Latest Developments in the Effects of
Intermittent Fasting on Weight Loss and Glycolipid Metabolism

doi:10.12114/j.issn.1007-9572.2021.00.329

Abstract

Abstract:

Dietary intervention is an important approach to treating obesity. Intermittent fasting (IF) is a eating pattern alternating between eating and energy-restricted fasting or fasting periods, whose types mainly include alternate-day fasting, periodic fasting, time-restricted fasting, Ramadan fasting and so on. Available research has shown that IF manages obesity and obesity-related metabolic disorders to improve health through a variety of mechanisms, but there is no conclusive evidence as to which IF regimen is more sustainable and effective. To provide evidence for in-depth promotion of the application of IF, we introduced several common IF regimens, and reviewed the latest developments in the effects and safety of IF in losing weight, and improving blood glucose and lipids, and found that IF is beneficial to weight loss, blood glucose and lipids reduction, as well as insulin resistance decrease with relatively high safety, but attentions should be paid to individual differences during the actual implementation of IF.

Key words: Intermittent fasting, Obesity, Weight loss, Glucose metabolism, Lipid metabolism

摘要：

饮食干预是治疗肥胖的重要措施。间歇性禁食（IF）是一种正常能量和能量限制（或完全禁食）交替进行的膳食模式，主要类型包括隔日禁食、周期性禁食、限时禁食、斋月禁食等。现有研究表明，IF可通过多种机制改善肥胖及相关代谢紊乱，并促进健康。然而，何种IF方案对肥胖及相关代谢紊乱的干预效果更佳目前尚无定论。本文在介绍IF常见方案的基础上，针对IF在减轻体质量，改善血糖、血脂等方面发挥的作用及IF疗法的安全性进行综述，旨在为IF的深度推广、运用提供依据。本研究发现，IF不仅对减重有益，还有助于降低血糖和体脂，改善血脂谱，减轻胰岛素抵抗。同时IF具有较高的安全性，但在实施时仍需关注个体差异，结合个体实际。

关键词: 间歇性禁食, 肥胖, 减重, 糖代谢, 脂代谢

CLC Number:

R163R459.3

BA Tao, WANG Xiaoli, CHANG Xiangyun.

Latest Developments in the Effects of Intermittent Fasting on Weight Loss and Glycolipid Metabolism [J]. Chinese General Practice, 2022, 25(01): 122-126.

巴涛,王晓丽,常向云. 间歇性禁食对减重和糖脂代谢作用的研究进展[J]. 中国全科医学, 2022, 25(01): 122-126. DOI: 10.12114/j.issn.1007-9572.2021.00.329.

References

[1] RANGEL-HUERTA O D, PASTOR-VILLAESCUSA B, GIL A. Are we close to defining a metabolomic signature of human obesity? A systematic review of metabolomics studies[J]. Metabolomics，2019，15(6):93-124. DOI：10.1007/s11306-019-1553-y.

[2] HUA J, ZHANG L, GAO D，et al. Prevalence of overweight and obesity among people aged 18 years and over between 2013 and 2018 in Hunan，China[J]. Int J Env Res Pub He，2020，17(11):4048-4060. DOI：10.3390/ijerph17114048.

[3] ZHANG L, WANG Z, WANG X，et al. Prevalence of overweight and obesity in China：results from a cross-sectional study of 441 thousand adults，2012—2015[J]. Obes Res Clin Pract，2020，14(2):119-126. DOI：10.1016/j.orcp.2020.02.005.

[4] FITZPATRICK S L, WISCHENKA D, APPELHANS B M，et al. An evidence-based guide for obesity treatment in primary care[J]. Am J Med，2016，129(1):e111-117. DOI：10.1016/j.amjmed.2015.07.015.

[5] MCGOWAN B M. A practical guide to engaging individuals with obesity[J]. Obesity Facts，2016，9(3):182-192. DOI：10.1159/000445193.

