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Archive 1Archive 2

Classification

The connection to the "Food" wiki project seems extremely tenuous and I think it probably ought to be deleted. Intermittent fasting as described here is more of a medical/biological technique theorized to produce certain benefits. Mkcmkc (talk) 17:44, 12 December 2008 (UTC)

Just as a matter of background information, whether or not a WikiProject considers an article to be within their scope is 100% their choice. WPMED is allowed to decline this article, even though you think this is a "medical" article (WP:WikiProject Health and fitness might be a better match); similarly, WPFOOD is allowed to support it even though you don't think that it's a food-related article. Project banners are not meant to duplicate the category system or to provide a definitive answer about what the topic relates to. WhatamIdoing (talk) 20:41, 13 December 2008 (UTC)
Okay. Just to be clear, I don't care whether WPMED accepts the article or not. Rather, my point is that it seems absurd for WPFOOD to associate with it. Intermittent Fasting simply has nothing to do with food per se, in my opinion. Mkcmkc (talk) 16:31, 14 December 2008 (UTC)
Personally, I would say that this ought to go under some biochemistry project - the interesting thing about IF is whether it can activate Sirt1 in the same way resveratrol or calorie restriction can, which is a biochemical question. --129.49.7.125 (talk) 16:14, 2 February 2009 (UTC)

Authoritative material

Please consider whether contributions are authoritative (with respect to the Wikipedia guidelines). People with web pages or who work as trainers, etc., are almost certainly not authoritative on the subject of intermittent fasting. References to peer reviewed articles in recognized scientific journals are the best material. Books published by non-authorities seem a little grayer to me--perhaps someone else can look at our list. Mkcmkc (talk) 17:48, 10 March 2009 (UTC)

PLoS ONE? Please.

I just deleted information based on a study published in PLoS ONE. Let me quote Wikipedia's own article on PLoS ONE:

Submissions go through pre-publication peer review but are not excluded on the basis of lack of perceived importance or adherence to a scientific field.

What that means is that there is no actual peer review. Just a request for comments. They'll literally publish anything if you pay their submission fee. As I said in the revision comments, it is the Wikipedia of fringe science. References from it should be blacklisted. --76.202.218.218 (talk) 04:17, 29 March 2009 (UTC)

Until you can point to a formal Wikipedia policy page that explicitly states that PLoS Journals are disallowed, please grind your axe elsewhere. Mkcmkc (talk) 02:41, 30 March 2009 (UTC)
As one of the academic editors and peer reviewers for PLoS ONE, I can guarantee that there is a process of peer review. The quote above -- which I'm about to go modify on that entry -- is inaccurate. PLoS ONE doesn't impose an arbitrary significance threshold on its papers; in other words it won't turn away a paper with a good result just because the result is small in scope or of limited interest outside a specialized field. That's the basis for the "not excluded on the basis of perceived importance" claim, but it's clear that the anonymous claimant doesn't really understand what that means in the context of scientific publishing. As for "adherence to a scientific field," this is so poorly defined that I can't even argue against it. Mycophage (talk) 21:46, 28 May 2009 (UTC)
Actually someone already beat me to it. The new text, complete with actual references, is much more accurate: "It does not restrict itself to a specific scientific area in an effort to facilitate publication of research on topics outside, or between, traditional science categories.[3] In addition, it does not use presumed importance of a paper as a criterion for rejection. Instead, PLoS ONE only verifies whether experiments were conducted rigorously and astutely and permits the scientific community to ascertain importance, post publication, through debate and comment." Mycophage (talk) 21:47, 28 May 2009 (UTC)

Subject Bias

Though I like how the article starts out, the latter half of it is scarce and has a general tone of fuzzy 'maybe's; for what it's worth, I view IF neither as a good nor bad practice. While the article does address how IF does not have clear benefits, it should incorporate negative side effects and some counter-argumentation for balance. Even though there is a lack of authoritative literature relative to other health subjects like stevia or general fasting, I feel a need for alternative perspectives such as the classic contrary or neutral POV in sacrifice of peer-reviewed/authoritative references.

I compromised and chose to, though hesitantly, include one web article essay to balance out the pool of disputable 'beneficials'; however, that reference was removed without a replacement; the reason given being a lack of peer-review. Though it is better to have one that is than one that isn't, what about the several sources in the 'External References' section? Being popular media, I don't think these hold to this standard. I am not suggesting that these links should be removed, but seeing how the informal sources add some information that can be better substantiated in the future, a little leniency should be held for other similar sources.

Hopefully POV will be covered in the future, though it has been some time since the creation of this article. IF is still relatively new in respect to publicity, so these 'authoritative references' aren't easy to come up for alternative perspectives.

This is a mindset I apply to new articles: in short term, compromises with rigorous references and less solid informal references may be necessary in order to develop a more balanced article. Once better established, we can start pruning lesser citations. As an endnote, not all facets of information on a topic will be equally represented by authoritative sources in early stages; it's counterproductive therefore to dutifully enforce all sources to be of high reputation, rigor, or confirmed peer-review. Veryfaststuff (talk) 22:13, 30 March 2010 (UTC)

Information about the downsides of IF are welcome, but bring us science. (One of the reasons that the article is a bit one-sided at this point is that virtually every study that's been done has had a beneficial result.) Regards, Mkcmkc (talk) 23:02, 28 December 2010 (UTC)

To improve POV balance I included some information High Meal Frequency Diets, which largely lack the benefits of IF in the research discussed. Do you guys think this information is suitable here, or would be best be moved into a "High Meal Frequency Diets" page and include a related link to that page here? Supaiku (talk) 17:49, 6 May 2011 (UTC)


I found an article that takes a slightly more skeptical view:

“An Objective Look at Intermittent Fasting” by Alan Aragon & Ryan Zielonka
http://alanaragon.com/an-objective-look-at-intermittent-fasting.html

If nothing else, it’s a wealth of (51) citations (which I haven’t verified). Perhaps someone with more time than me can find something useful therein. — Dan337 (talk) 01:12, 13 January 2012 (UTC)

I was suprised that no criticism that this is a reflection of an eating disorder has been made. There are quite a lot of people who binge and starve themselves. Until a few years ago nobody would have recommended this 24.207.129.95 (talk) 05:33, 22 June 2012 (UTC)



No criticism????!!!

Is almost a rule that most articles have a Criticism or Arguments against section, is this article systematically biased?? --Camilo Sánchez Talk to me 00:22, 12 July 2012 (UTC)

I just pressed the Random Article button fifty times, and not a single one had a criticism section. I don't think criticism sections are as common as you think. Though if you find some well sourced criticism on the subject of this article, feel free to put it in the page Doopbridge (talk) 08:22, 7 August 2012 (UTC)
Criticism sections aren't always a good way of writing an article. If there's anything critical to say, then it's often best to include it within the main body of text as appropriate. So, for instance, if a study showed that intermittent fasting was useless against hypertension, then it should go into a section or paragraph about hypertension. Sophie means wisdom (talk) 19:09, 17 August 2012 (UTC)



Primary/secondary research guidelines?

What's the problem with the inclusion of primary research, like "Time-Restricted Feeding without Reducing Caloric Intake Prevents Metabolic Diseases in Mice Fed a High-Fat Diet"? And doesn't "Food restriction by intermittent fasting induces diabetes and obesity and aggravates spontaneous atherosclerosis development in hypercholesterolaemic mice." also counts as primary research? Why is it still included/why wasn't it not excluded at the same time?--Extremophile (talk) 23:55, 18 June 2014 (UTC)

It should probably go. Alexbrn talk|contribs|COI 04:51, 19 June 2014 (UTC)

Fasting In the Media

A potential inlusion of a 'Fasting in the media' section

Potential edited summary write up on documentary: "The Franco-German television channel ARTE aired a documentary on fasting. The program examines the potential role to be played by fasting in the healthcare systems of industrialized countries, including in the treatment of diabetes, hypertension, obesity, and cancer, and as a way to reduce the potential overconsumption of pharmaceuticals. The film spotlights five major centers of fasting: In Germany, the film profiles the Buchinger Clinic in Überlingen, as well as the Department of Natural Medicine at the Charité University Hospital in Berlin. At the Centre National de Recherche Scientifique in Strasbourg, France, Professor Yvon Le Maho and his team investigate instinctive fasting in the animal kingdom."

Original Write up on the documentary from one of the sources: "Fasting as medical therapy is now experiencing a revival thanks to the groundbreaking research by Professor Valter Longo in the areas of anti-aging and cancer therapy. The Franco-German television channel ARTE aired an excellent scientific documentary on fasting. Produced by the renowned French documentary duo, Sylvie Gilman and Thierry Vincent de Lestrade, the program examines the potential role to be played by fasting in the healthcare systems of industrialized countries, including in the treatment of diabetes, hypertension, obesity, and cancer, and as a way to reduce the explosive overconsumption of pharmaceuticals. In presenting fasting as a proven complementary therapy, the film spotlights five major centers of fasting science and therapy: In Germany, the film profiles the Buchinger Clinic in Überlingen, as well as the Department of Natural Medicine at the Charité University Hospital in Berlin. At the Buchinger Clinics in Überlingen and Marbella, more than 250,000 fasting therapies have been medically supervised in the last 60 years. The Buchinger Clinics are Europe’s largest clinics for therapeutic fasting and have profound experience in the medical applications of fasting. At the Centre National de Recherche Scientifique in Strasbourg, France, Professor Yvon Le Maho and his team use the latest technology to investigate instinctive fasting in the animal kingdom. Hundreds of publications have shown that the ability to fast is a natural physiological adaptation of humans and animals to life on the planet Earth. The availability of food changes from winter to summer, and therefore a succession of eating and fasting periods is absolutely normal. Doctors and clinics in Russia have amassed extensive knowledge and experience in therapeutic fasting, including a wealth of scientific publications during the Soviet era that have never been translated and remain virtually unknown outside Russia. In the United States, there is a tradition of fasting in the alternative scene. "

