{"title":"不同类型间歇性禁食对代谢结果的影响：综述和网络荟萃分析。","authors":"Yu-En Chen, Hui-Li Tsai, Yu-Kang Tu, Ling-Wei Chen","doi":"10.1186/s12916-024-03716-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Intermittent fasting (IF) holds promise for enhancing metabolic health. However, the optimum IF forms and their superiority over continuous energy restriction (CER) remain unclear due to disconnected findings.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and the Cochrane databases for meta-analyses of randomized controlled trials (RCTs) investigating the association between IF and metabolic health outcomes. Subsequently, we performed an umbrella review and network meta-analysis (NMA) to evaluate the efficacy of different forms of IF (time-restricted eating (TRE), alternate-day fasting (ADF), and 5:2 diet (regular eating for 5 days and energy restriction for 2 days per week)) compared to CER and usual diets on metabolic health outcomes. To assess the certainty of both direct and indirect estimates, we employed the Confidence in Network Meta-Analysis (CINeMA) approach. Additionally, we calculated the surface under the cumulative ranking curve (SUCRA) for each dietary strategy to determine their ranking in terms of metabolic health benefits.</p><p><strong>Results: </strong>Ten of the best and non-redundant meta-analysis studies, involving 153 original studies and 9846 participants, were included. When considering direct evidence only, all IF forms significantly reduced body weight compared to usual diets. In NMA incorporating indirect evidence, all IF regimens also significantly reduced body weight compared to usual diets. In the SUCRA of NMA, IF ranked higher than usual diets or CER in 85.4% and 56.1% of the outcomes, respectively. 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引用次数: 0
摘要
背景：间歇性禁食（IF）有望促进代谢健康。然而，由于研究结果相互脱节，间歇性禁食的最佳形式及其优于持续能量限制（CER）的情况仍不清楚：方法：我们系统地检索了 PubMed、Embase 和 Cochrane 数据库中调查 IF 与代谢健康结果之间关系的随机对照试验 (RCT) 的荟萃分析。随后，我们进行了总综述和网络荟萃分析（NMA），以评估不同形式的 IF（限时进食（TRE）、隔日禁食（ADF）和 5:2 饮食（每周 5 天正常进食，2 天限制能量摄入））与 CER 和常规饮食相比对代谢健康结果的疗效。为了评估直接和间接估计值的确定性，我们采用了 "网络置信度元分析"（CINeMA）方法。此外，我们还计算了每种膳食策略的累积排名曲线下表面积（SUCRA），以确定它们在代谢健康益处方面的排名：结果：我们纳入了 10 项最好的非冗余荟萃分析研究，涉及 153 项原始研究和 9846 名参与者。如果只考虑直接证据，与普通饮食相比，所有 IF 方式都能显著降低体重。在纳入间接证据的 NMA 中，与普通饮食相比，所有 IF 方案也都能显著降低体重。在 NMA 的 SUCRA 中，在 85.4% 和 56.1% 的结果中，IF 的排名分别高于普通饮食或 CER。在改善代谢健康方面，ADF的总体排名最高（排名第一：64.3%，排名第二：14.3%）：总的来说，所有 IF 形式都显示出改善代谢健康的潜力，其中 ADF 似乎在所有调查结果显示出更好的效果。需要进一步开展高质量的试验，以确认 IF 对代谢健康的（相对）疗效：试验注册：PROSPERO（记录编号：CRD42022302690）。
Effects of different types of intermittent fasting on metabolic outcomes: an umbrella review and network meta-analysis.
Background: Intermittent fasting (IF) holds promise for enhancing metabolic health. However, the optimum IF forms and their superiority over continuous energy restriction (CER) remain unclear due to disconnected findings.
Methods: We systematically searched PubMed, Embase, and the Cochrane databases for meta-analyses of randomized controlled trials (RCTs) investigating the association between IF and metabolic health outcomes. Subsequently, we performed an umbrella review and network meta-analysis (NMA) to evaluate the efficacy of different forms of IF (time-restricted eating (TRE), alternate-day fasting (ADF), and 5:2 diet (regular eating for 5 days and energy restriction for 2 days per week)) compared to CER and usual diets on metabolic health outcomes. To assess the certainty of both direct and indirect estimates, we employed the Confidence in Network Meta-Analysis (CINeMA) approach. Additionally, we calculated the surface under the cumulative ranking curve (SUCRA) for each dietary strategy to determine their ranking in terms of metabolic health benefits.
Results: Ten of the best and non-redundant meta-analysis studies, involving 153 original studies and 9846 participants, were included. When considering direct evidence only, all IF forms significantly reduced body weight compared to usual diets. In NMA incorporating indirect evidence, all IF regimens also significantly reduced body weight compared to usual diets. In the SUCRA of NMA, IF ranked higher than usual diets or CER in 85.4% and 56.1% of the outcomes, respectively. ADF had the highest overall ranking for improving metabolic health (ranked first: 64.3%, ranked second: 14.3%).
Conclusions: Overall, all IF forms demonstrate potentials to improve metabolic health, with ADF appearing to produce better outcomes across investigated outcomes. Further high-quality trials are warranted to confirm the (relative) efficacy of IF on metabolic health.
期刊介绍：
BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.
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