Impact of Intermittent Fasting on Lipid Profile-A Quasi-Randomized Clinical Trial

Naseer Ahmed, Javeria Farooq, Hasan Salman Siddiqi, Sultan Ayoub Meo, Bibi Kulsoom, Abid H Laghari, Humaira Jamshed, Farooq Pasha, Naseer Ahmed, Javeria Farooq, Hasan Salman Siddiqi, Sultan Ayoub Meo, Bibi Kulsoom, Abid H Laghari, Humaira Jamshed, Farooq Pasha

Abstract

Background: Sub-optimal HDL is a prognostic marker of cardiovascular disease. South Asia has a high prevalence of sub-optimal HDL compared to other parts of the world. Intermittent fasting (IF) is a type of energy restriction which may improve serum HDL and other lipids thereby reducing the risk of cardiovascular diseases. Objective: The aim of the study was to evaluate the effect of IF on lipid profile and HDL-cholesterol in a sample of South Asian adults. Methods: A 6-week quasi-experimental (non-randomized) clinical trial was conducted on participants with low HDL (< 40 mg/dl for men and < 50 mg/dl for women). Participants of the control group were recommended not to change their diet. The intervention group was recommended to fast for ~12 h during day time, three times per week for 6 weeks. Pulse rate, blood pressure, body weight, waist circumference, serum lipid profile, and blood glucose levels were measured at baseline and after 6 weeks. Result: A total of 40 participants were enrolled in the study (N = 20 in each group), while 35 (20 control and 15 intervention) completed the trial and were included in data analysis of the study. Body measurements, including body weight, BMI and waist circumference, showed significant interaction effects (p's < 0.001), indicating that there were larger reductions in the IF group than in the control group. Significant interaction effects were also observed for total (p = 0.033), HDL (p = 0.0001), and LDL cholesterol (p = 0.010) with larger improvements in the IF group. Conclusion: This study suggests that intermittent fasting may protect cardiovascular health by improving the lipid profile and raising the sub-optimal HDL. Intermittent fasting may be adopted as a lifestyle intervention for the prevention, management and treatment of cardiovascular disorders. Clinical Trial Registration: NCT03805776, registered on January 16, 2019, https://ichgcp.net/clinical-trials-registry/NCT03805776.

Keywords: cardioprotection; healthy life style; intermittent fasting; lipid profile; weight reduction.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Ahmed, Farooq, Siddiqi, Meo, Kulsoom, Laghari, Jamshed and Pasha.

Figures

Figure 1
Figure 1
Flow chart of the study trial.
Figure 2
Figure 2
Multiplot figure of body measurements and blood glucose level of control and intervention group at baseline and post study. *p < 0.05, **p < 0.001.
Figure 3
Figure 3
Multiplot figure of lipid levels of control and intervention group at baseline and post study. *p < 0.05, **p < 0.001.

