不同类型间歇性禁食对代谢结局的影响：伞式评价和网络荟萃分析。
Effects of different types of intermittent fasting on metabolic outcomes: an umbrella review and network meta-analysis.
机构信息
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei, 100, Taiwan.
Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei, 100, Taiwan.
出版信息
BMC Med. 2024 Nov 13;22(1):529. doi: 10.1186/s12916-024-03716-1.
BACKGROUND
Intermittent fasting (IF) holds promise for enhancing metabolic health. However, the optimum IF forms and their superiority over continuous energy restriction (CER) remain unclear due to disconnected findings.
METHODS
We systematically searched PubMed, Embase, and the Cochrane databases for meta-analyses of randomized controlled trials (RCTs) investigating the association between IF and metabolic health outcomes. Subsequently, we performed an umbrella review and network meta-analysis (NMA) to evaluate the efficacy of different forms of IF (time-restricted eating (TRE), alternate-day fasting (ADF), and 5:2 diet (regular eating for 5 days and energy restriction for 2 days per week)) compared to CER and usual diets on metabolic health outcomes. To assess the certainty of both direct and indirect estimates, we employed the Confidence in Network Meta-Analysis (CINeMA) approach. Additionally, we calculated the surface under the cumulative ranking curve (SUCRA) for each dietary strategy to determine their ranking in terms of metabolic health benefits.
RESULTS
Ten of the best and non-redundant meta-analysis studies, involving 153 original studies and 9846 participants, were included. When considering direct evidence only, all IF forms significantly reduced body weight compared to usual diets. In NMA incorporating indirect evidence, all IF regimens also significantly reduced body weight compared to usual diets. In the SUCRA of NMA, IF ranked higher than usual diets or CER in 85.4% and 56.1% of the outcomes, respectively. ADF had the highest overall ranking for improving metabolic health (ranked first: 64.3%, ranked second: 14.3%).
CONCLUSIONS
Overall, all IF forms demonstrate potentials to improve metabolic health, with ADF appearing to produce better outcomes across investigated outcomes. Further high-quality trials are warranted to confirm the (relative) efficacy of IF on metabolic health.
TRIAL REGISTRATION
PROSPERO (record no: CRD42022302690).
背景
间歇性禁食（IF）有望改善代谢健康。然而，由于研究结果不相关，最佳 IF 形式及其优于持续能量限制（CER）的优势仍不清楚。
方法
我们系统地检索了 PubMed、Embase 和 Cochrane 数据库，以寻找关于 IF 与代谢健康结果之间关联的随机对照试验（RCT）的荟萃分析。随后，我们进行了伞式审查和网络荟萃分析（NMA），以评估不同形式的 IF（限时进食（TRE）、隔日禁食（ADF）和 5:2 饮食（每周正常进食 5 天，限制能量 2 天））与 CER 和常规饮食相比在代谢健康结果方面的疗效。为了评估直接和间接估计的确定性，我们采用了置信网络荟萃分析（CINeMA）方法。此外，我们计算了每种饮食策略的累积排序曲线下面积（SUCRA），以确定它们在改善代谢健康方面的排名。
结果
纳入了 10 项最佳且非冗余的荟萃分析研究，涉及 153 项原始研究和 9846 名参与者。仅考虑直接证据时，所有 IF 形式与常规饮食相比均显著降低体重。在纳入间接证据的 NMA 中，与常规饮食相比，所有 IF 方案也显著降低体重。在 NMA 的 SUCRA 中，IF 在 85.4%和 56.1%的结局中均优于常规饮食或 CER。ADF 在改善代谢健康方面的总体排名最高（排名第一：64.3%，排名第二：14.3%）。
结论
总体而言，所有 IF 形式都显示出改善代谢健康的潜力，ADF 在调查的结果中显示出更好的效果。需要进一步进行高质量的试验来确认 IF 对代谢健康的（相对）疗效。
试验注册
PROSPERO（记录号：CRD42022302690）。
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