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Benefits, mechanisms, and risks of intermittent fasting in metabolic syndrome and type 2 diabetes

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Abstract

One of the emergent nutritional strategies for improving multiple features of cardiometabolic diseases is the practice of intermittent fasting (IF), which consists of alternating periods of eating and fasting. IF can reduce circulating glucose and insulin levels, fat mass, and the risk of developing age-related pathologies. IF appears to upregulate evolution-conserved adaptive cellular responses, such as stress-response pathways, autophagy, and mitochondrial function. IF was also observed to modulate the circadian rhythms of hormones like insulin or leptin, among others, which levels change in conditions of food abundance and deficit. However, some contradictory results regarding the duration of the interventions and the anterior metabolic status of the participants suggest that more and longer studies are needed in order to draw conclusions. This review summarizes the current knowledge regarding the role of IF in the modulation of mechanisms involved in type 2 diabetes, as well as the risks.

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Acknowledgements

The authors are grateful to Coimbra Health School (ESTeSC) for the equipment used.

Funding

This work was supported by the Portuguese Science and Technology Foundation (FCT): Strategic Project UIDB/04539/2020 (CIBB).

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Lisandra Joaquim was responsible for literature search and for the first draft. Ana Faria and Helena Loureiro were involved in manuscript reading and correction, while Paulo Matafome was responsible for the last version of the manuscript and is the senior author. ‘The authors declare that all data were generated in-house and that no paper mill was used’.

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Correspondence to Paulo Matafome.

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Key points

- IF is an emergent nutritional strategy for improving multiple features of cardiometabolic and age-related pathologies, due to weight and insulin resistance reduction.

- IF upregulates evolution-conserved adaptive cellular responses, such as stress-response pathways, autophagy, and mitochondrial function

- IF regulates the circadian rhythms of hormones like insulin or leptin, among others.

- Too long interventions, severe energy restriction, and the anterior metabolic status of the participants may conduce to the opposite effects.

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Joaquim, L., Faria, A., Loureiro, H. et al. Benefits, mechanisms, and risks of intermittent fasting in metabolic syndrome and type 2 diabetes. J Physiol Biochem 78, 295–305 (2022). https://doi.org/10.1007/s13105-021-00839-4

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