The effects of intermittent fasting regimens in middle-age and older adults: Current state of evidence

Anton, Stephen D.; Ezzati, Armin; Witt, Danielle; McLaren, Christian; Vial, Patricia

doi:10.1016/j.exger.2021.111617

Cited by 21 publications

(21 citation statements)

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“…By contrast, few trials assessed prolonged IF periods comparable to our three-month active trial period. A secondary analysis of two pilot studies by Kesztyüs et al observed a similar timeline and fasting regimen over three months [ 47 ]. They included a heterogeneous study population with generally healthy employees (1st cohort) and abdominal obese patients (2nd cohort) from a general practitioner’s office.…”

Section: Discussionmentioning

confidence: 99%

“…Particularly the non-obese patient population in our trial did not lose a significant amount of weight, making this form of IF safe for people even on the lower scale of a normal BMI. Similarly, Kesztyüs et al found a greater reduction in weight in their obese population, while the mixed, average weight population experienced a reduction of only −0.4 points in BMI after three months of IF [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

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Intermittent Fasting—Short- and Long-Term Quality of Life, Fatigue, and Safety in Healthy Volunteers: A Prospective, Clinical Trial

et al. 2022

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Background: Intermittent fasting (IF) is defined as an eating pattern without calorie restrictions, alternating between periods of fasting and eating. In the past decades IF has not only become a popular weight-reducing diet but is thought to improve Quality of Life (QoL) and fatigue. However, very little evidence exists for the general population. Thus, we aimed to assess the impact of a 16-h fasting period per day over a three-month study period on QoL and especially fatigue in healthy people. Methods: We conducted a prospective cohort study including healthy subjects. All participants fasted 16 h for at least five days a week while maintaining their normal lifestyle. In the study, we analysed blood samples as well as QoL through standardized questionnaires (WHO-5 questionnaire, Short Form Health 36). Furthermore, we measured the degree of fatigue with the Fatigue Assessment Scale (FAS) and Fatigue Severity Scale (FSS) as well as compliance, activity records, and weight alterations. All endpoints were evaluated at baseline, after two weeks, four weeks, and three months of IF. Results: A total of 30 participants fasted for the entire study period. The results of the WHO-5 questionnaire (15.6 ± 4.6 vs. 18 ± 3.6, p < 0.0019) demonstrated a significant increase in QoL. For long-term QoL six out of eight domains measured by the Short Form Health 36 (SF-36) significantly improved (e.g., physical health: 92.3 ± 11.6 vs. 96.5 ± 6.3, p = 0.015; mental health: 75.5 ± 12.0 vs. 81.7 ± 9.0; p < 0.001 and body pain: 74.1 ± 31.8 vs. 89.5 ± 14.9; p = 0.008) after three months. Fatigue significantly decreased from 10.3 ± 3.2 to 8.4 ± 2.5; p = 0.002 for mental fatigue and from 12.6 ± 3.8 to 10.7 ± 3.3; p = 0.002 measured by the FAS. The mean FSS-Score at baseline was 3.5 ± 1.2 compared to 2.9 ± 1.1 (scale 1–7) after three months (p < 0.001). Notably, the proliferation marker IGF-1 was significantly reduced. No clinically significant changes in laboratory parameters were observed that would have endangered a participant’s safety. Conclusions: IF according to the 16:8 regime over a fasting period of three months significantly improved several aspects of the QoL and decreased fatigue in healthy people, while maintaining a good safety profile. The practicability of this diet was also demonstrated for shift workers and people with a high percentage of active labour. Apart from the improvement in QoL and fatigue, the significant reduction in IGF-1, which can act as an accelerator of tumour development and progression, might be an indicator of the potential benefits of IF for patients with cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intermittent Fasting—Short- and Long-Term Quality of Life, Fatigue, and Safety in Healthy Volunteers: A Prospective, Clinical Trial

et al. 2022

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“…We first tested if the kinetics of fasting ketosis, particularly the production of BHB, changes with age, a topic surprisingly understudied given the links between aging biology and fasting 32 . Male and female C57BL/6N mice of three ages (young adult, 3 months old; middle-aged adult, 12 months old; and older adult, 22 months old) were fasted for 16 hours (6am-10pm) and monitored every 2 hours with blood drawn for glucose and BHB measurements.…”

