Timing of energy intake and the therapeutic potential of intermittent fasting and time-restricted eating in NAFLD
Year: 2023
Type: review
Abstract: Non-alcoholic fatty liver disease (NAFLD) represents a major public health concern and is associated with a substantial global burden of liver-related and cardiovascular-related morbidity and mortality. High total energy intake coupled with unhealthy consumption of ultra-processed foods and saturated fats have long been regarded as major dietary drivers of NAFLD. However, there is an accumulating body of evidence demonstrating that the timing of energy intake across a the day is also an important determinant of individual risk for NAFLD and associated metabolic conditions. This review summarises the available observational and epidemiological data describing associations between eating patterns and metabolic disease, including the negative effects of irregular meal patterns, skipping breakfast and night-time eating on liver health. We suggest that that these harmful behaviours deserve greater consideration in the risk stratification and management of patients with NAFLD particularly in a 24-hour society with continuous availability of food and with up to 20% of the population now engaged in shiftwork with mistimed eating patterns. We also draw on studies reporting the liver-specific impact of Ramadan, which represents a unique real-world opportunity to explore the physiological impact of fasting. By highlighting data from preclinical and pilot human studies, we present a further biological rationale for manipulating timing of energy intake to improve metabolic health and discuss how this may be mediated through restoration of natural circadian rhythms. Lastly, we comprehensively review the landscape of human trials of intermittent fasting and time-restricted eating in metabolic disease and offer a look to the future about how these dietary strategies may benefit patients with NAFLD and non-alcoholic steatohepatitis.
Source: Gut
Language: English
Topic: Dietary Effects on Health
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: Developing and testing an intervention for shiftwork sleep disorder in NHS workers, Compartmentalisation of liver lipid flux determines atherogenic lipoprotein production and liver fat accumulation: the relevance of dietary macronutrient composition, G2792775314, G371840255, G4613715315, G4855964044, Circadian iron metabolism, implications for health, and response to inflammatory disease., G5044293661, Wellcome Trust Doctoral Training Fellowship Scheme for Clinicians, G5269537831, G654890342, Dissecting the steroid metabolome in the pathogenesis and treatment of metabolic liver disease, G7800054703, Wellcome Trust Doctoral Training Fellowship Scheme for Clinicians, BUD23 drives system-wide adaptations to energy metabolism
OpenAlex ID: W4379740468