Straif K.
        • Baan R.
        • Grosse Y.
        • et al.
        Carcinogenicity of shift-work, painting, and fire-fighting.
        Lance Oncol. 2007; 8: 1065-1066
        • Stevens R.G.
        • Blask D.E.
        • Brainard G.C.
        • et al.
        Meeting report: The role of environmental lighting and circadian disruption in cancer and other diseases.
        Environ Health Perspect. 2007; 115: 1357-1362
        • Stevens R.G.
        • Rea M.S.
        Light in the built environment: Potential role of circadian disruption in endocrine disruption and breast cancer.
        Cancer Cause Control. 2001; 12: 279-287
        • Grundy A.
        • Richardson H.
        • Burstyn I.
        • et al.
        Increased risk of breast cancer associated with long-term shift work in Canada.
        Occup Environ Med. 2013; 70: 831-838
        • Savvidis C.
        • Koutsilieris M.
        Circadian rhythm disruption in cancer biology.
        Mol Med. 2012; 18: 1249-1260
        • Jakubowicz D.
        • Barnea M.
        • Wainstein J.
        • Froy O.
        High caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women.
        Obesity. 2013; 21: 2504-2512
        • Cahill L.E.
        • Chiuve S.E.
        • Mekary R.A.
        • et al.
        Prospective study of breakfast eating and incident coronary heart disease in a cohort of male US health professionals.
        Circulation. 2013; 128: 337-343
        • Vander Wal J.S.
        Night eating syndrome: A critical review of the literature.
        Clin Psychol Rev. 2012; 32: 49-59
        • Qin L.Q.
        • Li J.
        • Wang Y.
        • Wang J.
        • Xu J.Y.
        • Kaneko T.
        The effects of nocturnal life on endocrine circadian patterns in healthy adults.
        Life Sci. 2003; 73: 2467-2475
        • Bo S.
        • Musso G.
        • Beccuti G.
        • et al.
        Consuming more of daily caloric intake at dinner predisposes to obesity. A 6-year population-based prospective cohort study.
        PLoS One. 2014; (24;9:e108467)
        • Sanders S.W.
        • Moore J.G.
        Gastrointestinal chronopharmacology: Physiology, pharmacology and therapeutic implications.
        Pharmacol Ther. 1992; 54: 1-15
        • Ekmekcioglu C.
        • Touitou Y.
        Chronobiological aspects of food intake and metabolism and their relevance on energy balance and weight regulation.
        Obes Rev. 2011; 12: 14-25
        • Ridaura V.K.
        • Faith J.J.
        • Rey F.E.
        • et al.
        Cultured gut microbiota from twins discordant for obesity modulate adiposity and metabolic phenotypes in mice.
        Science. 2013; 341: 10
        • Turnbaugh P.J.
        • Ley R.E.
        • Mahowald M.A.
        • Magrini V.
        • Mardis E.R.
        • Gordon J.I.
        An obesity-associated gut microbiome with increased capacity for energy harvest.
        Nature. 2006; 444: 1027-1031
        • Tilg H.
        • Kaser A.
        Gut microbiome, obesity, and metabolic dysfunction.
        J Clin Invest. 2011; 121: 2126-2132
        • Shen J.
        • Obin M.S.
        • Zhao L.
        The gut microbiota, obesity and insulin resistance.
        Mol Aspect Med. 2013; 34: 39-58
        • Thaiss C.A.
        • Zeevi D.
        • Levy M.
        • et al.
        transkingdom control of microbiota diurnal oscillations promotes metabolic homeostasis.
        Cell. 2014; 159: 514-529
        • Freedman L.S.
        • Commins J.M.
        • Moler J.E.
        • et al.
        Pooled results from 5 validation studies of dietary self-report instruments using recovery biomarkers for energy and protein intake.
        Am J Epidemiol. 2014; 180: 172-188
        • Schiavo-Cardozo D.
        • Lima M.M.
        • Pareja J.C.
        • Geloneze B.
        Appetite-regulating hormones from the upper gut: Disrupted control of xenin and ghrelin in night workers.
        Clin Endocrinol. 2013; 79: 807-811
        • Crispim C.A.
        • Waterhouse J.
        • Damaso A.R.
        • et al.
        Hormonal appetite control is altered by shift work: A preliminary study.
        Metab Clin Exp. 2011; 60: 1726-1735
        • Wirth M.D.
        • Burch J.
        • Shivappa N.
        • et al.
        Dietary inflammatory index scores differ by shift work status: NHANES 2005 to 2010.
        J Occup Environ Med. 2014; 56: 145-148
        • Antelmi E.
        • Vinai P.
        • Pizza F.
        • Marcatelli M.
        • Speciale M.
        • Provini F.
        Nocturnal eating is part of the clinical spectrum of restless legs syndrome and an underestimated risk factor for increased body mass index.
        SleepMed. 2014; 15: 168-172
        • Yamaguchi M.
        • Uemura H.
        • Katsuura-Kamano S.
        • et al.
        Relationship of dietary factors and habits with sleep-wake regularity.
        Asia Pac J Clin Nutr. 2013; 22: 457-465
        • Gallicchio L.
        • Kalesan B.
        Sleep duration and mortality: A systematic review and meta-analysis.
        J Sleep Res. 2009; 18: 148-158
        • Grandner M.A.
        • Hale L.
        • Moore M.
        • Patel N.P.
        Mortality associated with short sleep duration: The evidence, the possible mechanisms, and the future.
        Sleep Med Rev. 2010; 14: 191-203
        • Spiegel K.
        • Knutson K.
        • Leproult R.
        • Tasali E.
        • Van Cauter E.
        Sleep loss: A novel risk factor for insulin resistance and Type 2 diabetes.
        J Appl Physiol. 2005; 99: 2008-2019
        • Buxton O.M.
        • Marcelli E.
        Short and long sleep are positively associated with obesity, diabetes, hypertension, and cardiovascular disease among adults in the United States.
        Soc Sci Med. 2010; 71: 1027-1036
        • Patel S.R.
        • Hu F.B.
        Short sleep duration and weight gain: a systematic review.
        Obesity. 2008; 16: 643-653
        • Ford E.S.
        • Li C.
        • Wheaton A.G.
        • Chapman D.P.
        • Perry G.S.
        • Croft J.B.
        Sleep duration and body mass index and waist circumference among U.S. adults.
        Obesity. 2014; 22: 598-607
        • Bass J.
        • Takahashi J.S.
        Circadian integration of metabolism and energetics.
        Science. 2010; 330: 1349-1354