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Intermittent Fasting on Human Health and Disease

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (15 June 2024) | Viewed by 20942

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Department of Biochemistry, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania
Interests: effects of natural/synthetic compounds on cellular pathways; oxidative stress; cardiometabolic disease
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Special Issue Information

Dear Colleagues,

Intermittent fasting is a dietary pattern in which individuals alternate between periods of fasting and non-fasting. This type of nutritional approach has gained interest in recent years due to its potential health benefits, including weight loss, improved insulin sensitivity, and the reduced risk of chronic diseases such as cardiovascular disease and type 2 diabetes.

Intermittent fasting has been shown to modulate metabolic pathways, through the activation of adaptive cellular stress responses, which may play an important role in reducing oxidative stress and inflammation, inducing DNA repair and authophagy and improving mitochondrial function; all of these processes are interlinked with the occurrence and development of a plethora of pathologies, such as cancer, Alzheimer's disease, atherosclerosis, etc., and therefore intermittent fasting has the potential to reduce their frequency in large populations. Additionally, it has been demonstrated to increase the production of neuroprotective and anti-inflammatory factors, improving cognitive function, and protecting against age-related neurodegenerative diseases.

In conclusion, intermittent fasting has been shown to have potential health benefits in the prevention and management of chronic diseases and in the process of biological aging. However, more profound research is needed to determine the efficacy and safety of intermittent fasting in humans and to fully understand the underlying mechanisms by which this nutritional approach exerts its effects on human health and disease.

The purpose of this Special Issue on “Intermittent Fasting on Human Health and Disease” is to aggregate studies that examine the mechanisms through which intermittent fasting may enhance health and longevity, as well as to provide an overview of the clinical significance of this dietary pattern for the prevention and treatment of cancer, metabolic disorders, cardiovascular disease, and neurodegenerative diseases.

The Special Issue welcomes contributions from a broad range of fields and invites researchers and nutrition experts to submit their original research studies, review articles, and communications that relate to this important health domain.

Dr. Cristina Manuela Drăgoi
Prof. Dr. Denisa Marilena Margină
Guest Editors

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Keywords

  • intermittent fasting
  • cancer
  • cardio-metabolic diseases
  • oxidative stress
  • diabetes
  • insulin resistance
  • age-related diseases
  • metabolism
  • autophagy
  • inflammation
  • neurologic protection

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Published Papers (8 papers)

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Editorial

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3 pages, 237 KiB  
Editorial
Intermittent Fasting on Human Health and Disease
by Denisa Marilena Margină and Cristina Manuela Drăgoi
Nutrients 2023, 15(21), 4491; https://doi.org/10.3390/nu15214491 - 24 Oct 2023
Cited by 1 | Viewed by 3047
Abstract
Chronic non-communicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide, but most of all in industrialized countries, and are fundamentally correlated to improper nutrition and impaired lifestyle behaviours [...] Full article
(This article belongs to the Special Issue Intermittent Fasting on Human Health and Disease)

