Intermittent Fasting: More than Just a Dieting Trend


  • Islamic Azad University, Department of Nutrition, Science and Research Branch, Tehran, Iran, Islamic Republic of


Intermittent Fasting (IF) is a term used for eating patterns that cycle between a period of fasting and non-fasting over a defined period of time. It has attracted considerable scientific and popular attention; as it is claimed to have profound beneficial effects on various indices of health. The purpose of this review is to peer into available articles about effects of IF on health and various diseases. Studies of IF on human subjects have demonstrated efficacy for weight loss and various conditions such as addressing high fasting blood glucose and insulin resistance in diabetes, suppressing inflammatory response, addressing lipid profile through lowering total cholesterol and triglycerides and enhancing cardiovascular status through adjusting lipid profile. Moreover, It seems to demonstrate better compliance reported by patients. Although IF has shown promise for counteracting the disease process or alleviating it, large sample and detailed clinical trials are required to discover exact mechanisms and draw firm conclusion.


Intermittent fasting, diabetes, obesity, lipid profile, disease, inflammation

Full Text:


Kerndt, P.R., Naughton, J.L., Driscoll, C.E. and Loxterkamp, D.A. Fasting: the history, pathophysiology and complications. West J. Med., 1982, 137, 379-399.

Klempel, M.C., Kroeger, C.M. and Varady, K A. (x). Alternate day fasting increases LDL particle size independently of dietary fat content in obese humans. Eur. J. Clin. Nutr., 1982, 67, 783785. doi:10.1038/ejcn.2013.83

Trepanowski, J.F., Kroeger, C.M., Barnosky, A., Klempel, M.C., Bhutani, S., Hoddy, K.K. Rood, J., et al. Effect of alternate-day fasting on weight loss, weight maintenance and cardioprotection among metabolically healthy obese adults: a randomized clinical trial. JAMA. Int. Med., 2017, 177, 930-938.

Moro, T., Tinsley, G., Bianco, A., Marcolin, G., Pacelli, Q.F., Battaglia, G., Paoli, A., et al. Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation and cardiovascular risk factors in resistance-trained males.J. Transl. Med., 2016, 14, 290. doi:10.1186/s12967-016-1044-0

Santos, H.O. and Macedo, R.C.O. Impact of intermittent fasting on the lipid profile: Assessment associated with diet and weight loss. Clin. Nutr. ESPEN., 2018, 24, 14-21. doi:10.1016/ j.clnesp.2018.01.002

Tinsley, G.M. and La Bounty, P.M. Effects of intermittent fasting on body composition and clinical health markers in humans. Nutr. Rev., 2015, 73, 661-674. doi:10.1093/nutrit/nuv041

Seimon, R.V., Roekenes, J.A., Zibellini, J., Zhu, B., Gibson, A.A., Hills, A.P., et al. Do intermittent diets provide physiological benefits over continuous diets for weight loss?A systematic review of clinical trials. Endocrinol., 2015, 418, 153-172.

Bhutani, S., Klempel, M.C., Kroeger, C.M., Trepanowski, J.F. and Varady, K.A. Alternate day fasting and endurance exercise combine to reduce body weight and favorably alter plasma lipids in obese humans. Obesity (Silver Spring), 2013, 21, 1370-1379. doi:10.1002/oby.20353

Varady, K.A., Bhutani, S., Klempel, M.C., Kroeger, C.M., Trepanowski, J.F., Haus, J. M., Calvo, Y., et al. Alternate day fasting for weight loss in normal weight and overweight subjects: a randomized controlled trial. Nutr. J., 2013, 12, 146. doi:10.1186/1475-2891-12-146.

Varady, K.A., Bhutani, S., Church, E.C. and Klempel, M.C.J.T.A. Short-term modified alternateday fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults. J. O. C. N. 2009, 90, 1138-1143.

Varady, K.A., Hudak, C.S. and Hellerstein, M.K. Modified alternate-day fasting and cardioprotection: relation to adipose tissue dynamics and dietary fat intake. Metabol., 2009, 58, 803-811. doi:10.1016/j.metabol.2009.01.018

Klempel, M.C., Kroeger, C.M., Bhutani, S., Trepanowski, J.F. and Varady, K.A.J. Intermittent fasting combined with calorie restriction is effective for weight loss and cardio-protection in obese women. Nutr. J., 2012, 11, 98.

Aksungar, F.B., Eren, A., Ure, S., Teskin, O. and Ates, G. Effects of intermittent fasting on serum lipid levels, coagulation status and plasma homocysteine levels. Ann. Nutr. Metab., 2005, 49, 77-82. doi:10.1159/000084739

de Azevedo, F.R., Ikeoka, D. and Caramelli, B. Effects of intermittent fasting on metabolism in men. Rev. Assoc. Med. Bras., 2013, 59, 167-173.

