INTERMITTENT FASTING AND METABOLIC HEALTH: EVIDENCE FROM CLINICAL STUDIES
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6170Keywords:
Alternate-day Fasting, Body Composition, Intermittent Fasting, Metabolic Risk, Metabolism, Time-restricted EatingAbstract
Background: While overweight and obesity currently affect more than 1.9 billion adults worldwide and represent major risk factors for the development of metabolic diseases, intermittent fasting (IF), also referred to as intermittent energy restriction (IER), is a dietary strategy characterized by the alternation of periods of habitual food and drink consumption with periods of voluntary fasting or substantial energy restriction.
Aim: This review aims to analyze recent evidence regarding the effects of intermittent fasting in comparison with conventional dietary recommendations in overweight and obese individuals. The objective is to provide evidence-based insights that may assist clinicians and patients in determining whether intermittent fasting constitutes a feasible and effective alternative to traditional dietary interventions for optimizing metabolic health and reducing the risk of chronic disease development.
Methods: To conduct this review, Pubmed and Google Scholar were searched independently for relevant articles. Numerous studies were reviewed, followed by an in-depth analysis, and compilation of their implications in health and disease.
Results: Intermittent fasting (IF) is generally as effective as, but not necessarily superior to, traditional daily caloric restriction (DCR) for weight loss.
Conclusions: While the short-term benefits (typically 3–6 months) are well-documented, there is a consensus that more high-quality, long-term randomized controlled trials (12 months or longer) are required. Further research is needed to evaluate IF’s impact on hard clinical endpoints such as cardiovascular events, mortality, and its long-term safety in diverse or high-risk populations.
References
Derron, N., Güntner, A. T., Weber, I. C., Braun, J., Koska, İ. Ö., Othman, A., et al. (2025). Alternate-day fasting elicits larger changes in fat mass than time-restricted eating in adults without obesity – a randomized clinical trial. Clin Nutr, 53, 212–21. https://doi.org/10.1016/j.clnu.2025.08.033
Vasim, I., Majeed, C. N., & DeBoer, M. D. (2022). Intermittent fasting and metabolic health. Nutrients, 14(3), 631. https://doi.org/10.3390/nu14030631
Liu, D., Huang, Y., Huang, C., Yang, S., Wei, X., Zhang, P., et al. (2022). Calorie restriction with or without time-restricted eating in weight loss. N Engl J Med, 386(16), 1495–504. https://doi.org/10.1056/NEJMoa2114833
Ostendorf, D. M., Caldwell, A. E., Zaman, A., Pan, Z., Bing, K., Wayland, L. T., et al. (2022). Comparison of weight loss induced by daily caloric restriction versus intermittent fasting (DRIFT) in individuals with obesity: Study protocol for a 52-week randomized clinical trial. Trials, 23(1), 718. https://doi.org/10.1186/s13063-022-06523-2
Brasse, P., Zerdka, J., Staszkiewicz, K., Staszkiewicz, K. K., Piszka, M., Kwapien, E., et al. (2025). Intermittent fasting: Efficacy, safety, and its impact on body weight, glucose metabolism, and gut microbiota. Cureus. https://doi.org/10.7759/cureus.97773
Ezpeleta, M., Cienfuegos, S., Lin, S., Pavlou, V., Gabel, K., Tussing-Humphreys, L., et al. (2024). Time-restricted eating: Watching the clock to treat obesity. Cell Metab, 36(2), 301–14. https://doi.org/10.1016/j.cmet.2023.12.004
De Cabo, R., & Mattson, M. P. (2019). Effects of intermittent fasting on health, aging, and disease. N Engl J Med, 381(26), 2541–51. https://doi.org/10.1056/NEJMra1905136
Templeman, I., Thompson, D., Gonzalez, J., Walhin, J. P., Reeves, S., Rogers, P. J., et al. (2018). Intermittent fasting, energy balance and associated health outcomes in adults: Study protocol for a randomised controlled trial. Trials, 19(1), 86. https://doi.org/10.1186/s13063-018-2451-8
Garegnani, L. I., Oltra, G., Ivaldi, D., Burgos, M. A., Andrenacci, P. J., Rico, S., et al. (2026). Intermittent fasting for adults with overweight or obesity. Cochrane Database Syst Rev, 2026(2). https://doi.org/10.1002/14651858.CD015610.pub2
