The Benefits of Fasting?

039680310-woman-holds-empty-white-plate-Should you fast? Advocates of fasting believe it improves human longevity, perhaps via a mechanism of reduced inflammatory factors and things like LDL cholesterol. Now comes a study Rick and I discuss on PodMed this week and published in JAMA Internal Medicine that seems to refute this assertion, at least in the setting of weight loss. The specific aim of this study was to assess whether alternating days of fasting, with calories restricted to 25% of each subject's daily energy needs, versus standard caloric restriction of 75% of energy needs daily, or no intervention produced more, sustainable weight loss and improvement in cardiovascular risk factors.

100 adult participants with an average BMI of 34 were randomized to six months of the intervention or control followed by six months of follow-up. The study found that alternate fasting did not improve weight loss or sustainability, and that LDL cholesterol was actually higher in the fasting group relative to the daily caloric restriction group. Other metabolic markers, including blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C-reactive protein, or homocysteine concentrations at month 6 or 12, were the same between groups. Moreover,  about 40% of the fasting group dropped out of the study, finding compliance simply too difficult. Hmmm. Sounds like for either weight loss, maintenance, or improvement of metabolic risk factors alternate day fasting isn't helpful.

Other topics this week include Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Type 1 Diabetes and in Type 2 diabetes in JAMA, Declining Risk of Sudden Death in Heart Failure in NEJM, and in JAMA Pediatrics, Educational and Health Outcomes of Children Treated for Attention-Deficit/Hyperactivity Disorder. Until next week, y'all live well.



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