Intermittent Fasting for Aging, Wellness & Longevity

The concept of fasting for spiritual & cultural reasons are undertaken as part of religious activities across the world by followers of many religions.  More recently, fasting has been demonstrated to be associated with significant health benefits including influencing aging and healthspan.  Intermittent fasting (IF) refers to an eating pattern where individuals cycle between periods of eating and fasting.  Instead of focusing on what you eat, it emphasizes when you eat.  The idea behind intermittent fasting is that it gives your body time to process food more efficiently, leading to various health benefits.  Potential benefits of intermittent fasting include weight loss, improved metabolism, and better blood sugar control.

Clinical Summary (Dr. Kastoori Iyengar, MD. MBA.)

Although the science underlying benefits of fasting (initially focused on caloric restriction, CR) has been demonstrated in numerous cellular and animal models, there is a growing number of experimental studies and randomized clinical trials suggesting that the amount and timing of food intake as well as the daily time window during which food is consumed, are crucial determinants of cardiovascular and cognitive health.   Recently, different forms of fasting have become an increasingly attractive strategy to directly address aging, improve healthspan and potentially limit or delay the onset of aging related disorders including cardiovascular, metabolic and neurological diseases.

Intermittent fasting (IF) is a pattern of eating that alternate between periods of eating and fasting.  It involves cycling between periods of eating and fasting, typically through methods like (that are popular):

• 16/8 method (16 hours of fasting, 8-hour eating window)

• 5:2 approach (5 normal eating days, 2 non-consecutive days of restricted calories)

• 24-hour fasts once or twice per week

Caloric restriction, on the other hand, involves reducing daily caloric intake by about 20-40% while maintaining proper nutrition. While different in approach, both IF and CR trigger similar cellular and metabolic responses in our bodies.

Clinical evidence suggests that intermittent fasting may confer several health benefits, including weight loss and improved insulin sensitivity, potentially reducing the risk of type 2 diabetes. It may also enhance lipid profiles and reduce markers of inflammation, thus lowering the risk of cardiovascular disease. Additionally, IF has been shown to stimulate autophagy, a process of cellular repair, and may have neuroprotective effects by increasing brain-derived neurotrophic factor (BDNF). Some studies also suggest a potential role in promoting longevity through mechanisms similar to those seen with caloric restriction. However, more research is needed, and caution is advised for individuals with pre-existing medical conditions or those at risk of nutritional deficiencies.

Clinical Benefits In Randomized Controlled Clinical Trails

·        Weight loss: Intermittent fasting increased weight loss compared to eating over 12 hours or more throughout the day

·        Improved blood pressure: Time-restricted eating improved diastolic blood pressure

• Enhanced mood: Participants reported improved mood with intermittent fasting

• Better glucose tolerance: Intermittent fasting led to greater improvements in postprandial glucose metabolism in adults at increased risk of developing type 2 diabetes

• Reduced insulin resistance: Intermittent fasting significantly improved the homeostatic model assessment of insulin resistance (HOMA-IR)

• Improved Metabolic Syndrome Score: Participants following intermittent fasting showed a significant improvement in their Metabolic Syndrome Score

• Glycemic control: A 5:2 intermittent fasting meal replacement approach achieved better glycemic control compared to metformin and empagliflozin in adults with type 2 diabetes

• ·        Reduced body mass index (BMI): Modified alternate-day fasting was associated with a moderate reduction in BMI in adults with overweight or obesity

• Improved cardiometabolic risk factors: Intermittent fasting showed benefits for various cardiometabolic risk factors in adults with overweight or obesity

• It's important to note that while these benefits have been observed in clinical trials, some studies have shown mixed results or no significant improvements in certain health markers. More research is needed to fully understand the long-term effects and optimal protocols for intermittent fasting