Wang, B., Wang, C., & Li, H. (2025). The impact of intermittent fasting on body composition and cardiometabolic outcomes in overweight and obese adults: A systematic review and meta-analysis of randomized controlled trials. Nutr J, 24(1), 120. https://doi.org/10.1186/s12937-025-01178-6
Manoogian, E. N. C., Wilkinson, M. J., O’Neal, M., Laing, K., Nguyen, J., Van, D., et al. (2024). Time-restricted eating in adults with metabolic syndrome: A randomized controlled trial. Ann Intern Med, 177(11), 1462–70. https://doi.org/10.7326/M24-0859
Catenacci, V. A., Ostendorf, D. M., Pan, Z., Kaizer, L. K., Creasy, S. A., Zaman, A., et al. (2025). The effect of 4:3 intermittent fasting on weight loss at 12 months: A randomized clinical trial. Ann Intern Med, 178(5), 634–44. https://doi.org/10.7326/ANNALS-24-01631
Gómez-Pérez, A. M., Bandera-Merchán, B., Martínez-Montoro, J. I., Gutiérrez-Bedmar, M., Díaz-Perdigones, C., Subiri-Verdugo, A., et al. (2025). Effect of a ketogenic diet, time-restricted eating, or alternate-day fasting on changes in ambulatory blood pressure: A sub-analysis of a randomized clinical trial. Eur J Prev Cardiol, zwaf567. https://doi.org/10.1093/eurjpc/zwaf567
Trepanowski, J. F., Kroeger, C. M., Barnosky, A., Klempel, M. C., Bhutani, S., Hoddy, K. K., et al. (2017). Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults: A randomized clinical trial. JAMA Intern Med, 177(7), 930. https://doi.org/10.1001/jamainternmed.2017.0936
Jane, L., Atkinson, G., Jaime, V., Hamilton, S., Waller, G., & Harrison, S. (2015). . Intermittent fasting interventions for the treatment of overweight and obesity in adults aged 18 years and over: a systematic review protocol: JBI Database Syst Rev Implement Rep, 13(10), 60–8. https://doi.org/10.11124/jbisrir-2015-2363
Sutton, E. F., Beyl, R., Early, K. S., Cefalu, W. T., Ravussin, E., & Peterson, C. M. (2018). Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metab, 27(6), 1212-1221.e3. https://doi.org/10.1016/j.cmet.2018.04.010
Song, D. K., & Kim, Y. W. (2023). Beneficial effects of intermittent fasting: A narrative review. J Yeungnam Med Sci, 40(1), 4–11. https://doi.org/10.12701/jyms.2022.00010
Martínez-Rodríguez, A., Rubio-Arias, J. A., García-De Frutos, J. M., Vicente-Martínez, M., & Gunnarsson, T. P. (2021). Effect of high-intensity interval training and intermittent fasting on body composition and physical performance in active women. Int J Environ Res Public Health, 18(12), 6431. https://doi.org/10.3390/ijerph18126431
Chair, S. Y., Cai, H., Cao, X., Qin, Y., Cheng, H. Y., & Ng, M. T. (2022). Intermittent fasting in weight loss and cardiometabolic risk reduction: A randomized controlled trial. J Nurs Res, 30(1), e185. https://doi.org/10.1097/jnr.0000000000000469
Lin, S., Cienfuegos, S., Ezpeleta, M., Gabel, K., Pavlou, V., Mulas, A., et al. (2023). Time-restricted eating without calorie counting for weight loss in a racially diverse population: A randomized controlled trial. Ann Intern Med, 176(7), 885–95. https://doi.org/10.7326/M23-0052
Patikorn, C., Roubal, K., Veettil, S. K., Chandran, V., Pham, T., Lee, Y. Y., et al. (2021). Intermittent fasting and obesity-related health outcomes: An umbrella review of meta-analyses of randomized clinical trials. JAMA Netw Open, 4(12), e2139558. https://doi.org/10.1001/jamanetworkopen.2021.39558
Cloos, A., Geisler, S., & Isenmann, E. (2025). Similar body composition outcomes following volumetric diet and time-restricted eating in middle-aged individuals: A 12-week randomized controlled trial. Nutr J, 24(1), 94. https://doi.org/10.1186/s12937-025-01167-9
He, M., Wang, J., Liang, Q., Li, M., Guo, H., Wang, Y., et al. (2022). Time-restricted eating with or without low-carbohydrate diet reduces visceral fat and improves metabolic syndrome: A randomized trial. Cell Rep Med, 3(10), 100777. https://doi.org/10.1016/j.xcrm.2022.100777
Steger, F. L., Jamshed, H., Bryan, D. R., Richman, J. S., Warriner, A. H., Hanick, C. J., et al. (2023). Early time‐restricted eating affects weight, metabolic health, mood, and sleep in adherent completers: A secondary analysis. Obesity, 31(S1), 96–107. https://doi.org/10.1002/oby.23614
Oldenburg, N., Mashek, D. G., Harnack, L., Wang, Q., Manoogian, E. N. C., Evanoff, N., et al. (2025). Time‐restricted eating, caloric reduction, and unrestricted eating effects on weight and metabolism: A randomized trial. Obesity, 33(4), 671–84. https://doi.org/10.1002/oby.24252
