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Tolerance of a diet is a determinant of its potential effectiveness and maintenance of benefits obtained, such as weight loss or biomarker improvement.<ref>{{cite journal |last1=Freire |first1=R |title=Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. |journal=Nutrition |date=4 July 2019 |volume=69 |pages=110549 |doi=10.1016/j.nut.2019.07.001 |pmid=31525701}}</ref> A 2019 review found that drop-out rates varied widely from 2% to 38% for intermittent fasting, and from 0% to 50% for a calorie restriction diet.<ref name="Cioffi2018" />
Tolerance of a diet is a determinant of its potential effectiveness and maintenance of benefits obtained, such as weight loss or biomarker improvement.<ref>{{cite journal |last1=Freire |first1=R |title=Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. |journal=Nutrition |date=4 July 2019 |volume=69 |pages=110549 |doi=10.1016/j.nut.2019.07.001 |pmid=31525701}}</ref> A 2019 review found that drop-out rates varied widely from 2% to 38% for intermittent fasting, and from 0% to 50% for a calorie restriction diet.<ref name="Cioffi2018" />


===Mechanism===
===Mechanism of weight loss===
The Set-Point Theory, first introduced in 1953, postulated that each body has a preprogrammed fixed weight, with regulatory mechanisms to compensate. This theory was quickly adopted and used to explain failures in developing effective and sustained weight loss procedures. A 2019 systematic review of multiple weight change procedures, including alternate day fasting and time-restricted feeding but also exercise and overeating, found systematic "energetic errors" for all these procedures. This shows that the body cannot precisely compensate for errors in energy/calorie intake, countering the Set-Point Theory and potentially explaining both [[weight loss]] and weight gain such as [[obesity]]. This review was conducted on short term studies, therefore such a mechanism cannot be excluded in the long term, as evidence is currently lacking on this timeframe.<ref>{{cite journal |last1=Levitsky |first1=DA |last2=Sewall |first2=A |last3=Zhong |first3=Y |last4=Barre |first4=L |last5=Shoen |first5=S |last6=Agaronnik |first6=N |last7=LeClair |first7=JL |last8=Zhuo |first8=W |last9=Pacanowski |first9=C |title=Quantifying the imprecision of energy intake of humans to compensate for imposed energetic errors: A challenge to the physiological control of human food intake. |journal=Appetite |date=1 February 2019 |volume=133 |pages=337-343 |doi=10.1016/j.appet.2018.11.017 |pmid=30476522}}</ref>
A 2019 review of weight-change diets, including alternate day fasting and time-restricted feeding, found that people were unable to sustain fasting due to an "energetic error" in determining and adhering to the reduction of energy intake.<ref>{{cite journal |last1=Levitsky |first1=DA |last2=Sewall |first2=A |last3=Zhong |first3=Y |last4=Barre |first4=L |last5=Shoen |first5=S |last6=Agaronnik |first6=N |last7=LeClair |first7=JL |last8=Zhuo |first8=W |last9=Pacanowski |first9=C |title=Quantifying the imprecision of energy intake of humans to compensate for imposed energetic errors: A challenge to the physiological control of human food intake. |journal=Appetite |date=1 February 2019 |volume=133 |pages=337-343 |doi=10.1016/j.appet.2018.11.017 |pmid=30476522}}</ref>


== See also ==
== See also ==

Revision as of 23:36, 30 September 2019

Intermittent fasting (IF) is an umbrella term for various eating patterns designed to improve health that cycle between a period of fasting (or reduced calorie intake) and non-fasting over a defined period. Three methods of intermittent fasting are alternate-day fasting, whole-day fasting, and time-restricted feeding. IF is sometimes considered a type of food faddism.[1][2]

The science around intermittent fasting is preliminary and uncertain.[3] Intermittent fasting is under research to determine if it can produce weight loss and improve general health, whether in the short term or long term.[4][5][6][7][8] There is limited evidence that intermittent fasting achieves similar weight loss results to conventional calorie restriction in the short term for overweight or obese individuals,[9][10] and has a specific regulating effect on insulin that is not observed in a calorie reduction diet.[11]

The US National Institute on Aging recommends against intermittent fasting because of uncertainties about its effectiveness and safety.[3]

Types

Three methods of intermittent fasting are alternate-day fasting, whole-day fasting, and time-restricted feeding.[7]

