Exploring the Impact of Intermittent Fasting on Metabolic Syndrome, Prediabetes and Type 2 Diabetes: a systematic review
DOI:
https://doi.org/10.12775/JEHS.2023.24.01.011Keywords
intermittent fasting, metabolic syndrome, prediabetes, type 2 diabetes, obesityAbstract
Introduction: Metabolic syndrome, prediabetes and type 2 diabetes mellitus represent a growing and interconnected health challenge, gaining significant attention due to their high prevalence and impact they have on individuals' well-being. Intermittent Fasting (IF), involving cycling between periods of fasting and eating, has emerged as a promising dietary approach garnering substantial attention for its potential therapeutic effects on metabolic health.
Purpose: This review aims to explore the impact of intermittent fasting on metabolic disease by examining recent studies.
Methods: A review of the recent literature was conducted to explore potential positive effects of IF on relevant metabolic parameters.
Results: The findings from the reviewed studies demonstrated favorable effects of IF associated with improvements in glycemic control as improved insulin sensitivity and decreased HbA1c levels. Additionally, it led to significant reductions in body weight and waist circumference. Beneficial effects on lipid profiles, such as reduced triglyceride levels, were also observed in some studies.
Conclusions: The reviewed studies provide strong evidence supporting the effectiveness of IF regimens in improving metabolic factors, including weight, insulin sensitivity and lipid profiles in individuals with abnormal glucose metabolism. IF offers a promising dietary strategy potentially providing additional benefits beyond conventional dietary interventions. However, further research is needed to elucidate the long-term effects, optimal fasting protocols and potential mechanisms underlying the benefits of intermittent fasting in these conditions.
References
. Diabetes Canada Clinical Practice Guidelines Expert Committee, Punthakee, Z., Goldenberg, R., & Katz, P. (2018). Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome. Canadian journal of diabetes, 42 Suppl 1, S10–S15. https://doi.org/10.1016/j.jcjd.2017.10.003
. Engin A. (2017). The Definition and Prevalence of Obesity and Metabolic Syndrome. Advances in experimental medicine and biology, 960, 1–17. https://doi.org/10.1007/978-3-319-48382-5_1
. Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 2019 May;15(5):288-298. doi: 10.1038/s41574-019-0176-8. PMID: 30814686.
. Jaacks LM, Vandevijvere S, Pan A, McGowan CJ, Wallace C, Imamura F, Mozaffarian D, Swinburn B, Ezzati M. The obesity transition: stages of the global epidemic. Lancet Diabetes Endocrinol. 2019 Mar;7(3):231-240. doi: 10.1016/S2213-8587(19)30026-9. Epub 2019 Jan 28. PMID: 30704950; PMCID: PMC7360432.
. WHO European Regional Obesity Report 2022. Copenhagen: WHO Regional Office for Europe; 2022. Licence: CC BY-NC-SA 3.0 IGO.
. Malik, S., & Wong, N. D. (2009). Metabolic syndrome, cardiovascular risk and screening for subclinical atherosclerosis. Expert review of cardiovascular therapy, 7(3), 273–280. https://doi.org/10.1586/14779072.7.3.273
. Zhang, F., Liu, L., Zhang, C., Ji, S., Mei, Z., & Li, T. (2021). Association of Metabolic Syndrome and Its Components With Risk of Stroke Recurrence and Mortality: A Meta-analysis. Neurology, 97(7), e695–e705. https://doi.org/10.1212/WNL.0000000000012415
.Tremmel M, Gerdtham UG, Nilsson PM, Saha S. Economic Burden of Obesity: A Systematic Literature Review. Int J Environ Res Public Health. 2017 Apr 19;14(4):435. doi: 10.3390/ijerph14040435. PMID: 28422077; PMCID: PMC5409636.
. Elortegui Pascual P, Rolands MR, Eldridge AL, Kassis A, Mainardi F, Lê KA, Karagounis LG, Gut P, Varady KA. A meta-analysis comparing the effectiveness of alternate day fasting, the 5:2 diet, and time-restricted eating for weight loss. Obesity (Silver Spring). 2023 Feb;31 Suppl 1(Suppl 1):9-21. doi: 10.1002/oby.23568. Epub 2022 Nov 8. PMID: 36349432; PMCID: PMC10098946.
. Zang BY, He LX, Xue L. Intermittent Fasting: Potential Bridge of Obesity and Diabetes to Health? Nutrients. 2022 Feb 25;14(5):981. doi: 10.3390/nu14050981. PMID: 35267959; PMCID: PMC8912812.
. Song DK, Kim YW. Beneficial effects of intermittent fasting: a narrative review. J Yeungnam Med Sci. 2023 Jan;40(1):4-11. doi: 10.12701/jyms.2022.00010. Epub 2022 Apr 4. PMID: 35368155; PMCID: PMC9946909
. Saklayen MG. The Global Epidemic of the Metabolic Syndrome. Curr Hypertens Rep. 2018 Feb 26;20(2):12. doi: 10.1007/s11906-018-0812-z. PMID: 29480368; PMCID: PMC5866840.
.Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012 Jun 16;379(9833):2279-90. doi: 10.1016/S0140-6736(12)60283-9. Epub 2012 Jun 9. PMID: 22683128; PMCID: PMC3891203.
. Batista, T. M., Haider, N., & Kahn, C. R. (2021). Defining the underlying defect in insulin action in type 2 diabetes. Diabetologia, 64(5), 994–1006. https://doi.org/10.1007/s00125-021-05415-5
. Freeman, A. M., & Pennings, N. (2022). Insulin Resistance. In StatPearls. StatPearls Publishing.
. Russo, S., Kwiatkowski, M., Govorukhina, N., Bischoff, R., & Melgert, B. N. (2021). Meta-Inflammation and Metabolic Reprogramming of Macrophages in Diabetes and Obesity: The Importance of Metabolites. Frontiers in immunology, 12, 746151. https://doi.org/10.3389/fimmu.2021.746151
. Iqbal, J., Al Qarni, A., Hawwari, A., Alghanem, A. F., & Ahmed, G. (2018). Metabolic Syndrome, Dyslipidemia and Regulation of Lipoprotein Metabolism. Current diabetes reviews, 14(5), 427–433. https://doi.org/10.2174/1573399813666170705161039
. Elortegui Pascual P, Rolands MR, Eldridge AL, Kassis A, Mainardi F, Lê KA, Karagounis LG, Gut P, Varady KA. A meta-analysis comparing the effectiveness of alternate day fasting, the 5:2 diet, and time-restricted eating for weight loss. Obesity (Silver Spring). 2023 Feb;31 Suppl 1(Suppl 1):9-21. doi: 10.1002/oby.23568. Epub 2022 Nov 8. PMID: 36349432; PMCID: PMC10098946.
.He, S., Wang, J., Zhang, J., & Xu, J. (2021). Intermittent Versus Continuous Energy Restriction for Weight Loss and Metabolic Improvement: A Meta-Analysis and Systematic Review. Obesity (Silver Spring, Md.), 29(1), 108–115. https://doi.org/10.1002/oby.23023
. Rynders, C. A., Thomas, E. A., Zaman, A., Pan, Z., Catenacci, V. A., & Melanson, E. L. (2019). Effectiveness of Intermittent Fasting and Time-Restricted Feeding Compared to Continuous Energy Restriction for Weight Loss. Nutrients, 11(10), 2442. https://doi.org/10.3390/nu11102442
. Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG 3rd, Leeuwenburgh C, Mattson MP. Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting. Obesity (Silver Spring). 2018 Feb;26(2):254-268. doi: 10.1002/oby.22065. Epub 2017 Oct 31. PMID: 29086496; PMCID: PMC5783752.
.Wang, Y., & Wu, R. (2022). The Effect of Fasting on Human Metabolism and Psychological Health. Disease markers, 2022, 5653739. https://doi.org/10.1155/2022/5653739
. de Cabo R, Mattson MP. Effects of Intermittent Fasting on Health, Aging, and Disease. N Engl J Med. 2019 Dec 26;381(26):2541-2551. doi: 10.1056/NEJMra1905136. Erratum in: N Engl J Med. 2020 Jan 16;382(3):298. Erratum in: N Engl J Med. 2020 Mar 5;382(10):978. PMID: 31881139.
. Duregon E, Pomatto-Watson LCDD, Bernier M, Price NL, de Cabo R. Intermittent fasting: from calories to time restriction. Geroscience. 2021 Jun;43(3):1083-1092. doi: 10.1007/s11357-021-00335-z. Epub 2021 Mar 9. PMID: 33686571; PMCID: PMC8190218.
. Puchalska P, Crawford PA. Multi-dimensional Roles of Ketone Bodies in Fuel Metabolism, Signaling, and Therapeutics. Cell Metab. 2017 Feb 7;25(2):262-284. doi: 10.1016/j.cmet.2016.12.022. PMID: 28178565; PMCID: PMC5313038.
. Kolb H, Kempf K, Röhling M, Lenzen-Schulte M, Schloot NC, Martin S. Ketone bodies: from enemy to friend and guardian angel. BMC Med. 2021 Dec 9;19(1):313. doi: 10.1186/s12916-021-02185-0. PMID: 34879839; PMCID: PMC8656040.
