Efficacy of intermittent fasting on improving liver function in individuals with metabolic disorders: a systematic review and meta-analysis
Abstract Background Intermittent fasting (IF) can be an effective dietary therapy for weight loss and improving cardiometabolic health. However, there is scant evidence regarding the role of IF on indicators of liver function, particularly in adults with metabolic disorders. Therefore, we performed...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12986-024-00885-x |
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| author | Mousa Khalafi Sara K Rosenkranz Faeghe Ghasemi Shokoufeh Kheradmand Aref Habibi Maleki Mallikarjuna Korivi Jung-Piao Tsao |
| author_facet | Mousa Khalafi Sara K Rosenkranz Faeghe Ghasemi Shokoufeh Kheradmand Aref Habibi Maleki Mallikarjuna Korivi Jung-Piao Tsao |
| author_sort | Mousa Khalafi |
| collection | DOAJ |
| description | Abstract Background Intermittent fasting (IF) can be an effective dietary therapy for weight loss and improving cardiometabolic health. However, there is scant evidence regarding the role of IF on indicators of liver function, particularly in adults with metabolic disorders. Therefore, we performed a systematic review and meta-analysis to investigate the effects of IF on liver function in adults with metabolic disorders. Methods Three primary electronic databases including PubMed, Web of Science, and Scopus, were searched from inception to September 2024 to identify original studies that used IF interventions with or without control groups in adults with metabolic disorders. Inclusion criteria were (1) studies of human participants with metabolic diseases, (2) interventions that evaluated the effects of IF, (3) with or without a control group, and (4) measured liver fat, liver steatosis, liver fibrosis, or liver enzymes, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) as primary outcomes. Standardized mean differences (SMD) and 95% confidence intervals were calculated using random effects models. Heterogeneity was assessed using the Cochran’s Q statistic and I-squared statistic (I2). Publication bias was assessed using the visual inspection of funnel plots and Egger’s tests. The risk of bias was assessed using the PEDro scale and the NIH quality assessment tool. Results A total 21 studies involving 1,226 participants with metabolic disorders were included in the meta-analysis. Overall, IF effectively decreased liver fat with a large effect size [SMD: -1.22 (95% CI: -1.63 to -0.80), p = 0.001], liver steatosis with a medium effect size [SMD: -0.73 (95% CI: -1.12 to -0.35), p = 0.001], ALT with a small effect size [SMD: -0.44 (95% CI: -0.58 to -0.30), p = 0.001], and AST with a small effect size [SMD: -0.30 (95% CI: -0.49 to -0.11), p = 0.001], but not liver fibrosis [SMD: -0.28 (95% CI: -0.59 to 0.02), p = 0.07]. Subgroup analyses showed that IF decreased liver fat and ALT significantly, independent of IF mode, participant age, health status, weight status, and intervention duration. IF significantly decreased liver fibrosis in those with obesity; and decreased AST following 5:2 diets, in middle-aged adults, adults with obesity, and regardless of health status or intervention duration. Conclusions IF seems to be an effective dietary therapy for improving liver function in adults with metabolic disorders, and many of liver function-related benefits occur regardless of IF mode, intervention duration, or participant health status. Limitations Significant heterogeneity, small numbers of studies and inclusion of non-randomized trials or single-group pre-post trials were the main limitation of our meta-analysis. Further randomized clinical trials are needed to elucidate the effects of IF on liver function in adults with metabolic disorders. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-4b1f6c54e327478d9787912aca065b792025-01-12T12:10:37ZengBMCNutrition & Metabolism1743-70752025-01-0122111510.1186/s12986-024-00885-xEfficacy of intermittent fasting on improving liver function in individuals with metabolic disorders: a systematic review and meta-analysisMousa Khalafi0Sara K Rosenkranz1Faeghe Ghasemi2Shokoufeh Kheradmand3Aref Habibi Maleki4Mallikarjuna Korivi5Jung-Piao Tsao6Department of Physical Education and Sport Sciences, Faculty of Humanities, University of KashanDepartment of Kinesiology and Nutrition Sciences, University of Nevada Las VegasDepartment of Exercise Physiology, Faculty of Sport Sciences, University of GuilanDepartment of Exercise Physiology, Faculty of Sport Sciences, University of MazandaranPhysiology Research Center, Iran University of Medical SciencesInstitute of Human Movement