[6] MILANO W, DEBIASIO V, DIMUNZIO W，et al. Obesity：the new global epidemic pharmacological treatment，opportunities and limits for personalized therapy[J]. Endocr Metab Immune，2020，20(8):1232-1243. DOI：10.2174/1871530320666200515112853.

[7] SHARAIHA R Z, HAJIFATHALIAN K, KUMAR R，et al. Five-year outcomes of endoscopic sleeve gastroplasty for the treatment of obesity[J]. Clin Gastroenterol H，2021，19(5):1051-1057. DOI：10.1016/j.cgh.2020.09.055.

[8] ANTON S D, MOEHL K, DONAHOO W T，et al. Flipping the metabolic switch：understanding and applying the health benefits of fasting[J]. Obesity，2018，26(2):254-268. DOI：10.1002/oby.22065.

[9] DECABO R, MATTSON M P. Effects of intermittent fasting on health，aging，and disease[J]. New Eng J Med，2019，381(26):2541-2551. DOI：10.1056/NEJMra1905136.

[10] TRIPOLT N J, STEKOVIC S, ABERER F，et al. Intermittent fasting（alternate day fasting）in healthy，non-obese adults：protocol for a cohort trial with an embedded randomized controlled pilot trial[J]. Adv Ther，2018，35(8):1265-1283. DOI：10.1007/s12325-018-0746-5.

[11] PARVARESH A, RAZAVI R, ABBASI B，et al. Modified alternate-day fasting vs. calorie restriction in the treatment of patients with metabolic syndrome：a randomized clinical trial[J]. Complement Ther Med，2019，47(12):102187. DOI：10.1016/j.ctim.2019.08.021.

[12] TEMPLEMAN I, GONZALEZ J T, THOMPSON D，et al. The role of intermittent fasting and meal timing in weight management and metabolic health[J]. P Nutr Soc，2020，79(1):76-87. DOI：10.1017/s0029665119000636.

[13] TINSLEY G M, LABOUNTY P M. Effects of intermittent fasting on body composition and clinical health markers in humans[J]. Nutr Rev，2015，73(10):661-674. DOI：10.1093/nutrit/nuv041.

[14] STEKOVIC S, HOFER S J, TRIPOLT N，et al. Alternate day fasting improves physiological and molecular markers of aging in healthy，non-obese humans[J]. Cell Metab，2019，30(3):462-476. DOI：10.1016/j.cmet.2019.07.016.

[15] CAI H, QIN Y L, SHI Z Y，et al. Effects of alternate-day fasting on body weight and dyslipidaemia in patients with non-alcoholic fatty liver disease：a randomised controlled trial[J]. BMC Gastroenterol，2019，19(1):219-227. DOI：10.1186/s12876-019-1132-8.

[16] LILJA S, STOLL C, KRAMMER U，et al. Christensenella five days periodic fasting elevates levels of longevity related and sirtuin expression in humans[J]. Int J Mol Sci，2021，22(5):2331-2346. DOI：10.3390/ijms22052331.

[17] WILHELMI-DE-TOLEDO F, GRUNDLER F, SIRTORI C R，et al. Unravelling the health effects of fasting：a long road from obesity treatment to healthy life span increase and improved cognition[J]. Ann Med，2020，52(5):147-161. DOI：10.1080/07853890.2020.1770849.

[18] HORNE B D, MUHLESTEIN J B, MAY H T，et al. Relation of routine，periodic fasting to risk of diabetes mellitus，and coronary artery disease in patients undergoing coronary angiography[J]. Am J Cardio，2012，109(11):1558-1562. DOI：10.1016/j.amjcard.2012.01.379.

[19] BARTHOLOMEW C L, MUHLESTEIN J B, ANDERSON J L，et al. Association of periodic fasting lifestyles with survival and incident major adverse cardiovascular events in patients undergoing cardiac catheterization[J]. Eur J Prev Cardiol，2020，20(9):zwaa050. DOI：10.1093/eurjpc/zwaa050.

[20] SADEGHIAN M, RAHMANI S, KHALESI S，et al. A review of fasting effects on the response of cancer to chemotherapy[J]. Clin Nutr，2020，40(4):1669-1681 DOI：10.1016/j.clnu.2020.10.037.