References

    1. Andersson C, Lyass A, Vasan RS, Massaro JM, D'Agostino RB, Sr., et al. . Long-term risk of cardiovascular events across a spectrum of adverse major plasma lipid combinations in the Framingham heart study. Am Heart J. (2014) 168:878–83.e1. 10.1016/j.ahj.2014.08.007
    1. Huxley RR, Barzi F, Lam TH, Czernichow S, Fang X, Welborn T, et al. . Isolated low levels of high-density lipoprotein cholesterol are associated with an increased risk of coronary heart disease: an individual participant data meta-analysis of 23 studies in the Asia-Pacific region. Circulation. (2011) 124:2056–64. 10.1161/CIRCULATIONAHA.111.028373
    1. Orozco-Beltran D, Gil-Guillen VF, Redon J, Martin-Moreno JM, Pallares-Carratala V, Navarro-Perez J, et al. Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study. PLoS ONE. (2017) 12:e0186196 10.1371/journal.pone.0186196
    1. Nagao M, Nakajima H, Toh R, Hirata K-I, Ishida T. Cardioprotective effects of high-density lipoprotein beyond its anti-atherogenic action. J Atheroscler Thromb. (2018) 25:985–93. 10.5551/jat.RV17025
    1. Kaur N, Pandey A, Negi H, Shafiq N, Reddy S, Kaur H, et al. . Effect of HDL-raising drugs on cardiovascular outcomes: a systematic review and meta-regression. PLoS ONE. (2014) 9:e94585. 10.1371/journal.pone.0094585
    1. Martin B, Mattson MP, Maudsley S. Caloric restriction and intermittent fasting: two potential diets for successful brain aging. Ageing Res Rev. (2006) 5:332–53. 10.1016/j.arr.2006.04.002
    1. Ahmet I, Wan R, Mattson MP, Lakatta EG, Talan M. Cardioprotection by intermittent fasting in rats. Circulation. (2005) 112:3115–21. 10.1161/CIRCULATIONAHA.105.563817
    1. Trepanowski JF, Kroeger CM, Barnosky A, Klempel MC, Bhutani S, Hoddy KK, et al. . Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults: a randomized clinical trial. JAMA Internal Med. (2017) 177:930–8. 10.1001/jamainternmed.2017.0936
    1. Eshghinia S, Mohammadzadeh F. The effects of modified alternate-day fasting diet on weight loss and CAD risk factors in overweight and obese women. J Diabetes Metab Disord. (2013) 12:4. 10.1186/2251-6581-12-4
    1. Varady KA, Bhutani S, Klempel MC, Kroeger CM, Trepanowski JF, Haus JM, et al. . Alternate day fasting for weight loss in normal weight and overweight subjects: a randomized controlled trial. Nutri J. (2013) 12:146. 10.1186/1475-2891-12-146
    1. Bhutani S, Klempel MC, Kroeger CM, Trepanowski JF, Varady KA. Alternate day fasting and endurance exercise combine to reduce body weight and favorably alter plasma lipids in obese humans. Obesity. (2013) 21:1370–9. 10.1002/oby.20353
    1. Keogh JB, Pedersen E, Petersen KS, Clifton PM. Effects of intermittent compared to continuous energy restriction on short-term weight loss and long-term weight loss maintenance. Clin Obesity. (2014) 4:150–6. 10.1111/cob.12052
    1. Stockman M-C, Thomas D, Burke J, Apovian CM. Intermittent fasting: is the wait worth the weight? Curr Obes Rep. (2018) 7:172–85. 10.1007/s13679-018-0308-9
    1. Kul S, Savaş E, Öztürk ZA, Karadag G. Does ramadan fasting alter body weight and blood lipids and fasting blood glucose in a healthy population? A meta-analysis. J Religion Health. (2014) 53:929–42. 10.1007/s10943-013-9687-0
    1. Sadeghirad B, Motaghipisheh S, Kolahdooz F, Zahedi MJ, Haghdoost AA. Islamic fasting and weight loss: a systematic review and meta-analysis. Pub Health Nutrit. (2014) 17:396–406. 10.1017/S1368980012005046
    1. Trepanowski JF, Bloomer RJ. The impact of religious fasting on human health. Nutrit J. (2010) 9:57. 10.1186/1475-2891-9-57
    1. Lessan N, Ali T. Energy metabolism and intermittent fasting: the ramadan perspective. Nutrients. (2019) 11:1192. 10.3390/nu11051192
    1. Santos HO, Macedo RCO. Impact of intermittent fasting on the lipid profile: assessment associated with diet and weight loss. Clin Nutrit ESPEN. (2018) 24:14–21. 10.1016/j.clnesp.2018.01.002
    1. Ganesan K, Habboush Y, Sultan S. Intermittent fasting: the choice for a healthier lifestyle. Cureus. (2018) 10:e2947. 10.7759/cureus.2947
    1. Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG, et al. . Flipping the metabolic switch: understanding and applying the health benefits of fasting. Obesity. (2018) 26:254–68. 10.1002/oby.22065
    1. de Cabo R, Mattson MP. Effects of intermittent fasting on health, aging, and disease. N Engl J Med. (2019) 381:2541–51. 10.1056/NEJMra1905136
    1. Malinowski B, Zalewska K, Wesierska A, Sokołowska MM, Socha M, Liczner G, et al. . Intermittent fasting in cardiovascular disorders—an overview. Nutrients. (2019) 11:673. 10.3390/nu11030673
    1. Adlouni A, Ghalim N, Saile R, Hda N, Parra H-J, Benslimane A. Beneficial effect on serum apo AI, apo B and Lp AI levels of Ramadan fasting. Clin Chim Acta. (1998) 271:179–89. 10.1016/S0009-8981(97)00245-3
    1. Ara T, Jahan N, Sultana N, Choudhury R, Yeasmin T. Effect of Ramadan fasting on total cholesterol (TC) Low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) in healthy adult male. J Bangladesh Soc Physiol. (2016) 10:46 10.3329/jbsp.v10i2.27163
    1. Shibata N, Jishage K, Arita M, Watanabe M, Kawase Y, Nishikawa K, et al. . Regulation of hepatic cholesterol synthesis by a novel protein (SPF) that accelerates cholesterol biosynthesis. FASEB J. (2006) 20:2642–4. 10.1096/fj.06-6368fje

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe