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Revisión sistemática2021Financiación no declaradaAcceso abierto

Intermittent Fasting and Obesity-Related Health Outcomes: An Umbrella Review of Meta-analyses of Randomized Clinical Trials

Patikorn C, Roubal K, Veettil SK, Chandran V, Pham T, Lee YY, Giovannucci EL, Varady KA, Chaiyakunapruk N

JAMA network open · 219 citas

Etiquetas de revisión

Financiación no declarada

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Cómo se estudió

Diseño
Revisión sistemática (indexado por PubMed)
Estudiado en
Personas
Resultado principal
Marcadores de salud y funcionamiento

Quién lo pagó

Financiación
Financiación no declarada

Publicación

Publicado
2021-12-17 · JAMA Netw Open · vol. 4 · número 12 · pág. e2139558
Editorial
American Medical Association
Citado
296 citas · más que el 100% de estudios similares · 21.3× el promedio de su campo
Impacto
Entre el 10 % más citado de su campo
Referencias
40 trabajos
Acceso
Acceso abierto (revista) · CC-BY
Áreas de investigación
Dietary Effects on Health · Diet and metabolism studies · Genetics, Aging, and Longevity in Model Organisms
Palabras clave
Medicine, Body mass index, Meta-analysis, Obesity, Randomized controlled trial, Internal medicine, Physical therapy
MeSH
humans, obesity, weight loss, treatment outcome, fasting, models, statistical, meta-analysis as topic, randomized controlled trials as topic, non-alcoholic fatty liver disease, heart disease risk factors

9 autores

  • Chanthawat Patikorn🇹🇭Chulalongkorn University
  • Kiera Roubal🇺🇸University of Wisconsin–Madison
  • Sajesh Kalkandi Veettil🇺🇸University of Utah
  • Viji Pulikkel Chandran🇮🇳Manipal Academy of Higher Education
  • Tuan Anh Pham🇺🇸University of Utah
  • Yeong Yeh Lee🇲🇾Hospital Universiti Sains Malaysia
  • Edward L. Giovannucci🇺🇸Harvard University
  • Krista A Varady🇺🇸University of Illinois Chicago
  • Nathorn Chaiyakunapruk🇺🇸 · autor de correspondenciaUniversity of Utah

Resumen

El texto original del estudio, en el idioma en que se publicó.

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.

Objective

To 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 relevance

In 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.

Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).

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