Effects of intermittent fasting combined with physical exercise on cardiometabolic outcomes: systematic review and meta-analysis of clinical studies

Fatemeh Kazeminasab; Maryam Baharlooie; Bahareh Karimi; Khatereh Mokhtari; Sara K Rosenkranz; Heitor O Santos

doi:10.1093/nutrit/nuad155

Effects of intermittent fasting combined with physical exercise on cardiometabolic outcomes: systematic review and meta-analysis of clinical studies

Nutr Rev. 2023 Dec 15:nuad155. doi: 10.1093/nutrit/nuad155. Online ahead of print.

Authors

Fatemeh Kazeminasab¹, Maryam Baharlooie², Bahareh Karimi², Khatereh Mokhtari³, Sara K Rosenkranz⁴, Heitor O Santos⁵

Affiliations

¹ Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
² Department of Cell and Molecular Biology and Microbiology Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran.
³ Department of Animal Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran.
⁴ Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, USA.
⁵ Postgraduate Program, Faculdade UNIGUAÇU, Cascavel, Brazil.

PMID: 38102800
DOI: 10.1093/nutrit/nuad155

Abstract

Context: Different intermittent fasting (IF) protocols have been proven to be efficient in improving cardiometabolic markers, but further research is needed to examine whether or not combining IF regimens plus physical exercise is superior to control diets (ie, nonfasting eating) plus physical exercise in this setting.

Objective: The aim of this study was to determine whether or not combining IF plus exercise interventions is more favorable than a control diet plus exercise for improving cardiometabolic health outcomes.

Data source: PubMed, Scopus, and Web of Science were comprehensively searched until April 2023.

Data extraction: Electronic databases were searched for clinical trials that determined the effect of IF plus exercise vs a control diet plus exercise on body weight, lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides, and total cholesterol), and systolic and diastolic blood pressure (SBP and DBP, respectively). Analyses were conducted for IF plus exercise vs a nonfasting diet plus exercise to calculate weighted mean differences (WMDs).

Data analysis: The meta-analysis included a total of 14 studies, with a total sample of 360 adults with or without obesity. The duration ranged from 4 to 52 weeks. IF plus exercise decreased body weight (WMD = -1.83 kg; P = 0.001), LDL (WMD = -5.35 mg/dL; P = 0.03), and SBP (WMD = -2.99 mm Hg; P = 0.003) significantly more than a control diet plus exercise. HDL (WMD = 1.57 mg/dL; P = 0.4) and total cholesterol (WMD = -2.24 mg/dL; P = 0.3) did not change significantly for IF plus exercise vs a control diet plus exercise, but there was a trend for reducing triglycerides (WMD = -13.13 mg/dL; P = 0.07) and DBP (WMD = 2.13 mm Hg; P = 0.05), which shows clinical magnitude.

Conclusion: IF plus exercise improved some cardiometabolic outcomes (body weight, blood pressure, and lipid profile) compared with a control diet plus exercise.

Systematic review registration: PROSPERO registration no. CRD42023423878.

Keywords: blood pressure; exercise training; intermittent fasting; lipid profile; obesity.