. 2024 Mar 11;70:102519. doi: 10.1016/j.eclinm.2024.102519

Table 2.

Summary of significant associations of intermittent fasting with health outcomes supported by moderate to high quality of evidence.

Author, year, ref	Outcomes	Intermittent fasting/control	No. of studies	Metrics	Summary effects (95% CI)	p-value	I², %	GRADE	AMSTAR
Anthropometric measures
Schwinghackl et al., 2020⁵³	Body weight	TWF, MADF/CER	13	MD	−0.55 (−1.01, −0.09)	0.019	0.0	Moderate	High
Schwinghackl et al., 2020⁵³	Body weight	TWF/CER	9	MD	−1.37 (−2.24, −0.49)	0.002	0.0	Moderate	High
He et al., 2021⁶²	Body weight	MADF, TWF/CER	11	MD	−0.95 (−1.63, −0.27)	0.006	21.3	Moderate	High
Li et al., 2022¹⁷	Body weight	TWF, MADF/RD	4	MD	−2.48 (−3.22, −1.74)	<0.001	0.0	Moderate	High
Zaman et al., 2023³⁷	Body weight	TRE/Unrestricted diet	14	MD	−2.25 (−3.09, −1.42)	<0.001	93.8	Moderate	High
Zaman et al., 2023³⁷	Body weight	TRE (7–9 h)/Unrestricted diet	7	MD	−2.30 (−4.37, −0.23)	<0.001	81.2	Moderate	High
Liu et al., 2023³⁴	Body weight	TRE/Normal diet	4	MD	−3.08 (−5.29, −0.86)	0.006	0.0	Moderate	High
Liang et al., 2023³³	Body weight	TRE, TRE + RT, TRE + Diet/Non-intervention diet	23	MD	−1.69 (−2.27, −1.11)	<0.001	97.5	Moderate	Low
Liang et al., 2023³³	Body weight	TRE/Non-intervention diet	15	MD	−1.77 (−2.52, −1.02)	<0.001	98.1	Moderate	Low
Liang et al., 2023³³	Body mass index	TRE, TRE + RT, TRE + Diet/Non-intervention diet	15	MD	−0.46 (−0.67, −0.24)	<0.001	78.2	Moderate	High
Liang et al., 2023³³	Body mass index	TRE/Non-intervention diet	8	MD	−0.59 (−1.09, −0.09)	0.021	78.4	Moderate	High
Zaki et al., 2022²⁰	Body mass index	TWF/NA	3	SMD	−0.40 (−0.68, −0.11)	0.006	3.5	Moderate	High
Li et al., 2022¹⁷	Body mass index	TWF, MADF/RD	3	MD	−0.90 (−1.00, −0.78)	<0.001	0.0	Moderate	High
Allaf et al., 2021³¹	Body mass index	ADF, TWF/CER	9	MD	−0.43 (−0.76, −0.10)	0.010	34.0	Moderate	High
Cui et al., 2020	Body mass index	ADF/RD	4	MD	−1.20 (−1.44, −0.96)	<0.001	0.0	Moderate	High
Gu et al., 2022¹⁶	Waist circumference	ADF, TRE, ADF + CR/Non-intervention diet	7	MD	−1.02 (−1.99, −0.06)	0.038	0.0	High	High
Gu et al., 2022¹⁶	Waist circumference	ADF/Non-intervention diet	3	MD	−1.17 (−2.19, −0.15)	0.024	0.0	Moderate	High
Zaman et al., 2023³⁷	Waist circumference	TRE/Unrestricted diet	8	MD	−2.21 (−4.36, −0.07)	0.043	82.9	Moderate	High
Liang et al., 2023³³	Fat mass	TRE, TRE + RT, TRE + Diet/Non-intervention diet	14	MD	−1.02 (−1.74, −0.31)	0.005	97.1	Moderate	High
Gu et al., 2022¹⁶	Fat mass	ADF, TRE, ADF + CR/Non-intervention diet	12	MD	−0.72 (−1.32, −0.12)	0.019	0.0	High	High
Gu et al., 2022¹⁶	Fat mass	ADF/Non-intervention diet	4	MD	−0.70 (−1.38, −0.02)	0.044	0.0	High	High
Zaman et al., 2023³⁷	Fat mass	TRE/Unrestricted diet	9	SMD	−0.69 (−1.20, −0.17)	0.009	84.7	Moderate	High
Liu et al., 2023³⁴	Fat mass	TRE/Normal diet	6	MD	−1.79 (−2.61, −0.97)	<0.001	0.0	Moderate	High
He et al., 2021⁶²	Fat mass	MADF (4:3)/CER	3	MD	−1.06 (−1.98, −0.13)	0.025	0.0	Moderate	High
Schwinghackl et al., 2020⁵³	Fat mass	TWF/CER	7	MD	−0.82 (−1.35, −0.29)	0.002	0.0	Moderate	High
Schwinghackl et al., 2020⁵³	Fat mass	TWF, MADF/CER	10	MD	−0.66 (−1.14, −0.19)	0.010	0.0	Moderate	High
Gu et al., 2022¹⁶	Fat free mass	ADF, TRE, TWF, ADF + CR/Non-intervention diet	13	MD	0.98 (0.18, 1.78)	0.016	0.0	High	High
Zeng et al., 2022³⁸	Fat free mass	MADF, TRE, TWF/Non-intervention diet	3	MD	−0.63 (−1.22, −0.04)	0.036	0.0	Moderate	High
