Effect of early time-restricted feeding on the metabolic profile of adults with excess weight: A systematic review with meta-analysis

Pureza, Isabele Rejane de Oliveira Maranhão; Macêna, Mateus de Lima; Silva, André Eduardo da; Praxedes, Dafiny Rodrigues Silva; Vasconcelos, Laí­s Gomes Lessa; Bueno, Nassib Bezerra

doi:10.1016/j.clnu.2020.10.031

Cited by 56 publications

(54 citation statements)

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“…In another trial of early time-restricted feeding (eTRF), both LDL-cholesterol and HDL-cholesterol increased in the morning, which can be attributed to the period of prolonged fasting. The metabolism of these people had a greater dependence on fat oxidation [ 21 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Intermittent Fasting and the Possible Benefits in Obesity, Diabetes, and Multiple Sclerosis: A Systematic Review of Randomized Clinical Trials

Morales-Suárez-Varela

Sánchez

Peraita-Costa

et al. 2021

Nutrients

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Intermittent fasting has become popular in recent years and is controversially presented as a possible therapeutic adjunct. A bibliographic review of the literature on intermittent fasting and obesity, diabetes, and multiple sclerosis was carried out. The scientific quality of the methodology and the results obtained were evaluated in pairs. Intermittent fasting has beneficial effects on the lipid profile, and it is associated with weight loss and a modification of the distribution of abdominal fat in people with obesity and type 2 diabetes as well as an improvement in the control of glycemic levels. In patients with multiple sclerosis, the data available are too scarce to draw any firm conclusions, but it does appear that intermittent fasting may be a safe and feasible intervention. However, it is necessary to continue investigating its long-term effects since so far, the studies carried out are small and of short duration.

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Section: Discussionmentioning

confidence: 99%

Intermittent Fasting and the Possible Benefits in Obesity, Diabetes, and Multiple Sclerosis: A Systematic Review of Randomized Clinical Trials

Morales-Suárez-Varela

Sánchez

Peraita-Costa

et al. 2021

Nutrients

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“…Ketosis has gained interest over recent years due to its induced benefits that it imparts on several health conditions [1,2]. Ketosis is associated with a delay in the onset of diseases and increased longevity [3].…”

Section: Introductionmentioning

confidence: 99%

Epigenetic landscape in blood leukocytes following ketosis and weight loss induced by a very low calorie ketogenic diet (VLCKD) in patients with obesity

et al. 2021

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Background: The molecular mechanisms underlying the potential health benefits of a ketogenic diet are unknown and could be mediated by epigenetic mechanisms. Objective: To identify the changes in the obesity-related methylome that are mediated by the induced weight loss or are dependent on ketosis in subjects with obesity underwent a very-low calorie ketogenic diet (VLCKD). Methods: Twenty-one patients with obesity (n ¼ 12 women, 47.9 ± 1.02 yr, 33.0 ± 0.2 kg/m 2 ) after 6 months on a VLCKD and 12 normal weight volunteers (n ¼ 6 women, 50.3 ± 6.2 yrs, 22.7 ± 1.5 kg/m 2 ) were studied. Data from the Infinium MethylationEPIC BeadChip methylomes of blood leukocytes were obtained at time points of ketotic phases (basal, maximum ketosis, and out of ketosis) during VLCKD (n ¼ 10) and at baseline in volunteers (n ¼ 12). Results were further validated by pyrosequencing in representative cohort of patients on a VLCKD (n ¼ 18) and correlated with gene expression. Results: After weight reduction by VLCKD, differences were found at 988 CpG sites (786 unique genes). The VLCKD altered methylation levels in patients with obesity had high resemblance with those from normal weight volunteers and was concomitant with a downregulation of DNA methyltransferases (DNMT)1, 3a and 3b. Most of the encoded genes were involved in metabolic processes, protein metabolism, and muscle, organ, and skeletal system development. Novel genes representing the top scoring associated events were identified, including ZNF331, FGFRL1 (VLCKD-induced weight loss) and CBFA2T3, C3orf38, JSRP1, and LRFN4 (VLCKD-induced ketosis). Interestingly, ZNF331 and FGFRL1 were validated in an independent cohort and inversely correlated with gene expression. Conclusions: The beneficial effects of VLCKD therapy on obesity involve a methylome more suggestive of normal weight that could be mainly mediated by the VLCKD-induced ketosis rather than weight loss.

