9
Fasting (e.g., alternative day, intermittent, time-restricted
eating)
As effective as continuous caloric restriction for overall caloric
restriction.
Potential Advantages Potential Disadvantages
• Reducing "decision fatigue"
regarding food selection
• Quickly reversible
• May better f it in day-to-day
patient scheduling (including
Ramadan)
• May reduce caloric intake with
variable effects on lean body
mass, resting metabolic rate,
and total energy expenditure,
often dependent upon physical
activity
• May reduce body weight and
improve metabolic parameters
(e.g. improve insulin sensitivity,
blood pressure, lipids, and
inflammatory markers)
• Does not necessarily emphasize
healthful meal quality
• May not be appropriate for patients
with eating disorders (e.g., bulimia or
binge-eating disorder)
• Increases the risk of hypoglycemia
among patients with diabetes
mellitus who do not appropriately
adjust their hypoglycemic anti-
diabetes drug treatments (e.g.,
insulin, sulfonylurea)
• Unclear if sustainable on a lifetime
basis for a lifelong disease (i.e.,
obesity)
• Most long-term evidence of eff icacy,
health benef its and safety are derived
f rom animal studies
• Prolonged fasting (not intermittent
fasting) may promote gout, urate
nephrolithiasis, postural hypotension,
and cardiac dysrhythmias
