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Background/objectivesAlternate day fasting (ADF) is a subtype of intermittent fasting and is defined as a continuous sequence of a fast day (100% energy restriction, zero calories) and a feed day (ad libitum food consumption), resulting in roughly 36-h fasting periods. Previous studies demonstrated weight reductions and improvements of cardiovascular risk factors with ADF in obese subjects. However, rigorous data on potential endocrine, metabolic and cardiovascular effects, besides weight loss, are lacking. Therefore we aim to investigate the short- and mid- to long-term clinical and molecular effects of ADF in healthy non-obese subjects.MethodsWe will perform a prospective cohort study with an embedded randomized controlled trial (RCT) including 90 healthy subjects. Thirty of them will have performed ADF for at least 6 months (mid-term group). Sixty healthy subjects without a particular diet before enrolment will serve as the control group. These subjects will be 1:1 randomized to either continuing their current diet or performing ADF for 4 weeks. All subjects will undergo study procedures that will be repeated in RCT participants after 4 weeks. These procedures will include assessment of outcome parameters, dual-energy X-ray absorptiometry, measurement of endothelial function, an oral glucose tolerance test, 24-h blood pressure measurement, retinal vessel analysis, echocardiography and physical activity measurement by an accelerometer. Blood, sputum, buccal mucosa and faeces will be collected for laboratory analyses. Participants in the RCT will wear a continuous glucose monitor to verify adherence to the study intervention.Planned outcomesThe aim of this project is to investigate the effects of ADF on human physiology and molecular cellular processes. This investigation should gain in-depth mechanistic insights into the concept of ADF and form the basis for larger subsequent cohort recruitment and consecutive intervention studies.Trial registrationNCT02673515; registered 24 November 2015. Current protocol date/version: 7 February 2017/version 1.8.

Aim: Eating and feeding behaviours of autistic individuals and related consequences have been mainly investigated in autistic children or in autistic adults with intellectual disabilities. Behaviours such as food selectivity or food neophobia have been shown to persist into adolescence and adulthood and are associated with aversive consequences. However, much less is known about the eating behaviours of autistic adults without intellectual disabilities, especially those of women. By means of a scoping review, we aim to assess the extent of the scientific literature on what is known about the eating behaviours of these women and the possible consequences of such eating behaviour.Method: Medline, Cochrane, PubMed and PsycInfo databases were searched according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results:Five studies met the eligibility criteria and were included in this review. Autistic women not only reported high levels of eating behaviour frequently seen in autism spectrum disorders (ASD), but also high levels of disordered eating behaviour, similar to that of women with eating disorders. Conclusions: Autistic women seem to exhibit high levels of eating behaviour frequently seen in ASD as well as disordered eating behaviour. Future research needs to shed light on what underlies these problematic eating behaviours, in order to help to adapt current treatment modalities to meet the unique needs of these women.

Zusammenfassung Zielsetzung In deutschen Krankenhäusern binden schlecht abgestimmte Prozesse Ressourcen und münden in Versorgungsengpässen. Negative Auswirkungen dessen und Verbesserungsmöglichkeiten sollen aufgezeigt werden. Methodik Deskriptive systematische Literaturanalyse (Jhg. 2003–2020) in den Datenbanken PubMed und EBSCOhost. Ergebnisse Von 860 Publikationen wurden 54 eingeschlossen. Lean-Management, Normalization Theory und Model for Improvement wurden beschrieben. Bedeutung eines Multi-Stakeholder Ansatzes wurde ausgeführt. Schlussfolgerung Holistische Prozessoptimierungen können zunehmende Versorgungsengpässe abmildern. Früh sollten strategische in operative Ziele übersetzt und messbar gemacht werden. Innerklinische Projektbüros sollten Prozessimplementierungen begleiten und die Ausrichtung an Patientenversorgungs- und ökonomischen Aspekten im interdisziplinären Kontext steuern.