  • "Eat, Fast and Live Longer" – (BBC Horizon Documentary)

Michael Mosley has set himself a truly ambitious goal: he wants to live longer, stay younger and lose weight in the bargain. And he wants to make as few changes to his life as possible along the way. He discovers the powerful new science behind the ancient idea of fasting, and he thinks he's found a way of doing it that still allows him to enjoy his food. Michael tests out the science of fasting on himself - with life-changing results http://www.bbc.co.uk/programmes/b01lxyzc

  • some miscelaneous sources in media from the web:

• Routine Periodic Fasting Is Good for Your Health, and Your Heart, Study Suggests, ScienceDaily (Apr. 3, 2011) http://www.sciencedaily.com/releases/2011/04/110403090259.htm

• Fasting Weakens Cancer in Mice http://www.sciencedaily.com/releases/2012/02/120208152254.htm

• Fasting could help fight cancer, By Roger Highfield, Science Editor http://www.telegraph.co.uk/science/science-news/3337872/Fasting-could-help-fight-cancer.html

• Fasting and cancer, Starving the Beast, The Economist, Feb 9th 2012, 22:02 by T.C. http://www.economist.com/blogs/babbage/2012/02/fasting-and-cancer

• Fasting can help protect against brain diseases, scientists say: Claim that giving up almost all food for one or two days a week can counteract impact of Alzheimer's and Parkinson's http://www.guardian.co.uk/society/2012/feb/18/fasting-protect-brain-diseases-scientists

  • A few medical sources to sort through for potential inclusion of some of the more credible ones (some will be less credible or less current than others or some are more on caloric restriction and not actual fasting so perhaps to be sorted seperately into caloric restriction wikipedia page if any wikipeida community wish to submit):

1. Fasting cycles retard growth of tumors and sensitize a range of cancer cell types to chemotherapy. Lee C, Raffaghello L, Brandhorst S, Safdie FM, Bianchi G, Martin-Montalvo A, Pistoia V, Wei M, Hwang S, Merlino A, Emionite L, de Cabo R, Longo VD. Andrus Gerontology Center, Department of Biological Sciences, Norris Cancer Center, University of Southern California, 3715 McClintock Avenue, Los Angeles, CA 90089-0191, USA. http://www.ncbi.nlm.nih.gov/pubmed/22323820 Abstract: Short-term starvation (or fasting) protects normal cells, mice, and potentially humans from the harmful side effects of a variety of chemotherapy drugs. Here, we show that treatment with starvation conditions sensitized yeast cells (Saccharomyces cerevisiae) expressing the oncogene-like RAS2(val19) to oxidative stress and 15 of 17 mammalian cancer cell lines to chemotherapeutic agents. Cycles of starvation were as effective as chemotherapeutic agents in delaying progression of different tumors and increased the effectiveness of these drugs against melanoma, glioma, and breast cancer cells. In mouse models of neuroblastoma, fasting cycles plus chemotherapy drugs--but not either treatment alone--resulted in long-term cancer-free survival. In 4T1 breast cancer cells, short-term starvation resulted in increased phosphorylation of the stress-sensitizing Akt and S6 kinases, increased oxidative stress, caspase-3 cleavage, DNA damage, and apoptosis. These studies suggest that multiple cycles of fasting promote differential stress sensitization in a wide range of tumors and could potentially replace or augment the efficacy of certain chemotherapy drugs in the treatment of various cancers.

2. Fasting and cancer treatment in humans: A case series report. Fernando M. Safdie,1,6 Tanya Dorff,2,3,6 David Quinn,2,3 Luigi Fontana,4 Min Wei,1 Changhan Lee,1 Pinchas Cohen,5 and Valter D. Longo1 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815756/ Abstract: Short-term fasting (48 hours) was shown to be effective in protecting normal cells and mice but not cancer cells against high dose chemotherapy, termed Differential Stress Resistance (DSR), but the feasibility and effect of fasting in cancer patients undergoing chemotherapy is unknown. Here we describe 10 cases in which patients diagnosed with a variety of malignancies had voluntarily fasted prior to (48-140 hours) and/or following (5-56 hours) chemotherapy. None of these patients, who received an average of 4 cycles of various chemotherapy drugs in combination with fasting, reported significant side effects caused by the fasting itself other than hunger and lightheadedness. Chemotherapy associated toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) of the National Cancer Institute (NCI). The six patients who underwent chemotherapy with or without fasting reported a reduction in fatigue, weakness, and gastrointestinal side effects while fasting. In those patients whose cancer progression could be assessed, fasting did not prevent the chemotherapy-induced reduction of tumor volume or tumor markers. Although the 10 cases presented here suggest that fasting in combination with chemotherapy is feasible, safe, and has the potential to ameliorate side effects caused by chemotherapies, they are not meant to establish practice guidelines for patients undergoing chemotherapy. Only controlled-randomized clinical trials will determine the effect of fasting on clinical outcomes including quality of life and therapeutic index.

3. ‘Short-term therapeutic fasting (7 days) in the treatment of chronic pain and fatigue syndromes--well-being and side effects with and without mineral supplements’ - Michalsen A, Weidenhammer W, Melchart D, Langhorst J, Saha J, Dobos G. Department of Internal Medicine V and Integrative Medicine, Kliniken Essen Mitte, Am Deimelsberg 34 a, 45276 Essen, Germany. 2002 http://www.ncbi.nlm.nih.gov/pubmed/12232494

4. ‘The short-term (7 days) effects of fasting on the neuroendocrine system in patients with chronic pain syndromes.’ - Michalsen A, Schneider S, Rodenbeck A, Lüdtke R, Huether G, Dobos GJ. Department of Internal Medicine V and Integrative Medicine, Kliniken Essen Mitte, Am Deimelsberg 34 a, 45276 Essen, Germany. 2003 http://www.ncbi.nlm.nih.gov/pubmed/12608732

5. 2010 / CellCycle / Fasting and differential chemotherapy protection in patients / Rafaghello, Prof. Valter Longo, et al./ DOI: 10.4161/cc.9.22.13954

6. 2010 / Trends in Pharmacological Sciences / Calorie restriction and cancer prevention: metabolic and molecular mechanisms / Prof Valter D. Longo and Luigi Fontana / DOI: 10.1016/j.tips.2009.11.004

7. 2007 / PNAS / Starvation‐dependent differential stress resistance protects normal but not cancer against high‐dose chemotherapy / Lizzia Raffaghello, Prof. Valter Longo, et al. / DOI: 10.1073"pnas.0708100105

8. 2011 / Oncogene Research / Fasting vs dietary restriction in cellular protection and cancer treatment: from model organisms to patients / Changhan Lee and Prof. Valter Longo / DOI: 10.1038/onc.2011.91

9. ‘Medically supervised water-only fasting in the treatment of hypertension.’ Goldhamer A, Lisle D, Parpia B, Anderson SV, Campbell TC. Center for Conservative Therapy, Penngrove, Calif, USA. 2002 http://www.ncbi.nlm.nih.gov/pubmed/11416824

10. ‘Medically supervised water-only fasting in the treatment of borderline hypertension.; - Goldhamer AC, Lisle DJ, Sultana P, Anderson SV, Parpia B, Hughes B, Campbell TC. TrueNorth Health Center, Rohnert Park, CA 2002 http://www.ncbi.nlm.nih.gov/pubmed/12470446

11. ‘Prolonged fasting (7-21 days) as a method of mood enhancement in chronic pain syndromes: a review of clinical evidence and mechanisms.’ - Michalsen A. Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre, Germany. 2010 http://www.ncbi.nlm.nih.gov/pubmed/20425196 Abstract: Periods of deliberate fasting with restriction to intake of solid food are practiced worldwide, mostly based on a traditional, cultural, or religious background. Recent evidence from clinical trials shows that medically supervised modified fasting (200-500 kcal nutritional intake/day) with periods from 7 to 21 days is efficacious in the treatment of rheumatic diseases and chronic pain syndromes. Here, fasting is frequently accompanied by increased alertness and mood enhancement. The beneficial claims of fasting are supported by experimental research, which has found fasting to be associated with increased brain availability of serotonin, endogenous opioids, and endocannabinoids. Fasting-induced neuroendocrine activation and mild cellular stress response with increased production of neurotrophic factors may also contribute to the mood enhancement of fasting. Fasting treatments may be useful as an adjunctive therapeutic approach in chronic pain patients. The mood-enhancing and pain-relieving effect of therapeutic fasting should be further evaluated in randomized clinical trials.

12. ‘Caloric restriction in primates and relevance to humans.’ - Roth GS, Ingram DK, Lane MA. Laboratory of Neurosciences, Gerontology Research Center, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224, USA. 2001 http://www.ncbi.nlm.nih.gov/pubmed/11795522 Abstract: Dietary caloric restriction (CR) is the only intervention conclusively and reproducibly shown to slow aging and maintain health and vitality in mammals. Although this paradigm has been known for over 60 years, its precise biological mechanisms and applicability to humans remain unknown. We began addressing the latter question in 1987 with the first controlled study of CR in primates (rhesus and squirrel monkeys, which are evolutionarily much closer to humans than the rodents most frequently employed in CR studies). To date, our results strongly suggest that the same beneficial "antiaging" and/or "antidisease" effects observed in CR rodents also occur in primates. These include lower plasma insulin levels and greater sensitivity; lower body temperatures; reduced cholesterol, triglycerides, blood pressure, and arterial stiffness; elevated HDL; and slower age-related decline in circulating levels of DHEAS. Collectively, these biomarkers suggest that CR primates will be less likely to incur diabetes, cardiovascular problems, and other age-related diseases and may in fact be aging more slowly than fully fed counterparts. Despite these very encouraging results, it is unlikely that most humans would be willing to maintain a 30% reduced diet for the bulk of their adult life span, even if it meant more healthy years.