[21] MORO T, TINSLEY G, BIANCO A，et al. Effects of eight weeks of time-restricted feeding（16/8）on basal metabolism，maximal strength，body composition，inflammation，and cardiovascular risk factors in resistance-trained males[J]. J Transl Med，2016，14(1):290-300. DOI：10.1186/s12967-016-1044-0.

[22] YE Y, XU H, XIE Z，et al. Time-restricted feeding reduces the detrimental effects of a high-fat diet，possibly by modulating the circadian rhythm of hepatic lipid metabolism and gut microbiota[J]. Front Nutr，2020，14(7):285-296. DOI：10.3389/fnut.2020.596285.

[23] SUTTON E F, BEYL R, EARLY K S，et al. Early time-restricted feeding improves insulin sensitivity，blood pressure，and oxidative stress even without weight loss in men with prediabetes[J]. Cell Metab，2018，27(6):1212-1221. DOI：10.1016/j.cmet.2018.04.010.

[24] JAMSHED H, BEYL R A, DELLA-MANNA D L，et al. Early time-restricted feeding improves 24-hour glucose levels and affects markers of the circadian clock，aging，and autophagy in humans nutrients[J]. Nutrients，2019，11(6):1234-1250. DOI：10.3390/nu11061234.

[25] TURBITT W J, ORLANDELLA R M, GIBSON J T，et al.Therapeutic time-restricted feeding reduces renal tumor bioluminescence in mice but fails to improve anti-CTLA-4 efficacy[J]. Anticancer Res，2020，40(10):5445-5456. DOI：10.21873/anticanres.14555.

[26] DAMIANI G, WATAD A, BRIDGEWOOD C，et al. The impact of ramadan fasting on the reduction of PASI score，in moderate-to-severe psoriatic patients：a real-life multicenter study[J]. Nutrients，2019，11(2):277-287. DOI：10.3390/nu11020277.

[27] CHERIF A, ROELANDS B, MEEUSEN R，et al. Effects of intermittent fasting，caloric restriction，and ramadan intermittent fasting on cognitive performance at rest and during exercise in adults[J]. Sports Med，2016，46(1):35-47. DOI：10.1007/s40279-015-0408-6.

[28] UENO T, KOMATSU M. Autophagy in the liver：functions in health and disease[J]. Nat Rev Gastro Hepat，2017，14(3):170-184. DOI：10.1038/nrgastro.2016.185.

[29] LI G, XIE C, LU S，et al. Intermittent fasting promotes white adipose browning and decreases obesity by shaping the gut microbiota[J]. Cell Metab，2017，26(5):801-820. DOI：10.1016/j.cmet.2017.10.007.

[30] ZEB F, WU X, CHEN L，et al. Effect of time-restricted feeding on metabolic risk and circadian rhythm associated with gut microbiome in healthy males[J]. Br J Nutr，2020，123(11):1216-1226. DOI：10.1017/s0007114519003428.

[31] FREIRE R. Scientific evidence of diets for weight loss：different macronutrient composition，intermittent fasting，and popular diets[J]. Nutrition，2020，69(7):549-554. DOI：10.1016/j.nut.2019.07.001.

[32] 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[J]. Nutr J，2013，12(1):146-154. DOI：10.1186/1475-2891-12-146.

[33] DOMASZEWSKI P, KONIECZNY M, PAKOSZ P，et al. Effect of a six-week intermittent fasting intervention program on the composition of the human body in women over 60 years of age[J]. Int J Environ Res Public Health，2020，17(11):4138-4147. DOI：10.3390/ijerph17114138.

[34] UROOJ A, PAI KOTEBAGILU N, SHIVANNA L M，et al. Effect of ramadan fasting on body composition，biochemical profile，and antioxidant status in a sample of healthy individuals[J]. Int J Endocrinol Metab，2020，18(4):e107641. DOI：10.5812/ijem.107641.

