Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Department of Cardiology, Medical University of Graz, Graz, Austria; BioTechMed Graz, Graz, Austria.
Can J Cardiol. 2024 Aug;40(8):1445-1457. doi: 10.1016/j.cjca.2024.02.004. Epub 2024 Feb 12.
Population aging and the associated increase in cardiovascular disease rates pose serious threats to global public health. Different forms of fasting have become an increasingly attractive strategy to directly address aging and potentially limit or delay the onset of cardiovascular diseases. A growing number of experimental studies and clinical trials indicate that the amount and timing of food intake as well as the daily time window during which food is consumed, are crucial determinants of cardiovascular health. Indeed, intermittent fasting counteracts the molecular hallmarks of cardiovascular aging and promotes different aspects of cardiometabolic health, including blood pressure and glycemic control, as well as body weight reduction. In this report, we summarize current evidence from randomized clinical trials of intermittent fasting on body weight and composition as well as cardiovascular and metabolic risk factors. Moreover, we critically discuss the preventive and therapeutic potential of intermittent fasting, but also possible detrimental effects in the context of cardiovascular aging and related disease. We delve into the physiological mechanisms through which intermittent fasting might improve cardiovascular health, and raise important factors to consider in the design of clinical trials on the efficacy of intermittent fasting to reduce major adverse cardiovascular events among aged individuals at high risk of cardiovascular disease. We conclude that despite growing evidence and interest among the lay and scientific communities in the cardiovascular health-improving effects of intermittent fasting, further research efforts and appropriate caution are warranted before broadly implementing intermittent fasting regimens, especially in elderly persons.
人口老龄化以及由此导致的心血管疾病发病率的上升,对全球公共健康构成了严重威胁。不同形式的禁食已经成为一种越来越有吸引力的策略,可以直接解决衰老问题,并有可能限制或延缓心血管疾病的发生。越来越多的实验研究和临床试验表明,食物摄入的量和时间以及进食的每日时间窗口,是心血管健康的关键决定因素。事实上,间歇性禁食可以抵抗心血管衰老的分子特征,并促进心脏代谢健康的不同方面,包括血压和血糖控制以及体重减轻。在本报告中,我们总结了间歇性禁食对体重和成分以及心血管和代谢风险因素的随机临床试验的现有证据。此外,我们还批判性地讨论了间歇性禁食的预防和治疗潜力,但也讨论了在心血管衰老和相关疾病的背景下可能产生的有害影响。我们深入探讨了间歇性禁食可能改善心血管健康的生理机制,并提出了在设计临床试验时需要考虑的重要因素,以评估间歇性禁食在减少高心血管疾病风险的老年个体中主要不良心血管事件的疗效。我们的结论是,尽管间歇性禁食对心血管健康的有益影响在普通民众和科学界中引起了越来越多的关注和兴趣,但在广泛实施间歇性禁食方案之前,特别是在老年人中,还需要进一步的研究努力和适当的谨慎。