School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
School of Medicine, University of São Paulo (USP), São Paulo, Brazil.
Am J Clin Nutr. 2022 Apr 1;115(4):991-1004. doi: 10.1093/ajcn/nqab433.
Chronobiology plays a crucial role in modulating many physiologic systems in which there is nutritional synergism with meal timing. Given that intermittent fasting (IF) has grown as a flexible dietary method consisting of delayed or early eating windows, this scoping review addresses the effects of IF protocols on metabolism as they relate to clinical nutrition and the circadian system. Although nocturnal habits are associated with circadian misalignments and impaired cardiometabolic profile-and nutritional physiology is better orchestrated during the day-most findings are based on animal experiments or human studies with observational designs or acute meal tests. Well-controlled randomized clinical trials employing IF protocols of delayed or early eating windows have sometimes demonstrated clinical benefits, such as improved glycemic and lipid profiles, as well as weight loss. However, IF does not appear to be more effective than traditional diets at the group level, and its effects largely depend on energy restriction. Thus, efforts must be made to identify patient biological rhythms, preferences, routines, and medical conditions before individual dietary prescription in clinical practice.
生物钟生物学在调节许多生理系统中起着关键作用，其中与用餐时间存在营养协同作用。鉴于间歇性禁食（IF）已作为一种灵活的饮食方法发展起来，包括延迟或提前进食窗口，本范围综述探讨了 IF 方案对代谢的影响，因为它们与临床营养和昼夜节律系统有关。尽管夜间习惯与昼夜节律失调和受损的心脏代谢特征有关，并且营养生理学在白天更好地协调——但大多数发现是基于动物实验或人类观察性设计或急性膳食测试研究。采用延迟或提前进食窗口的 IF 方案的对照良好的随机临床试验有时显示出临床益处，例如改善血糖和血脂谱以及体重减轻。然而，IF 在组水平上似乎并不比传统饮食更有效，其效果在很大程度上取决于能量限制。因此，在临床实践中进行个体化饮食处方之前，必须努力确定患者的生物节律、偏好、日常生活和医疗状况。
