The same conclusion was reached by a 12-month trial that found no significant differences in adherence, weight loss and maintenance, and cardiovascular protection between intermittent fasting (25% of energy needs on fast days 125% of energy needs on alternating “feast days”) compared to a moderate continuous energy restriction (75% of energy needs every day) ( Trepanowski et al., 2017). For example, a short-term randomized study, comparing alternate-day fasting with moderate daily caloric restriction in adults with obesity, found no significant between-group differences in change in weight body composition, lipids and insulin sensitivity index after 8-weeks of treatment, and no significant differences in weight regain after 24 weeks of unsupervised follow-up ( Catenacci et al., 2016). Other trials with shorter duration achieved the same conclusion as the Headland et al. The study did not find significant differences in weight loss and in the modification of the cardiovascular risk factors among the three groups at both 12 and 24 months ( Headland, Clifton, & Keogh, 2019, 2020). The only published clinical study with long-term outcome data (i.e., 24 months) on weight loss and cardiovascular risk factors is a one-year randomized parallel trial which randomized 332 adults with overweight or obesity to one of three groups: (1) continuous energy restriction (1000 kcal/day for women and 1200 kcal/day for men) (2) week-on-week-off energy restriction (alternating between the same energy restriction as the continuous group for one week and one week of habitual diet) or (3) 5:2 (500 kcal/day on modified fast days each week for women and 600 kcal/day for men, the 2 days of energy restriction could be consecutive or non-consecutive). Therefore, it is not known whether the observed positive effects on risk factors are the result of intermittent fasting or calorie restriction per se. Furthermore, most studies did not compare the long-term effects of intermittent fasting with continuous energy restriction. To date no data are available on the effect of intermitting fasting on clinically important outcomes, such as the onset of cardiovascular diseases, cancer, and lifer expectancy in humans. The few clinical published studies assessed only the short-term (weeks or months) effect of this intervention on weight loss and some non-communicable diseases risk factors. These dietary practices in its more common forms (e.g., alternate fasting days 5:2 intermittent fasting, i.e., fasting 2 days each week daily time-restricted feeding) ( Anton et al., 2018) has been proposed to treat obesity, diabetes, cardiovascular diseases, cancer, neurodegenerative diseases, asthma, multiple sclerosis, osteoarthritis, surgical tissue lesions and ischemic and to prolong life expectancy ( de Cabo & Mattson, 2019).ĭata supporting the beneficial effects of intermittent fasting derives from preclinical studies on animals (e.g. Intermittent fasting has been recently proposed as an eating pattern strategy to elicit, through the metabolic switch from the use of glucose as fuel source to the use of fatty acids and ketone bodies, the improvement of insulin resistance, obesity, dyslipidemia, high blood pressure and cognitive functions, the increased resistance to stress, the suppression of inflammation and the increase of life expectancy ( de Cabo & Mattson, 2019). These data indicate that regular eating, not intermitting fast, is the best choice for adopting a healthy eating control and avoiding the development of unregulated and, in some cases, disturbed eating behavior. Moreover, the procedure of regular eating, adopted by the “enhanced” cognitive behavior therapy for eating disorders (CBT-E), results in a rapid decease in the frequency of binge-episodes in patients with bulimia nervosa and binge-eating disorders. Instead, several studies found an association between delayed eating (i.e., spending many hours during the day without eating) and increased risk of developing episodes of overeating and binge eating. ![]() No data are available on the effect of intermitting fasting on clinically important outcomes in humans, such as the onset of cardiovascular diseases, cancer, and life expectancy. ![]() However, data supporting the beneficial health effects of intermittent fasting mainly derive from preclinical studies in animals and short-term clinical studies on weight loss and non-communicable disease risk factors, with no significant differences on these outcomes when intermittent fasting has been compared with moderate continuous energy restriction in humans. ![]() Intermitting fasting has been proposed as a dietary strategy to improve general health indicators, slow or reverse disease processes and aging.
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