Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting

Objective Intermittent fasting (IF) is a term used to describe a variety of eating patterns in which no or few calories are consumed for time periods that can range from 12 hours to several days, on a recurring basis. This review is focused on the physiological responses of major organ systems, incl...

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Published in:Obesity (Silver Spring, Md.) Vol. 26; no. 2; pp. 254 - 268
Main Authors: Anton, Stephen D., Moehl, Keelin, Donahoo, William T., Marosi, Krisztina, Lee, Stephanie A., Mainous, Arch G., Leeuwenburgh, Christiaan, Mattson, Mark P.
Format: Journal Article
Language:English
Published: United States Blackwell Publishing Ltd 01.02.2018
Subjects:
Body composition
Brain
Clinical trials
Diabetes
Eating - physiology
Energy
Energy Intake - physiology
Exercise
Fasting
Fasting - metabolism
Fasting - physiology
Fatty acids
Feeding Behavior - physiology
Glucose
Humans
Insulin resistance
Lipids
Metabolic syndrome
Obesity
Physical fitness
Physiology
Risk factors
Weight control
ISSN:1930-7381, 1930-739X, 1930-739X
Online Access:Get full text
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Summary:Objective Intermittent fasting (IF) is a term used to describe a variety of eating patterns in which no or few calories are consumed for time periods that can range from 12 hours to several days, on a recurring basis. This review is focused on the physiological responses of major organ systems, including the musculoskeletal system, to the onset of the metabolic switch: the point of negative energy balance at which liver glycogen stores are depleted and fatty acids are mobilized (typically beyond 12 hours after cessation of food intake). Results and Conclusions Emerging findings suggest that the metabolic switch from glucose to fatty acid‐derived ketones represents an evolutionarily conserved trigger point that shifts metabolism from lipid/cholesterol synthesis and fat storage to mobilization of fat through fatty acid oxidation and fatty acid‐derived ketones, which serve to preserve muscle mass and function. Thus, IF regimens that induce the metabolic switch have the potential to improve body composition in overweight individuals. Moreover, IF regimens also induce the coordinated activation of signaling pathways that optimize physiological function, enhance performance, and slow aging and disease processes. Future randomized controlled IF trials should use biomarkers of the metabolic switch (e.g., plasma ketone levels) as a measure of compliance and of the magnitude of negative energy balance during the fasting period.
Bibliography:Drs. Anton and Leeuwenburgh are supported by the University of Florida's Claude D. Pepper Older Americans Independence Center (NIH/NIA P30AG028740). Drs. Moehl, Marosi, and Mattson are supported by the National Institute on Aging Intramural Research Program.
The authors declared no conflict of interest.
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ISSN:1930-7381
1930-739X
1930-739X
DOI:10.1002/oby.22065