13. ‘The impact of religious fasting on human health.’ Trepanowski JF, Bloomer RJ. Cardiorespiratory/Metabolic Laboratory, The University of Memphis, Memphis, TN 38152, USA. http://www.ncbi.nlm.nih.gov/pubmed/21092212 Abstract: Greek Orthodox Christians fast for a total of 180 - 200 days each year, and their main fasting periods are the Nativity Fast (40 days prior to Christmas), Lent (48 days prior to Easter), and the Assumption (15 days in August). Some of the more favorable effects of these fasts include the lowering of body mass, total cholesterol, LDL-C, and the LDL-C/HDL-C ratio. The Biblical-based Daniel Fast prohibits the consumption of animal products, refined carbohydrates, food additives, preservatives, sweeteners, flavorings, caffeine, and alcohol. It is most commonly partaken for 21 days, although fasts of 10 and 40 days have been observed. Our initial investigation of the Daniel Fast noted favorable effects on several health-related outcomes, including: blood pressure, blood lipids, insulin sensitivity, and biomarkers of oxidative stress. This review summarizes the health-specific effects of these fasts and provides suggestions for future research.

14. ‘The Effects of Caloric Restriction on Health and Longevity.’ Green JL, Sawaya FJ, Dollar AL. Emory University, 49 Jesse Hill Jr Drive SE, Atlanta, GA, 30303, USA 2011 Abstract: OPINION STATEMENT: There is increasing evidence that restricting caloric intake may have considerable health benefits in humans. Significant evidence in non-primate animals demonstrates that caloric restriction increases average and maximal life span. However, historically, caloric intake reduction in humans has been involuntary and accompanied by poverty, malnutrition, poor sanitation, and a lack of modern health care. As a result, caloric restriction in people typically has been accompanied by a reduction of both average and maximal life span. Conversely, improvements in standards of living usually are accompanied by an increased food supply and resultant improved health and longevity. The majority of the world is now in a new era where an abundance of caloric intake and its associated obesity are causing widespread chronic illness and premature death. What would happen if one were to institute caloric restriction with high-quality nutrition within an environment of modern sanitation and health care? This review argues that improved health and improved average life span would quite likely result. A lengthening of maximal human life span with this combination is perhaps possible but by no means certain.

15. A.J.Carlson and F. Hoelzel, “Nutrition, Senescence and Rejuvenescence”. Public Health Reports Vol.67 No.2. February 1952 Chicago.

16. H.L.Taylor, “American Journal of Physiology”. pp143-148 1945.

17. A.J.Carlson and F. Hoelzel, “Apparent Prolongation of Lifespan of Rats by Intermittent Fasting”. Journal of Nutrition, 31:363 1946.

18. Sergius Morgulis, “Fasting and Undernutrition”. University of Nebraska, E.P. Dutton, New York 1923.

19. A.J.Carlson, “The Control of Hunger in Health and Disease”. University of Chicago 1916.

20. Margaret M. Kunde, “The After Effects of Prolonged Fasting on the Basal Metabolic Rate”. Journal of Metabolic Research 1923, 3, 399 – 449.

21. R.H. Weindruch, J.A.Kristie, K.Cheney and R.L.Walford, “The Influence of Controlled Dietary Restriction on Immunologic Function and Ageing”. Federation Proceedings U.C.L.A. 389:2007 (1979)

22. ‘Caloric restriction in C57BL/6J mice mimics therapeutic fasting in humans.’ - Mahoney LB, Denny CA, Seyfried TN. Biology Department, Boston College, Chestnut Hill, MA, USA. 2006

23. ‘Clinical Aspects of the Ketogenic Diet’ - Adam L. Hartman, Eileen P. G. Vining, The John M. Freeman Pediatric Epilepsy Center, Johns Hopkins Medical Institutions, Baltimore, Maryland U.S.A. http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2007.00914.x/full

24. ‘Fasting increases the in vivo gene delivery of AAV vectors.’ - Moulay G, Scherman D, Kichler A., Genethon, Evry, France. http://www.ncbi.nlm.nih.gov/pubmed/21207763

25. ‘Greek Orthodox fasting rituals: a hidden characteristic of the Mediterranean diet of Crete.’ Sarri KO, Linardakis MK, Bervanaki FN, Tzanakis NE, Kafatos AG. Department of Social Medicine, University of Crete, School of Medicine, PO Box 2208, Iraklion 71003, Greece. 2004 http://www.ncbi.nlm.nih.gov/pubmed/15333159

26. ‘Incorporation of fasting therapy in an integrative medicine ward: evaluation of outcome, safety, and effects on lifestyle adherence in a large prospective cohort study.’ - Michalsen A, Hoffmann B, Moebus S, Bäcker M, Langhorst J, Dobos GJ. Department of Integrative and Internal Medicine V, Kliniken Essen-Mitte, and Complementary and Integrative Medicine of the Alfred Krupp von Bohlen und Halbach Foundation, University Duisburg-Essen, Essen, Germany. 2005 http://www.ncbi.nlm.nih.gov/pubmed/16131283

27. Short-term dietary restriction and fasting precondition against ischemia reperfusion injury in mice.’ Mitchell JR, Verweij M, Brand K, van de Ven M, Goemaere N, van den Engel S, Chu T, Forrer F, Müller C, de Jong M, van IJcken W, IJzermans JN, Hoeijmakers JH, de Bruin RW. Department of Genetics, Erasmus Medical Center, Cancer Genomics Center, Dr. Molewaterplein 50, 3015 GE, Rotterdam, The Netherlands. 2010 http://www.ncbi.nlm.nih.gov/pubmed/19878145

28. ‘A trial of fasting cure for PCB-poisoned patients in Taiwan.’ 1984 Imamura M, Tung TC. http://www.ncbi.nlm.nih.gov/pubmed/6422746

29. ‘Brain Metabolism during Fasting’ O. E. Owen, A. P. Morgan, H. G. Kemp, J. M. Sullivan, M. G. Herrera, and G. F. Cahill, Jr., Elliott P. Joslin Research Laboratory, Department of Medicine, Harvard Medical School, the Cardiovascular Unit, the Peter Bent Brigham Hospital, and the Diabetes Foundation, Inc., Boston, Massachusetts 1967 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292907/?page=6

30. ‘Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease.’ Fuhrman J, Sarter B, Calabro DJ. Hunterdon Medical Center, Flemington, NJ, USA. 2002 http://www.ncbi.nlm.nih.gov/pubmed/12126162

31. There is also a highly dubious case in India of a man called Prahlad Jani whom claims to have lived without not just food but also water for years. Observation studies of Jani have been conducted, one in 2003 and one in 2010, both involving Sudhir Shah, a neurologist at the Sterling Hospitals in Ahmedabad, India. http://en.wikipedia.org/wiki/Prahlad_Jani

SpringSummerAutumn (talk) 14:38, 20 November 2012 (UTC)

"Fasting in the media" section? I don't see exactly the point. Is there a section like "diabetes the media"? Or "myocardial infarction in the media"? That probably would be more relevant, given the frequent misportrayal of heart attacks on TV and movies. Perhaps an "in the media" section should be basically some short descriptive text of whatever fuss that there may be specifically about that (if that's really the case), with a link to the article on "food faddism". --Extremophile (talk) 00:06, 19 June 2014 (UTC)
I like the fasting in the media section. Looks good from my brief overview. I don't think food faddism is a relevant link as it deals with charades and not everyone thinks of IF as a charade... makeswell (talk) 21:17, 27 June 2014 (UTC)

Martin Berkhan, Brad Pilon, Ori Hofmekler

Why is there no mention of the pioneers and godfathers of IF? It was thanks to these guys that IF came to be rediscovered in the 21st Century. — Preceding unsigned comment added by 92.11.229.89 (talk) 04:18, 20 July 2016 (UTC)

Proposed merge with 5:2 diet

Been open a month, all supports, snow close. I will implement Jytdog (talk) 01:29, 28 July 2017 (UTC)

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

The 5:2 diet is just one example of intermittent fasting, so it would probably make more sense to describe it here on this page. WhatamIdoing (talk) 18:35, 28 June 2017 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Mice research

The following statement and reference were removed because it is primary research, far from being confirmed or relevant to humans. The preliminary study is WP:PRIMARY, not relevant at all to "preventive and therapeutic" effects on "obesity and metabolic disorders", and is unencyclopedic to include since it is years/decades away from sufficient confirmation. Such as statement needs a high-quality clinical systematic review of human studies or meta-analysis of randomized controlled trials per WP:MEDRS. --Zefr (talk) 17:21, 21 November 2017 (UTC)

A 2017 study on mice suggests that isocaloric intermittent fasting can be a preventive and therapeutic approach against obesity and metabolic disorders.[1]

References

  1. ^ Kim, Kyoung-Han; et al. (2017). "Intermittent fasting promotes adipose thermogenesis and metabolic homeostasis via VEGF-mediated alternative activation of macrophage". Cell Research. 27: 1309–1326. doi:10.1038//cr.2017.126. PMID 29039412. {{cite journal}}: Explicit use of et al. in: |author1= (help)
You reverted my recent edit and stated that adding the 2017 research study on mice was "unencyclopedic." I would have thought that to be encyclopedic, i.e. comprehensive in terms of information, all releveant research related to intermittent fasting (human and animal) would be referenced. In fact, I think that the article is decidedly unencyclopedic because it only contains references to human-based research on the subject. Darlig 🎸 Talk to me 17:26, 21 November 2017 (UTC)
See WP:NOTJOURNAL, #6-7 and WP:MEDANIMAL for why laboratory research is not included in the encyclopedia to represent health or disease effects in humans. --Zefr (talk) 17:34, 21 November 2017 (UTC)
@Zefr:, perhaps you could tell me where I would find a reference on Wikipedia to this research study. You appear to think that including it is original reseach - it isn't. I drew no conclusions from it but simply stated the conclusions that the researchers draw themselves. I also don't think you understand what primary source information is in the context of a Wikipedia article. Darlig 🎸 Talk to me 17:40, 21 November 2017 (UTC)
There is nothing further to add to this discussion. You would benefit from reading and applying the guidelines I provided above. --Zefr (talk) 18:08, 21 November 2017 (UTC)
@Zefr:,I read both WP:NOTJOURNAL, #6-7 and WP:MEDANIMAL. There are multiple studies on animals related to intermittent fasting that I think would be of interest to any encyclopedic reader. While I agree the article should not over-emphasize animal studies, the fact that there are myriad animal studies should be mentioned. If you don't want to discuss this at all, I may ask for some help in resolving this issue. Thanks! Darlig 🎸 Talk to me 19:04, 21 November 2017 (UTC)
As intermittent fasting is a human health issue, a higher source standard is needed to support content. Mouse studies are WP:PRIMARY, far from the reviews on human results used now in the Research section. We need systematic reviews and/or a meta-analysis of completed high-quality clinical trials (humans), sources that would comply with WP:MEDRS. The purpose of WP:NOTJOURNAL is to encourage that we not write the encyclopedia like it is the Discussion section of a research paper. Enough said. --Zefr (talk) 15:09, 24 November 2017 (UTC)

