Molecular Mechanisms and Clinical Translation of Intermittent Fasting on Adipose Tissue Heterogeneity
Year: 2025
Type: article
Abstract: Adipose tissue heterogeneity, particularly the pathogenic role of visceral adipose tissue (VAT) in metabolic diseases, poses significant clinical challenges. Current research confirms that intermittent fasting (IF) induces depot-specific adaptations: VAT exhibits lipid conservation mechanisms while subcutaneous adipose tissue (SAT) demonstrates thermogenic plasticity through microbiota crosstalk. The gut-liver axis further mediates systemic metabolic synchronization during IF. However, precise frameworks for stratifying IF protocols based on adipose biology remain underdeveloped. This review synthesizes molecular mechanisms driving VAT/SAT differential responses to IF, evaluates depot-specific efficacy of major regimens, and establishes a visceral fat ratio (VFR)-based precision framework. Key findings indicate that early time-restricted eating (eTRE) preferentially reduces VAT with glycemic stability, whereas alternate-day fasting (ADF) carries long-term rebound risks. Integration of circadian-aligned exercise and behavioral support significantly enhances intervention sustainability. This analysis provides clinically actionable stratification: high-VFR individuals benefit maximally from eTRE-exercise synergy, while moderate-VFR phenotypes require vigilant cardiometabolic monitoring during ADF. The framework addresses critical implementation barriers including lean mass preservation and adolescent contraindications. Future research should prioritize digital adherence platforms and biomarker-defined feeding windows to optimize personalization. This work establishes a mechanism-informed foundation for translating adipose-specific IF benefits while highlighting unresolved questions regarding long-term vascular impacts and tissue-specific circadian reprogramming.
Source: Theoretical and Natural Science
Author: Fan Yang
Institution: Beijing University of Chinese Medicine
Language: English
Topic: Dietary Effects on Health
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4413181818