Intermittent Fasting Regimens have a Limited Effect on Circulating Markers of Oxidative Stress in Overweight/Obese Individuals: A Systematic Review of Randomized Controlled Trials

Background: The US population faces a continual increase in obesity prevalence, raising health concerns due to associated comorbidities ranked as leading causes of preventable, premature death world-wide. Scientists have found a link between obesity-associated conditions and oxidative stress (OS). To date, renewed interest in the effectiveness of dietary regimens in decreasing body weight is a popular research topic. Intermittent fasting (IF) is a popular and promising weight management strategy. To date, there have been no systematic reviews examining whether IF can reduce oxidative stress in overweight/obese adults. <br/><br/>Objective: Conduct a systematic review to evaluate the effects of intermittent fasting (IF) regimens on circulating markers of oxidative stress in overweight/obese adults compared to continuous calorie restriction (CR). <br/><br/>Methods: Databases PubMed, SCOPUS, ProQuest, and Cochrane were searched on February 21, 2021 for eligible articles limiting selection to those in the English language. Predefined search terms and restrictions were applied by two of the authors conducting the search. References from articles generated were also considered. Selected articles were limited to randomized controlled trials (RCTs) and human trials evaluating the effects of intermittent fasting (IF) dietary regimens in comparison to continuous calorie restriction (CR). Study populations considered were limited to those within the range of 18-65 years having a body mass index (BMI) of ≥25 kg/m2 and in otherwise generally good health with the absence of pre-existing acute or chronic conditions. The Academy of Nutrition and Dietetics Evidence Analysis Library Quality Rating Worksheet was used to assess the methodological quality of each of the studies and the Academy of Nutrition and Dietetics Grade Definitions and Conclusion Grading Table were used to appraise the quality of evidence.<br/><br/>Results: Six articles met eligibility criteria and were included in this review. Cumulatively 355 overweight/obese participants were assessed. Quality ratings performed by two of the authors revealed a high-quality rating for all six of the articles. One of the articles reported a significant IF associated difference in circulating 8-isoprostane concentrations and another article reported a significant decrease in circulating oxidative lipoproteins concentrations. The remaining articles showed no significant difference on OS markers following IF. <br/><br/>Conclusions: Based on the six articles included in this systematic review, IF was concluded to have limited impact on reducing circulating markers of OS in overweight/obese adults. Overall, the evidence was heterogeneous in relation to IF interventions and outcomes precluding a meta-analysis. Consequently, evidence to make dietary recommendations for reducing oxidative stress with IF interventions is insufficient at this point.