Safety of Every-Other-Day Fasting in the Treatment of Spinal Cord Injury

Zheng, Jinqi; Liu, Jiancheng; Jiang, Yue; Pang, Rizhao; Yang, Xiao; Liu, Hao; Lin, Nanping; Li, Yunming; Xiong, Deqi; Chen, Xueqin; Li, Yuan; Liu, Jie; Plunet, Ward T.; Wang, Wenchun; Zhang, Anren

doi:10.1097/phm.0000000000001727

Cited by 4 publications

(6 citation statements)

References 31 publications

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“…In addition, a significant improvement in regional fat-free mass and a decrease in regional fat mass were observed in this group (42). In another RCT, an 8-week intervention with intermittent fasting led to a significant decrease in fasting glucose and body weight but did not influence BMI (43). A 7-month nutritional education with personalized diet in otherwise healthy SCI individuals did not influence blood pressure, lipid profile or anthropometric measurements (44).…”

Section: Cardiometabolic Risk Factorsmentioning

confidence: 77%

Mapping of Dietary Interventions Beneficial in the Prevention of Secondary Health Conditions in Spinal Cord Injured Population: A Systematic Review

Stojic

Eriks‐Hoogland

Gamba

et al. 2023

The Journal of nutrition, health and aging

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Objectives Individuals with spinal cord injury are at risk of secondary health conditions (SHC) that develop as a consequence of autonomic dysfunction, prolonged oxidative stress and inflammation, and physical inactivity coupled with inadequate energy and nutritional intake. SHC can be debilitating and even life-threatening, and its prevention remains one of the major challenges in the continuum of medical care of aging SCI population. An unhealthy diet is a major driver of inflammation, oxidative stress, and unfavourable metabolic status and may be a practical preventive target to tackle increased SHC risk post-injury. Aims To provide a catalogue of dietary interventions beneficial in prevention of SHC among individuals with SCI by conducting a systematic review of the literature on dietary interventions and dietary supplementation in promoting health and well-being after the injury. In addition, we aimed to provide a summary of observational studies exploring the association between habitual diet (macro- and micronutrients intake and dietary patterns) and health patterns following the injury. Method This review was registered at PROSPERO (University of York) with registration number CRD42022373773. Four medical databases (EMBASE.com, MEDLINE [Ovid], Cochrane CENTRAL, and Web of Science Core Collection) and Google Scholar were searched from inception until 11th July 2022. Studies were included if they were clinical trials or observational studies conducted in adult individuals with SCI and provided information of interest. Based on strength of the study design and risk of bias assessment (using the NIH tool), we classified studies from Level 1 (most reliable studies) to Level 4 (least reliable studies). Results Of 12,313 unique citations, 47 articles (based on 43 original studies) comprising 32 interventional (22 RCTs, 3 NRCT, and 7 pre-post studies) and 11 observational studies (2 cohort studies, 2 case-control, 1 post-intervention follow-up study, and 6 cross-sectional studies) were included in the present systematic review. Twenty studies (46.5%) were classified as Level 1 or 2, indicating high/moderate methodological quality. Based on those studies, dietary strategies including high protein diet, intermittent fasting, balanced diet in combination with physical conditioning and electrical stimulation, and dietary supplementation including alpha-lipoic acid, creatine, vitamin D, and cranberry-derived supplements and probiotics were mapped as the most promising in prevention of SHC among individuals with SCI. Conclusions To develop timely and effective preventive strategies targeting major SHC (e.g., cardiometabolic diseases, urinary tract infections) in SCI, further research is warranted to confirm the effectiveness of dietary strategies/interventions identified through the current systematic review of the literature.

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Section: Cardiometabolic Risk Factorsmentioning

confidence: 77%

Mapping of Dietary Interventions Beneficial in the Prevention of Secondary Health Conditions in Spinal Cord Injured Population: A Systematic Review

Stojic

Eriks‐Hoogland

Gamba

et al. 2023

The Journal of nutrition, health and aging

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“…EODF can exert neuroprotective effects and facilitate functional recovery in SCI rats. To allow clinical translation of EODF, we previously conducted a safety study of EODF in patients with SCI (Zheng et al, 2021), and although most of the subjects completed this clinical study, it was found through a post-survey follow-up that this dietary intervention required patients to endure hunger on fasting days, and that many SCI patients and families were less willing to attempt it again. We have also contemplated whether the gut microbiota after EODF intervention could be used as a clinical alternative to EODF.…”

Section: Discussionmentioning

confidence: 99%

Gut microbiota and transcriptome dynamics in every-other-day fasting are associated with neuroprotection in rats with spinal cord injury

Wang

Zhao

Zhou³

et al. 2023

Front. Microbiol.