[35] HEILBRONN L K, SMITH S R, MARTIN C K，et al. Alternate-day fasting in nonobese subjects：effects on body weight，body composition，and energy metabolism[J]. Am J Clin Nutr，2005，81(1):69-73. DOI：10.1093/ajcn/81.1.69.

[36] FERNANDO H A, ZIBELLINI J, HARRIS R A，et al. Effect of ramadan fasting on weight and body composition in healthy non-athlete adults：a systematic review and Meta-analysis[J]. Nutrients，2019，11(2):478-502. DOI：10.3390/nu11020478.

[37] VARADY K A. Intermittent versus daily calorie restriction：which diet regimen is more effective for weight loss[J]. Obes Rev，2011，12(7):e593-601. DOI：10.1111/j.1467-789X.2011.00873.x.

[38] BAUMEIER C，KAISER D，HEEREN J，et al. Caloric restriction and intermittent fasting alter hepatic lipid droplet proteome and diacylglycerol species and prevent diabetes in NZO mice［J］. Biochim Biophys Acta，2015，1851（5）：566-576. DOI：10.1016/j.bbalip.2015.01.013.

[39] YANG W，CAO M，MAO X，et al. Alternate-day fasting protects the livers of mice against high-fat diet-induced inflammation associated with the suppression of Toll-like receptor 4/nuclear factor kappa B signaling［J］. Nutr Res，2016，36（6）：586-593. DOI：10.1016/j.nutres.2016.02.001.

[40] VARADY K A. Impact of intermittent fasting on glucose homeostasis［J］. Curr Opin Clin Nutr Metab Care，2016，19（4）：300-302. DOI：10.1097/mco.0000000000000291.

[41] MATTSON M P. Energy intake and exercise as determinants of brain health and vulnerability to injury and disease［J］. Cell Metab，2012，16（6）：706-722. DOI：10.1016/j.cmet.2012.08.012.

[42] MATTSON M P，MOEHL K，GHENA N，et al. Intermittent metabolic switching，neuroplasticity and brain health［J］. Nat Rev Neurosci，2018，19（2）：63-80. DOI：10.1038/nrn.2017.156.

[43] MUNHOZ A C，VILAS-BOAS E A，PANVELOSKI-COSTA A C，et al. Intermittent fasting for twelve weeks leads to increases in fat mass and hyperinsulinemia in young female wistar rats［J］.Nutrients，2020，12（4）：1029-1053. DOI：10.3390/

nu12041029.

[44] ALLAF M，ELGHAZALY H，MOHAMED O G，et al. Intermittent fasting for the prevention of cardiovascular disease［J］. Cochrane Database Syst Rev，2021，1（1）：29-48. DOI：10.1002/14651858.CD013496.pub2.

[45] MINDIKOGLU A L，ABDULSADA M M，JAIN A，et al. Intermittent fasting from dawn to sunset for four consecutive weeks induces anticancer serum proteome response and improves metabolic syndrome［J］. Sci Rep，2020，10（1）：18341-18355. DOI：10.1038/s41598-020-73767-w.

[46] ARNASON T G，BOWEN M W，MANSELL K D. Effects of intermittent fasting on health markers in those with type 2 diabetes：a pilot study［J］. World J Diabetes，2017，8（4）：154-164. DOI：10.4239/wjd.v8.i4.154.

[47] BESHYAH S A，CHOWDHURY T A，GHOURI N，et al. Risk of diabetic ketoacidosis during Ramadan fasting：a critical reappraisal［J］. Diabetes Res Clin Pract，2019，151（5）：290-298. DOI：10.1016/j.diabres.2019.02.027.

[48] LESSAN N，HANNOUN Z，HASAN H，et al. Glucose excursions and glycaemic control during Ramadan fasting in diabetic patients：insights from continuous glucose monitoring（CGM）［J］. Diabetes Metab，2015，41（1）：28-36. DOI：10.1016/j.diabet.2014.11.004.

[49] LEE J Y，TAN C S，LEE S W. Ramadan fasting alters sleep behavior in type 2 diabetes patients［J］. J Diabetes，2019，11（1）：93-94. DOI：10.1111/1753-0407.12838.

