Time‐limited diets and the gut microbiota in cardiometabolic disease

Abstract

In recent years, intermittent fasting (IF), including periodic fasting and time-restricted feeding (TRF), has been increasingly suggested to constitute a promising treatment for cardiometabolic diseases (CMD). A deliberate daily pause in food consumption influences the gut microbiome and the host circadian clock, resulting in improved cardiometabolic health. Understanding the molecular mechanisms by which circadian host-microbiome interactions affect host metabolism and immunity may add a potentially important dimension to effective implementation of IF diets. In this review, we discuss emerging evidence potentially linking compositional and functional alterations of the gut microbiome with IF impacts on mammalian metabolism and risk of development of hypertension, type 2 diabetes (T2D), obesity, and their longterm micro-and macrovascular complications. We highlight the challenges and unknowns in causally linking diurnal bacterial signals with dietary cues and downstream metabolic consequences and means of harnessing these signals toward future microbiome integration into precision medicine.cardiometabolic disease, circadian rhythms, gut microbiome, intermittent fasting, timerestricted feeding Highlights• Time-specific diet is a novel nutritional approach to prevent and treat cardiometabolic disease.• Feeding-fasting cycles shape gut microbial composition and metabolite production. These alterations may play a causative role in driving the cardiometabolic benefits of intermittent fasting.• Despite the impressive results in animals, human studies show contradicting results, possibly due to intraindividual variation involved in the hostmicrobiome response to diet.

Intermittent fasting and time-restricted eating role in dietary interventions and precision nutrition

“…Refers to restricting the time when meals are consumed within 24 h. Most TRE studies to date ranged from 4–12 h of eating window without caloric restriction. Some investigators consider TRE a chrono-nutritional strategy ( 14 , 15 ). The flexibility of the TRE protocols allows for maintaining individual eating pattern preferences, which may facilitate adherence to and compliance with the diet protocol.…”

“…FMD differs from the IF in that it allows for reduced calorie intake instead of complete abstinence of food during the fasting period FMD constitutes periodic cycles of consecutive days consuming a reduced-calorie diet followed by eating ad libitum ( 15 , 16 ). FMD could be a plant-based diet, low in protein and sugar content.…”

“…IF and TRE can alter the microbiome composition and the host circadian rhythm or biological clock, thereby improving cardiometabolic health ( 15 ). However, individual variations of the host-microbe interactions may alter the host's response to diet.…”

Fasting and refeeding triggers specific changes in bile acid profiles and gut microbiota

“…Supplementation with Akkermansia improves gut‐barrier function and metabolic endotoxemia, thereby improving the systemic metabolism 26,29,30 . Diet pattern (the type, amount, and timing of the meals) is a key factor that restructures the gut microbiota 31–33 . Sustained caloric restriction (CR) during very‐low‐calorie diet (VLCD), 34 intermittent fasting (IF), 35 and long‐term fasting 36 have an impact on the gut microbiome.…”

“… 26 , 29 , 30 Diet pattern (the type, amount, and timing of the meals) is a key factor that restructures the gut microbiota. 31 , 32 , 33 Sustained caloric restriction (CR) during very‐low‐calorie diet (VLCD), 34 intermittent fasting (IF), 35 and long‐term fasting 36 have an impact on the gut microbiome. Schwartzenberg et al found weight loss caused by VLCD was associated with impaired nutrient absorption and Clostridioides difficile enrichment, and enrichment in Clostridium difficile was associated with decreased BAs levels.…”