Eliopoulos Aristides G, Gkouskou Kalliopi K, Tsioufis Konstantinos, Sanoudou Despina
Department of Biology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Center for New Biotechnologies and Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Front Nutr. 2025 Jan 17;12:1524125. doi: 10.3389/fnut.2025.1524125. eCollection 2025.
Intermittent fasting has been linked to metabolic health by improving lipid profiles, reducing body weight, and increasing insulin sensitivity. However, several randomized clinical trials have shown that intermittent fasting is not more effective than standard daily caloric restriction for short-term weight loss or cardiometabolic improvements in patients with obesity. Observational studies also suggest cardiovascular benefits from extended rather than reduced eating windows, and indicate that long-term intermittent fasting regimens may increase the risk of cardiovascular disease mortality. In this perspective, we discuss evidence that may support potential adverse effects of intermittent fasting on cardiovascular health through the loss of lean mass, circadian misalignment and poor dietary choices associated with reward-based eating. Given the ongoing revolution in obesity pharmacotherapy, we argue that future research should integrate anti-obesity medications with dietary strategies that confer robust benefits to cardiometabolic health, combine exercise regimens, and consider genetic factors to personalize obesity treatment. Comprehensive approaches combining diet, pharmacotherapy, and lifestyle modifications will become crucial for managing obesity and minimizing long-term cardiovascular risk.
间歇性禁食已通过改善血脂水平、减轻体重和提高胰岛素敏感性与代谢健康联系起来。然而，几项随机临床试验表明，对于肥胖患者的短期体重减轻或心脏代谢改善，间歇性禁食并不比标准的每日热量限制更有效。观察性研究还表明，延长进食窗口而非缩短进食窗口对心血管有益，并指出长期间歇性禁食方案可能会增加心血管疾病死亡风险。从这个角度来看，我们讨论了一些证据，这些证据可能支持间歇性禁食通过瘦体重减少、昼夜节律失调以及与基于奖励的饮食相关的不良饮食选择对心血管健康产生潜在不利影响。鉴于肥胖药物治疗正在进行的变革，我们认为未来的研究应将抗肥胖药物与对心脏代谢健康有显著益处的饮食策略相结合，结合运动方案，并考虑遗传因素以实现肥胖治疗的个性化。将饮食、药物治疗和生活方式改变相结合的综合方法对于管理肥胖和将长期心血管风险降至最低至关重要。