  • Alternate-day fasting (ADF) is the strictest form of IF. This involves 24-hours complete fasting followed by a 24-hour non-fasting period.[7]
    • An adjusted form of ADF is alternate-day modified fasting (ADMF) which allows the consumption of approximately 25% of daily calorie needs on fasting days instead of full fasting.[4]
  • Whole-day fasting involves regular one or two fasting days per week. A 5:2 diet requires five non-fasting days and 2 fasting days in a week. During the fasting days, it allows approximately 500 to 600 calories or about 25% of regular daily caloric intake.[7]
  • Time-restricted feeding involves eating only during a certain number of hours each day. An example can be 16:8 diets which advocate 16 fasting hours cycled by 8 non-fasting hours.[7]

Intermittent fasting has a different duration (less than 48 hours) than long term, periodic fasting (more than 48 hours).[4][12]

As of 2019 intermittent fasting is a popular fad diet, attracting celebrity endorsement and strong interest from the lay public.[2]

UK

Intermittent fasting (specifically the 5:2 diet) became popular in the UK in 2012[13][14][15] after the BBC2 television Horizon documentary Eat, Fast and Live Longer.[16] Via sales of best-selling books, it became widely practiced.[17][18]

North America

In the United States, intermittent fasting has become a trend among Silicon Valley companies.[19] According to NHS Choices as of 2012, people considering the 5:2 diet should first consult a physician, as fasting can sometimes be unsafe.[17][20] A news item in the Canadian Medical Association Journal expressed concern that promotional material for the diet showed people eating high-calorie food, such as hamburgers and chips, and that this could encourage binge eating since the implication was that "if you fast two days a week, you can devour as much junk as your gullet can swallow during the remaining five days".[21]

Commercialization

As of 2019, interest in intermittent fasting led some companies to commercialize diet coaching, dietary supplements, and full meal packages.[19][22] These companies have been criticized for offering products or services that are expensive and not backed by science.[22][23]

Research

Overall, the science around intermittent fasting is preliminary and uncertain because of a lack of good quality human trials.[3] The US National Institute on Aging recognizes that IF has shown weight loss efficacy in several studies on obese or overweight individuals, but recommends against intermittent fasting because of uncertainties about its effectiveness and safety.[3]

Weight loss and health biomarkers

There is limited evidence that intermittent fasting achives weight loss comparable to a calorie restricted diet.[9][10] Alternate day fasting does not appear to affect lean body mass, similarly to a calorie restricted diet, but contrary to a very-low-calorie diet.[7][24] Intermittent fasting does not seem to affect bone health.[25]

Alternate day fasting improves cardiovascular and metabolic biomarkers similarly to calorie restriction diet for overweight or obese individuals.[9][10][12][26] Intermittent fasting further improves fasting insulin concentrations and reduces IGF-1 levels, the latter further reducing caloric intake, whereas these effects on insulin were observed with calorie restriction diet only when the caloric reduction was at least 50% compared to the usual daily caloric intake.[9][11]

The reviewed clinical trials were run mostly on overweight or obese middle-aged women from the US and the UK, limiting interpretation of the results. Intermittent fasting has not yet been studied in children, the elderly, or underweight people, and could be harmful in these populations.[3][9][10][27] The long-term sustainability of the intermittent fasting effects is unknown, as of 2018.[3][28] The clinical relevance for long term general health is uncertain, and it remains unclear whether the beneficial effects are due solely to weight loss or to an additional "flip switch" mechanism specific to intermittent fasting.[9][26][29] Intermittent fasting and calorie restriction diets, although under active research, are not recommended for non-obese or non-overweight individuals by the US National Institute on Aging until more clinical trials are conducted.[3]

Other effects

Nocturnal eating has been linked to impaired sleep quality.[4] There is no evidence that fasting can prevent or treat cancer.[12][30] Athletic performance does not benefit from intermittent fasting.[31]

Adverse effects

Reviews of preliminary clinical studies and randomized clinical trials found that short-term intermittent fasting may produce minor adverse effects, such as continuous feelings of weakness and hunger, headaches, fainting, or dehydration. However, the data remain sparse, as most studies did not systematically collect data about adverse effects.[11][32]

Long-term, periodic fasting may cause eating disorders or malnutrition, with increased susceptibility to infectious diseases.[32]

Tolerance

Tolerance of a diet is a determinant of its potential effectiveness and maintenance of benefits obtained, such as weight loss or biomarker improvement.[33] A 2019 review found that drop-out rates varied widely from 2% to 38% for intermittent fasting, and from 0% to 50% for a calorie restriction diet.[9]

Mechanism of weight loss

A 2019 review of weight-change diets, including alternate day fasting and time-restricted feeding, found that people were unable to sustain fasting due to an "energetic error" in determining and adhering to the reduction of energy intake.[34]