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“…Intermittent Fasting and Obesity-Related Health Outcomes were supported by a very low level of evidence (61%), followed by low (5 associations [18%]), moderate (5 associations [18%]), and high (1 association [4%]) levels of evidence, respectively. These associations, which mostly involved adults with overweight or obesity, demonstrated beneficial outcomes associated with IF for BMI, 25,28 body weight, [26][27][28] fat mass, 5,25,27,28 LDL-C, 7 total cholesterol, 28 triglyceride, 7,28 fasting plasma glucose, 8,26 fasting insulin, 27 HOMA-IR, 8 and blood pressure. 25 IF was found to be associated with reductions in fat-free mass.…”

Section: Jama Network Open | Nutrition Obesity and Exercisementioning

confidence: 98%

“…The identified associations comprised 5 types of IF, including 2 outcomes associated with zero-calorie ADF (2%), 28 51 with MADF (49%), 6,7,22,25,27,28 28 with 5:2 diet (27%), 7,[22][23][24]27 and 23 with TRE (22%). 5,6,8,26 Associations analyzed included 42 (40%) anthropometric measures (ie, body mass index There were 3 associations (3%) that were specifically evaluated in healthy normal weight adults.…”

Section: Description and Summary Of Associationsmentioning

confidence: 99%

“… 3 Several systematic reviews and meta-analyses of randomized clinical trials (RCTs) have been published and demonstrated several health benefits of IF as well. 5 , 6 , 7 , 8 However, many of these meta-analyses focused on a subset of types of IF or specific health outcomes. To date, there has been little synthesis of the strength and quality of this evidence in aggregate.…”

Section: Introductionmentioning

confidence: 99%

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Intermittent Fasting and Obesity-Related Health Outcomes

et al. 2021

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IMPORTANCE Several meta-analyses of randomized clinical trials (RCTs) have demonstrated the many health benefits of intermittent fasting (IF). However, there has been little synthesis of the strength and quality of this evidence in aggregate to date. OBJECTIVETo grade the evidence from published meta-analyses of RCTs that assessed the associations of IF (zero-calorie alternate-day fasting, modified alternate-day fasting, the 5:2 diet, and time-restricted eating) with obesity-related health outcomes. EVIDENCE REVIEW PubMed, Embase, and Cochrane database of systematic reviews were searched from database inception to January 12, 2021. Data analysis was conducted from April 2021 through July 2021. Meta-analyses of RCTs investigating effects of IF in adults were included. The effect sizes of IF were recalculated using a random-effects model. We assessed the quality of evidence per association by applying the GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluations) as high, moderate, low, and very low.FINDINGS A total of 11 meta-analyses comprising 130 RCTs (median [IQR] sample size, 38 [24-69] participants; median [IQR] follow-up period, 3 [2-5] months) were included describing 104 unique associations of different types of IF with obesity-related health outcomes (median [IQR] studies per association, 4 [3-5]). There were 28 statistically significant associations (27%) that demonstrated the beneficial outcomes for body mass index, body weight, fat mass, low-density lipoprotein cholesterol, total cholesterol, triglycerides, fasting plasma glucose, fasting insulin, homeostatic model assessment of insulin resistance, and blood pressure. IF was found to be associated with reduced fat-free mass. One significant association (1%) supported by high-quality evidence was modified alternate-day fasting for 1 to 2 months, which was associated with moderate reduction in body mass index in healthy adults and adults with overweight, obesity, or nonalcoholic fatty liver disease compared with regular diet. Six associations (6%) were supported by moderate quality evidence. The remaining associations found to be significant were supported by very low (75 associations [72%]) to low (22 associations [21%]) quality evidence. CONCLUSIONS AND RELEVANCEIn this umbrella review, we found beneficial associations of IF with anthropometric and cardiometabolic outcomes supported by moderate to high quality of evidence, which supports the role of IF, especially modified alternate-day fasting, as a weight loss approach for adults with overweight or obesity. More clinical trials with long-term follow-up are needed to investigate the effects of IF on clinical outcomes such as cardiovascular events and mortality.

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Effect of early time-restricted feeding on the metabolic profile of adults with excess weight: A systematic review with meta-analysis

Cited by 56 publications

References 45 publications

Intermittent Fasting and the Possible Benefits in Obesity, Diabetes, and Multiple Sclerosis: A Systematic Review of Randomized Clinical Trials

Intermittent Fasting and the Possible Benefits in Obesity, Diabetes, and Multiple Sclerosis: A Systematic Review of Randomized Clinical Trials

Epigenetic landscape in blood leukocytes following ketosis and weight loss induced by a very low calorie ketogenic diet (VLCKD) in patients with obesity

Intermittent Fasting and Obesity-Related Health Outcomes

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