New addition

I plan on expanding on this Wiki article with these sources. Sl2763 (talk) 00:00, 4 March 2018 (UTC) Bibliography (links of articles)

https://www.sciencedirect.com/science/article/pii/S0378512214002680

https://www.sciencedirect.com/science/article/pii/S1568163716302513

https://www.sciencedirect.com/science/article/pii/S0303720715300800 *

https://www.sciencedirect.com/science/article/pii/S1550413116302509

https://www.sciencedirect.com/science/article/pii/S095528630400261X

https://www.sciencedirect.com/science/article/pii/S1568163716302513

https://www.sciencedirect.com/science/article/pii/S0378512214002680

http://onlinelibrary.wiley.com/doi/10.1002/oby.22065/full

http://onlinelibrary.wiley.com/doi/10.1111/nure.12104/full

Some of those are already in use and others are not of sufficient quality to include. I put a star beside the only one that's useable, in my opinion. We need WP:MEDRS-quality revews for this article. Here's a Wikiproject tutorial on MEDRS for clarification. --Zefr (talk) 01:17, 4 March 2018 (UTC)
Translating those into PMIDs which are more useful...
  • PMID 25216760 (2014)
  • PMID 27810402 (2017)
  • PMID 26384657 (2015)
  • PMID 27304506 PMC 5388543 (2016)
  • PMID 15741046 (2005)
  • PMID 27810402 (2017)
  • PMID 25216760 (2014) (repeat of first one)
  • PMID 29086496 (2018) (already used in the article)
  • PMID 24739093 (2014) (already used in the article)
The 2005 one is too old. I reckon zefr likes PMID 26384657 because it is clearly focused on clinical trial evidence. Jytdog (talk) 22:12, 5 March 2018 (UTC)

I also added more potential articles that can be used.

Besides that one article that was starred, are any of these other articles usable? Thank you! Sl2763 (talk) 13:02, 12 March 2018 (UTC)

Comments provided. --Zefr (talk) 15:58, 12 March 2018 (UTC)

Feedback on student assignment regarding intermittent fasting

Hi, I have written three paragraphs about intermittent fasting that could be an addition to the information already on this page. I would love some feedback on it! I will link my Sandbox below. https://en.wikipedia.org/wiki/User:Sl2763/sandbox Thank you! Sl2763 (talk) 14:27, 5 May 2018 (UTC)

Your choice of reviews is ok. Note that the St.-Onge and Patterson reviews are available as free full links, so please provide the respective URLs in your ref formats. Regarding your text, I feel you go into too much detail. You could be succinct in reducing the overall content at least by half, leaving out details and generalizing from the sources. You could try another draft in your sandbox, or post a draft to the Talk page. --Zefr (talk) 16:54, 5 May 2018 (UTC)

I think that while the three paragraphs are good, the content could be boiled down a little bit. The studies should be a bit more generalized and shouldn't look that closely to the results of the original studies. Shujins (talk) 04:09, 9 May 2018 (UTC)

Additions to the page

Hi all!

I have written some new sections that I think could potentially supplement the information on the page! Additionally, I reformatted some of the information into different sections that I think would better frame the information. The link to that writing is here: https://en.wikipedia.org/wiki/User:Heyitsj3/sandbox Please let me know what you think! — Preceding unsigned comment added by Heyitsj3 (talk • contribs) 07:27, 10 May 2018 (UTC)

More Additions

I think this article is very interesting and deserves to be expanded upon. As such, I have written a few more paragraphs that I believe add some more context and information on the topic. I would be interested in hearing your opinions and hope you learn more about the topic. The link to my sandbox page can be found here: https://en.wikipedia.org/wiki/User:Tcarnella/sandbox — Preceding unsigned comment added by Tcarnella (talk • contribs) 15:04, 11 May 2018 (UTC)

Balance needed IMO

IMO balance is needed. Also the Mediterranean diet can hardly be described as plant based...It includes "moderate to high consumption of fish", for example. This needs fixing. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663587/ Regarding the health benefits of caloric restriction, here's a few suggestions to start with:

https://www.nature.com/articles/s41598-018-24146-z https://endpoints.elysiumhealth.com/the-science-of-fasting-2f5b56a2a65d https://www.ncbi.nlm.nih.gov/pubmed/27233359 https://www.nature.com/articles/s41598-018-24146-z https://www.nature.com/articles/d41586-018-03431-x https://www.scientificamerican.com/article/the-hunger-gains-extreme-calorie-restriction-diet-shows-anti-aging-results/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696577/ https://www.the-scientist.com/?articles.view/articleNo/18456/title/Scientists-Finding-Evidence-Of-Caloric-Restriction-s-Benefits/ https://www.newscientist.com/article/2164602-calorie-restriction-may-extend-lifespan-by-changing-your-sleep/ https://www.sciencedaily.com/releases/2017/12/171219215510.htm — Preceding unsigned comment added by CanisLupisArctus (talk • contribs) 23:24, 5 June 2018 (UTC)

Ori Hofmekler, Brad Pilon, and Martin Berkhan

Why are these guys and their work not mentioned in the article at all?

They are the pioneers of the modern IF systems, and the author of "The 8-Hour Diet" blatantly ripped off Berkhan's 'Leangains' system without crediting him.

The history (scientific and popular) of the practice should indeed be described, but I do not know enough about it, so please feel free if you have enough quality material! --Signimu (talk) 23:26, 29 July 2018 (UTC)

Research section mixes primary and secondary sources

The major changes to Research include some refs that are animal trials and other that are individual clinical trials, mixed in with secondary refs that meet MEDRS. Concerned about ref #1, as used repeatedly, but the abstract of the article states a lot of content based on animal trials. David notMD (talk) 22:48, 29 July 2018 (UTC)

Hello @David notMD:, thank you for your feedback. There was already rodents studies before my changes, but anyway I now have removed them all except for one. The last rodents study based result I have left is about the mechanisms, as I think it might be interesting and is clearly stated to be on rodents, but please feel free to remove if you feel this is not right. About the first reference, yes I am aware of that and I tried to limit the description of results here that were done on human, only the sleep and gut microbiome part was totally based on rodents but I have found another source since then describing similar results on humans. Please feel free to review what I wrote, I tried my best to clarify what was discovered on humans only by comparing different sources, but I might always have missed something ;-) --Signimu (talk) 23:07, 29 July 2018 (UTC)
My concern here is that is a very popular article - more than 80,000 visits per month over past six months - and I believe that any changes should be conservative and rigorously referenced. The topic is outside my area of scientific expertise. I hope that knowledgeable editors will weight in. David notMD (talk) 23:28, 29 July 2018 (UTC)
Arg, I'm unlucky, this is the second time I recently stumble on a "hot" scientific topic... This one has been a long time interest of mine but I only recently found reliable scientific material, hence why I have edited. Unfortunately, the popularity of the topic probably influences the amount of scientific research material available, so that's no coincidence. Although I tried my best to rely on high-quality reviews (particularly from Nature Publishing Group), I concur reviewing that it would be best if my changes could be reviewed, but also please keep in mind the previous state was not really satisfactory either, as it was mainly a front for the 5:2 diet. @Zefr: maybe might help? --Signimu (talk) 00:45, 30 July 2018 (UTC)
I have also asked for help on the WikiProject Medicine [1]. --Signimu (talk) 01:00, 30 July 2018 (UTC)
Thank you for the material :-) Unfortunately the reputation of the publisher (MDPI) seems to be debatable[2][3][4][5][6], so we can't use that to assess the quality. So I set out to read the paper to evaluate its quality on its own merits, and it seems to be mostly about ADMF and 5:2 variants (with low calorie intake allowed on fasting days) versus continuous energy restriction. For these parts, I can recognize some of the most notable papers in the domain, and the arguments and inference are sound. However for intermittent fasting, the subject is only sparsely covered, and is mostly contradicting the recent systematic reviews, including the Nature ones, based mostly on a few selected results on animal studies... So my opinion is that this material can be interesting to complement ADMF and 5:2 infos (although most infos are already written and backed by other sources), but should be avoided for any IF claim as this was clearly not the focus of the article. But I would prefer that someone else take a look first before using this as a reference. --Signimu (talk) 19:14, 30 July 2018 (UTC)

Reverts

Hello @Zefr:, you just reverted my 2 contributions, could you please explain the reasons? I am aware of WP:MEDRS and I think the references I added fit in the content guidelines. --Signimu (talk) 18:23, 29 July 2018 (UTC)

