Intermittent fasting for the prevention of cardiovascular disease

Allaf, Mohammad E.; Elghazaly, Hussein; Mohamed, Omer G; Fareen, Mohamed Firas Khan; Zaman, Sadia; Salmasi, Abdul-Majeed; Tsilidis, Kostas; Dehghan, Abbas

doi:10.1002/14651858.cd013496.pub2

Cited by 37 publications

(13 citation statements)

References 175 publications

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“…Moreover, another clinical trial specifically comparing the post-prandial indices of cardiometabolic risk between intermittent calorie restriction for two days per week and chronic calorie restriction in protocols extending to 3 months found that intermittent restriction was more effective in reducing post-prandial lipemia and insulinemia (Antoni et al, 2018). Nevertheless, a recent systematic review of clinical studies comparing IF to chronic calorie restriction found intermittent fasting to be more effective in weight reduction without a clear effect on blood glucose levels (Allaf et al, 2021). Indeed, this confirms the view of earlier investigation that different fasting protocols were not clearly effective in reducing blood glucose levels, and hence effectiveness in diabetes (Barnosky et al, 2014b).…”

Section: Cardiometabolic Syndrome and Therapeutic Or Intermittent Fastingsupporting

confidence: 57%

“…In another study that employed the Buchinger fasting protocol (fasting period between 4 and 21 days), adverse effects were reported in less than 1% of the 1,422 study subjects (Wilhelmi De Toledo et al, 2019). A review of studies following patients for up to twelve months only reported mild headaches as adverse outcomes of intermittent fasting (Allaf et al, 2021). Indeed, this indicates that prolonged alternate day fasting and complete fasting protocols are safe and well tolerated, and provides clinical evidence for their feasible utilization.…”

Section: Discussionmentioning

confidence: 99%

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Modulatory Effect of Intermittent Fasting on Adipose Tissue Inflammation: Amelioration of Cardiovascular Dysfunction in Early Metabolic Impairment

et al. 2021

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Cardiometabolic syndrome (CMS) is a cluster of maladaptive cardiovascular, renal, thrombotic, inflammatory, and metabolic disorders. It confers a high risk of cardiovascular mortality and morbidity. CMS is triggered by major shifts in lifestyle and dietary habits with increased consumption of refined, calorie-dense diets. Evidence indicates that diet-induced CMS is linked to Adipose tissue (AT) inflammation. This led to the proposal that adipose inflammation may be involved in metabolic derangements, such as insulin resistance and poor glycemic control, as well as the contribution to the inflammatory process predisposing patients to increased cardiovascular risk. Therefore, in the absence of direct pharmacological interventions for the subclinical phase of CMS, time restricted feeding regimens were anticipated to alleviate early metabolic damage and subsequent comorbidities. These regimens, referred to as intermittent fasting (IF), showed a strong positive impact on the metabolic state of obese and non-obese human subjects and animal models, positive AT remodeling in face of overnutrition and high fat diet (HFD) consumption, and improved CV outcomes. Here, we summarize the available evidence on the role of adipose inflammation in triggering cardiovascular impairment in the context of diet induced CMS with an emphasis on the involvement of perivascular adipose tissue. As well, we propose some possible molecular pathways linking intermittent fasting to the ameliorative effect on adipose inflammation and cardiovascular dysfunction under such circumstances. We highlight a number of targets, whose function changes in perivascular adipose tissue inflammation and could be modified by intermittent fasting acting as a novel approach to ameliorate the inflammatory status.

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Section: Cardiometabolic Syndrome and Therapeutic Or Intermittent Fastingsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Modulatory Effect of Intermittent Fasting on Adipose Tissue Inflammation: Amelioration of Cardiovascular Dysfunction in Early Metabolic Impairment

et al. 2021

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“…While adherence to ICR was high in our study, especially during the 12-week intervention phase [ 22 ], we acknowledge that the 5:2 diet is a mild form of ICR and that further studies on other types of ICR in relation to the microbiome are needed. However, recent meta-analyses of randomized studies do not suggest stronger effects of ICR vs. CCR diets on established metabolic biomarkers, which may speak against differential effects of ICR on the microbiome [ 69 – 71 ].…”

Section: Discussionmentioning

confidence: 99%

Calorie restriction improves metabolic state independently of gut microbiome composition: a randomized dietary intervention trial

et al. 2022

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Background The gut microbiota has been suggested to play a significant role in the development of overweight and obesity. However, the effects of calorie restriction on gut microbiota of overweight and obese adults, especially over longer durations, are largely unexplored. Methods Here, we longitudinally analyzed the effects of intermittent calorie restriction (ICR) operationalized as the 5:2 diet versus continuous calorie restriction (CCR) on fecal microbiota of 147 overweight or obese adults in a 50-week parallel-arm randomized controlled trial, the HELENA Trial. The primary outcome of the trial was the differential effects of ICR versus CCR on gene expression in subcutaneous adipose tissue. Changes in the gut microbiome, which are the focus of this publication, were defined as exploratory endpoint of the trial. The trial comprised a 12-week intervention period, a 12-week maintenance period, and a final follow-up period of 26 weeks. Results Both diets resulted in ~5% weight loss. However, except for Lactobacillales being enriched after ICR, post-intervention microbiome composition did not significantly differ between groups. Overall weight loss was associated with significant metabolic improvements, but not with changes in the gut microbiome. Nonetheless, the abundance of the Dorea genus at baseline was moderately predictive of subsequent weight loss (AUROC of 0.74 for distinguishing the highest versus lowest weight loss quartiles). Despite the lack of consistent intervention effects on microbiome composition, significant study group-independent co-variation between gut bacterial families and metabolic biomarkers, anthropometric measures, and dietary composition was detectable. Our analysis in particular revealed associations between insulin sensitivity (HOMA-IR) and Akkermansiaceae, Christensenellaceae, and Tanerellaceae. It also suggests the possibility of a beneficial modulation of the latter two intestinal taxa by a diet high in vegetables and fiber, and low in processed meat. Conclusions Overall, our results suggest that the gut microbiome remains stable and highly individual-specific under dietary calorie restriction. Trial registration The trial, including the present microbiome component, was prospectively registered at ClinicalTrials.govNCT02449148 on May 20, 2015.

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“…These effects were associated with lower concentrations of insulin-like growth factor-1 (IGF-1) and higher adiponectin levels, while leptin was not found reduced after adjusting for body fat mass ( 29 ). By contrast, a recent meta-analysis concluded that the evidence supporting a positive effect of intermittent fasting on glucose remains uncertain, despite the robust body weight-lowering effect ( 55 ). Interestingly, the analysis suggested that both intermittent fasting and caloric restriction equally improve cardiometabolic risk factors.…”

Section: Dietary Approaches For Improving Cardiometabolic Healthmentioning

confidence: 99%

Targeting Cardiovascular Risk Factors Through Dietary Adaptations and Caloric Restriction Mimetics

et al. 2021

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The average human life expectancy continues to rise globally and so does the prevalence and absolute burden of cardiovascular disease. Dietary restriction promotes longevity and improves various cardiovascular risk factors, including hypertension, obesity, diabetes mellitus, and metabolic syndrome. However, low adherence to caloric restriction renders this stringent dietary intervention challenging to adopt as a standard practice for cardiovascular disease prevention. Hence, alternative eating patterns and strategies that recapitulate the salutary benefits of caloric restriction are under intense investigation. Here, we first provide an overview of alternative interventions, including intermittent fasting, alternate-day fasting and the Mediterranean diet, along with their cardiometabolic effects in animal models and humans. We then present emerging pharmacological alternatives, including spermidine, NAD+ precursors, resveratrol, and metformin, as promising caloric restriction mimetics, and briefly touch on the mechanisms underpinning their cardiometabolic and health-promoting effects. We conclude that implementation of feasible dietary approaches holds the promise to attenuate the burden of cardiovascular disease and facilitate healthy aging in humans.

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Intermittent fasting for the prevention of cardiovascular disease

Cited by 37 publications

References 175 publications

Modulatory Effect of Intermittent Fasting on Adipose Tissue Inflammation: Amelioration of Cardiovascular Dysfunction in Early Metabolic Impairment

Modulatory Effect of Intermittent Fasting on Adipose Tissue Inflammation: Amelioration of Cardiovascular Dysfunction in Early Metabolic Impairment

Calorie restriction improves metabolic state independently of gut microbiome composition: a randomized dietary intervention trial

Targeting Cardiovascular Risk Factors Through Dietary Adaptations and Caloric Restriction Mimetics

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