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Intermittent fasting

From Wikipedia, the free encyclopedia

Intermittent fasting is a strategy for meals timing scheduling.
Intermittent fasting is a strategy for meals timing scheduling.

Intermittent fasting, also known as intermittent energy restriction, is an umbrella term for various meal timing schedules that cycle between voluntary fasting (or reduced calorie intake) and non-fasting over a given period.[1][2] Low-caloric drinks may be used during intermittent fasting, contrary to strict fasting which disallows fluid intake in some religious practices.[3][4]

Three methods of intermittent fasting are alternate-day fasting, periodic fasting, and time-restricted feeding.[5] Intermittent fasting may be similar to a calorie restriction diet.[1] Although being studied in the 21st century as a practice to possibly reduce the risk of diet-related diseases,[1][6][7][8] intermittent fasting is also regarded as a fad.[9]

The science concerning intermittent fasting is preliminary and inconclusive.[10] The American Heart Association (AHA) states that intermittent fasting may produce weight loss, reduce insulin resistance, and lower the risk of cardiometabolic diseases, although its long-term sustainability is unknown.[1] The US National Institute on Aging (NIA) recommends against intermittent fasting because of uncertainties about its effectiveness and safety, particularly for the elderly.[10]

Diverse forms of intermittent fasting exist in various religious practices, including Vrata in Hinduism, Ramadan fasting (Islam), Yom Kippur fasting (Judaism), Orthodox Christian fasting, Fast Sunday (LDS Church), and Buddhist fasting.[2][11]

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An alternate day fasting schedule, that alternates between usual eating (feast days) and fast days with reduced or no calories
An alternate day fasting schedule, that alternates between usual eating (feast days) and fast days with reduced or no calories

Three methods of intermittent fasting are alternate-day fasting, periodic fasting, and time-restricted feeding:[2][5][9][12][13]

  • Alternate-day fasting involves alternating between a 24-hours "fast day" when the person eats less than 25% of usual energy needs, followed by a 24-hour non-fasting "feast day" period. It is the strictest form of intermittent fasting because there are more days of fasting per week.[1][5] There are two subtypes:[3][9]
    • Complete alternate-day fasting (or total intermittent energy restriction), where no calories are consumed on fast days.
    • modified alternate-day fasting (or partial intermittent energy restriction) which allows the consumption of up to 25% of daily calorie needs on fasting days instead of complete fasting.
  • Periodic fasting or whole-day fasting involves any period of consecutive fasting of more than 24h, such as the 5:2 diet where there are 1 or 2 fast days per week, to the more extreme version with several days or weeks of fasting. During the fasting days, it may be allowed approximately 500 to 600 calories or about 25% of regular daily caloric intake instead of complete fasting.[1][3][5][14]
  • Time-restricted feeding involves eating only during a certain number of hours each day. Skipping a meal and the 16:8 diet (16 fasting hours cycled by 8 non-fasting hours) are examples. This schedule is thought to be leveraging the circadian rhythm.[1][5][15]


The science concerning intermittent fasting is preliminary and uncertain due to an absence of studies on its long term effects.[1][10] There is preliminary evidence that intermittent fasting may be effective for weight loss, may decrease insulin resistance and fasting insulin, and may improve cardiovascular and metabolic health, although the long term sustainability of these effects has not been studied.[1]

The AHA recommends intermittent fasting as an option for weight loss and calorie control as part of an "intentional approach to eating that focuses on the timing and frequency of meals and snacks as the basis of a healthier lifestyle and improved risk factor management".[1] For overweight people, fasting may be integrated into a wider dietary change, such as "placing snacks strategically before meals that might be associated with overeating", planning meals and snacks throughout the day to help manage hunger and control meal portions, and "promote consistent overnight fast periods".[1] The AHA noted that eating some food on a fast day (instead of a complete fast) produced the greatest weight loss and decreases in insulin resistance, when at least 4% weight loss was achieved by obese individuals.[1]

Although intermittent fasting showed weight loss success in several studies on obese or overweight individuals, the NIA does not recommend intermittent fasting for non-overweight individuals because of uncertainties about its effectiveness and safety, especially for older adults.[10]

Usage trends

As of 2019, intermittent fasting is a common fad diet, attracting celebrity endorsements and public interest.[16]


Intermittent fasting (specifically the 5:2 diet) became popular in the UK in 2012[17][18] after the BBC2 television Horizon documentary Eat, Fast and Live Longer.[19] Via sales of best-selling books, it became widely practiced.[20][21]

North America

In the United States, intermittent fasting became a fad among Silicon Valley companies.[22] According to NHS Choices, as of 2012, people considering the 5:2 diet should first consult a physician, as fasting can sometimes be unsafe.[20][23] A news item in the Canadian Medical Association Journal expressed concern that promotional material for the diet showed people eating high-calorie food, such as hamburgers and chips, and that this could encourage binge eating since the implication was that "if you fast two days a week, you can devour as much junk as your gullet can swallow during the remaining five days".[24]


