Thread by @EricTopol

How ironic for @NEJM to publish a systematic review on time-restricting eating and fasting for #ChristmasDay #diet
nejm.org/doi/full/10.10… by de Cabo and Mattson @HopkinsMedicine

@NEJM @HopkinsMedicine The review combines/conflates experimental and human studies of fasting, caloric restriction and time-restricted eating and makes a strong case for promoting cardio- metabolic health, and suggests other benefits

@NEJM @HopkinsMedicine It also provides a teaching set of recommendations for doctors and the medical community for implementing time-restricted feeding or 5:2 intermittent fasting,
warning that hunger and irritability😠will disappear in ~1 month

@NEJM @HopkinsMedicine Yes, adoption will be difficult:
1st: "a diet of 3 meals w/ snacks every day is so ingrained in our culture that a change in this eating pattern will rarely be contemplated."
2nd: noted above
3rd: Third, most physicians are not trained to prescribe specific intermittent-fasting..

@NEJM @HopkinsMedicine The review nicely delves into the mechanistic benefit of ketone bodies. Just reducing calories by 500-700 for 1 day leads to their marked elevation, with salutary metabolic effects
#ketogenic

@NEJM @HopkinsMedicine A @sciencemagazine review last year ("A Time to Fast") did a better job of partitioning and defining the 4 different approaches
science.sciencemag.org/content/362/64…
the senior author, de Cabo, is also an author of the new @NEJM review

@NEJM @HopkinsMedicine @sciencemagazine There were some notable papers earlier this year on the topic
Here is the "feast on fasting" series in @CellCellPress on potential immune system benefits

https://twitter.com/EricTopol/status/1164557925106384896

The @NEJM and @sciencemagazine reviews emphasize the metabolic effects of fasting, but there are recent reports like this one indicating a gut #microbiome impact cell.com/cell-reports/f… @CellPressNews

@NEJM @sciencemagazine @CellPressNews While experimental model studies for benefits of intermittent fasting are abundant, there's a paucity of randomized trials in people. Here's a small, recent, encouraging one @Cell_Metabolism

https://twitter.com/EricTopol/status/1166363416287559680

@NEJM @sciencemagazine @CellPressNews @Cell_Metabolism A footnote [*] to add to the very positive @NEJM review
1. We tend to over-emphasize financial COI while overlooking personal COI. Mattson, the co-author, "has been practicing intermittent fasting for 30 years" eatingwell.com/article/206168… @EatingWell

@NEJM @sciencemagazine @CellPressNews @Cell_Metabolism @EatingWell 2. Exclusion (or not including) of the citation of relevant but negative meta-analyses like this one indicates bias and lack of balance
…nslational-medicine.biomedcentral.com/articles/10.11… @BioMedCentral #openaccess by @CioffiIolanda
Simona Bo and colleagues @unito

@NEJM @HopkinsMedicine At least @AP waited until after the holidays😉
apnews.com/f4d1474ebeb549… by @candicechoi

@NEJM @HopkinsMedicine + A small 4 week randomized trial of time-restricted feeding (TRF) in male college students sciencedirect.com/science/articl… via @ethanjweiss
w/ improvements in body weight, blood pressure, HDL in BOTH TRF and controls, by @MJM_PhD @hswaldman @HHP_TXST @txst_news