Pang, B. W. J., Yang, Y., Rashiqah, N., Huang, C. B., & Sim, D. W. (2025). Effects of four weeks of alternate-day fasting with or without protein supplementation—a randomized controlled trial. Nutrients, 17(23), 3691. https://doi.org/10.3390/nu17233691
Yu, Z., & Ueda, T. (2025). Early time-restricted eating improves weight loss while preserving muscle: An 8-week trial in young women. Nutrients, 17(6), 1022. https://doi.org/10.3390/nu17061022
Cui, T., Sun, Y., Ye, W., Liu, Y., & Korivi, M. (2025). Efficacy of time restricted eating and resistance training on body composition and mood profiles among young adults with overweight/obesity: A randomized controlled trial. J Int Soc Sports Nutr, 22(1), 2481127. https://doi.org/10.1080/15502783.2025.2481127
Guo, L., Xi, Y., Jin, W., Yuan, H., Qin, G., Chen, S., et al. (2024). A 5:2 intermittent fasting meal replacement diet and glycemic control for adults with diabetes: The EARLY randomized clinical trial. JAMA Netw Open, 7(6), e2416786. https://doi.org/10.1001/jamanetworkopen.2024.16786
Sukkriang, N., & Buranapin, S. (2024). Effect of intermittent fasting 16:8 and 14:10 compared with control‐group on weight reduction and metabolic outcomes in obesity with type 2 diabetes patients: A randomized controlled trial. J Diabetes Investig, 15(9), 1297–305. https://doi.org/10.1111/jdi.14186
Hegedus, E., Vu, M. H., Salvy, S. J., Bakhsh, J., Goran, M. I., Raymond, J. K., et al. (2024). Randomized controlled feasibility trial of late 8-hour time-restricted eating for adolescents with type 2 diabetes. J Acad Nutr Diet, 124(8), 1014–28. https://doi.org/10.1016/j.jand.2023.10.012
Li, L., Li, R., Tian, Q., Luo, Y., Li, R., Lin, X., et al. (2024). Effects of healthy low-carbohydrate diet and time-restricted eating on weight and gut microbiome in adults with overweight or obesity: Feeding RCT. Cell Rep Med, 5(11), 101801. https://doi.org/10.1016/j.xcrm.2024.101801
Bonham, M. P., Leung, G. K. W., Rogers, M., Davis, R., Clark, A. B., Davis, C., et al. (2025). Intermittent fasting for weight loss in night shift workers: A three-arm, superiority randomised clinical trial. eBioMedicine, 117, 105803. https://doi.org/10.1016/j.ebiom.2025.105803
Arciero, P. J., Arciero, K. M., Poe, M., Mohr, A. E., Ives, S. J., Arciero, A., et al. (2022). Intermittent fasting two days versus one day per week, matched for total energy intake and expenditure, increases weight loss in overweight/obese men and women. Nutr J, 21(1), 36. https://doi.org/10.1186/s12937-022-00790-0
Pammer, A., Obermayer, A., Stadler, J. T., Pferschy, P. N., Tripolt, N. J., Habisch, H., et al. (2024). Effects of dietary interventions and intermittent fasting on HDL function in obese individuals with T2DM: A randomized controlled trial. Cardiovasc Diabetol, 23(1), 339. https://doi.org/10.1186/s12933-024-02426-5
Ruddick-Collins, L. C., Morgan, P. J., Fyfe, C. L., Filipe, J. A. N., Horgan, G. W., Westerterp, K. R., et al. (2022). Timing of daily calorie loading affects appetite and hunger responses without changes in energy metabolism in healthy subjects with obesity. Cell Metab, 34(10), 1472-1485.e6. https://doi.org/10.1016/j.cmet.2022.08.001
Lin, S., Cienfuegos, S., Ezpeleta, M., Gabel, K., Pavlou, V., Alexandria, S. J., et al. (2024). Time-restricted eating versus daily calorie restriction: Effect on sleep in adults with obesity over 12 months. Nutrients, 16(20), 3528. https://doi.org/10.3390/nu16203528
Pavlou, V., Cienfuegos, S., Lin, S., Ezpeleta, M., Ready, K., Corapi, S., et al. (2023). Effect of time-restricted eating on weight loss in adults with type 2 diabetes: A randomized clinical trial. JAMA Netw Open, 6(10), e2339337. https://doi.org/10.1001/jamanetworkopen.2023.39337
Breit, M. J., Caldwell, A. E., Ostendorf, D. M., Pan, Z., Creasy, S. A., Swanson, B., et al. (2025). Effects of 4:3 intermittent fasting on eating behaviors and appetite hormones: A secondary analysis of a 12-month behavioral weight loss intervention. Nutrients, 17(14), 2385. https://doi.org/10.3390/nu17142385
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Copyright (c) 2026 Adam Skrobarczyk, Karolina Rycman, Izabella Sośniak, Agnieszka Dobrowolska, Zuzanna Drewniak, Marta Rząsa, Kamil Wendrychowicz, Filip Wróbel

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