Intermittent fasting linked to higher risk of cardiovascular death, research suggests (NBC News Article)

[MarcNotMark]

https://www.nbcnews.com/health/hear...-fasting-risk-cardiovascular-death-rcna143853


Intermittent fasting, a diet pattern that involves alternating between periods of fasting and eating, can lower blood pressure and help some people lose weight, past research has indicated.

But an analysis presented Monday at the American Heart Association’s scientific sessions in Chicago challenges the notion that intermittent fasting is good for heart health. Instead, researchers from Shanghai Jiao Tong University School of Medicine in China found that people who restricted food consumption to less than eight hours per day had a 91% higher risk of dying from cardiovascular disease over a median period of eight years, relative to people who ate across 12 to 16 hours.


It’s some of the first research investigating the association between time-restricted eating (a type of intermittent fasting) and the risk of death from cardiovascular disease.

 

[Hoopoe]

Maybe people who do time-restricted eating are often people who are trying to treat their cardiovascular risk factors like obesity, high blood pressure and diabetes.

 

[Midnattsol]

Maybe people who do time-restricted eating are often people who are trying to treat their cardiovascular risk factors like obesity, high blood pressure and diabetes.

Intermittent fasting is also used quite a lot in some fitness environments.

Edit: And health conscious folks. Lots of talk about autophagy.

 

[Hoopoe]

I know because I have done it for a while (dinner before 17:00). But I'm drifting away from it.

 

[Midnattsol]

I'm not a fan, especially not for women. The research that find positive effects are usually weight loss studies without a control group, when there is a control group that loses the same amount of weight there are seldom any difference between the groups. Also, huge variation in study designs (number of hours fasting, which meals are skipped, if people are asked/encouraged to change their general diet in addition to fasting ++). There are a handful of interesting studies, but on the whole I've not been impressed.

A pet peeve for me is the lack of data on sex hormones, again especially for women as fasting can cause changes in menstruation. Since the majority of studies are on overweight/obese participants, this is often ignored since "they have irregular periods anyway". Though since fasting is hailed as great to increase testosterone levels in men sex hormones should be measured for men as well.

On the risk of CVD - one of the things that is often said about fasting is that one can eat whatever and still get results, so I wonder if one compared the diet of people who fast with those who don't, how different they could be. some use it as an excuse to eat terribly because they are maintaining their weight at weight alone is seen as a marker for health.

 

[JemPD]

One thing that confuses me about these 'fasting' regimes, is that i'd hardly consider it fasting to not eat between 8pm & 12 noon - loads of people skip breakfast & dont eat till lunch & then dont eat again after their evening meal at 7ish.
Also loads of people - like me, generally dont eat until evening meal, i normally feel nauseated until about 4pm, so all my calories are consumed between 4 & midnght.
This was often the case before i was ill too, - wether skipping breakfast or breakfast and lunch. Not as an attempt to lose weight i just always feel sick in the mornings, always have, even as a child. I'd never have thought myself to be 'fasting'

 

[Midnattsol]

One thing that confuses me about these 'fasting' regimes, is that i'd hardly consider it fasting to not eat between 8pm & 12 noon - loads of people skip breakfast & dont eat till lunch & then dont eat again after their evening meal at 7ish.
Also loads of people - like me, generally dont eat until evening meal, i normally feel nauseated until about 4pm, so all my calories are consumed between 4 & midnght.
This was often the case before i was ill too, - wether skipping breakfast or breakfast and lunch. Not as an attempt to lose weight i just always feel sick in the mornings, always have, even as a child. I'd never have thought myself to be 'fasting'

Obvious issues of selection bias aside, I'd love a study that compare those that "fast" naturally like this and those who don't! I know many who simply aren't hungry for breakfast and always found it a chore to eat, while for me if I were to skip a meal it would more likely be an evening meal than breakfast although I've found I don't function well if I do this for an extended period of time (but it can be as little as eating some nuts in the evening to feel ok).

 

[Murph]

I'm not sure they've identified people doing intermittent fasting very well, as opposed to people skipping meals. They have a 2-day eating recall then an 8 year follow up.
You want a big sample size for that. They have 20,000 people but even still I'm not sure that's enough given the limitations. if you have a mix of people with really stressful jobs or meth addictions in with your purposeful intermittent fasters then the sample is muddy.

