Intermittent fasting for weight management and metabolic health: An updated comprehensive umbrella review of health outcomes
Zixin Hua MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorSiyu Yang MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorJiqian Li MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorYiqi Sun MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorYin Liao MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorSiyang Song PhD
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorSheng Cheng MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorZhe Li MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorZe Li PhD
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorDandan Li MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorHeng Guo MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorHongge Yang PhD
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorYingming Zheng MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorCorresponding Author
Xingang Li PhD
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Correspondence
Xingang Li, PhD, Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing, 100050, China.
Email: lxg198320022003@163.com
Search for more papers by this authorZixin Hua MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorSiyu Yang MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorJiqian Li MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorYiqi Sun MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorYin Liao MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorSiyang Song PhD
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorSheng Cheng MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorZhe Li MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorZe Li PhD
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorDandan Li MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorHeng Guo MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorHongge Yang PhD
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorYingming Zheng MPharm
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorCorresponding Author
Xingang Li PhD
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Correspondence
Xingang Li, PhD, Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing, 100050, China.
Email: lxg198320022003@163.com
Search for more papers by this authorAbstract
Aims
To provide an updated comprehensive evaluation of the quality and evidence association of existing studies on health outcomes related to intermittent fasting (IF).
Materials and Methods
We conducted a systematic search of PubMed, Web of Science, Cochrane Library, and Embase databases, covering literature up to June 2024. Meta-analyses and systematic reviews that include adult populations and quantitatively analyse health outcomes related to IF interventional studies are included. For evidence with complete data, we reanalyzed health evidence effect sizes and 95% confidence intervals using random-effects models. Article quality and the certainty of the evidence were graded using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2), Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, and a standardized credibility grading system.
Results
Twelve meta-analysis studies and 122 health outcome associations with IF were identified. High-quality evidence indicated significant associations between time-restricted eating (TRE) and weight loss, fat mass reduction, decreased fasting insulin and glycosylated haemoglobin levels in overweight or obese adults, as well as between the 5:2 diet and reduced low-density lipoprotein cholesterol levels. Moderate-to-low-quality evidence suggested associations between modified alternate-day fasting and improvements in body weight, lipid profile and blood pressure. Additionally, high-to-low-quality evidence showed that IF regimens effectively improved liver health in non-alcoholic fatty liver disease.
Conclusions
This umbrella review highlights IF, especially TRE, as a promising intervention for weight and metabolic health, particularly beneficial for overweight or obese adults. We also highlight the need for further extensive research to understand the long-term effects, individualized IF plans and potential adverse effects of IF in different populations.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflicts of interest.
Open Research
PEER REVIEW
The peer review history for this article is available at https://www.webofscience.com/api/gateway/wos/peer-review/10.1111/dom.16092.
DATA AVAILABILITY STATEMENT
The datasets utilized and/or analysed throughout the present study are obtainable from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| dom16092-sup-0001-Tables.docxWord 2007 document , 214.8 KB | Table S1. Search strategy. Table S2. Literature and reasons for exclusion. Table S3. Summary of AMSTAR-2 scoring results for included meta-analyses. Table S4. Overlap rate analysis. Table S5. Summary of statistically non-significant associations. Table S6. GRADE scoring criteria for statistically significant associations of intermittent fasting with health outcomes. Table S7. GRADE scoring criteria for non-statistically significant associations of intermittent fasting with health outcomes. Table S8. Summary of sensitivity analysis results excluding studies with high risk of bias. Table S9. Summary of sensitivity analysis results excluding studies with small sample size (< 25th percentile). File S1. Supplementary data. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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