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. 2020 Nov 24:7:586036.
doi: 10.3389/fnut.2020.586036. eCollection 2020.

Health Effects of Alternate-Day Fasting in Adults: A Systematic Review and Meta-Analysis

Yuanshan Cui  1   2 , Tong Cai  1   3 , Zhongbao Zhou  2 , Yingmei Mu  4 , Youyi Lu  1 , Zhenli Gao  1 , Jitao Wu  1 , Yong Zhang  2
Affiliations

Health Effects of Alternate-Day Fasting in Adults: A Systematic Review and Meta-Analysis

Yuanshan Cui et al. Front Nutr. .

Abstract

Background: Alternate-day fasting (ADF) method is becoming more and more popular among adults. This meta-analysis aims to evaluate the effects of ADF on adults. Methods: Randomized controlled trials (RCTs) of ADF were searched using PubMed (1988 to March 2020), EMBASE (1995 to March 2020), and the Cochrane Controlled Trials Register. A systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. The datum was calculated by RevMan version 5.3.0. The original references for relating articles were also reviewed. Results: Seven randomized controlled trials involving 269 participants (152 in the ADF group and 117 in the control group) were studied. In this meta-analysis, compared with the control group, the ADF group showed statistically significant reductions in weight (p < 0.00001) and body mass index (p < 0.00001). Besides, the ADF group showed significant differences in terms of total cholesterol (p = 0.001), low-density lipoprotein (p = 0.01), triglycerides (p = 0.02), fat mass (p = 0.002), lean mass (p = 0.002), systolic blood pressure (p = 0.003), diastolic blood pressure (p = 0.007), and total calorie intake (p = 0.007). At the same time, the analysis demonstrated that the ADF group had a same effect compared with control group in aspects of high-density lipoprotein (p = 0.27), homeostasis model assessment-insulin resistance (p = 0.55), and fasting blood sugar (p = 0.09). Conclusions: This meta-analysis suggests that ADF is a viable diet strategy for weight loss, and it has a substantial improvement in risk indicators for diseases in obese or normal people.

Keywords: alternate day fasting; body weight; calorie restriction (CR); meta-analysis; randomized controlled trials (RCT); weight loss.

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Figures

Figure 1
Figure 1
Risk of bias summary and graph. RCT, randomized controlled trials.
Figure 2
Figure 2
Flowchart of the study selection process. RCT, randomized controlled trials.
Figure 3
Figure 3
Funnel plot of the studies included in our meta-analysis. MD, mean difference; SE, standard error.
Figure 4
Figure 4
Forest plots showing changes between two groups in (A) weight, (B) body mass index (BMI), (C) total calorie intake; SD, standard deviation; IV, inverse variance; CI, confidence interval; df, degrees of freedom.
Figure 5
Figure 5
Forest plots showing changes between two groups in (A) total cholesterol (TC), (B) triglycerides (TG), (C) low-density lipoprotein (LDL), (D) high-density lipoprotein (HDL), (E) fasting blood sugar (FBS), (F) homeostasis model assessment-insulin resistance (HOMA-IR); SD, standard deviation; IV, inverse variance; CI, confidence interval; df, degrees of freedom.
Figure 6
Figure 6
Forest plots showing changes between two groups in (A) fat mass, (B) lean mass, (C) systolic blood pressure (SBP), (D) diastolic blood pressure (DBP); total calorie intake; SD, standard deviation; IV, inverse variance; CI, confidence interval; df, degrees of freedom.
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