See also

References

  1. ^ Collier R (2013). "Intermittent fasting: the next big weight loss fad". CMAJ. 185 (8): E321-2. doi:10.1503/cmaj.109-4437. PMC 3652955. PMID 23529969.
  2. ^ a b Arbolario K (26 August 2019). "Intermittent Fasting: Exposing The Dangers Of This Fad Diet". Medical Daily. Intermittent fasting is all the rage these days when it comes to the weight loss and fitness community. Given the large number of people including celebrities who swear by it, it's not surprising why this diet is getting a lot of attention.
  3. ^ a b c d e f g "Calorie restriction and fasting diets: What do we know?". National Institute on Aging, US National Institutes of Health. 2018-08-14. Retrieved 29 September 2019.
  4. ^ a b c d Patterson, Ruth E.; Sears, Dorothy D. (21 August 2017). "Metabolic effects of intermittent fasting". Annual Review of Nutrition. 37 (1): 371–393. doi:10.1146/annurev-nutr-071816-064634. PMID 28715993.
  5. ^ Davis, C S; Clarke, R E; Coulter, S N; Rounsefell, K N; Walker, R E; Rauch, C E; Huggins, C E; Ryan, L (25 November 2015). "Intermittent energy restriction and weight loss: a systematic review". European Journal of Clinical Nutrition. 70 (3): 292–299. doi:10.1038/ejcn.2015.195. PMID 26603882.
  6. ^ Johnstone, A (26 December 2014). "Fasting for weight loss: an effective strategy or latest dieting trend?". International Journal of Obesity. 39 (5): 727–733. doi:10.1038/ijo.2014.214. PMID 25540982.
  7. ^ a b c d e f Tinsley, GM; La Bounty, PM (1 October 2015). "Effects of intermittent fasting on body composition and clinical health markers in humans". Nutrition Reviews. 73 (10): 661–74. doi:10.1093/nutrit/nuv041. PMID 26374764.
  8. ^ Harvie, Michelle N; Howell, Tony (July 2016). "Could Intermittent Energy Restriction and Intermittent Fasting Reduce Rates of Cancer in Obese, Overweight, and Normal-Weight Subjects? A Summary of Evidence". Advances in Nutrition. 7 (4): 690–705. doi:10.3945/an.115.011767. ISSN 2156-5376. PMC 4942870. PMID 27422504.
  9. ^ a b c d e f g Cioffi, Iolanda; Evangelista, Andrea; Ponzo, Valentina; Ciccone, Giovannino; Soldati, Laura; Santarpia, Lidia; Contaldo, Franco; Pasanisi, Fabrizio; Ghigo, Ezio; Bo, Simona (24 December 2018). "Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials". Journal of Translational Medicine. 16 (1): 371. doi:10.1186/s12967-018-1748-4. ISSN 1479-5876.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  10. ^ a b c d Harris L, Hamilton S, Azevedo LB, Olajide J, De Brún C, Waller G, Whittaker V, Sharp T, Lean M, Hankey C, Ells L (February 2018). "Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis". JBI Database System Rev Implement Rep. 16 (2): 507–547. doi:10.11124/JBISRIR-2016-003248. PMID 29419624.
  11. ^ a b c Rahmani, J; Kord Varkaneh, H; Clark, C; Zand, H; Bawadi, H; Ryan, PM; Fatahi, S; Zhang, Y (August 2019). "The influence of fasting and energy restricting diets on IGF-1 levels in humans: A systematic review and meta-analysis". Ageing research reviews. 53: 100910. doi:10.1016/j.arr.2019.100910. PMID 31116995.
  12. ^ a b c Mattson, M. P; Longo, V. D; Harvie, M (2017). "Impact of intermittent fasting on health and disease processes". Ageing Research Reviews. 39: 46–58. doi:10.1016/j.arr.2016.10.005. PMC 5411330. PMID 27810402.
  13. ^ "How to diet". Live Well - NHS Choices. UK National Health Service. 9 December 2011. Retrieved 10 February 2014.
  14. ^ Trueland, Jennifer (2013). "Fast and effective?". Nursing Standard. 28 (16): 26–7. doi:10.7748/ns2013.12.28.16.26.s28. PMID 24345130.
  15. ^ Healy A (11 June 2013). "Dietitians warn against fad diets". Irish Times. Archived from the original on 28 July 2017.
  16. ^ Mosley, Michael (5 September 2012). "Eat, Fast & Live Longer". Horizon. Episode 49x03. BBC. 2. Retrieved 10 February 2014. {{cite episode}}: Unknown parameter |serieslink= ignored (|series-link= suggested) (help)