As of 2019, interest in intermittent fasting led some companies to commercialize diet coaching, dietary supplements, and full meal packages.[22][25] These companies have been criticized for offering products or services that are expensive and not backed by science.[25][26]


Weight loss and health biomarkers

There is some limited evidence that intermittent fasting produces weight loss comparable to a calorie restricted diet.[6][7][8][27][28][29] Alternate day fasting does not affect lean body mass,[5][30] although one review found a small decrease.[31] Intermittent fasting does not affect bone health.[32] Alternate day fasting improves cardiovascular and metabolic biomarkers similarly to a calorie restriction diet for overweight or obese individuals.[6][8][13][14]

The reviewed clinical trials were conducted mostly on overweight or obese middle-aged women from the US and the UK, limiting interpretation of the results. Intermittent fasting has not yet been studied in children, the elderly, or underweight people, and could be harmful in these populations.[10][6][8][33] Intermittent fasting, although under active research, is not recommended for non-overweight individuals.[10] The long-term sustainability of the intermittent fasting effects is unknown, as of 2018.[10][34][35]

Other effects

Night-time eating has been linked to impaired sleep quality.[3] There is no evidence that fasting has any beneficial effect (prevention, treatment, drugs interaction) for cancer, and is thus not recommended in France,[14][36][37] or in the UK.[38] Athletic performance does not benefit from intermittent fasting.[39] Periodic fasting may have minor effect on chronic pain and mood disorders.[40][41][42]

Adverse effects

Reviews of preliminary clinical studies found that short-term intermittent fasting may produce minor adverse effects, such as continuous feelings of weakness and hunger, headaches, fainting, or dehydration. However, the data remain sparse, as most studies did not analyze adverse effects specifically.[6][28][43][44] A 2018 systematic review found no major adverse effect.[6] Long-term, extreme periodic fasting may cause eating disorders or malnutrition, with increased susceptibility to infectious diseases.[43] Intermittent fasting is not recommended for pregnant or breastfeeding women, or for children and adolescents during maturation.[12]


Tolerance of a diet is a determinant of its potential effectiveness and maintenance of benefits obtained, such as weight loss or biomarker improvement.[28] A 2019 review found that drop-out rates varied widely from 2% to 38% for intermittent fasting, and from 0% to 50% for a calorie restriction diet.[6]


A 2019 review of weight-change interventions, including alternate day fasting, time-restricted feeding, exercise and overeating, found that body weight homeostasis could not precisely correct for "energetic errors" – the loss or gain of calories – in the short-term.[45]


Fasting is an ancient tradition, having been practiced by many cultures and religions over centuries.[9][46][47] A modern type of intermittent fasting, the 5:2 diet, began in the United Kingdom in 2012.[48][49]

Religious fasting

Various forms of intermittent fasting exist in religious practices across the world.[2][11] Religious fasting regimens include Vrata in Hinduism, Islamic fasting (Ramadan) (Islam), Yom Kippur fasting (Judaism), Orthodox Christian fasting, Fast Sunday (The Church of Jesus Christ of Latter-day Saints), and Buddhist fasting.[11] Certain religious fasting practices only require abstinence from certain foods, while others, like the Jewish fast on Yom Kippur, last for a short period of time and would cause negligible effects on body weight.[11] In Buddhism, fasting is undertaken as part of the monastic training of Theravada Buddhist monks, who fast daily from noon to sunrise of the next day.[50]

Islam engages in a fasting practice reflective of intermittent fasting in terms of both food consumption and diet consistency.[11] The duration of the Ramadan fast is between 29 and 30 days, depending on the year, and consists of not eating or drinking from sunrise until sunset.[11] During the holiday, Muslims eat twice per day: once in the morning before dawn and once in the evening after dusk.[11] A meta-analysis on the health of Muslims during Ramadan shows significant weight loss during the fasting period of up to 1.51 kilograms (3.3 lb), but this weight was regained within about two weeks of Ramadan ending.[51] The analysis concluded that "Ramadan provides an opportunity to lose weight, but structured and consistent lifestyle modifications are necessary to achieve lasting weight loss."[51] One review found similarities between Ramadan and time-restricted feeding, with the main dissimilarity being the disallowance of water drinking with Islamic fasting.[4] Negative effects of Ramadan fasting include increased risk of hypoglycemia in diabetics as well as inadequate levels of certain nutrients.[11]

Ramadan fasting, which disallows drinking during the fasting period, is hazardous for pregnant women as it is associated with risks of inducing labour and causing gestational diabetes, although it does not appear to affect the child's weight.[52][53][54]

See also


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