间歇性禁食对超重和肥胖成年人身体成分及心脏代谢健康的长期影响：一项系统评价与荟萃分析

Longer-term effects of intermittent fasting on body composition and cardiometabolic health in adults with overweight and obesity: A systematic review and meta-analysis.

作者信息

Khalafi Mousa, Maleki Aref Habibi, Ehsanifar Mahsa, Symonds Michael E, Rosenkranz Sara K

机构信息

Department of Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.

Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran.

出版信息

Obes Rev. 2025 Feb;26(2):e13855. doi: 10.1111/obr.13855. Epub 2024 Nov 5.

DOI:10.1111/obr.13855

PMID:39501676

Abstract

The aim of the present study was to investigate the effects of long-term intermittent fasting (IF) on body composition and cardiometabolic health in adults with overweight and obesity. PubMed, Web of Science, and Scopus were searched from inception to March 2024 to identify original randomized trials that investigated the effects of IF versus either a control diet (CON) and/or continuous caloric restriction (CR). Participants were adults with overweight and obesity and intervention durations were ≥ 6 months. Overall, a total of 24 studies involving 2032 participants were included in the meta-analysis. Compared with CON, IF significantly reduced body weight [WMD: -2.84 kg], BMI [WMD: -1.41 kg.m], fat mass [WMD: -3.06 kg], fat-free mass [WMD: -0.81 kg], waist circumference [WMD: -3.85 cm], visceral fat [SMD: -0.37], fasting glucose [WMD: -0.14 mmol/l], triglycerides [WMD: -0.12 mmol/l], and diastolic blood pressure [WMD: -2.24 mmHg]. Conversely, IF significantly increased high-density lipoproteins [WMD: 0.04 mmol/l] when compared with CON, but had no effects on insulin, hemoglobin A1c%, total cholesterol, low-density lipoprotein, or systolic blood pressure. Compared with CR, IF significantly reduced fat mass [WMD: -0.70 kg], body fat percentage [WMD: -0.59%], and DBP [WMD: -0.91 mmHg], and increased HDL [WMD: 0.03 mmol/l], with no other significant effects. Subgroup analyses showed that the mode of IF and intervention duration were the primary moderators of IF effects on the markers. In adults with overweight or obesity, IF and CR are comparably effective for reducing body weight and adiposity, as well as for improving cardiometabolic health markers.

摘要

本研究的目的是调查长期间歇性禁食（IF）对超重和肥胖成年人身体成分和心脏代谢健康的影响。检索了PubMed、科学网和Scopus数据库，时间跨度从创建到2024年3月，以确定研究IF与对照饮食（CON）和/或持续热量限制（CR）相比效果的原始随机试验。参与者为超重和肥胖成年人，干预持续时间≥6个月。总体而言，共有24项涉及2032名参与者的研究纳入了荟萃分析。与CON相比，IF显著降低了体重[加权均数差（WMD）：-2.84 kg]、体重指数（BMI）[WMD：-1.41 kg/m²]、脂肪量[WMD：-3.06 kg]、去脂体重[WMD：-0.81 kg]、腰围[WMD：-3.85 cm]、内脏脂肪[标准化均数差（SMD）：-0.37]、空腹血糖[WMD：-0.14 mmol/L]、甘油三酯[WMD：-0.12 mmol/L]和舒张压[WMD：-2.24 mmHg]。相反，与CON相比，IF显著增加了高密度脂蛋白[WMD：0.04 mmol/L]，但对胰岛素、糖化血红蛋白百分比、总胆固醇、低密度脂蛋白或收缩压没有影响。与CR相比，IF显著降低了脂肪量[WMD：-0.70 kg]、体脂百分比[WMD：-0.59%]和舒张压[WMD：-0.91 mmHg]，并增加了高密度脂蛋白[WMD：0.03 mmol/L]，没有其他显著影响。亚组分析表明，IF模式和干预持续时间是IF对各项指标影响的主要调节因素。在超重或肥胖成年人中，IF和CR在减轻体重和肥胖以及改善心脏代谢健康指标方面效果相当。