[50] MONNIER L，EL-AZRAK A，LESSAN N，et al. Ramadan and diabetes：what we see，learn and understand from continuous glucose monitoring［J］. Diabetes Metab，2015，41（6）：456-462. DOI：10.1016/j.diabet.2015.09.002.

[51] LI G，XIE C，LU S，et al. Intermittent fasting promotes white adipose browning and decreases obesity by shaping the gut microbiota［J］. Cell Metab，2017，26（4）：672-685. DOI：10.1016/j.cmet.2017.08.019.

[52] MARINHO T S，ORNELLAS F，AGUILA M B，et al. Browning of the subcutaneous adipocytes in diet-induced obese mouse submitted to intermittent fasting［J］. Mol Cell Endocrinol，2020，513（8）：872-881. DOI：10.1016/j.mce.2020.110872.

[53] LESSAN N，ALI T. Energy metabolism and intermittent fasting：the Ramadan perspective［J］. Nutrients，2019，11（5）：1192-1208. DOI：10.3390/nu11051192.

[54] AHMED N，FAROOQ J，SIDDIQI H S，et al. Impact of intermittent fasting on lipid profile：a quasi-randomized clinical trial［J］. Front Nutr，2020，7（3）：596787-596795. DOI：10.3389/fnut.2020.596787.

[55] FANTI M，MISHRA A，LONGO V D，et al. Time-restricted eating，intermittent fasting，and fasting-mimicking diets in weight loss［J］. Curr Obes Rep，2021，10（2）：70-80. DOI：10.1007/s13679-021-00424-2.

[56] GUO Y，LUO S，YE Y，et al. Intermittent fasting improves cardiometabolic risk factors and alters gut microbiota in metabolic syndrome patients［J］. J Clin Endocrinol Metab，2021，106（1）：64-79. DOI：10.1210/clinem/dgaa644.

[57] MAO T，WEI Q，ZHAO F，et al. Short-term fasting reshapes fat tissue［J］. Endocr J，2021，68（4）：387-398. DOI：10.1507/endocrj.EJ20-0405.

[58] GRAJOWER M M，HORNE B D. Clinical management of intermittent fasting in patients with diabetes mellitus［J］.Nutrients，2019，11（4）：873-884. DOI：10.3390/nu11040873.

[59] BESHYAH S A，HASSANEIN M，AHMEDANI M Y，et al. Diabetic hypoglycaemia during Ramadan fasting：a trans-national observational real-world study［J］. Diabetes Res Clin Pract，2019，150（4）：315-321. DOI：10.1016/j.diabres.2019.01.039.

[60] CARTER S，CLIFTON P M，KEOGH J B. The effect of intermittent compared with continuous energy restriction on glycaemic control in patients with type 2 diabetes：24-month follow-up of a randomised noninferiority trial［J］. Diabetes Res Clin Pract，2019，151（3）：11-19. DOI：10.1016/j.diabres.2019.03.022.

[61] MALINOWSKI B，ZALEWSKA K，WÄ-SIERSKA A，et al. Intermittent fasting in cardiovascular disorders：an overview［J］. Nutrients，2019，11（3）：673-691. DOI：10.3390/nu11030673.

Latest Developments in the Effects of Intermittent Fasting on Weight Loss and Glycolipid Metabolism

