Silverii Giovanni Antonio, Cresci Barbara, Benvenuti Federica, Santagiuliana Federica, Rotella Francesco, Mannucci Edoardo
Florence University, Biomedical Sciences Department, Italy.
Careggi Hospital, Diabetology, Italy.
Nutr Metab Cardiovasc Dis. 2023 Aug;33(8):1481-1489. doi: 10.1016/j.numecd.2023.05.005. Epub 2023 May 10.
AIM: To assess whether intermittent fasting (IF) diets are associated with improvement in weight loss, metabolic parameters, and subjective well-being, in people with obesity. DATA SYNTHESIS: We performed a Meta-analysis of Randomized Controlled Trials longer than 2 months, retrieved through an extensive search on MedLine, Cochrane CENTRAL Library, and Embase online databases, comparing weight loss with IF diets and control diets in people with Body Mass index (BMI) > 30 kg/m. We retrieved 9 trials, enrolling 540 patients. IF was not associated with a significantly greater reduction of body weight or BMI at any time point with respect to controls or in respect to continuous restricted diets, with low-to moderate quality of evidence; no significant difference in efficacy between alternate day fasting and time restricted eating was found. Differences in fasting plasma glucose, total or high-density lipoprotein cholesterol or blood pressure at any time point were not statistically significant, whereas a reduction of low-density lipoprotein cholesterol (MD -8.39 [-15.96, -0.81] mg/dl, P = 0.03; I = 0%) was observed at 2-4 months, but not in the longer term. Data on psychological parameters and overall well-being were insufficient to perform a formal meta-analysis, whereas a qualitative synthesis did not show any difference between IF and controls. CONCLUSIONS: IF is not associated with greater or lesser weight loss than non-intermittent fasting diets. Further data on psychological parameters and overall well-being are needed to properly assess the role of IF diets in the management of obesity.
目的:评估间歇性禁食(IF)饮食是否与肥胖人群体重减轻、代谢参数改善及主观幸福感的提升相关。 数据综合分析:我们对通过广泛检索MedLine、Cochrane中央图书馆和Embase在线数据库获得的超过2个月的随机对照试验进行了荟萃分析,比较了体重指数(BMI)>30 kg/m²的肥胖人群采用IF饮食与对照饮食后的体重减轻情况。我们检索到9项试验,纳入了540名患者。与对照组或持续限制饮食相比,在任何时间点,IF均未显示出与体重或BMI显著更大程度的降低相关,证据质量低至中等;交替日禁食和限时进食在疗效上未发现显著差异。在任何时间点,空腹血糖、总胆固醇或高密度脂蛋白胆固醇或血压的差异均无统计学意义,而在2至4个月时观察到低密度脂蛋白胆固醇有所降低(MD -8.39 [-15.96, -0.81] mg/dl,P = 0.03;I² = 0%),但长期来看并非如此。关于心理参数和总体幸福感的数据不足以进行正式的荟萃分析,而定性综合分析未显示IF与对照组之间存在任何差异。 结论:与非间歇性禁食饮食相比,IF在体重减轻方面并无差异。需要更多关于心理参数和总体幸福感的数据,以正确评估IF饮食在肥胖管理中的作用。
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