Your edits did not improve the article, and your poor use of grammar creates work for other editors. Please practice English in your sandbox. --Zefr (talk) 18:28, 29 July 2018 (UTC)
Discussion below is not about improving the article; left note on user's talk page. --Zefr (talk) 21:16, 29 July 2018 (UTC)
I am not going to pretend I am native, but I think you are a bit too much overreacting here. My English is not so bad as to exclude me from contribution, or else any non native writer should be excluded (which is not part of the WP rules nor recommandations as far as I know). If that is the only reason for you to try to exclude, I would recommend you from refraining to revert me again... Iterative editing/enhancement is not an exclusion factor, it is the basis of Wikipedia. --Signimu (talk) 18:38, 29 July 2018 (UTC)
@Zefr: Can you please clarify why you thought the writing was poor? What kind of enhancement would you propose, so that I can understand what you expect? --Signimu (talk) 19:50, 29 July 2018 (UTC)
After your posting at TeaHouse, I agree with seeing poor wording. See my example there. David notMD (talk) 22:46, 29 July 2018 (UTC)
@David notMD: Thank you! I just saw your message, I am going to read it and try to apply your advices as anyway I am done with the "reviewing sources and adding new content" part of my writing process :-) --Signimu (talk) 23:09, 29 July 2018 (UTC)

@Zefr: Thank you for reviewing the changes, but although I agree that rewriting with a more WP:NOTADVICE style would be good, I disagree with this huge deletion that also removed parts that were clearly not "advices" like. I plan on rewriting in a draft and revert your changes with this new rewrite, if you disagree, please describe more your thoughts on the matter so that we can work them out together :-) --Signimu (talk) 19:26, 30 July 2018 (UTC)

Put your draft on the talk page first for review and discussion by editors before adding any changes to the article. Thanks. --Zefr (talk) 19:36, 30 July 2018 (UTC)
@Zefr: What about WP:BOLD? Also you do not explain your deletion of parts that were clearly pertinent on the research and correctly referenced with qualitative material... I am all for collaborative editing but not for being tutored. Please try to be a bit more cooperative, by explaining what you are expecting instead of having me guessing... This would save time for everyone. --Signimu (talk)
@Zefr: As I understand it, you seem to be very wary of stylistic issues, since most of your reverts were for this reason. I get it, and if you do not want to spend time correcting my contributions, you can just tell me to fix these issues, and I will try my best to improve the article. I think this would be a better way to cooperate and enhance the quality of the article. --Signimu (talk) 20:19, 30 July 2018 (UTC)
@Zefr: I finished my rewrite, please review it if you have some time :-) And thank you for your feedback, I think the article is better now, I hope the new version will please you and everyone! I tried to be as concise but as accurate as possible. If you would like to remove some references, please first make sure that the info is in at least one of the remaining refs, as practically all sentences are highly condensed summaries of multiple sources! --Signimu (talk) 23:57, 30 July 2018 (UTC)

Biomarkers, weight loss and health

@Zefr: Thank you very much for your copy-edition :-) @Zefr, David notMD, and Ozzie10aaaa: I would like to discuss about the sentence "Improvements in several [...] biomarkers [...] were recorded, proportionally to the amount of weight loss." that was edited into "Preliminary evidence indicates that improvements in [...] biomarkers [...] occurred.": the biomarkers improvement appears to be well documented, all the reviews concur on this point given the amount of evidence, including on reasonably large cohorts. However, the change recorded was often correlated with weight loss, so some reviews argued that this improvement might be due to weight loss, not fasting directly (but yes this is a debatable argument, not an evidence). Also the improvement in biomarkers does not necessarily lead to better health or resolving pathologies such as obesity or diabetes, the reviews are also clear on that point. What do you guys think about it? Should these points be clarified in the paragraph? Thank you very much in advance for your thoughts :-) --Signimu (talk) 01:32, 1 August 2018 (UTC)

I feel it's important not to make too much of these sources. Feeding and fasting clinical studies are fraught with subject compliance and other experimental design problems, and are unlikely to yield consistent biomarker evidence when future larger studies are published. We should favor the Research section being understated rather than leading users to believe these fasting methods have wider effects than just weight loss. --Zefr (talk) 02:12, 1 August 2018 (UTC)
@Zefr: Thank you for your fast reply! :-) The biomarkers changes are well documented according to most reviews even in cohorts (using correlation so it's not necessarily causation), but yes it might be due solely to weight loss although this argument is only a hypothesis. I would prefer being explicit than implicit but the current state is OK for me :-) --Signimu (talk) 14:33, 2 August 2018 (UTC)

Future research

Future scientific works on the conversion between white adipocyte tissue to brown adipocyte tissue might be worth monitoring as a possible mechanism underlying the effects of intermittent fasting:

Also a study on a big cohort (2500+) women correlating the duration of night fasting and breast cancer recurrence [11]. --Signimu (talk) 14:34, 4 August 2018 (UTC)
And a book specifically on "optimizing" intermittent fasting and physical performance, might find additional interesting information pertaining to the athletic use of fasting: Bouhlel, E., & Shephard, R. J. (2015). Optimizing physical performance during fasting and dietary restriction: implications for athletes and sports medicine. CRC Press. --Signimu (talk) 15:11, 4 August 2018 (UTC)

Preliminary research?

Hello @Zefr:, the last change[12] modified a lot the content of the article in the Research section, being retitled "Preliminary reseach" and with a content that goes into this vision. Could you precise what is your definition of preliminary research? I do not research in the domain, but it looks to me that when there are multiple systematic reviews in high-profile scientific journals published over a decade, it doesn't look like preliminary anymore... Thank you for your clarification. --Signimu (talk) 14:30, 28 October 2018 (UTC)

All the studies to date are preliminary, as they involve small numbers of subjects (hundreds or less) and short durations of study (weeks), leaving conclusions uncertain and "preliminary". By comparison, clinical studies of new drugs require tens of thousands of subjects and years of study to prove efficacy and safety, following which systematic reviews or meta-analyses on completed trials are conducted. That is the standard upon which WP:MEDASSESS is based. --Zefr (talk) 14:45, 28 October 2018 (UTC)
@Zefr: As much as I agree that more subjects the better, and that bigger cohorts would be beneficial for this field of study, WP:MEDASSESS makes no recommendation on the number of subjects in the quality assessment of a source, and furthermore clearly defines that cohort studies are to be considered of less quality than systematic reviews, which this article is full of. There are for example 2 from Nature sub-journals alone. So I think that qualifying these sources as "preliminary research" is unwarranted. I understand what you mean as I said in the beginning, but we need to account for the field of study: we can't expect the same number of participants in any field, because it depends on the resources. To take your example, drugs trials are funded by pharmaceutical companies, whereas no private company is likely to fund a trial on intermittent fasting since there is no product to sell (the purpose being to eat less!). So I agree that more subjects would be better, but hundreds of subjects in different trials with reproduced effects and reported in systematic reviews in notable journals such as Nature is I think sufficient to not qualify this research as "preliminary" anymore. So if this is your only argument for "preliminary research", I'd suggest we rollback to the previous version, as I think this is prejudiciable as the definition you use is quite different from what Wikipedia:Identifying_reliable_sources_(medicine)#Other_sources suggest as preliminary works. Thank you for reading. --Signimu (talk) 19:14, 1 November 2018 (UTC)
WP:MEDASSESS emphasizes in the left pyramid (top) that secondary reviews are preferred for the encyclopedia. Described in WP:MEDDEF, "Wikipedia articles should be based on reliable, independent, published secondary or tertiary sources. For biomedical content, primary sources should generally not be used." This edit and the current version relied on general conclusions from reviews, not the more specific, preliminary (primary), potentially misleading findings which have yet to be replicated by larger studies and reviews. As there have been no disputes raised by other editors since October 8, the current version seems accepted. Following WP:CON, other editors would need to endorse the changes you wish. --Zefr (talk) 22:45, 1 November 2018 (UTC)
@Zefr: Please ping me when you reply, so I can get a notification There is currently no consensus on your change, since I stated that I disagreed with it. There is no timelimit for consensus as far as I know. So this statement is at best fallacious. However, I understand that the current situation does not suit me nor the previous state did suit you, so I propose we try to advance forward. I guessed that the issue was that some of the material is indeed preliminary, I won't argue with that, but I think that putting everything under the "preliminary" umbrella is quite an amalgame. What I propose is that we rewrite the article, because anyway it's not very encyclopedic to have a "Research" section: I think there is enough material now to make several sections like "Influence on body composition", "Therapeutic use", etc. Short sections, but better than having scientifically grounded information segregated in a section... What do you think? I give it a try and you check it out? --Signimu (talk) 21:35, 2 November 2018 (UTC)
And to clarify how this would resolve the issue: then anything that is preliminary should be in a "Preliminary research" section or stated explicitly as primary (if there are still some left). --Signimu (talk) 21:37, 2 November 2018 (UTC)
I am now trying to review again all the references, and honestly I don't remember why I used most of them XD I think I'll now add a hidden XML parameter "insight=something" where I will describe the main insight I gathered and why I use it, this will ease collaboration I hope, so that it will be easier to evaluate the reliability of a source for a claim! --Signimu (talk) 00:07, 3 November 2018 (UTC)
Signimu: For the Wikiproject Medicine category, the article is rated "start-class" for good reason: the quality of reviews on clinical studies is too low to justify any suggestion of "therapeutic use", and there is little basis to think this will change in the near future. Also, discussion of "influence on body composition" will be confounded by the different study designs of duration, calorie restriction, physical activity, individual differences in food choice, methods of analysis, etc. – examples that help explain why this research topic is difficult, if not impossible under usual research conditions, to control study variables. I don't see a solution at this early stage of research to justify much change to the article, due mainly to the near-impossibility to rigorously design and control variables in clinical studies. --Zefr (talk) 15:54, 3 November 2018 (UTC)
@Zefr: Thank you for your reply. The WP:MED rating was done in 2008[13], much has changed since then, although I don't think it justifies a change of rating yet. The "influence on body composition" was an example, and I think that it was clearly shown that intermittent fasting (or at least alternate-day modified fasting) does not impact lean body mass. But that was just an example, I will take my time to review the references (I spent too much time on NAFLD!), and I will see if I can offer something pertinent. The idea is just to avoid the pitfalls of a "Research" section as WP:MOS describes[14]. --Signimu (talk) 17:10, 7 November 2018 (UTC)