  17. ^ a b Fleming, Amy (27 January 2015). "Fasting facts: is the 5:2 diet too good to be true?". The Guardian. Retrieved 18 January 2018.
  18. ^ "The UK's Hot New 5:2 Diet Craze Hits The U.S. - Weight Loss Miracle?". Forbes. 17 May 2013. Retrieved 10 February 2014.
  19. ^ a b Solon, Olivia (2017-09-04). "The Silicon Valley execs who don't eat for days: 'It's not dieting, it's biohacking'". The Guardian. Retrieved 2018-11-05.
  20. ^ "News analysis: Does the 5:2 intermittent fasting diet work?". Health News. UK National Health Service - NHS Choices. May 2013. Retrieved 23 November 2016.
  21. ^ Collier, R (2013). "Intermittent fasting: The science of going without". Canadian Medical Association Journal. 185 (9): E363–4. doi:10.1503/cmaj.109-4451. PMC 3680567. PMID 23569168.
  22. ^ a b Giles, Tom (24 April 2018). "Silicon Valley wants to cash in on fasting". Bloomberg News. Retrieved 8 November 2018.
  23. ^ "Not so fast: Pros and cons of the newest diet trend". Harvard Health Publishing, Harvard University Medical School. 31 July 2019. Retrieved 28 August 2019.
  24. ^ Alhamdan, BA; Garcia-Alvarez, A; Alzahrnai, AH; Karanxha, J; Stretchberry, DR; Contrera, KJ; Utria, AF; Cheskin, LJ (September 2016). "Alternate-day versus daily energy restriction diets: which is more effective for weight loss? A systematic review and meta-analysis". Obesity Science and Practice. 2 (3): 293–302. doi:10.1002/osp4.52. PMID 27708846.
  25. ^ Veronese, N; Reginster, JY (June 2019). "The effects of calorie restriction, intermittent fasting and vegetarian diets on bone health". Aging Clinical and Experimental Research. 31 (6): 753–758. doi:10.1007/s40520-019-01174-x. PMID 30903600.
  26. ^ a b Anton, SD; Moehl, K; Donahoo, WT; Marosi, K; Lee, SA; Mainous AG, 3rd; Leeuwenburgh, C; Mattson, MP (1 February 2018). "Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting". Obesity. 26 (2): 254–268. doi:10.1002/oby.22065. PMC 5783752. PMID 29086496.{{cite journal}}: CS1 maint: numeric names: authors list (link)
  27. ^ Longo, Valter D; Mattson, Mark P (2014). "Fasting: Molecular Mechanisms and Clinical Applications". Cell Metabolism. 19 (2): 181–92. doi:10.1016/j.cmet.2013.12.008. PMC 3946160. PMID 24440038.
  28. ^ Harris, L; McGarty, A; Hutchison, L; Ells, L; Hankey, C (January 2018). "Short-term intermittent energy restriction interventions for weight management: a systematic review and meta-analysis". Obesity Reviews. 19 (1): 1–13. doi:10.1111/obr.12593. PMID 28975722.
  29. ^ Peterson, Courtney M. (2019). "Intermittent Fasting Induces Weight Loss, but the Effects on Cardiometabolic Health are Modulated by Energy Balance". Obesity. 27 (1): 11–11. doi:10.1002/oby.22384. ISSN 1930-739X.
  30. ^ "Réseau NACRe - Réseau National Alimentation Cancer Recherche - Rapport NACRe jeûne regimes restrictifs cancer 2017". www6.inra.fr (in French). November 2017. Retrieved 19 September 2018.
  31. ^ Levy, E; Chu, T (July 2019). "Intermittent Fasting and Its Effects on Athletic Performance: A Review". Current sports medicine reports. 18 (7): 266–269. doi:10.1249/JSR.0000000000000614. PMID 31283627.
  32. ^ a b Horne, B. D.; Muhlestein, J. B.; Anderson, J. L. (2015). "Health effects of intermittent fasting: Hormesis or harm? A systematic review". The American Journal of Clinical Nutrition. 102 (2): 464–70. doi:10.3945/ajcn.115.109553. PMID 26135345.
  33. ^ Freire, R (4 July 2019). "Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets". Nutrition. 69: 110549. doi:10.1016/j.nut.2019.07.001. PMID 31525701.
  34. ^ Levitsky, DA; Sewall, A; Zhong, Y; Barre, L; Shoen, S; Agaronnik, N; LeClair, JL; Zhuo, W; Pacanowski, C (1 February 2019). "Quantifying the imprecision of energy intake of humans to compensate for imposed energetic errors: A challenge to the physiological control of human food intake". Appetite. 133: 337–343. doi:10.1016/j.appet.2018.11.017. PMID 30476522.
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