and Sports Engineering, College of Physical Education and Health Sciences, Zhejiang Normal UniversityDepartment of Sports Medicine, China Medical UniversityAbstract Background Intermittent fasting (IF) can be an effective dietary therapy for weight loss and improving cardiometabolic health. However, there is scant evidence regarding the role of IF on indicators of liver function, particularly in adults with metabolic disorders. Therefore, we performed a systematic review and meta-analysis to investigate the effects of IF on liver function in adults with metabolic disorders. Methods Three primary electronic databases including PubMed, Web of Science, and Scopus, were searched from inception to September 2024 to identify original studies that used IF interventions with or without control groups in adults with metabolic disorders. Inclusion criteria were (1) studies of human participants with metabolic diseases, (2) interventions that evaluated the effects of IF, (3) with or without a control group, and (4) measured liver fat, liver steatosis, liver fibrosis, or liver enzymes, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) as primary outcomes. Standardized mean differences (SMD) and 95% confidence intervals were calculated using random effects models. Heterogeneity was assessed using the Cochran’s Q statistic and I-squared statistic (I2). Publication bias was assessed using the visual inspection of funnel plots and Egger’s tests. The risk of bias was assessed using the PEDro scale and the NIH quality assessment tool. Results A total 21 studies involving 1,226 participants with metabolic disorders were included in the meta-analysis. Overall, IF effectively decreased liver fat with a large effect size [SMD: -1.22 (95% CI: -1.63 to -0.80), p = 0.001], liver steatosis with a medium effect size [SMD: -0.73 (95% CI: -1.12 to -0.35), p = 0.001], ALT with a small effect size [SMD: -0.44 (95% CI: -0.58 to -0.30), p = 0.001], and AST with a small effect size [SMD: -0.30 (95% CI: -0.49 to -0.11), p = 0.001], but not liver fibrosis [SMD: -0.28 (95% CI: -0.59 to 0.02), p = 0.07]. Subgroup analyses showed that IF decreased liver fat and ALT significantly, independent of IF mode, participant age, health status, weight status, and intervention duration. IF significantly decreased liver fibrosis in those with obesity; and decreased AST following 5:2 diets, in middle-aged adults, adults with obesity, and regardless of health status or intervention duration. Conclusions IF seems to be an effective dietary therapy for improving liver function in adults with metabolic disorders, and many of liver function-related benefits occur regardless of IF mode, intervention duration, or participant health status. Limitations Significant heterogeneity, small numbers of studies and inclusion of non-randomized trials or single-group pre-post trials were the main limitation of our meta-analysis. Further randomized clinical trials are needed to elucidate the effects of IF on liver function in adults with metabolic disorders.https://doi.org/10.1186/s12986-024-00885-xDietary strategyFatty liverMetabolic syndromeObesityLifestyle intervention |
| spellingShingle | Mousa Khalafi Sara K Rosenkranz Faeghe Ghasemi Shokoufeh Kheradmand Aref Habibi Maleki Mallikarjuna Korivi Jung-Piao Tsao Efficacy of intermittent fasting on improving liver function in individuals with metabolic disorders: a systematic review and meta-analysis Nutrition & Metabolism Dietary strategy Fatty liver Metabolic syndrome Obesity Lifestyle intervention |
| title | Efficacy of intermittent fasting on improving liver function in individuals with metabolic disorders: a systematic review and meta-analysis |
| title_full | Efficacy of intermittent fasting on improving liver function in individuals with metabolic disorders: a systematic review and meta-analysis |
| title_fullStr | Efficacy of intermittent fasting on improving liver function in individuals with metabolic disorders: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy of intermittent fasting on improving liver function in individuals with metabolic disorders: a systematic review and meta-analysis |
| title_short | Efficacy of intermittent fasting on improving liver function in individuals with metabolic disorders: a systematic review and meta-analysis |
| title_sort | efficacy of intermittent fasting on improving liver function in individuals with metabolic disorders a systematic review and meta analysis |
| topic | Dietary strategy Fatty liver Metabolic syndrome Obesity Lifestyle intervention |
| url | https://doi.org/10.1186/s12986-024-00885-x |
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