Liang et al., 2023³³	Lean mass	TRE, TRE + RT, TRE + Diet/Non-intervention diet	5	MD	−0.67 (−1.12, −0.22)	0.003	83.3	Moderate	High
Zaman et al., 2023³⁷	Lean mass	TRE/Unrestricted diet	8	MD	−0.69 (−1.26, −0.13)	0.016	77.5	Moderate	High
Lipid profile
Xu et al., 2023³⁶	HDL-cholesterol	TWF, MADF, ADF, IER/CER	12	MD	0.03 (0.01, 0.05)	0.010	0.0	High	High
Kim et al., 2022¹⁴	LDL-cholesterol	TWF/CER	6	SMD	−0.20 (−0.38, −0.02)	0.027	0.0	High	High
Gu et al., 2022¹⁶	Total cholesterol	ADF/Non-intervention diet	5	SMD	−0.29 (−0.48, −0.10)	0.003	0.0	High	High
Gu et al., 2022¹⁶	Triacylglycerols	ADF, TRE, TWF, ADF + CR/Non-intervention diet	15	SMD	−0.23 (−0.39, −0.06)	0.007	17.0	High	High
Zaman et al., 2023³⁷	Triacylglycerols	TRE/Unrestricted diet	9	MD	−18.19 (−32.07, −4.31)	0.010	97.2	Moderate	High
Zaman et al., 2023³⁷	Triacylglycerols	TRE (7–9 h)/Unrestricted diet	4	MD	−30.65 (−52.39, −8.90)	0.006	30.9	Moderate	High
Zaman et al., 2023³⁷	Triacylglycerols	TRE (10–12 h)/Unrestricted diet	3	MD	−27.51 (−40.12, −14.90)	<0.001	44.9	Moderate	High
Glycemic profile
Zaman et al., 2023³⁷	Fasting glucose	TRE (7–9 h)/Unrestricted diet	4	MD	−2.82 (−4.51, −1.12)	0.001	0.0	Moderate	High
Liang et al., 2023³³	Fasting glucose	TRE, TRE + RT, TRE + Diet/Non-intervention diet	15	MD	−1.45 (−2.72, −0.18)	0.025	67.7	Moderate	High
Gu et al., 2022¹⁶	Fasting insulin	ADF, TRE, TWF/Non-intervention diet	13	SMD	−0.21 (−0.40, −0.02)	0.030	0.0	High	High
Gu et al., 2022¹⁶	Fasting insulin	TRE (16:8)/Non-intervention diet	7	SMD	−0.31 (−0.60, −0.02)	0.035	0.0	Moderate	High
Liang et al., 2023³³	Fasting insulin	TRE, TRE + RT, TRE + Diet/Non-intervention diet	14	MD	−0.81 (−1.59, −0.03)	0.042	94.0	Moderate	High
Gu et al., 2022¹⁶	HOMA-IR	ADF, TRE, TWF/Non-intervention diet	8	MD	−0.35 (−0.65, −0.04)	0.030	0.0	Moderate	High
Circulatory system index
Kim et al., 2022¹⁴	Systolic blood pressure	TWF, MADF, TRE/CER	9	SMD	0.21 (0.05, 0.36)	0.008	0.0	High	High
Liang et al., 2023³³	Systolic blood pressure	TRE, TRE + RT, TRE + Diet/Non-intervention diet	11	MD	−3.48 (−6.23, −0.73)	0.013	90.6	Moderate	High
Liang et al., 2023³³	Diastolic blood pressure	TRE, TRE + RT, TRE + Diet/Non-intervention diet	16	MD	−1.46 (−2.67, −0.26)	0.017	96.6	Moderate	High
Liang et al., 2023³³	Diastolic blood pressure	TRE/Non-intervention diet	9	MD	−1.90 (−3.73, −0.08)	0.041	95.0	Moderate	High
Chen et al., 2021¹²	Diastolic blood pressure	TRE/Habitual diet	4	MD	−5.10 (−6.27, −3.93)	<0.001	31.3	Moderate	High
Zaman et al., 2023³⁷	Diastolic blood pressure	TRE (4–6 h)/Unrestricted diet	2	MD	−5.41 (−6.25, −4.57)	<0.001	0.0	Moderate	High
Other
Lange et al., 2022⁶³	Serum ALT	IF/Non-intervention diet	4	MD	−10.35 (−19.90, −0.80)	0.034	0.0	Moderate	Low
Liu et al., 2023³⁴	Tetosterone	TRE/Normal diet	4	SMD	−0.51 (−0.93, −0.10)	0.016	0.0	Moderate	High

AMSTAR, A Measurement Tool to Assess Systematic Reviews; ADF, alternate-day fasting; CER, continuous energy restriction; CR, continuous restriction; GRADE, Grading of Recommendations Assessment, Development and Evaluation; HOMA-IR, homeostatic model assessment for insulin resistance; MADF, modified alternate-day fasting; MD, mean difference; NA, not available; RD, regular diet; Ref, reference; RT, resistance training; TRE, time-restricted eating; TWF, twice-per-week fasting; SMD, standardized mean difference.