Klempel, M.C., Kroeger, C.M. and Varady, K.A. Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet. Metabol., 2013, 62, 137-143.

Johnstone, A.M. Fasting - the ultimate diet? Obes. Rev, 2007, 8, 211-222. doi:10.1111/j.1467789X.2006.00266.x

Heilbronn, L.K., Civitarese, A.E., Bogacka, I., Smith, S.R., Hulver, M. and Ravussin, E. Glucose tolerance and skeletal muscle gene expression in response to alternate day fasting. Obes.Res., 2005, 13, 574-581. doi:10.1038/oby.2005.61

Johnstone, A. Fasting for weight loss: an effective strategy or latest dieting trend? Int. J. Obes (Lond)., 2015, 39, 727-733. doi:10.1038/ijo.2014.214

Varady, K.A., Dam, V.T., Klempel, M.C., Horne, M., Cruz, R., Kroeger, C.M. and Santosa, S.

Effects of weight loss via high fat vs. low fat alternate day fasting diets on free fatty acid profiles.Sci. Rep., 2015, 5, 7561.

Harvie, M., Wright, C., Pegington, M., McMullan, D., Mitchell, E., Martin, B., Maudsley, S., et al.

The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women. Br. J. Nutr.,2013, 110, 1534-1547.

Harvie, M.N., Pegington, M., Mattson, M.P., Frystyk, J., Dillon, B., Evans, G., Howell, A., et al. The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: a randomized trial in young overweight women. Int. J. Obes (Lond).,, 2011, 35, 714-727. doi:10.1038/ijo.2010.171

Hill, J.O., Schlundt, D.G., Sbrocco, T., Sharp, T., Pope-Cordle, J., Stetson, B. and Heim, C.Evaluation of an alternating-calorie diet with and without exercise in the treatment of obesity. Am. J. Clini. Nutr., 1989, 50, 248-254.

Ash, S., Reeves, M.M., Yeo, S., Morrison, G., Carey, D. and Capra, S. Effect of intensive dietetic interventions on weight and glycaemic control in overweight men with Type II diabetes: a randomised trial. Int. J. Obes. Relat. Metab. Disord., 2003, 27, 797-802. doi:10.1038/ sj.ijo.0802295

Harvie, M., Wright, C., Pegington, M., McMullan, D., Mitchell, E., Martin, B., Howell, A., et al. The effect of intermittent energy and carbohydrate restriction Vs. daily energy restriction on weight loss and metabolic disease risk markers in overweight women. Br. J. Nutr., 2013, 110, 15341547. doi:10.1017/S0007114513000792

Varady, K.A., Bhutani, S., Klempel, M.C. and Kroeger, C.M. Comparison of effects of diet versus exercise weight loss regimens on LDL and HDL particle size in obese adults. Lipids Health Dis., 2011, 10, 119. doi:10.1186/1476-511X-10-119

Mattson, M.P., Longo, V.D. and Harvie, M. Impact of intermittent fasting on health and disease processes. Ageing Res. Rev., 2017, 39, 46-58. doi:10.1016/j.arr.2016.10.005

Eshghinia, S. and Mohammadzadeh, F. The effects of modified alternate-day fasting diet on weight loss and CAD risk factors in overweight and obese women. J. Diabet. Metab. Disord., 2013, 12, 4. doi:10.1186/2251-6581-12-4

Heilbronn, L.K., Smith, S.R., Martin, C.K., Anton, S.D. and Ravussin, E. Alternate-day fasting in nonobese subjects: effects on body weight, body composition and energy metabolism.Am. J. Clin. Nutr., 2005, 81, 69-73. doi:10.1093/ajcn/81.1.69

Johnson, J.B., Summer, W., Cutler, R.G., Martin, B., Hyun, D.H., Dixit, V.D., Mattson, M. P., et al.

Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma. Free Radic. Bio. Med., 2007, 42, 665-674. doi:10.1016/j.freeradbiomed.2006.12.005

Wing, R.R., Blair, E.H., Bononi, P., Marcus, M.D., Watanabe, R. and Bergman, R.N. Diabet.Care, 1994, 17, 30-36.