 

[Midnattsol]

I'm not sure they've identified people doing intermittent fasting very well, as opposed to people skipping meals. They have a 2-day eating recall then an 8 year follow up.
You want a big sample size for that. They have 20,000 people but even still I'm not sure that's enough given the limitations. if you have a mix of people with really stressful jobs or meth addictions in with your purposeful intermittent fasters then the sample is muddy.

All the cool kids are calling meal skipping intermittent fasting Sadly classification from dietary data in cohort study is often quite limited.

 

[Samuel]

i misinterpreted and thought 91 percent of them died? big effect size! then "relative to". oh.

i wonder what @alex3619 thinks as i think he was talking at one point about restricting to small number of hours for ... was it prediabetes? diabetes?

i eat one meal per day because i only have a helper to make one meal and cannot wake up and brush teeth and shave for mask sealing before then all the time much less eat anything.

teeth need to be high priority so even a banana would need rinsing with baking soda and salt water and staying in mouth a while before brushing. which i cannot do usually as i have to sleep or rest most of a 24h day. i leave fluoride on for hours with the intention that most of it is with mask on, then it is up to whether i remember to take mask off and start eating.

i eat from late at night when i realize i can [exec dys] to even later at night. this takes a long time beause of gastroparesis and having to rest.

i do get a lot of heart palpitations recently but probably that is completely unrelated. no idea what causes that.

 

[alex3619]

i wonder what @alex3619 thinks

I think it is far too premature and there are way too many problems with the study. Its NOT peer reviewed. I have heard its a poster presentation.

They selected people as doing time restricted eating based on two days information on food. We have no idea what their comorbidities were. We have no idea if they were actually on any fasting protocol. The study results are, and I am being generous, only suggestive.

A lot of longevity research suggests fasting increases lifespan. Mortality goes down. Obviously this can be overdone, and abnormalities start appearing at about forty days without food in an average overweight person. The world fasting record is, if I recall correctly, a little over a year. Electrolyte abnormalities are a big issue with prolonged fasting.

We also need to realize that fasting was a normal daily event for most people more than a century ago.

As an aside, many with hormone issues do high fat carnivore dieting rather than fasting. While there are many studies on fasting though, there are not that many on carnivore diets so its mostly anecdotal claims.

Fasting is not for everyone, however fasting at normal weight may not involve calorie restriction. Just a break everyday for the body to recover from food metabolic issues. Fasting might be very dangerous for anyone with already restricted eating, and underweight, but then this might be a form of fasting for some if they cannot organize food or even eat. I have lost count of how many times I have heard ME patients say they have major issues getting proper nutrition. In my own case when my ME got worse for some years I went from nearly every meal in a month being healthy to maybe one meal a month I had the energy to prepare and consume that I could call healthy. This was when my diabetes worsened. I respond badly to most diabetic medication, especially Metformin (I might have died) so I am experimenting with fasting, and have been for years.

ME presents extra issues for fasting that most do not face. Given we have major issues exercising we have to be aware of potential muscle loss. This is only typically a concern with fasting for many days. My current hypothesis is fasting means I have to raise my protein intake over what I am used to. Current data suggests that protein metabolism from a single meal can have valid muscle absorption for over 100g of protein, it used to be thought it had a maximum of 40g, but this data is only for exercising people. I have no idea if its applicable to people with ME.

I saw a comment on this study that those in the "fasting" group had a much higher rate of smoking. This would distort the results. It also says nothing about what they were eating, such as the quality of their nutrition and how much trans fats they were consuming.

Even if this study finding was true, my next question would be how much more dangerous is fasting than not fasting for someone with major health issues such as diabetes? This is not answered in the study.

 

[Subtropical Island]

They selected people as doing time restricted eating based on two days information on food. We have no idea what their comorbidities were. We have no idea if they were actually on any fasting protocol.

I saw a comment on this study that those in the "fasting" group had a much higher rate of smoking. This would distort the results. It also says nothing about what they were eating,

 

[Arnie Pye]

Some videos debunking this :