REVIEW   

Minerva Gastroenterology 2021 September;67(3):289-98

DOI: 10.23736/S2724-5985.20.02757-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

The efficacy of fasting regimens on health outcomes: a systematic overview

Andrea A. SARRO ¹ ✉, Anil B. PAYEDIMARRI ¹, Diego D. CONCINA ¹, Marco F. FARSONI ¹, Nicola N. PIU ¹, Carmela RINALDI ^{1, 2}, Massimiliano P. PANELLA ¹

¹ Department of Translational Medicine (DIMET), University of Eastern Piedmont, Novara, Italy; ² Maggiore della Carità University Hospital, Novara, Italy

INTRODUCTION: Fasting can be defined as abstinence or reduction from food, drink, or both, for a defined period. There are many different types of fasting regimens, such as Ramadan fasting, intermittent fasting, Christian Orthodox fasting. The aim of this overview is to provide an exhaustive summary on the beneficial effects and harms associated with fasting regimens and discuss mechanisms by which this non-pharmacological approach might lead to improve human health.
EVIDENCE ACQUISITION: A systematic search was performed on MEDLINE (PubMed), Embase, Cochrane Library and CINHAL. We included systematic reviews (SRs) that report on impact of different types of fasting regimens on health. Selection of SRs, data extraction and quality assessment were undertaken in duplicate.
EVIDENCE SYNTHESIS: A total of 21 SRs were included. Cumulatively, 97 health outcomes were identified. Of them, cardiovascular risk factors were the most frequently analyzed. Ramadan fasting is associated with significant improvements in body weight and visceral lean mass, high-density lipoprotein cholesterol (HDL-c), and with reductions in low-density lipoprotein cholesterol (LDL-c) and total cholesterol (T-chol), especially in cardiac patients. Similarly, reviews on Intermittent and Orthodox fasting proved benefits of those on weight, BMI, lipidic and glucose profile, inflammatory markers.
CONCLUSIONS: Fasting regimens showed potential beneficial effects on several health indicators in adult populations. Nevertheless, evidence on some specific health dimensions (cognitive function, well-being, quality of life) is limited. Thus, in the future, further RCTs or cohort studies with good methodological quality and larger sample sizes are warranted to better understand the underlying biological mechanism and the benefits on multidimensional aspects of health.

KEY WORDS: Fasting; Systematic review; Cholesterol