From starvation to time-restricted eating: a review of fasting physiology.

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM International Journal of Obesity Pub Date : 2024-10-05 DOI:10.1038/s41366-024-01641-0
Candida J Rebello, Dachuan Zhang, Joseph C Anderson, Rebecca F Bowman, Pamela M Peeke, Frank L Greenway
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Abstract

We have long known that subjects with obesity who fast for several weeks survive. Calculations that assume the brain can only use glucose indicated that all carbohydrate and protein sources would be consumed by the brain within several weeks yet subjects with obesity who fasted for several weeks survived. This anomaly led to the determination of the metabolic role of ketone bodies. Subsequent studies transformed our understanding of ketone bodies and illustrated the value of challenging the norm and adapting theory to evidence. Although prolonged fasting is no longer a treatment for obesity, the early studies of starvation provided valuable insights about macronutrient metabolism and ketone body adaptations that fasting elicits. Intermittent fasting and its variants such as time-restricted eating are fasting models that are far less regimented than starvation and severe calorie restriction; yet they produce metabolic benefits. The mechanisms that produce the metabolic changes that intermittent fasting elicits are relatively unknown. In this article, we review the physiology of starvation, starvation adaptation diets, diet-induced ketosis, and intermittent fasting. Understanding the premise and physiology that these regimens induce is necessary to draw parallels and provoke thoughts on the mechanisms underlying the metabolic benefits of intermittent fasting and its variants.

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从饥饿到限时进食:禁食生理学回顾。
我们早就知道,禁食数周的肥胖症患者能够存活下来。假设大脑只能使用葡萄糖的计算表明,所有碳水化合物和蛋白质都会在几周内被大脑消耗掉,但禁食几周的肥胖症患者却能存活下来。这一反常现象促使我们确定了酮体在新陈代谢中的作用。随后的研究改变了我们对酮体的认识,并说明了挑战常规和根据证据调整理论的价值。虽然长时间禁食不再是治疗肥胖症的方法,但早期的饥饿研究为我们提供了有关禁食引起的宏量营养素代谢和酮体适应的宝贵见解。间歇性禁食及其变体,如限时进食,是远不如饥饿和严格限制卡路里摄入量那样严格的禁食模式,但它们却能产生新陈代谢方面的益处。间歇性禁食引起新陈代谢变化的机制还相对未知。在本文中,我们将回顾饥饿、饥饿适应饮食、饮食诱导酮症和间歇性禁食的生理学原理。了解这些方案诱导的前提和生理学是必要的,以便对间歇性禁食及其变体的代谢益处的内在机制进行比较和思考。
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来源期刊
International Journal of Obesity
International Journal of Obesity 医学-内分泌学与代谢
CiteScore
10.00
自引率
2.00%
发文量
221
审稿时长
3 months
期刊介绍: The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders. We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.
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