间歇性禁食对减重和糖脂代谢作用的研究进展

PDF

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	LI Jixin, QIU Linjie, REN Yan, WANG Wenru, LI Meijie, ZHANG Jin. The Correlation of Dietary Inflammatory Index with Overweight, Obesity and Abdominal Obesity: a Meta-analysis [J]. Chinese General Practice, 2023, 26(32): 4089-4097.
[2]	PAN Yaojia, WANG Weiqiang, YI Weizhuo, GAO Bing, FU Fanglin, HAN Zheng, SUN Meng, DONG Yaqin, GU Huaicong. Relationship between Triglyceride-glucose Index and Risk of Cardiovascular Diseases in Middle-aged Obese Residents of Different Genders [J]. Chinese General Practice, 2023, 26(29): 3628-3635.
[3]	WANG Qianqian, WANG Xiaohang, ZHOU Xiaoying, QIU Shanhu, SUN Zilin. Exercise is the Foundation of Weight Loss [J]. Chinese General Practice, 2023, 26(28): 3471-3476.
[4]	JIANG Qiuhui, LI Xuejun. Exercise is Not the Foundation of Weight Loss [J]. Chinese General Practice, 2023, 26(28): 3477-3481.
[5]	ZHANG Li, ZHENG Wei, WANG Jia, YUAN Xianxian, HAN Weiling, HUANG Junhua, TIAN Zhihong, LI Guanghui. Comparison of Gestational Weight Gain and Pregnancy Outcomes in Chinese Women with Singleton Pregnancy Using Standard of Recommendation for Weight Gain during Pregnancy Period and Guidelines by the Institute of Medicine [J]. Chinese General Practice, 2023, 26(24): 2959-2967.
[6]	YIN Cong, DIAO He, SHENG Wei, CAO Yan, BAI Wenpei. Influence of Daily Self-weighing Supported by Online Supervision on Body Composition and Emotions in Overweight/Obese Women with Anxiety and Depression [J]. Chinese General Practice, 2023, 26(24): 2992-2996.
[7]	LUO Rong, WANG Yu, MIAO Afeng, WU Xiaoke. Influencing Factors of Insulin Resistance in Polycystic Ovary Syndrome Patients with Normal Body Mass Index [J]. Chinese General Practice, 2023, 26(17): 2102-2107.
[8]	GUO Xian, ZHOU Yanbing, LIU Jingying, MU Jinhao, CAO Hui. Visualization Analysis of Global Advances and Hot Spots in Intermittent Fasting [J]. Chinese General Practice, 2023, 26(16): 2036-2046,2054.
[9]	ZHANG Lina, WANG Yan, ZHANG Kanghuai, LI Youjia. Clinical Research Progress of Tirzepatide: a New Hypoglycemic Agent [J]. Chinese General Practice, 2023, 26(15): 1902-1908.
[10]	WANG Fangfang, CUI Yanru, LI Jiayu, PANG Rizhao, ZHANG Anren. Possible Mechanism of Improving Neurodegenerative Diseases via Rejuvenation of Mitochondrial Function by Intermittent Fasting [J]. Chinese General Practice, 2023, 26(12): 1530-1536.
[11]	WANG Junwei, LIN Lingjun, SONG Linling, CHENG Xiaocui, NIE Xiuling. Association between Serum Potassium and Metabolic-associated Fatty Liver Disease in Patients with Primary Gout [J]. Chinese General Practice, 2023, 26(12): 1479-1484.
[12]	LIU Yanhui, CHEN Shuchun. Interpretation and Clinical Significance of the Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement [J]. Chinese General Practice, 2023, 26(12): 1422-1428.
[13]	CAI Ming, WANG Liyan, YANG Ruoyu, LIANG Leichao, YANG Yuanyuan, JIA Shihao, CHEN Ruiyi, REN Yu, LIU Qianle, HU Jingyun. Short-term High-intensity Interval Training Reduces the Accumulation of Advanced Glycation End Products and the Risk of Cardiovascular Disease in Normal Weight Obese Female University Students: a Randomized Controlled Trial [J]. Chinese General Practice, 2023, 26(12): 1472-1478.
[14]	DUAN Qian, ZHANG Peizhen. Latest Advances in Female Hormone-related Abnormal Lipid Metabolism and Relevant Exercise Interventions on Abnormal Lipid Metabolism in Postmenopausal Women [J]. Chinese General Practice, 2023, 26(12): 1536-1542.
[15]	YUAN Lijun, WEI Wenjing, ZHANG Xia, FU Ruiyuan, CHEN Qiu. Bariatric Surgery Increases the Risk of Fracture: a Meta-analysis [J]. Chinese General Practice, 2023, 26(11): 1382-1388.