Henry, R.R., Scheaffer, L. and Olefsky, J.M. Glycemic effects of intensive caloric restriction and isocaloric refeeding in noninsulin-dependent diabetes mellitus. J. Clin. Endocrinol. Metab., 1985, 61, 917-925. doi:10.1210/jcem-61-5-917

Barnosky, A.R., Hoddy, K.K., Unterman, T.G. and Varady, K.A. Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: a review of human findings. Transl. Res., 2014, 164, 302-311. doi:10.1016/j.trsl.2014.05.013

Williams, K.V., Mullen, M.L., Kelley, D. E. and Wing, R.R. The effect of short periods of caloric restriction on weight loss and glycemic control in type 2 diabetes. Diabet. Care, 1998, 21, 2-8.

Halberg, N., Henriksen, M., Soderhamn, N., Stallknecht, B., Ploug, T., Schjerling, P. and Dela, F. Effect of intermittent fasting and refeeding on insulin action in healthy men. J. Appl. Physiol., 2005, 99, 2128-2136. doi:10.1152/japplphysiol.00683.2005

Soeters, M.R., Lammers, N.M., Dubbelhuis, P.F., Ackermans, M., Jonkers-Schuitema, C.F., Fliers, E., Serlie, M.J., et al. Intermittent fasting does not affect whole-body glucose, lipid, or protein metabolism. Am. J. Clini. Nutr., 2009, 90, 1244-1251.

Hedrington, M.S. and Davis, S.N. Sexual Dimorphism in Glucose and Lipid Metabolism during Fasting, Hypoglycemia, and Exercise. Front Endocrinol (Lausanne)., 2015, 6, 61. doi:10.3389/ fendo.2015.00061

Gormsen, L., Gjedsted, J., Gjedde, S., Nørrelund, H., Christiansen, J.S., Schmitz, O., Moller, N., et al. Dose response effects of free fatty acids on amino acid metabolism and ureagenesis. Acta. Physiol., 2008, 192, 369-379.

Anastasiou, C.A., Karfopoulou, E. and Yannakoulia, M. Weight regaining: From statistics and behaviors to physiology and metabolism. Metabol., 2015, 64, 1395-1407. doi:10.1016/ j.metabol.2015.08.006

Varady, K.A., Roohk, D., Loe, Y.C., McEvoy-Hein, B.K. and Hellerstein, M.K. Effects of modified alternate-day fasting regimens on adipocyte size, triglyceride metabolism and plasma adiponectin levels in mice. J. Lipid Res., 2007, 48, 2212-2219. doi:10.1194/jlr.M700223-JLR200

Skaznik-Wikiel, M.E. and Polotsky, A.J. The health pros and cons of continuous versus intermittent calorie restriction: more questions than answers. Maturitas., 2014, 79, 275-278.

Mazidi, M., Rezaie, P., Chaudhri, O., Karimi, E. and Nematy, M. The effect of Ramadan fasting on cardiometabolic risk factors and anthropometrics parameters: A systematic review. Pak. J.

Med. Sci., 2015, 31, 1250-1255. doi:10.12669/pjms.315.7649

Shariatpanahi, Z.V., Shariatpanahi, M.V., Shahbazi, S., Hossaini, A. and Abadi, A.N. Effect of Ramadan fasting on some indices of insulin resistance and components of the metabolic syndrome in healthy male adults. Br. J. Nutr., 2008, 100, 147-151.

Al-Shafei, A.I. Ramadan fasting ameliorates oxidative stress and improves glycemic control and lipid profile in diabetic patients. Eur. J. Nutr., 2014, 53, 1475-1481. doi:10.1007/s00394014-0650-y

Shehab, A., Abdulle, A., El Issa, A., Al Suwaidi, J. and Nagelkerke, N. Favorable changes in lipid profile: the effects of fasting after Ramadan. PLoS One, 2012, 7, 47615. doi:10.1371/ journal.pone.0047615

Stote, K.S., Baer, D.J., Spears, K., Paul, D.R., Harris, G.K., Rumpler, W.V., Ingram, D.K., et al.

A controlled trial of reduced meal frequency without caloric restriction in healthy, normalweight, middle-aged adults. Am. J. Clini. Nutr., 2007, 85, 981-988.

Hutchison, A.T. and Heilbronn, L.K.J.B. Metabolic impacts of altering meal frequency and timing does when we eat matter? Biochem., , 2016, 124, 187-197.

Sacks, F.M., Bray, G.A., Carey, V.J., Smith, S.R., Ryan, D.H., Anton, S.D., Williamson, D.A., et al.

Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N. Engl. J. Med., 2009, 360, 859-873. doi:10.1056/NEJMoa0804748

Ahima, R.S. Adipose tissue as an endocrine organ. J. Clin. Endocrinol. Metab., 2006, 14, 242S-249S.