Substantial Edits

Hello, I plan on reworking much of article. I do not plan on taking away the current content, as it looks good, but I will add sections about the effects/uses of IF in medicine. I also plan to make the popular culture section more robust. I believe a concerns section is also needed in order to achieve a balanced article. --Kseses14 (talk) 02:58, 8 November 2018 (UTC)

Many of the sources you brought were not OK. Please review the notes on your talk page, and the student training for editing about health. Jytdog (talk) 04:49, 8 November 2018 (UTC)
Okay, thank you for your help. Kseses14 (talk) 15:36, 8 November 2018 (UTC)
Thank you both very much, you did what I was thinking to do but didn't by lack of time (and you did much better! Did not know about industry trying to cash in on this, need to be even more careful now ). --Signimu (talk) 13:08, 11 November 2018 (UTC)

Question about edits

@Jytdog: Hello, for the article about Intermittent Fatsting, I noticed that you removed the section that I added about evolutionary significance for the reason of "horrible sourcing." The Wikipedia guidelines about topics in health and medicine stipulate that journal review articles are the only acceptable sources for information directly related to the effect of the article's topic on humans, but this section was about the evolutionary reasoning behind intermittent fasting. Additionally, the TEDx talk was by Mark Mattson, one of the leading IF researchers whose papers I referenced heavily in my edits. Would you mind explaining to me the issue with this sourcing and the section in general. I understand that a TEDx talk is not the most reputable source, especially for medical purposes. If I were to find sourcing in review articles to back up this section on evolutionary significance (which do exist, I have checked), would the section itself be appropriate for the article? Kseses14 (talk) 16:28, 15 November 2018 (UTC)

Thanks for your note. You are talking about this section. Dealing with people's speculating about evolutionary roots of X (whatever it may be) is difficult. This is all speculation and not something that can actually be proven. One of the problems with the content is that you presented it as fact eg. In order to find food efficiently, people needed their brains to be performing at a high level when they had not been able to eat for periods of time.. This is not a fact but rather Mattson's notion (and please remember that all that evolutionary processes do, is allow individuals with an advantage to survive to out-propagate the others - advantage is always relative. If periods of starvation drove evolutionary changes in people (and it is an "if") it could be that people who had poor ability to store energy became weaker and people who could store it some did better - there is no need for a) the advantage to be about the brain per se nor b) for the brain to work better than normal-- it could just work less badly while others' brains worked worse. Lots of "evolutionary reasoning" - especially when described in popular media, goes off the rails this way into woo. Applying evolutionary processes to social groups is also tricky - at what point did humanoids develop societies in which they took care of each other (e.g. share food) thus thwarting some kinds of evolutionary pressure?
So please use reviews (no popular media or TedX), ideally not by Mattson but by someone independent (he seems to be the main propagator - the question you should ask is how his views are received in the field -- or perhaps better, what are the views in the field on this issue?), please summarize them carefully using subjunctive voice ("might have", and the like). The WEIGHT was about right in the section above, please keep it about that length. OK?Jytdog (talk) 17:02, 15 November 2018 (UTC)

Intermittent fasting is an eating PROTOCOL not a diet

The term diet defines the kind of foods a person usually eats, so a diet may recommend eating more proteins instead of carbs - intermittent fasting is an eating schedule that regulates food intake timing and in no way comprises recommendations on what kinds of food one should eat so the term protocol is more appropriate. They are completely different things so stop calling I.F. a diet!

Ok with the reasoning but I would prefer if the term was sourced, I remember seeing it being qualified as diet by some journal papers but I agree this is not the most precise (but better to reference, we are not here to requalify terms!). --Signimu (talk) 19:14, 21 February 2019 (UTC)

"Protocol" is odd. I've change to the non-jargon "diet plans", as used by here. Alexbrn (talk) 08:53, 22 February 2019 (UTC)

Fad diet

In recent years, intermittent fasting has been embraced by food faddists. I added a source which describes it as a fad diet, this might be controversial but I believe the source is reliable and needed [15]. The ketogenic and intermittent fasting thing has been highjacked by quacks. We may need to add a section on intermittent fasting and quackery. For background information on fasting and quackery, check the bottom section on the fasting article. Psychologist Guy (talk) 17:08, 2 June 2019 (UTC)

Not sure if more light should be given in this article to the faddists and quacks about using fasting for quick weight loss, and the section on Fasting trends addresses it adequately. The Kamath essay is short and unreferenced, so a more complete source from a peer-reviewed journal seems sufficient, such as PMID 25540982 (current ref #3). --Zefr (talk) 18:41, 2 June 2019 (UTC)
If you search long enough, you can find sources from reputable publications that can prove anything you could possibly want - for instance, here's a link from a practicing MD and Master of Public Health from Harvard, stating that Intermittent Fasting does have benefits and is not just, as you call it, a fad. I believe your edit was a little quick on the trigger and likely motivated by a point of view; ultimately, I don't know what your addition to the lead adds to the article as a whole, and I'm also not sure what it's supposed to achieve (from a NPOV), as there is plenty of research referenced and cited in the article itself. I would move to revert, though I'd like to hear your rationale first. --ThePaSch (talk) 17:31, 12 June 2019 (UTC)
Experimental designs, control of subjects, and costly financing of complex trials make rigorous diet research next to impossible. When writing for an encyclopedia, we're obligated to adhere to the best sourcing available. MEDRS-quality sources - like a systematic review of completed high-quality clinical trials (see top of left pyramid, WP:MEDASSESS) - are not likely to appear for intermittent fasting. I would not include a Harvard MD's blog as a source meeting the definition of "reputable publication". --Zefr (talk) 20:28, 12 June 2019 (UTC)
Then, consequently, the above source should also not be sufficient to justify modifying the article's lead, seeing as it isn't much more than a blog post from a medical practitioner either. An unregistered IP has removed it currently, and in my opinion, it should stay that way (as per their edit summary).--ThePaSch (talk) 08:26, 13 June 2019 (UTC)
How a diet is categorized is not WP:Biomedical information, so a different (and lower) standard of sourcing applies. In any case there are plenty of sources for what would seem to be an obvious fact; I've added one such. Alexbrn (talk) 08:37, 13 June 2019 (UTC)
Which circles around to the fact that such sources can be found for either viewpoint. It certainly seems to be a contentious issue, with credentialed individuals making claims either way; which is why I don't believe Wikipedia should make a commitment into either direction here. There is at least one relatively recent study that links Intermittent Fasting to improved levels of LDL, HDL and triglycerides. --ThePaSch (talk) 08:56, 13 June 2019 (UTC)
So far as I can see that source does not discuss faddishness at all. Alexbrn (talk) 09:03, 13 June 2019 (UTC)
It's certainly evidence to support its effectiveness in certain use cases, though, which would be a point against the initial clause of the added lead. I'm also, quite honestly, not fond of the expression "it has been described as" in general; as I've previously said, if you look long and hard enough, you can find anyone describe anything in any way. Given two hours, I'm confident I could find, say, ten sources that call it super effective and the best thing since sliced bread, and from otherwise reputable sources, too (as per the previously mentioned lower standard), and ten other sources that call it a fad and/or placebo at best - does that mean we should adjust the lead to "It's been called a fad, but it's also been called effective"? What bearing does it have on the informational content of any given article what someone from some place called that particular thing once? In my view, it's a classic view-peddling sentence; one that certainly sounds neutral at first glance, but actually conveys an inherent, pre-conceived notion. It's the lead paragraph of the article we're talking about, not the Reception-section in an entertainment article.--ThePaSch (talk) 10:30, 13 June 2019 (UTC)
We treat topics like serious sources do. They categorize it is a fad diet, so we follow. NPOV and all that. It's your novel view that effectiveness somehow bears on the question of its faddishness. These aspects are orthogonal in RS. Alexbrn (talk) 10:53, 13 June 2019 (UTC)
If retaining the information that this has been called a fad diet is so important to the integrity of the article, I still retain my opinion that the initial clause of the added lead should be removed, and the new sentence should just read "it has been described as a fad diet", since evidence regarding its effectiveness does seem to exist - and if we're allowing one doctor's blog post to constitute authoritative sourcing to that matter, then another doctor's blog post that claims the opposite should surely stand as well. --ThePaSch (talk) 12:10, 13 June 2019 (UTC)
You should note the supporting sources are not "blog posts" - one is a journal article. There has been no RS produced claiming "the opposite", blog post or otherwise. Alexbrn (talk) 12:13, 13 June 2019 (UTC)
I produced a source linking Intermittent Fasting to improved levels of LDL, HDL and triglycerides above. Here's a systematic review of studies that comes to the conclusion that it is effective in reducing weight, and confirms the aforementioned source in its effectiveness in aiding a dieter's lipid profile. --ThePaSch (talk) 12:40, 13 June 2019 (UTC)
Whether there is some way in which IF is "effective" has nothing to do with the question of whether it's faddish (as I already wrote). Besides, sources in iffy journals like Cureus are not reliable for anything. On the question of whether IF is faddish, we simply follow RS as we should. Trying to invoke sources which do not directly address that aspect is not on. Alexbrn (talk) 13:32, 13 June 2019 (UTC)
Again, as I already wrote, if you think the mention of its faddishness should be left in, I concur; what I'm now talking about is the part of the lead where "there is little evidence to support intermittent fasting", which is disputed by the sources I produced. If you don't think Cureus is a reliable source, here's another one, here's another one, and, in fact, a follow-up to the source you posted, which also states that there "is indeed a large body of research to support the health benefits of fasting, though most of it has been conducted on animals, not humans". "Still," it claims, "the results have been promising," because "fasting has been shown to improve biomarkers of disease, reduce oxidative stress and preserve learning and memory functioning". It also warns that "many doctors and nutrition experts are prone to dismissing fads out of hand," which could lead to a situation where "their patients and clients, while shielded from the ridiculous claims of overzealous dieting evangelists, may also lose out on the legitimate benefits of fasting done right". To reiterate: I am not contesting classifying this as a fad. My main issue was doing it in the lead paragraph of the article, though if you think it's so important to the article, I will gladly concur - my issue is the fact that a blanket statement was introduced where it is suggested that there "is little evidence to support intermittent fasting", which is demonstrably false, and not even backed by the source you brought up - in fact, that very source also claims that "intermittent fasting can also produce similar effects as intensive exercise," such as "increasing heart rate variability while reducing resting heart rate and blood pressure". The fact that there are risk factors involved for certain populations or that it may be difficult to get into has nothing to do with effectivity and is already mentioned in the article. --ThePaSch (talk) 14:34, 13 June 2019 (UTC)

