Effects of Periodic Fasting on Fatty Liver Index—A Prospective Observational Study

• Published in: Nutrients Vol. 11; no. 11; p. 2601
• Main Authors: Drinda, Stefan, Grundler, Franziska, Neumann, Thomas, Lehmann, Thomas, Steckhan, Nico, Michalsen, Andreas, Wilhelmi de Toledo, Francoise
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.10.2019; MDPI
• Subjects: Adult; Aged; body mass index; body weight; Diabetes; Exercise; Fasting; Fatty acids; Fatty liver; Fatty Liver - pathology; Female; Homeostasis; Humans; Insulin resistance; Lifestyles; Liver diseases; Male; Metabolic syndrome; Middle Aged; NMR; noninsulin-dependent diabetes mellitus; Nuclear magnetic resonance; Obesity; Observational studies; Physical fitness; Prospective Studies; Ramadan; Rheumatology; risk factors; Weight control; weight loss; Switzerland; Germany; periodic fasting; diabetes; fatty liver index; overweight; obesity
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11112601

This prospective observational trial investigated effects and safety of periodic fasting in subjects with and without type 2 diabetes mellitus (T2DM). The primary end point was set as the change of fatty liver index (FLI) as a surrogate parameter of non-alcoholic fatty liver disease (NAFLD). Six-hundred and ninety-seven subjects (38 with T2DM) were enrolled. A baseline FLI ≥ 60 (the threshold for fatty liver) was found in 264 subjects (37.9%). The mean duration of fasting was 8.5 ± 4.0 days (range 6–38). FLI decreased significantly (−14.02 ± 11.67; p < 0.0001), with a larger effect in individuals with T2DM (−19.15 ± 11.0; p < 0.0001; p = 0.002 compared to non-diabetic subjects). Body mass index (BMI) decreased by −1.51 ± 0.82 kg/m2, and 49.9% of the subjects lost ≥5% body weight. After fasting, nearly half of the 264 subjects with FLI ≥ 60 (highest risk category) shifted to a lower category. The improvement of FLI correlated with the number of fasting days (r = −0.20, p < 0.0001) and with the magnitude of BMI reduction (r = 0.14, p = 0.0001). Periodic fasting with concomitant weight reduction leads to significant rapid improvement of FLI in subjects with and without T2DM.