. Cignarella, F., Cantoni, C., Ghezzi, L., Salter, A., Dorsett, Y., Chen, L., Phillips, D., Weinstock, G. M., Fontana, L., Cross, A. H., Zhou, Y., & Piccio, L. (2018). Intermittent Fasting Confers Protection in CNS Autoimmunity by Altering the Gut Microbiota. Cell metabolism, 27(6), 1222–1235.e6. https://doi.org/10.1016/j.cmet.2018.05.006
. Chaudhary, R., Liu, B., Bensalem, J., Sargeant, T. J., Page, A. J., Wittert, G. A., Hutchison, A. T., & Heilbronn, L. K. (2022). Intermittent fasting activates markers of autophagy in mouse liver, but not muscle from mouse or humans. Nutrition (Burbank, Los Angeles County, Calif.), 101, 111662. https://doi.org/10.1016/j.nut.2022.111662
. Emiliano, A. B., Lopatinsky, N. R., Kraljević, M., Higuchi, S., He, Y., Haeusler, R. A., & Schwartz, G. J. (2022). Sex-specific differences in metabolic outcomes after sleeve gastrectomy and intermittent fasting in obese middle-aged mice. American journal of physiology. Endocrinology and metabolism, 323(1), E107–E121. https://doi.org/10.1152/ajpendo.00017.2022
. Hardie D. G. (2015). AMPK: positive and negative regulation, and its role in whole-body energy homeostasis. Current opinion in cell biology, 33, 1–7. https://doi.org/10.1016/j.ceb.2014.09.004
. Finkel T. (2015). The metabolic regulation of aging. Nature medicine, 21(12), 1416–1423. https://doi.org/10.1038/nm.3998
. Kim, K. H., Kim, Y. H., Son, J. E., Lee, J. H., Kim, S., Choe, M. S., Moon, J. H., Zhong, J., Fu, K., Lenglin, F., Yoo, J. A., Bilan, P. J., Klip, A., Nagy, A., Kim, J. R., Park, J. G., Hussein, S. M., Doh, K. O., Hui, C. C., & Sung, H. K. (2017). Intermittent fasting promotes adipose thermogenesis and metabolic homeostasis via VEGF-mediated alternative activation of macrophage. Cell research, 27(11), 1309–1326. https://doi.org/10.1038/cr.2017.126
. Liu, B., Page, A. J., Hutchison, A. T., Wittert, G. A., & Heilbronn, L. K. (2019). Intermittent fasting increases energy expenditure and promotes adipose tissue browning in mice. Nutrition (Burbank, Los Angeles County, Calif.), 66, 38–43. https://doi.org/10.1016/j.nut.2019.03.015
. Liu, B., Page, A. J., Hatzinikolas, G., Chen, M., Wittert, G. A., & Heilbronn, L. K. (2019). Intermittent Fasting Improves Glucose Tolerance and Promotes Adipose Tissue Remodeling in Male Mice Fed a High-Fat Diet. Endocrinology, 160(1), 169–180. https://doi.org/10.1210/en.2018-00701
. Sutton, E. F., Beyl, R., Early, K. S., Cefalu, W. T., Ravussin, E., & Peterson, C. M. (2018). Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell metabolism, 27(6), 1212–1221.e3. https://doi.org/10.1016/j.cmet.2018.04.010
. Guo, Y., Luo, S., Ye, Y., Yin, S., Fan, J., & Xia, M. (2021). Intermittent Fasting Improves Cardiometabolic Risk Factors and Alters Gut Microbiota in Metabolic Syndrome Patients. The Journal of clinical endocrinology and metabolism, 106(1), 64–79. https://doi.org/10.1210/clinem/dgaa644
. Mindikoglu, A. L., Abdulsada, M. M., Jain, A., Jalal, P. K., Devaraj, S., Wilhelm, Z. R., Opekun, A. R., & Jung, S. Y. (2020). Intermittent fasting from dawn to sunset for four consecutive weeks induces anticancer serum proteome response and improves metabolic syndrome. Scientific reports, 10(1), 18341. https://doi.org/10.1038/s41598-020-73767-w
. He, M., Wang, J., Liang, Q., Li, M., Guo, H., Wang, Y., Deji, C., Sui, J., Wang, Y. W., Liu, Y., Zheng, Y., Qian, B., Chen, H., Ma, M., Su, S., Geng, H., Zhou, W. X., Guo, X., Zhu, W. Z., Zhang, M., … Shi, B. (2022). Time-restricted eating with or without low-carbohydrate diet reduces visceral fat and improves metabolic syndrome: A randomized trial. Cell reports. Medicine, 3(10), 100777. https://doi.org/10.1016/j.xcrm.2022.100777
. Obermayer, A., Tripolt, N. J., Pferschy, P. N., Kojzar, H., Aziz, F., Müller, A., Schauer, M., Oulhaj, A., Aberer, F., Sourij, C., Habisch, H., Madl, T., Pieber, T., Obermayer-Pietsch, B., Stadlbauer, V., & Sourij, H. (2023). Efficacy and Safety of Intermittent Fasting in People With Insulin-Treated Type 2 Diabetes (INTERFAST-2)-A Randomized Controlled Trial. Diabetes care, 46(2), 463–468. https://doi.org/10.2337/dc22-1622
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Copyright (c) 2023 Karolina Kosieradzka, Katarzyna Kosecka, Patryk Rudziński, Aleksandra Cieślik, Dominik Adamowicz, Justyna Stańczyk, Inga Łopuszyńska, Astrik Meliksetian, Alicja Wosińska, Anna Jargieło
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