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Intermittent Fasting
Article in JAMA The Journal of the American Medical Association · October 2021
DOI: 10.1001/jama.2020.15140
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Zhaoping Li David Heber
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JAMA PATIENT PAGE
Intermittent Fasting
Intermittent fasting involves intervals of limiting food intake for extended periods of time.
This dietary approach may be used for attempts at weight loss, for
Intermittent fasting diets may limit the amount of time during the day
other health objectives, or as part of some religious practices. Popu- when a person can eat or may involve fasting for an entire day on a certain
lar intermittent fasting diets involve daily time-restricted feeding number of days per week.
(such as 16-24 hours of fasting) or intermittent full-day fasting Types of intermittent fasting
on 2 to 4 days (or more) per week. Some regimens allow very low
Fasting Feeding
calorie intake (500-700 calories per day) on a fasting day.
16:8 hour daily time-restricted fasting
What Happens to the Human Body During Periods
of Intermittent Fasting?
After an 8- to 12-hour period of fasting, the liver starts to break down
fatty acids to produce ketone bodies. The human body uses ke- 16 hours
tone bodies as an alternate source of fuel to sustain vital organs and fasting
tissues when the typical source (glucose) is not available. Studies 8 hours
feeding
have shown that intermittent fasting decreases blood inflamma-
tory markers and improves glucose regulation.
Does Intermittent Fasting Help People Lose Weight? Medical uses of intermittent fasting
Studies lasting between 12 weeks and 12 months have shown no dif-
Intermittent fasting may improve blood pressure, heart rate, cholesterol levels,
ference in weight loss when intermittent fasting is compared with and glycemic control. However, these improvements dissipate within weeks
a daily calorie-restricted diet. However, between 27% and 40% of after resumption of a normal diet.
these study participants dropped out of intermittent fasting, dem-
onstrating the challenge of adherence to intermittent fasting diets. ensure that nutritional needs are met. Intermittent fasting is not
recommended for pregnant or lactating women, frail older adults,
Does Intermittent Fasting Improve Health? individuals with immunodeficiency, or those with or at risk of eat-
Intermittent fasting has been shown to result in decreases in ing disorders. Intermittent fasting may be dangerous for patients
blood pressure, resting heart rate, cholesterol and triglycerides, with diabetes due to the increased likelihood of hypoglycemia (low
glucose, and insulin. While these improvements in cardiovascular blood sugar). Patients with diabetes or other health conditions who
risk factors typically begin within 2 to 4 weeks of starting an inter- are considering trying an intermittent fasting diet should discuss
mittent fasting diet, they dissipate within several weeks of resum- the potential benefits and risks with their doctor before starting.
ing a normal diet.
Potential Risks and Side Effects of Intermittent Fasting FOR MORE INFORMATION
Intermittent fasting may produce side effects including weakness, National Library of Medicine
hunger, dehydration, headaches, difficulty concentrating, low https://magazine.medlineplus.gov/article/5-questions-about-
blood pressure, or fainting. Discussion with a nutritionist or dieti- intermittent-fasting
cian is recommended before starting an intermittent fasting diet to
Authors: Zhaoping Li, MD, PhD; David Heber, MD, PhD The JAMA Patient Page is a public service of JAMA. The information and
Author Affiliations: Center for Human Nutrition, David Geffen School of Medicine at recommendations appearing on this page are appropriate in most instances, but they
UCLA, Los Angeles, California. are not a substitute for medical diagnosis. For specific information concerning your
personal medical condition, JAMA suggests that you consult your physician. This page
Conflict of Interest Disclosures: Dr Heber reported receipt of personal fees from may be photocopied noncommercially by physicians and other health care
Herbalife Nutrition. No other disclosures were reported. professionals to share with patients. To purchase bulk reprints, email reprints@
Sources: Horne BD, Grajower MM, Anderson JL. Limited evidence for the health jamanetwork.com.
effects and safety of intermittent fasting among patients with type 2 diabetes. JAMA.
2020;324(4):341-342. doi:10.1001/jama.2020.3908
de Cabo R, Mattson MP. Effects of intermittent fasting on health, aging, and disease.
N Engl J Med. 2019;381(26):2541-2551. doi:10.1056/NEJMra1905136
1338 JAMA October 5, 2021 Volume 326, Number 13 (Reprinted) jama.com
© 2021 American Medical Association. All rights reserved.
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