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IntroductionEvery-other-day fasting (EODF) is a classical intermittent fasting (IF) mode with neuroprotective effects that promotes motor function recovery after spinal cord injury (SCI) in rats. However, its dynamic effects on the gut microbiota and spinal cord transcriptome remain unknown.MethodsIn this study, 16S rRNA sequencing and RNA-seq analysis were used to investigate the effects of ad libitum (AL) and EODF dietary modes on the structural characteristics of rat gut microbiota in rats and the spinal cord transcriptome at various time points after SCI induction.ResultsOur results showed that both dietary modes affected the bacterial community composition in SCI rats, with EODF treatment inducing and suppressing dynamic changes in the abundances of potentially anti-inflammatory and pro-inflammatory bacteria. Furthermore, the differentially expressed genes (DEGs) enriched after EODF intervention in SCI rats were associated with various biological events, including immune inflammatory response, cell differentiation, protein modification, neural growth, and apoptosis. In particular, significant spatiotemporal differences were apparent in the DEGs associated with neuroprotection between the EODF and AL interventions. These DGEs were mainly focused on days 1, 3, and 7 after SCI. The relative abundance of certain genera was significantly correlated with DEGs associated with neuroprotective effects in the EODF-SCI group.DiscussionOur results showed that EODF treatment may exert neuroprotective effects by modulating the transcriptome expression profile following SCI in rats. Furthermore, gut microbiota may be partially involved in mediating these effects.

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“…A total of 746 articles were identified from the initial database search. After title and abstract screening, full text screening was conducted on 224 articles, and nine RCTs with 899 participants whose nationality were Chinese (excluding subjects in intervention groups irrelevant to the review) were included in the meta-analysis [12,[17][18][19][20][21][22][23][24].…”

Section: Study Selectionmentioning

confidence: 99%

“…The study characteristics of the nine RCTs included in the meta-analysis are summarized in Table 1. In general, three trials evaluated 16:8 TRE [12,21,23], one evaluated 14:10 TRE [19], two studies evaluated the 5:2 diet [20,22], one evaluated ADF [24], and two trials evaluated both 16:8 TRE and ADF [17,18]. Among them, three RCTs conducted interventions with multiple arms [17,18,23].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Effect of Intermittent Fasting on Cardiometabolic Health in the Chinese Population: A Meta-Analysis of Randomized Controlled Trials

Cheung,

Chan,

Chan

et al. 2024

Nutrients

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The efficacy of intermittent fasting (IF), as an emerging weight management strategy, in improving cardiometabolic health has been evaluated in various populations, but that among Chinese individuals has not been systematically studied. A comprehensive search on multiple databases was performed to identify eligible randomized controlled trials (RCTs) up to October 2022. The primary outcome was post-intervention weight loss, and secondary outcomes included changes in cardiometabolic indicators. Effect estimates were meta-analyzed using a random-effects model. In total, nine RCTs with 899 Chinese participants were included. Time-restricted eating was the most adopted IF protocol in this study (six out of nine), followed by alternate-day fasting. The IF intervention significantly reduced body weight, body mass index, body fat mass, homeostatic model assessment of insulin resistance, low-density lipoprotein cholesterol, and triglycerides when compared with control groups. However, no statistically significant reductions in waist circumference, total cholesterol, high-density lipoprotein cholesterol, fasting glucose, systolic blood pressure, and diastolic blood pressure were found. To sum up, IF can be a weight management strategy and may improve the cardiometabolic health of Chinese adults, but more long-term trials using different IF strategies are required to generate robust evidence of its efficacy.

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Safety of Every-Other-Day Fasting in the Treatment of Spinal Cord Injury

Abstract: Supplemental digital content is available in the text.

Cited by 4 publications

References 31 publications

Mapping of Dietary Interventions Beneficial in the Prevention of Secondary Health Conditions in Spinal Cord Injured Population: A Systematic Review

Mapping of Dietary Interventions Beneficial in the Prevention of Secondary Health Conditions in Spinal Cord Injured Population: A Systematic Review

Gut microbiota and transcriptome dynamics in every-other-day fasting are associated with neuroprotection in rats with spinal cord injury

Effect of Intermittent Fasting on Cardiometabolic Health in the Chinese Population: A Meta-Analysis of Randomized Controlled Trials

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