M. Karavetian (Canada)
Objective: Intermittent fasting (IF) consists of a variety of eating patterns characterized by extended periods of fasting, which is thought to contribute to the prevention and treatment of certain metabolic health conditions. However, adopting IF requires extensive commitment, time management, and resources. Evaluating the burden of IF interventions on individuals is critical to ensure that programs and recommendations are feasible and sustainable. The aim of this systematic review is to summarize the impact of IF interventions, irrelevant of comparator, on adult patient-reported outcomes as well as the barriers and facilitators to uptake and maintenance of these interventions.
Methods: We conducted a systematic review by searching MEDLINE, SCOPUS, Embase, APA PsycInfo, CINAHL, and Web of Science. Interventional studies evaluating any patient-reported outcome measure (PROM) in relation to any form of IF intervention were included. A single reviewer, assisted by active machine learning technology (ASReviews), screened the titles and abstracts. Two reviewers evaluated the full texts of all selected studies for inclusion. Data were extracted in duplicate from each study and summarized descriptively.
Results: 37,198 articles were found in database searches; 10,358 duplicates were removed. 6,042 titles/abstracts were screened using ASReview, stopping when no further relevant studies were found. Of the 22 articles included, 12 were randomized control trials, and 10 were nonrandomized interventions. There were 916 total participants across the studies with an average intervention duration of 12 weeks. Most studies (13/22) did not observe a change in feelings of hunger, appetite, diet satisfaction, sleepiness, stress and depression in participants taking part in IF dietary patterns when compared to participants in the comparator groups. Managing social dining engagements was seen as the main barrier to IF, but this was reportedly improved over time by advance planning. There was an increase in the ability to restrict food intake and dietary adherence for those implementing IF.
Conclusions: The findings of this systematic review indicate that the impact of IF on PROMs may render these interventions acceptable to individuals following these patterns. These results may contribute to IF interventions becoming more commonly implemented for the prevention and treatment of metabolic health conditions.