Research

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15 pages, 1376 KiB  
Article
Time-Restricted Eating Benefits on Pulmonary Function and Postural Balance in Overweight or Obese Women
by Sarra Miladi, Omar Hammouda, Ranya Ameur, Sirine C. Miladi, Walid Feki and Tarak Driss
Nutrients 2024, 16(17), 2919; https://doi.org/10.3390/nu16172919 - 1 Sep 2024
Viewed by 918
Abstract
This study aimed to evaluate the impact of time-restricted eating (TRE) on neuro-physiological parameters, objective and subjective sleep, pulmonary capacity, and postural balance among women with excess body weight. Methods: Thirty-one participants were assigned to either a TRE group (n = 15, 28.74 [...] Read more.
This study aimed to evaluate the impact of time-restricted eating (TRE) on neuro-physiological parameters, objective and subjective sleep, pulmonary capacity, and postural balance among women with excess body weight. Methods: Thirty-one participants were assigned to either a TRE group (n = 15, 28.74 ± 9.25 years, 88.32 ± 13.38 kg, and 32.71 ± 5.15 kg/m2), engaging in ad libitum 16 h fasting over a 12-week period, or a control group (CG, n = 16, 36.25 ± 11.52 years, 90.88 ± 19.01 kg, and 33.66 ± 6.18 kg/m2). The assessment of heart rate variability (HRV), spirometric parameters (forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/ FVC ratio, objective and subjective sleep assessments employing actigraphy and the Epworth Sleepiness Scale, and postural balance using the Y balance test (YBT) were conducted before and after the intervention. Results: No significant negative effects of TRE were observed for HRV and objective sleep parameters. Only the TRE group improved FEV1 in both sitting (p < 0.0005) and supine positions (p = 0.001). Furthermore, the TRE group showed improvement in postural balance performance compared to the CG in anterior (p = 0.03), postero-medial (p = 0.04), and postero-lateral directions (p = 0.003). Conclusion: This study highlights TRE as a feasible and safe dietary intervention with significant improvements in postural balance and pulmonary function, without any negative impact on HRV or objective sleep assessments among overweight or obese women. Full article
(This article belongs to the Special Issue Intermittent Fasting on Human Health and Disease)
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14 pages, 4075 KiB  
Article
Long-Term Fasting-Induced Ketosis in 1610 Subjects: Metabolic Regulation and Safety
by Franziska Grundler, Robin Mesnage, Philip M. M. Ruppert, Demetrios Kouretas and Françoise Wilhelmi de Toledo
Nutrients 2024, 16(12), 1849; https://doi.org/10.3390/nu16121849 - 13 Jun 2024
Viewed by 3707
Abstract
Background: There is a growing consensus that fasting-induced ketosis has beneficial effects on human physiology. Despite these compelling benefits, fasting-induced ketosis raises concerns in some clinicians because it is often inappropriately compared with the pathologic uncontrolled ketone production in diabetic ketoacidosis. The determinants [...] Read more.
Background: There is a growing consensus that fasting-induced ketosis has beneficial effects on human physiology. Despite these compelling benefits, fasting-induced ketosis raises concerns in some clinicians because it is often inappropriately compared with the pathologic uncontrolled ketone production in diabetic ketoacidosis. The determinants of the inter-individual differences in the intensity of ketosis during long-term fasting is unknown. Methods: We monitored daily variations in fasting ketonemia, as well as ketonuria, which is less invasive, in a large cohort of 1610 subjects, fasting between 4 and 21 days with the Buchinger Wilhelmi program, minimally supplemented with ~75–250 kcal (daily fruit juice, vegetable soup, and honey). Results: Ketonuria was detected in more than 95% of fasting subjects from day 4 onwards. Subjects consuming only soups, without fruit juice or honey, exhibited reduced caloric intake (72 kcal instead of 236 kcal) and carbohydrate intake (15.6 g instead of 56.5 g), leading to more intense ketonuria. Participants with high ketonuria were, in the majority, males, young, had a higher body weight, and had lower HDL-C and urea values. They had a larger decrease in blood glucose, glycated haemoglobin levels, body weight, and waist circumference. Furthermore, in the high-ketonuria group, a larger increase in blood uric acid concentration was observed. Conclusion: Our study showed that long-term fasting triggered ketosis, never reaching pathological levels, and that ketosis is influenced by age, gender, health, and the level of physical activity. Furthermore, it is modulated but not suppressed by minimal carbohydrate intake. Our study paves the way for better understanding how supplementation can modulate the therapeutic effects and tolerability of long-term fasting. Full article
(This article belongs to the Special Issue Intermittent Fasting on Human Health and Disease)
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11 pages, 414 KiB  
Article
A Mediterranean Eating Pattern Combining Energy and Time-Restricted Eating Improves Vaspin and Omentin Concentrations Compared to Intermittent Fasting in Overweight Individuals
by Spyridon N. Karras, Theocharis Koufakis, Djordje S. Popovic, Lilian Adamidou, Paraskevi Karalazou, Katerina Thisiadou, Pantelis Zebekakis, Kali Makedou and Kalliopi Kotsa
Nutrients 2023, 15(24), 5058; https://doi.org/10.3390/nu15245058 - 9 Dec 2023
Cited by 1 | Viewed by 2439
Abstract
Athonian Orthodox fasting (AOF) is characterized by energy- and time-restricted eating (TRE) and is based on the Mediterranean diet. We aimed to investigate the impact of AOF compared to another TRE model on vaspin, omentin, nesfatin, and visfatin levels. We included 25 individuals [...] Read more.
Athonian Orthodox fasting (AOF) is characterized by energy- and time-restricted eating (TRE) and is based on the Mediterranean diet. We aimed to investigate the impact of AOF compared to another TRE model on vaspin, omentin, nesfatin, and visfatin levels. We included 25 individuals (mean age 50.3 ± 8.6 years, 24% men) who practiced AOF and abstained from animal products, with the exception of seafood and fish. This group adopted a 12 h eating interval (08.00 to 20.00). In total, 12 participants (mean age 47.7 ± 8.7 years, 33.3% men) who practiced 16:8 TRE (eating from 09:00 to 17:00) and were allowed to consume meat served as the controls. Anthropometric and dietary data and adipokine levels were prospectively collected at three time points: at baseline, after the end of the diets (7 weeks), and 5 weeks after the participants returned to their typical eating habits (12 weeks from baseline). Vaspin levels decreased [795.8 (422.1–1299.4) (baseline) vs. 402.7 (203.8–818.9) (7 weeks) pg/mL, p = 0.002] and omentin levels increased [568.5 (437.7–1196.5) (baseline) vs. 659.0 (555.7–1810.8) (12 weeks) pg/mL, p = 0.001] in the AOF group, while none of the analyzed adipokines changed significantly in the TRE group. The variations observed in vaspin and omentin concentrations in the AOF group were independent of age, sex, changes in anthropometry and fat intake. In conclusion, AOF can significantly reduce vaspin and increase omentin, whose levels are known to increase and decrease, respectively, in obesity and type 2 diabetes. The implications of these findings for cardiometabolic health warrant further investigation. Full article
(This article belongs to the Special Issue Intermittent Fasting on Human Health and Disease)
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19 pages, 4952 KiB  
Article
Effects of Regular Exercise and Intermittent Fasting on Neurotransmitters, Inflammation, Oxidative Stress, and Brain-Derived Neurotrophic Factor in Cortex of Ovariectomized Rats
by Tarfa Albrahim, Raghad Alangry, Raghad Alotaibi, Leen Almandil and Sara Alburikan
Nutrients 2023, 15(19), 4270; https://doi.org/10.3390/nu15194270 - 6 Oct 2023
Cited by 3 | Viewed by 2882
Abstract
A collection of metabolic disorders and neurodegenerative diseases linked to oxidative stress and neuroinflammation frequently affect postmenopausal women or estrogen deprivation. Recent research has focused on alternative therapies that can enhance these women’s quality of life. This study set out to investigate the [...] Read more.
A collection of metabolic disorders and neurodegenerative diseases linked to oxidative stress and neuroinflammation frequently affect postmenopausal women or estrogen deprivation. Recent research has focused on alternative therapies that can enhance these women’s quality of life. This study set out to investigate the effects of physical exercise (EX) and intermittent fasting (IF) on oxidants/antioxidants, inflammatory cytokines, neurotransmitters, and brain-derived neurotrophic factor (BDNF) in the cortex of rats. Additionally, it sought to assess the response to oxidative stress and neuroinflammation in the brains of rats following ovariectomy (OVX) and the potential mechanisms of these interventions. Fifty female rats were divided into one of the following groups 30 days after bilateral OVX: Control, OVX, OVX + EX, OVX + IF, and OVX + EX + IF groups. The rats in the Control and OVX groups continued their normal activities and had unrestricted access to food and water, but the rats in the OVX + EX and OVX + EX + IF groups had a 4-week treadmill training program, and the rats in the OXV + IF and OVX + EX + IF groups fasted for 13 h each day. The rats were killed, the cerebral cortex was taken, tissue homogenates were created, and various parameters were estimated using these homogenates. The results show that ovariectomized rats had decreased levels of neurotransmitters (DA, NE, and SE), acetylcholinesterase, brain GSH (glutathione), SOD (superoxide dismutase), catalase, GPx (glutathione peroxidase), and TAC (total antioxidant capacity), as well as elevated levels of proinflammatory cytokines and mediators (TNF-α, IL-1β, Cox-2). While ovariectomy-induced declines in neurotransmitters, enzymatic and nonenzymatic molecules, neuroinflammation, and oxidative brain damage were considerably mitigated and prevented by treadmill exercise and intermittent fasting, BDNF was significantly increased. These results suggest that ovariectomy can impair rat neuronal function and regular treadmill exercise and intermittent fasting seem to protect against ovariectomy-induced neuronal impairment through the inhibition of oxidative stress and neuroinflammation and increased BDNF levels in the brain cortex. However, combining regular exercise and intermittent fasting did not provide additional benefits compared to either treatment alone. Full article
(This article belongs to the Special Issue Intermittent Fasting on Human Health and Disease)
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Review

