Division of Cardiology, State Key Laboratory of Systems Medicine for Cancer, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai 200127, China.
Nutrients. 2024 Jun 26;16(13):2018. doi: 10.3390/nu16132018.
(1) Background: The benefits of weight management are widely recognized, and prolonged fasting duration has become a common method for weight control. The suitability of time-restricted eating (TRE) for elderly individuals remains controversial. This study aims to examine the correlation between fasting duration and mortality within a nationally representative cohort of elderly individuals in the United States. (2) Methods: Data were extracted from a prospective cohort study conducted as part of the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Participants aged over 60 with complete data on dietary intake and mortality follow-up information were included. Fasting duration was assessed using two 24 h dietary recalls. All the participants were categorized into fasting duration quartiles. Mortality outcomes were ascertained through the National Death Index. Cox proportional hazards regression models were utilized to analyze the association between fasting duration and mortality. (3) Results: The final analysis included 10,561 elderly participants (mean age 69.89, 45.58% male). Individuals with the longest fasting duration (over 12.38 h) had a significantly higher risk of CVD mortality compared to those with a normal fasting duration (10.58-12.38 h). This elevated CVD mortality risk was particularly pronounced in males, individuals over 70 years old, and non-shift workers. A non-linear relationship was observed between fasting duration and all-cause mortality and CVD mortality. (4) Conclusions: Prolonged fasting periods are associated with a higher risk of CVD mortality in the elderly population, although this correlation is not evident for all-cause, cancer, or other-cause mortality. A fasting duration of 11.49 h correlates with the lowest mortality risk. Additionally, elderly individuals with the shortest fasting duration exhibit elevated hazard ratios for both cancer and other-cause mortality. As with any health intervention, clinicians should exercise caution when recommending a fasting regimen that is personalized to the health condition of people who are older. Further research through randomized controlled trials should be conducted to comprehensively investigate the impact of TRE on mortality.
（1）背景：体重管理的益处已被广泛认可，而延长禁食时间已成为控制体重的常用方法。限时进食（TRE）对老年人是否适用仍存在争议。本研究旨在调查美国具有代表性的老年人群体中禁食时间与死亡率之间的相关性。
（2）方法：数据来自于 2005 年至 2018 年进行的国家健康和营养检查调查（NHANES）的前瞻性队列研究。纳入了年龄在 60 岁以上且饮食摄入和死亡率随访信息完整的参与者。使用两次 24 小时膳食回顾评估禁食时间。所有参与者分为禁食时间四分位组。通过国家死亡索引确定死亡率结果。采用 Cox 比例风险回归模型分析禁食时间与死亡率之间的关系。
（3）结果：最终分析纳入了 10561 名老年参与者（平均年龄 69.89 岁，45.58%为男性）。与正常禁食时间（10.58-12.38 小时）相比，禁食时间最长（超过 12.38 小时）的个体患 CVD 死亡率的风险显著更高。这种升高的 CVD 死亡率风险在男性、70 岁以上的个体和非轮班工人中尤为明显。禁食时间与全因死亡率和 CVD 死亡率之间呈非线性关系。
（4）结论：老年人的禁食时间延长与 CVD 死亡率风险增加相关，尽管这种相关性在全因、癌症或其他原因死亡率方面并不明显。禁食时间为 11.49 小时与最低死亡率风险相关。此外，禁食时间最短的老年个体患癌症和其他原因死亡率的风险比更高。与任何健康干预一样，临床医生在为健康状况不同的老年人推荐个性化禁食方案时应谨慎。应通过随机对照试验进行进一步研究，以全面调查 TRE 对死亡率的影响。