Gredilla, R. and Barja, G. Mini review: the role of oxidative stress in relation to caloric restriction and longevity. Endocrinol., 2005, 146, 3713-3717. doi:10.1210/en.2005-0378

Rondinone, C.M. Adipocyte-derived hormones, cytokines, and mediators. Endocrine, 2006, 29, 81-90. doi:10.1385/ENDO:29:1:181

Descamps, O., Riondel, J., Ducros, V. and Roussel, A.M. Mitochondrial production of reactive oxygen species and incidence of age-associated lymphoma in OF1 mice: effect of alternateday fasting. Mech. Ageing Dev., 2005, 126, 1185-1191. doi:10.1016/j.mad.2005.06.007

Varady, K.A. and Hellerstein, M.K. Do calorie restriction or alternate-day fasting regimens modulate adipose tissue physiology in a way that reduces chronic disease risk? Nutr. Rev., 2008, 66, 333-342.

Soenen, S., Martens, E.A., Hochstenbach-Waelen, A., Lemmens, S.G. and WesterterpPlantenga, M.S. Normal Protein Intake Is Required for Body Weight Loss and Weight Maintenance, and Elevated Protein Intake for Additional Preservation of Resting Energy Expenditure and Fat Free Mass. J. Nutr., 2013, 143, 591-596.

Weinheimer, E.M., Sands, L.P. and Campbell, W.W. A systematic review of the separate and combined effects of energy restriction and exercise on fat-free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr. Rev., 2010, 68, 375-388. doi:10.1111/ adults with obesity. Obesity (Silver Spring), 2016, 24, 1874-1883. doi:10.1002/ oby.21581

Wing, R.R. and Phelan, S. Long-term weight loss maintenance. Am. J. Clini. Nutr., 2005, 82, 222S-225S.

Catenacci, V.A., Pan, Z., Ostendorf, D., Brannon, S., Gozansky, W.S., Mattson, M.P., Troy Donahoo, W., et al. A randomized pilot study comparing zero-calorie alternate-day fasting to daily caloric restriction in adults with obesity. Obesity (Silver Spring), 2016, 24, 1874-1883. doi:10.1002/oby.21581

Sun, Q., Townsend, M.K., Okereke, O.I., Franco, O.H., Hu, F.B. and Grodstein, F. Adiposity and weight change in mid-life in relation to healthy survival after age 70 in women: prospective cohort study. BMJ., 2009, 339, b3796. doi:10.1136/bmj.b3796

Wegman, M.P., Guo, M.H., Bennion, D.M., Shankar, M.N., Chrzanowski, S.M., Goldberg, L.A., Brantly, M.L., et al. Practicality of intermittent fasting in humans and its effect on oxidative stress and genes related to aging and metabolism. Rejuvenation Res., 2015, 18, 162-172. doi:10.1089/rej.2014.1624

Varady, K.A. and Hellerstein, M.K. Alternate-day fasting and chronic disease prevention: a review of human and animal trials. Am. J. clini. Nutr., 2007, 86, 7-13.

Lee, G.D., Wilson, M.A., Zhu, M., Wolkow, C.A., de Cabo, R., Ingram, D.K. and Zou, S. Dietary deprivation extends lifespan in Caenorhabditis elegans. Aging Cell., 2006, 5, 515-524. doi:10.1111/j.1474-9726.2006.00241.x

Safdie, F.M., Dorff, T., Quinn, D., Fontana, L., Wei, M., Lee, C., Longo, V.D., et al. Fasting and cancer treatment in humans: A case series report. Aging (Albany NY), 2009, 1, 988-1007. doi:10.18632/aging.100114

Longo, V. D. and Mattson, M.P. Fasting: molecular mechanisms and clinical applications. Cell.

Metab., 2014, 19, 181-192. doi:10.1016/j.cmet.2013.12.008

Flegal, K.M., Kit, B.K., Orpana, H. and Graubard, B.I. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA.,2013, 309, 71-82.

Aksungar, F.B., Topkaya, A.E. and Akyildiz, M. Interleukin-6, C-reactive protein and biochemical parameters during prolonged intermittent fasting. Ann. Nutr. Metab., 2007, 51, 88-95.doi:10.1159/000100954

Allard, J.S., Heilbronn, L.K., Smith, C., Hunt, N.D., Ingram, D.K., Ravussin, E., de Cabo, R.

In vitro cellular adaptations of indicators of longevity in response to treatment with serum collected from humans on calorie restricted diets. PLoS One, 2008, 3, 3211. doi:10.1371 journal.pone.0003211

Müller, H., de Toledo, F.W. and Resch, K.L. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand. J. Rheumatol., 2001, 30, 1-10.


  • There are currently no refbacks.