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19 pages, 726 KiB  
Review
Therapeutic Potential of Various Intermittent Fasting Regimens in Alleviating Type 2 Diabetes Mellitus and Prediabetes: A Narrative Review
by Sthembiso Msane, Andile Khathi and Aubrey Sosibo
Nutrients 2024, 16(16), 2692; https://doi.org/10.3390/nu16162692 - 14 Aug 2024
Cited by 1 | Viewed by 1174
Abstract
Intermittent fasting has drawn significant interest in the clinical research community due to its potential to address metabolic complications such as obesity and type 2 diabetes mellitus. Various intermittent fasting regimens include alternate-day fasting (24 h of fasting followed by 24 h of [...] Read more.
Intermittent fasting has drawn significant interest in the clinical research community due to its potential to address metabolic complications such as obesity and type 2 diabetes mellitus. Various intermittent fasting regimens include alternate-day fasting (24 h of fasting followed by 24 h of eating), time-restricted fasting (fasting for 14 h and eating within a 10 h window), and the 5:2 diet (fasting for two days and eating normally for the other five days). Intermittent fasting is associated with a reduced risk of type 2 diabetes mellitus-related complications and can slow their progression. The increasing global prevalence of type 2 diabetes mellitus highlights the importance of early management. Since prediabetes is a precursor to type 2 diabetes mellitus, understanding its progression is essential. However, the long-term effects of intermittent fasting on prediabetes are not yet well understood. Therefore, this review aims to comprehensively compile existing knowledge on the therapeutic effects of intermittent fasting in managing type 2 diabetes mellitus and prediabetes. Full article
(This article belongs to the Special Issue Intermittent Fasting on Human Health and Disease)
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33 pages, 986 KiB  
Review
The Beneficial Effects of Dietary Interventions on Gut Microbiota—An Up-to-Date Critical Review and Future Perspectives
by Carmen Purdel, Denisa Margină, Ines Adam-Dima and Anca Ungurianu
Nutrients 2023, 15(23), 5005; https://doi.org/10.3390/nu15235005 - 3 Dec 2023
Cited by 5 | Viewed by 3907
Abstract
Different dietary interventions, especially intermittent fasting, are widely used and promoted by physicians; these regimens have been studied lately for their impact on the gut microbiota composition/function and, consequently, on the general physiopathological processes of the host. Studies are showing that dietary components [...] Read more.
Different dietary interventions, especially intermittent fasting, are widely used and promoted by physicians; these regimens have been studied lately for their impact on the gut microbiota composition/function and, consequently, on the general physiopathological processes of the host. Studies are showing that dietary components modulate the microbiota, and, at the same time, the host metabolism is deeply influenced by the different products resulting from nutrient transformation in the microbiota compartment. This reciprocal relationship can potentially influence even drug metabolism for chronic drug regimens, significantly impacting human health/disease. Recently, the influence of various dietary restrictions on the gut microbiota and the differences between the effects were investigated. In this review, we explored the current knowledge of different dietary restrictions on animal and human gut microbiota and the impact of these changes on human health. Full article
(This article belongs to the Special Issue Intermittent Fasting on Human Health and Disease)
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Other