Animal studies and "promising" assessments pretty much adds up to "little evidence", which seems like a reasonable overall summary to me. It would be good to have an overview source. We shouldn't be using non-WP:MEDRS sources like PMID 23529969 for biomedical content (though it's useful for the "fad" question). Alexbrn (talk) 14:43, 13 June 2019 (UTC)

This addresses a very small part of the sources I cited. I remain of the opinion that the sentence, as it stands in the lead right now, is implying the process to be quackery; as was presumably very much intended by the author of the sentence, who described it as such on this very talk page. One could rewrite the sentence to say "There is evidence", and it wouldn't be any less true, yet its connotation would vastly change to the average reader. But ultimately, this is not my hill to die on - I've done my fair share of producing sources and formulating opinions, and if you consider all of them to be unreliable, unfitting and/or inapplicable, then so be it; I'm merely trying to establish a more neutral tone here. --ThePaSch (talk) 15:17, 13 June 2019 (UTC)
Looking at sources, PMID 28715993 offers a reasonable overview. We already cite it. From its conclusions it seems our article is well aligned with the science. There is obviously a lot of crap out there about IF, so it's good that Wikipedia is staying central & solid on this topic. Is IF considered "quackery"? Any sources on that? Alexbrn (talk) 15:34, 13 June 2019 (UTC)
My problem is that none of the article mentions any of the potential benefits - such as increased heart-rate variability, lowered blood pressure, improved lipid profile, and increased cardiovascular health. If we mention that heart damage has been observed in animal trials as a potential adverse effect, then why is there not a single word based on all the affirmative effects seen in similar trials? What point is there in including a sentence like "Long-term, periodic fasting may cause eating disorders or malnutrition, with increased susceptibility to infectious diseases, though there are no actual clinical trials demonstrating an association of intermittent fasting with these illnesses"? Mention something, then clarify that there's no clinical evidence - isn't this basically just hypothesis? Why is it in the article? To me, this article, as a whole, reads like it was written with an immense pre-conceived POV. Yes, there is a lot of crap about IF out there, but as I've stated earlier in this comment chain, it is always possible to pick and choose one's references - and, more granularly, what you ultimately actually cite from those references - to present something in as negative a light as one could possibly muster while still having everything in the article technically backed by the produced research. Many cited sources state beneficial effects, of which there is nothing to be seen in the article; indeed, the potential positives are merely stated to be "under preliminary research" despite there having been preliminary results as well, with nary a mention of them, but equally theoretical and insufficiently investigated indications of potential harm are immediately actually stated as a potential harm instead of relativized. To me, this article reads like was written by someone who has a bone to pick with the idea of Intermittent Fasting as a dietary device; and proceeded to not pick just a bone, but also many a cherry from the cited sources in this article. --ThePaSch (talk) 21:43, 13 June 2019 (UTC)
So far as I can see we are aligned with strong WP:MEDRS (e.g. the NHS) who emphasize caution. It is well-established what a healthy diet is, so it is not surprising that there is zero strong MEDRS recommending a fad diet like IF. If this changes - and that would represent a fundamental shift in thinking about human diet - then Wikipedia will follow. (Add: I have cut the rat stuff as undue.) Alexbrn (talk) 05:13, 14 June 2019 (UTC)

Adverse effects, inaccurate presentation of citation

This section of the article seems to misrepresent WP:NPOV the only research that it cites. The only reference is to a study that concludes:

"Clinical research studies of fasting with robust designs and high levels of clinical evidence are sparse in the literature. Whereas the few randomized controlled trials and observational clinical outcomes studies support the existence of a health benefit from fasting, substantial further research in humans is needed before the use of fasting as a health intervention can be recommended."

What the article selectively asserts from this study is:

"One 2015 review of preliminary clinical studies found that short-term intermittent fasting may produce minor adverse effects, such as continuous feelings of weakness and hunger, headaches, fainting, or dehydration.[33] Long-term, periodic fasting may cause eating disorders or malnutrition, with increased susceptibility to infectious diseases."

However this study did not find any of this either minor adverse effects or long-term more serious effects it simply noted the possibility in two sentences supported by no reference to other studies or data. It notes a single rat study that it states could but isn't known to indicate anything about human impact as the support for this. It appropriately doesn't draw a conclusion just raises the possibility. Citing this as the review study finding adverse effect when dicussing human impact is WP:UNDUE WP:CHERRYPICKING as would be citing any similarly weakly supported evidence of beneficial effects which it concludes there is definitely some of, although insufficient to rely on. There simply isn't enough evidence of either, at least from this source.

This section should be removed unless it can be rewritten sourced to actual findings rather than only speculation. Phil (talk) 01:32, 4 July 2019 (UTC)

Our article seems to represent the source accurately, and contrary to what you write we only say IF "may produce minor adverse effects ..." - a mild claim which appears to satisfy WP:V, and is on-point for an "Adverse effects" section. Are there better sources on this? Alexbrn (talk) 03:54, 4 July 2019 (UTC)

unable to improve article.

I made a few edits and they were just all reverted. Is there some reason this article can't be improved? What is with the Popular Culture section, that doesn't make sense. I'll at least try to fix that again. Volunteer1234 (talk) 01:13, 22 September 2019 (UTC)

There seems to be an anti-fasting editor out there. Some sentences do not reflect at all what the linked sources say (such as the limited efficacy for obese people, what the source says is that it has similar efficiency to calorie restriction, which is what was written before in this WP entry, nothing new). --Signimu (talk) 15:02, 29 September 2019 (UTC)

Sources checking

Hello everyone, I have checked the impact factor/SJR of all the recently added sources, and I found that the one using "Eastern Mediterranean health journal" has a very low impact factor (0.663 in 2016). Should we keep or remove it? Thank you for your feedback. --Signimu (talk) 01:35, 30 September 2019 (UTC)

Planned changes

Here are the sources of the changes I plan to add later:

  • AHA 2017 scientific statement [16]
  • Fad diet stronger source (fasting might be the oldest fad): Advanced Nutrition and Dietetics in Obesity (Wiley, 2018) p. 180, Hart, K. (2018). Fad diets and fasting for weight loss in obesity. Advanced Nutrition and Dietetics in Obesity, 177.
  • (Dropped, unreliable) Fad v2: some quantitative measures on Google Trends: [17]
  • Lean body mass might be reduced (so we have both systematic reviews that do not find any effect and one that does find, how to write that?) [18]
  • IF vs CER direct comparison: systematic review[19], simple review[20]
  • Confirmation for mechanism interpretation: (simple study, will only be used for talk)[21]

--Signimu (talk) 19:04, 1 October 2019 (UTC)

Addendum: IF vs CER another direct comparison (was added in the past, not sure why it was removed[22]?): systematic review[23] --Signimu (talk) 08:53, 2 October 2019 (UTC)

Medium.com is not a usable source. Alexbrn (talk) 19:12, 1 October 2019 (UTC)
@Alexbrn: Errr why is that so? Is there a specific WP rule regarding Medium? --Signimu (talk) 19:23, 1 October 2019 (UTC)
WP:SPS's are generally questionable. What is effectively a blog post by an advertising executive is unlikely to be considered a worthwhile source here, especially when there are plenty of better sources to hand. Alexbrn (talk) 19:33, 1 October 2019 (UTC)
@Alexbrn: Ok for the self-publishing part, that makes sense. However I did not find other sources giving quantitative estimates of the trend (although I did not really look for that kind of info, I'm more interested in the science than the cultural aspects of diets). Dropping the source, thanks for your feedback (and copyvio fix). (Please can you ping me so I get a notification of your replies?). --Signimu (talk) 19:45, 1 October 2019 (UTC)
@Zefr: Could you please check[24] (if you don't have access I can send you the doc) about the interpretation of the "Mechanism" section and tell me what you think about it? --Signimu (talk) 19:45, 1 October 2019 (UTC)
It's a loosely-designed (interviews, unreliable), preliminary research study (n=47) far from defining a 'mechanism', and is unusable as medical content for an encyclopedia. See MEDMOS, writing for the wrong audience. --Zefr (talk) 20:10, 1 October 2019 (UTC)
@Zefr: You are correct, but as I said it was not meant to add in the article. Notice it cites ref 35 that is currently in the entry[25], with this description: «All of these strategies [reduced portion sizes, others omitted desserts or snacks, and others increased exercise] are effective because humans do not completely compensate for the lost energy. After any of these changes, they will finish the day with a negative energy balance and will lose tissue.» --> Do you agree with this depiction of [26]? --Signimu (talk) 20:29, 1 October 2019 (UTC)
@Zefr: To clarify context: we have a disagreement of my addition[27]. Two reasons you gave: 1. WP:OR, which it is not, all infos written (including about Set Point Theory, its date, its widespread acceptance) are in the source, I thought it gave a meaningful context (biggest theory of body weight homeostasis), but if you find it too verbose it's certainly shortenable, 2. the interpretation of the results, this being your version[28][29]. To solve the latter, I tried to find a third-party view depicting the source, and the study above is what I found. Could we agree on using this 3rd-party as an indication on how to write the results? If not, could you please explain your rationale? Thank you. --Signimu (talk) 08:42, 2 October 2019 (UTC)