Section: Fasting-induced Ketosis Declines In Aging and Is Sex-dependentmentioning

confidence: 99%

Ketone body metabolism declines with age in mice in a sex-dependent manner

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Panda

et al. 2022

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Understanding how our cells maintain energy homeostasis has long been a focus of aging biology. A decline in energy metabolism is central to many age-related diseases such as Alzheimer's disease, heart failure, frailty, and delirium. Intervening on pathways involved in energy homeostasis can extend healthy lifespan. When the primary energy substrate glucose is scarce, mice and humans can partially switch cellular energetic needs to fat-derived ketone bodies (i.e., beta-hydroxybutyrate (BHB), acetoacetate, acetone). Aging is associated with glucose intolerance and insulin insensitivity, yet, surprisingly, what role ketone body metabolism might play in compensating for impaired glucose utilization in age-related diseases is understudied. Here, we investigate how endogenous ketone body production and utilization pathways are modulated by age across the lifespan of male and female C57BL/6N mice (3 mo old, 12 mo old, 22 mo old). We show how different ages have different metabolic and gene expression responses to 1-week ketogenic diet (KD). We hypothesized that there would be a compensatory ketogenic response with age but instead saw declines in plasma BHB concentrations under fasting and non-fasting conditions with strong sexual dimorphism. Under KD, both sexes increased BHB concentrations at all ages, but only males showed strong gene expression induction. We also observed tissue-specific changes with age in baseline ketone metabolism, and surprising induction of extrahepatic ketogenic genes under KD. We found significant residual blood concentrations of BHB in KD even after a knockout of liver BHB production. Overall, these findings show that older mice have impaired non-fasting ketogenesis but are capable of increasing their ketogenic capacity under stimulation (i.e., KD) to meet energetic demands in aging. Therapies to augment non-fasting ketogenesis or provide exogenous ketones may be useful to improve energy homeostasis in diseases and conditions of aging.

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“…The elderly could be interested in the potential advantages and therapeutic effects of fasting, but studies on subjects over 65 years old are rare, both in terms of health benefits, tolerance, and knowledge [ 22 , 23 ]. An explanation for the exclusion of elderly people from fasting studies could be the fear of poor tolerance and denutrition.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Fasting: Are Patients Aged 65 and Over Ready?

et al. 2022

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While being the main potential beneficiaries of therapeutic fasting’s health benefits, the elderly are frequently thought of as being too fragile to fast. The main objective of our survey was to review the knowledge, practices, and acceptability of therapeutic fasting in subjects aged 65 years and over. From September 2020 to March 2021, an online questionnaire was sent to subjects aged 65 and over, using the mailing list of local organizations working in the field of aging. The mean age of the 290 respondents was 73.8 ± 6.5 years, 75.2% were women and 54.1% had higher education. Among the respondents, 51.7% had already fasted and 80.7% deemed therapeutic fasting interesting, 83.1% would be willing to fast if it was proven beneficial for their health, and 77.2% if it was proven to decrease the burden of chronic diseases. Subjects aged 65 to 74 years considered themselves as having the greatest physical and motivational abilities to perform therapeutic fasting. People aged 65 years, or more, are interested in therapeutic fasting and a large majority would be ready to fast if such practice was proven beneficial. These results pave the way for future clinical trials evaluating therapeutic fasting in elderly subjects.

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The effects of intermittent fasting regimens in middle-age and older adults: Current state of evidence

Cited by 21 publications

References 50 publications

Intermittent Fasting—Short- and Long-Term Quality of Life, Fatigue, and Safety in Healthy Volunteers: A Prospective, Clinical Trial

Intermittent Fasting—Short- and Long-Term Quality of Life, Fatigue, and Safety in Healthy Volunteers: A Prospective, Clinical Trial

Ketone body metabolism declines with age in mice in a sex-dependent manner

Therapeutic Fasting: Are Patients Aged 65 and Over Ready?

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