Longer-term effects of intermittent fasting on body composition and cardiometabolic health in adults with overweight and obesity: A systematic review and meta-analysis
Corresponding Author
Mousa Khalafi
Department of Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
Correspondence
Mousa Khalafi, Department of Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
Email: [email protected]
Search for more papers by this authorAref Habibi Maleki
Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran
Search for more papers by this authorMahsa Ehsanifar
Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran
Search for more papers by this authorMichael E. Symonds
Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK
Search for more papers by this authorSara K. Rosenkranz
Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, USA
Search for more papers by this authorCorresponding Author
Mousa Khalafi
Department of Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
Correspondence
Mousa Khalafi, Department of Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
Email: [email protected]
Search for more papers by this authorAref Habibi Maleki
Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran
Search for more papers by this authorMahsa Ehsanifar
Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran
Search for more papers by this authorMichael E. Symonds
Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK
Search for more papers by this authorSara K. Rosenkranz
Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, USA
Search for more papers by this authorFunding information: This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.
Summary
The aim of the present study was to investigate the effects of long-term intermittent fasting (IF) on body composition and cardiometabolic health in adults with overweight and obesity. PubMed, Web of Science, and Scopus were searched from inception to March 2024 to identify original randomized trials that investigated the effects of IF versus either a control diet (CON) and/or continuous caloric restriction (CR). Participants were adults with overweight and obesity and intervention durations were ≥ 6 months. Overall, a total of 24 studies involving 2032 participants were included in the meta-analysis. Compared with CON, IF significantly reduced body weight [WMD: −2.84 kg], BMI [WMD: −1.41 kg.m2], fat mass [WMD: −3.06 kg], fat-free mass [WMD: −0.81 kg], waist circumference [WMD: −3.85 cm], visceral fat [SMD: −0.37], fasting glucose [WMD: −0.14 mmol/l], triglycerides [WMD: −0.12 mmol/l], and diastolic blood pressure [WMD: −2.24 mmHg]. Conversely, IF significantly increased high-density lipoproteins [WMD: 0.04 mmol/l] when compared with CON, but had no effects on insulin, hemoglobin A1c%, total cholesterol, low-density lipoprotein, or systolic blood pressure. Compared with CR, IF significantly reduced fat mass [WMD: −0.70 kg], body fat percentage [WMD: −0.59%], and DBP [WMD: −0.91 mmHg], and increased HDL [WMD: 0.03 mmol/l], with no other significant effects. Subgroup analyses showed that the mode of IF and intervention duration were the primary moderators of IF effects on the markers. In adults with overweight or obesity, IF and CR are comparably effective for reducing body weight and adiposity, as well as for improving cardiometabolic health markers.
CONFLICT OF INTEREST
The authors declare that they have no conflict of interest.
Supporting Information
| Filename | Description |
|---|---|
| obr13855-sup-001-Supplementary_Tables_and_Figures.pdfPDF document, 1.4 MB |
Table S1. Search strategy. Table S2. Risk of bias assessment. Table S3. Sensitivity analyses. Table S4. Summary of subgroup analysis for IF vs. CON. Table S5. Summary of subgroup analysis for IF vs. CR. Figure S1. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on body weight. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S2. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on BMI. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S3. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on fat mass. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S4. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on fat-free mass. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S5. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on waist circumference. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S6. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on visceral fat. Data are reported as SMD (95% confidence limits). SMD: standardized mean difference. Figure S7. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on body weight. Figure S8. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on BMI. Figure S9. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on fat mass. Figure S10. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on fat-free mass. Figure S11. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on waist circumference. Figure S12. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on visceral fat. Figure S13. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on fasting glucose. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S14. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on insulin. Data are reported as SMD (95% confidence limits). SMD: standardized mean difference. Figure S15. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on HbA1C. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S16. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on fasting glucose. Figure S17. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on insulin. Figure S18. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on HbA1C. Figure S19. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on TC. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S20. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on LDL. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S21. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on HDL. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S22. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on TG. Data are reported as SMD (95% confidence limits). SMD: standardized mean difference. Figure S23. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on TC. Figure S24. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on LDL. Figure S25. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on HDL. Figure S26. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on TG. Figure S27. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on SBP. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S28. Forest plot of the effects of intermittent fasting (IF) versus control diet (CON) on DBP. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S29. Funnel plot of intermittent fasting (IF) versus control diet (CON) on SBP. Figure S30. Funnel plot of the effects of intermittent fasting (IF) versus control diet (CON) on DBP. Figure S31. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on body weight. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S32. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on BMI. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S33. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on fat mass. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S34. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on fat%. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S35. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on FFM. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S36. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on waist circumference. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S37. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on visceral fat. Data are reported as SMD (95% confidence limits). SMD: standardized mean difference. Figure S38. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on body weight. Figure S39. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on BMI. Figure S40. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on fat mass. Figure S41. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on fat%. Figure S42. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on FFM. Figure S43. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on waist circumference. Figure S44. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on visceral fat. Figure S45. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on fasting glucose. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S46. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on insulin. Data are reported as SMD (95% confidence limits). SMD: standardized mean difference. Figure S47. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on HbA1c. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S48. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on fasting glucose. Figure S49. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on insulin. Figure S50. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on HbA1c. Figure S51. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on TC. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S52. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on LDL. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S53. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on HDL. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S54. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on TG. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S55. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on TC. Figure S56. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on LDL. Figure S57. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on HDL. Figure S58. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on TG. Figure 5S9. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on SBP. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S60. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on DBP. Data are reported as WMD (95% confidence limits). WMD: weighted mean difference. Figure S61. Forest plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on SBP. Figure S62. Funnel plot of the effects of intermittent fasting (IF) versus caloric restriction (CR) on DBP. |
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