Cardiometabolic and obesity risk outcomes of dawn-to-dusk, dry intermittent fasting: Insights from an umbrella review

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-03-11 DOI:10.1016/j.clnesp.2025.03.006

MoezAlIslam Faris , Dana N. Abdelrahim , Salah Eddine El Herrag , Meghit Boumediene Khaled , Katia Abu Shihab , Refat AlKurd , Mohammed Madkour

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引用次数: 0

Abstract

Background & aims

This umbrella review comprehensively and systematically summarizes meta-analyses on the impact of dawn-to-dusk, dry intermittent fasting of Ramadan (RIF) on cardiometabolic and glucose homeostasis indicators.

Methods

Twenty meta-analyses were examined on the effects of RIF on body fat percentage (BFP), fat mass, fat-free mass, body mass index (BMI), body weight (BW), waist circumference (WC), systolic and diastolic blood pressure (SBP, DBP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), and very low-density lipoprotein cholesterol (VLDL-C), fasting blood glucose (FBG), glycated hemoglobin (HbA1c), insulin resistance (HOMA-IR), serum insulin, leptin, and adiponectin. Results of continuous outcomes were pooled from included meta-analyses. We employed random-effects meta-analysis using the restricted maximum likelihood method to estimate heterogeneity. P-values were derived from standard meta-analytic tests, including Egger's test for small-study effects and the excess significance test for potential publication bias. Additionally, we applied criteria from Ioannidis' evidence classification to assess the credibility of the findings.

Results

In healthy subjects, RIF was associated with significant reductions in BW (Hedges' G = −0.33; 95 % confidence interval (CI) = −0.37, −0.29; p-value = 2.63 × 10–52), WC (Hedges' G = −0.30; 95 % CI = −0.38, −0.23; p-value = 5.73 × 10–15), BFP (Hedges' G = −0.26; 95 % CI = −0.37, −0.14; p-value = 6.81 × 10-06), DBP (n = 3,456; Hedges' G = −0.26; 95 % CI = −0.38, −0.15; p-value = 9.18 × 10-06), TC (n = 9,314; Hedges' G = −0.16; 95 % CI = −0.25, −0.07; p-value = 6.27 × 10-04), and TG levels (n = 9,020; Hedges' G = −0.16; 95 % CI = −0.24, −0.08; p-value = 6.87 × 10-05). Moreover, in general population, TG (n = 16,688; Hedges' G = −0.15; 95 % CI = −0.22, −0.08; p-value <0.01) and FBG (n = 16,106; Hedges’ G = −0.23; 95 % CI = −0.33, −0.13; p-value <0.01) were significantly reduced.

Conclusions

Dawn-to-dusk, dry RIF shows promise as a complementary therapy and preventive measure for reducing cardiometabolic and obesity-related risks. However, controlled studies are necessary to validate its effectiveness and fully understand its health implications.

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从黎明到黄昏干性间歇性禁食的心脏代谢和肥胖风险结局：来自一项综述的见解。

背景与目的：本综述全面、系统地总结了关于斋月（RIF）从黎明到黄昏干性间歇性禁食对心脏代谢和葡萄糖稳态指标影响的meta分析。方法:20项荟萃分析检测了RIF对体脂率（BFP）、脂肪质量、无脂质量、体重指数（BMI）、体重（BW）、腰围（WC）、收缩压和舒张压（SBP、DBP）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、甘油三酯（TG）、极低密度脂蛋白胆固醇（VLDL-C）、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、胰岛素抵抗（HOMA-IR），血清胰岛素，瘦素和脂联素。连续结局的结果从纳入的荟萃分析中汇总。我们采用随机效应荟萃分析，使用限制最大似然法来估计异质性。p值来自标准的荟萃分析检验，包括小研究效应的Egger检验和潜在发表偏倚的超额显著性检验。此外，我们应用Ioannidis的证据分类标准来评估研究结果的可信度。结果：在健康受试者中，RIF与体重显著降低相关(Hedges' G = -0.33；95%置信区间(CI) = -0.37, -0.29；p值= 2.63 × 10-52), WC (hedge ' G = -0.30；95% ci = -0.38, -0.23；p值= 5.73 × 10-15), BFP (hedge ' G = -0.26；95% ci = -0.37, -0.14；p值= 6.81 × 10-06), DBP (n=3,456；对冲的G = -0.26；95% ci = -0.38, -0.15；p值= 9.18 × 10-06), TC (n=9,314；对冲的G = -0.16；95% ci = -0.25, -0.07；p值= 6.27 x 10-04)， TG水平(n=9,020；对冲的G = -0.16；95% ci = -0.24, -0.08；p值= 6.87 × 10-05)。此外，在一般人群中，TG (n=16,688；套期保值的G = -0.15；95% ci = -0.22, -0.08；p值< 0.01)和FBG (n= 16106；对冲的G = -0.23；95% ci = -0.33, -0.13；p值< 0.01)显著降低。结论：从黎明到黄昏，干RIF有望作为一种补充治疗和预防措施，降低心脏代谢和肥胖相关的风险。然而，有必要进行对照研究来验证其有效性并充分了解其对健康的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.