13
Intermittent Fasting and Time-Restricted Eating
Fasting methods, including alternative-day, intermittent, or time-
restricted eating, may facilitate overall caloric restriction and
promote weight reduction.
The 5:2 Diet: Vitamins, minerals, and f iber supplementation depending
on patient requirement.
Fasting-Mimicking Diet: An intermittent fasting approach characterized
by low-protein, high-fat, and low-calorie intake, using prepackaged meals
over f ive days. All meals are plant-based and formulated to deliver 34% to
54% of the standard caloric intake. Should be used in periodic cycles every
two weeks to several months and last four to seven days.
Alternate-Day Fasting: Alternate-day fasting, which involves alternating
between days of regular caloric intake and days of caloric restriction.
Time-Restricted Eating: A dietary regimen in which food consumption is
conf ined to a designated time-f rame, typically encompassing an 8-hour
eating period succeeded by a 16-hour fasting interval.
Advantages Disadvantages
• Reduced decision fatigue
regarding food selection
• Quickly reversible
• May align more effectively
with daily patient
scheduling, including
during 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 contribute to weight
reduction and enhance
metabolic parameters,
including insulin sensitivity,
blood pressure, lipid levels,
and inflammatory markers
• May be improvements in
metabolic dysfunction-
associated steatotic liver
disease
• Risk of malnutrition if the meals
eaten during non-fasting times are
unhealthy; a nutritionist/ dietician
should monitor closely
• Does not necessarily emphasize
healthful meal quality
• May not be suitable for patients with
eating disorders, such as bulimia or
binge-eating disorder
• The risk of hypoglycemia is elevated
in individuals with diabetes mellitus
who do not properly modulate their
hypoglycemic pharmacotherapy, such
as with insulin and sulfonylureas
• May not be sustainable over a lifetime
for a chronic condition such as obesity
• Most long-term evidence about
eff icacy, health benef its, and safety is
primarily obtained f rom animal studies
• Prolonged fasting, as opposed to
intermittent fasting, may contribute
to the development of gout, urate
nephrolithiasis, postural hypotension,
and cardiac dysrhythmias
• May not improve metabolic health
in individuals with signif icant insulin
resistance if overall dietary quality and
energy balance during non fasting
periods remains poor.