13 pages, 497 KiB  
Protocol
Effect of Intermittent vs. Continuous Energy Restriction on Visceral Fat: Protocol for The Healthy Diet and Lifestyle Study 2 (HDLS2)
by Michelle Y. Lewis, Kim Yonemori, Alison Ross, Lynne R. Wilkens, John Shepherd, Kevin Cassel, Andrew Stenger, Christoph Rettenmeier, Unhee Lim, Carol Boushey and Loïc Le Marchand
Nutrients 2024, 16(10), 1478; https://doi.org/10.3390/nu16101478 - 14 May 2024
Viewed by 1730
Abstract
Obesity in the United States and Western countries represents a major health challenge associated with an increased risk of metabolic diseases, including cardiovascular disease, hypertension, diabetes, and certain cancers. Our past work revealed a more pronounced obesity–cancer link in certain ethnic groups, motivating [...] Read more.
Obesity in the United States and Western countries represents a major health challenge associated with an increased risk of metabolic diseases, including cardiovascular disease, hypertension, diabetes, and certain cancers. Our past work revealed a more pronounced obesity–cancer link in certain ethnic groups, motivating us to develop a tailored dietary intervention called the Healthy Diet and Lifestyle 2 (HDLS2). The study protocol is described herein for this randomized six-month trial examining the effects of intermittent energy restriction (5:2 Diet) plus the Mediterranean dietary pattern (IER + MED) on visceral adipose tissue (VAT), liver fat, and metabolic biomarkers, compared to a standard MED with daily energy restriction (DER + MED), in a diverse participant group. Using MRI and DXA scans for body composition analysis, as well as metabolic profiling, this research aims to contribute to nutritional guidelines and strategies for visceral obesity reduction. The potential benefits of IER + MED, particularly regarding VAT reduction and metabolic health improvement, could be pivotal in mitigating the obesity epidemic and its metabolic sequelae. The ongoing study will provide essential insights into the efficacy of these energy restriction approaches across varied racial/ethnic backgrounds, addressing an urgent need in nutrition and metabolic health research. Registered Trial, National Institutes of Health, ClinicalTrials.gov (NCT05132686). Full article
(This article belongs to the Special Issue Intermittent Fasting on Human Health and Disease)
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