No abstract

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

Background Direct-to-consumer mHealth devices are a potential asset to behavioral research but are rarely tested as intervention tools. This trial examined the accelerometer-based Fitbit tracker and website as a basis for a low-touch physical activity intervention. Purpose To evaluate, within a randomized controlled trial, the feasibility and preliminary efficacy of integrating the Fitbit tracker and website into a physical activity intervention for postmenopausal women. Methods Fifty-one inactive, postmenopausal women with BMI≥25.0 kg/m2 were randomized to a 16-week web-based self-monitoring intervention (N=25) or a comparison group (N=26). Those in the Web-Based Tracking Group received a Fitbit, an instructional session, and a follow-up call at 4 weeks. The comparison group received a standard pedometer. All were asked to perform 150 min/week of moderate-to-vigorous physical activity (MVPA). Physical activity outcomes were measured by the ActiGraph GT3X+ accelerometer. Results Data were collected and analyzed in 2013–2014. Participants were 60±7 years old with BMI=29.2±3.5 kg/m2. Relative to baseline, the Web-Based Tracking Group increased MVPA by 62±108 min/week (p<.01), MVPA in 10-min bouts by 38±83 min/week (p=.008), and steps by 789±1,979 (p=.01), compared to non-significant increases in the Pedometer Group (between-group p-values: .11, .28 and .30, respectively). The Web-Based Tracking Group wore the tracker on 95% of intervention days; 96% reported liking the website and 100% liked the tracker. Conclusions The Fitbit was well-accepted in this sample of women and was associated with increased physical activity at 16 weeks. By leveraging direct-to-consumer mHealth technologies that align with behavior change theories, researchers can strengthen physical activity interventions.

No abstract

OBJECTIVE -The objective of this study was to assess the risk of acute pancreatitis in patients with type 2 diabetes compared with that in patients without diabetes. We also examined the risk of biliary disease (defined as occurrence of cholelithiasis, acute cholecystitis, or cholecystectomy), which is a major cause of pancreatitis.RESEARCH DESIGN AND METHODS -We conducted a retrospective cohort study using a large, geographically diverse U.S. health care claims database. Eligible patients (Ն18 years) were enrolled for at least 12 continuous months (1999 -2005), with no incident events of pancreatitis or biliary disease during that 1 year baseline period. ICD-9 codes and prescription data were used to identify patients with type 2 diabetes; ICD-9 codes were also used to identify cases of pancreatitis and biliary disease. Overall, 337,067 patients with type 2 diabetes were matched on age and sex with 337,067 patients without diabetes. Incidence rates of disease and 95% CI were calculated per 100,000 person-years of exposure.RESULTS -The type 2 diabetic cohort had a 2.83-fold (95% CI 2.61-3.06) greater risk of pancreatitis and 1.91-fold (1.84 -1.99) greater risk of biliary disease compared with the nondiabetic cohort. Relative to patients of corresponding age without diabetes, younger type 2 diabetic patients had the highest risk of pancreatitis (Ͻ45 years: incidence rate ratio [IRR] CONCLUSIONS -These data suggest that patients with type 2 diabetes may have an increased risk of acute pancreatitis and biliary disease.