Clinical nutrition ESPEN · 2025
Cardiometabolic and obesity risk outcomes of dawn-to-dusk, dry intermittent fasting: Insights from an umbrella review.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Faris MoezAlIslam, Abdelrahim Dana N, El Herrag Salah Eddine, Khaled Meghit Boumediene, Shihab Katia Abu, AlKurd Refat, Madkour Mohammed
Аннотация
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.
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.