The set point theory is impossible to analyze experimentally even in a rigorous clinical setting, which your source did not establish. Speculating in this section about a psychophysiological mechanism for why weight loss is not sustainable after long-term fasting would be original research, and is unencyclopedic. The section content as stated is concise, accurate, and sufficient with the source used. --Zefr (talk) 14:27, 3 October 2019 (UTC)

@Zefr: Please, stop with the weaseling... Your version states that "ADF cannot work because of energy errors", whereas the source says "ADF (and overnutrition and exercise etc) work because the body cannot compensate for energy errors" (I paraphrase, not citing here). You simply can't say that your version is reflecting the source... About your opinion on set point theory, that may very well be perfectly valid, but isn't that WP:OR? Or can you provide a secondary source that describe what you say? --Signimu (talk) 17:48, 3 October 2019 (UTC)
No, WP:BURDEN on you - you have to show the source proving SPT is a thing, which science says it isn't. --Zefr (talk) 22:52, 3 October 2019 (UTC)
@Zefr: I'm not sure of your argument here? The systematic review does exactly that: it reminds that SPT was only just a theory, with some evidence (potentially due to simple measurement errors), and it tests a hypothesis that if true would not fit with SPT theory: if energetic errors (a quantification of body weight loss/gain) are not autocorrected, then this is an argument against SPT. Anyway, SPT is a theoretical framework for introducing the review, but the review itself does not rely on SPT for its analysis nor conclusion. So if anything, what you say here is totally in line with the conclusions of the review, and in contradiction to what is currently written (that ADF does not work because SPT does in fact exist). --Signimu (talk) 23:31, 3 October 2019 (UTC)
@Zefr: PS: about the IGF ref, you're right, it should be separated as it does not mention insulin concentration, I probably decided to mix both to save space but that's an amalgam. Anyway I'll do that when rewriting the article with the stronger refs above because they also talk about it, finishing Ghrelin now. --Signimu (talk) 23:36, 3 October 2019 (UTC)
Update done. Cleared IGF issue among other things I hope :-) --Signimu (talk) 03:01, 4 October 2019 (UTC)
@Alexbrn and Zefr: I just discovered the issue on faddism was already raised just a few months agoTalk:Intermittent_fasting/Archive_1#Fad_diet, with similar arguments. Why none of you did notify me of that? First, this shows that it has been a point of contention with no clear consensus and it would have saved a lot of time from arguing the same thing over again, but also Alexbrn you hid the fact that one of the two sources, the Collier paper, had an update! The older ref should have been replaced. Anyway, I've found a better academic source that takes a much less sensationalist stance, but seriously that's not cool. I honestly do want to work constructively with you, I expect the same honesty in return. I hope we can move forward towards making a better article together. --Signimu (talk) 05:14, 4 October 2019 (UTC)
Better watch out with the accusations. It's not my job to direct other editors to previous discussions (which I had forgotten anyway - with 568 articles on my watch list including many fad diet ones it is not possible to keep all historical discussions in mind). Alexbrn (talk) 05:32, 4 October 2019 (UTC)
@Alexbrn: Ok, agreed, but still you could have updated the Collier ref, but please accept my sincere apologies for asking you to remind of this past discussion, I agree you're not a robot, I was simply frustrated that we endured such a bad discussion that was just redundant. Thank you for your edits. About [30], there is literally a ref titled "Intermittent Fasting is Not A Fad". So maybe "sometimes" is not the best formulation, but "is" lacks nuance. I would propose "IF is also a fad diet" (and remove "popular" since it's redundant with the definition of fad diet). Thank you, I'll leave you free room for editing now. --Signimu (talk) 05:45, 4 October 2019 (UTC)
Since we now have the excellent source you found (the Wiley textbook) which flat out puts these IF diets in a table of fad diets, I don't think there's any doubt. We could trim away some of the other sources on this as redundant (the one mentioning celebrity endorsement adds something extra). Alexbrn (talk) 05:48, 4 October 2019 (UTC)
@Alexbrn: Agreed, thank you for your edits and your patience I did not know it was a "gold standard", I thought it was a simple academic monograph, why is it so good? Is it because it's part of the BDA series? --Signimu (talk) 13:30, 4 October 2019 (UTC)
@Zefr: My last proposition for the "mechanism" issue: [31]. --Signimu (talk) 16:57, 4 October 2019 (UTC)

Long-term effect of intermittent fasting

A slew of recent randomized controlled trials were very recently conducted on both obese and non-obese volunteers, for duration between 6 months to 1 year: [32][33][34][35][36][37][38] (see in particular the CALERIE study on 2 years), and particularly new developments for metabolic syndrome diseases that are known to be associated with insulin resistance: [39][40][41][42][43][44] (and a plan for a clinical trial by NIA[45])[46]. Also, see in particular the HELENA trial, which investigated the 5:2 scheme for in a real-life scenario for 150 overweight or obese individuals with cardiovascular risk and measuring the adipose tissue transcription over 1 year[47]. It will be interesting to monitor them, as I am confident a meta-analysis will probably pick up on these new developments in the field in the upcoming year, given the high coverage some of them had: [48][49][50][51][52][53]. This will allow us to develop the sections about long-term effects (be it positive or adverse) of intermittent fasting (and hopefully shed some additional light in the conditions for these effects). Likewise, the mechanisms behind intermittent fasting's effects on animal models are seeing interesting developments: [54][55][56][57][58][59], with preliminary evidence from non-controlled clinical trials on humans (increase in ketone body production)[60]. An excellent mini-review in a proceedings highlight the currently known differences between the variants of intermittent fasting, and suggest that there should be investigations into the possible "regularly protracted post-absorptive periods", in other words any specific health effects appearing after sustained periods of complete fasting (16 hours reported in current trials)[61]. Furthermore, intermittent fasting (and other approaches) might be effective for cancer patients doing immunotherapy by targeting glucose metabolism, but more research is needed[62]. Neuroplasticity promotion (including for traumatic brain injury protection) and pain relief is also investigated[63][64]. Interventions in obese adolescents is investigated[65]. A non-randomized study suggest that alternate day supplementation of iron in anemic women might be more efficient than continuous administration[66]. --Signimu (talk) 22:11, 29 September 2019 (UTC)

There are some systematic reviews I did not include in the entry: [67]. --Signimu (talk) 22:26, 29 September 2019 (UTC)

Addendum: a great study on adverse effects of therapeutic fasting (including periodic fasting): [68] and a study on "who is fasting?" in Germany, finding that its practice is more correlated with other factors such as higher education than the real benefits: [69]. --Signimu (talk) 02:04, 6 October 2019 (UTC)

Above you wrote "I propose to **strictly** adhere to WP:MEDRS". This does not appear to be the case sadly because on MEDRS, it says "Primary sources should generally not be used for medical content". Practically everything you link to is a primary source or taken from dubious open access journals. You did not link to any reliable systematic reviews. This which you link to [70] is hardly reliable. Cureus is an open access journal and its founder created the journal because he was "dissatisfied with the existing world of medical journals, which have become increasingly preoccupied with tenure and prestige" Psychologist Guy (talk) 23:14, 29 September 2019 (UTC)
@Psychologist Guy: Thank you for your feedback. Please do not misunderstand what I am writing in this section: the references here are solely as a future reminder, they do not appear anywhere on the main entry (only reviews, and foremost systematic reviews on RCTs, were used). I hope this clarifies the misunderstanding, if there is any other issue, please let me know. --Signimu (talk) 23:34, 29 September 2019 (UTC)
Ok my misunderstanding you are just collecting material here for future reference. On the article itself you have done some good edits with reliable sources but also some not so good edits, I am very tired to point out what is good and what is bad. I will leave that to another experienced editor :) This involves going through each of the sources you added. A few of them looked good but there are critics of intermittent fasting that characterise it as a fad diet, I don't think those criticisms should be removed entirely, it can't be denied that the link is there. I have studied the history of fasting and it is associated with quackery. A lot of these fad diets like low-carb or paleolithic diet are now promoting intermittent fasting programmes. Psychologist Guy (talk) 23:43, 29 September 2019 (UTC)
@Psychologist Guy: Thank you for pointing that out. As I wrote above, I am in favor of adding critics. And I think we should differenciate therapeutic intermittent fasting (as is done explicitly by some sources but only implicitly by most) from commercial/fad intermittent fasting, these are two very different things, and the edits I've done are mostly pertaining to the first (as I have no intellectual interest in the latter ). So I would like to do so but I fear that writing everywhere "therapeutic intermittent fasting" might be too verbose and be reverted. Do you have any suggestion? About adding critical sources about the adverse effects of intermittent fasting, please free to do so, but note that so far (and I am searching ANY review on therapeutic intermittent fasting), I have found no scientific evidence of adverse effects apart from the ones already written in the article (but keep in mind this pertains to scientifically controlled therapeutic fasting, not the fad diet ones -- although the 5:2 seems to be more and more used, and is the one investigated by NIA[71]).
PS: please also note that English is not my primary language so I may well have inelegantly written some parts (but the sense should always be correct), so I am honestly sorry about the time it may take to other editors and I am actively and continuously working on it (wink to Zefr ). --Signimu (talk) 23:57, 29 September 2019 (UTC)
I have restored the faddism content, which was completely removed! Also, this article is not about religious fasting, so I have removed content about that as off-topic. Alexbrn (talk) 03:38, 30 September 2019 (UTC)
@Alexbrn: Thank you for your edits, please continue the discussion in the previous section, this one was never meant as anything else than a future reminder to ease updates --Signimu (talk) 16:08, 30 September 2019 (UTC)

And now Signimu is trying to remove the fad categorization again, invoking WP:MEDRS.[72] This is exactly the kind of misapplication of MEDRS which had caused community concern.[73] To be clear: whether something is (or is not) a "fad diet" is not WP:Biomedical information and so MEDRS does not apply. Alexbrn (talk) 16:36, 30 September 2019 (UTC)

@Alexbrn: Please use correct indentation/spacing I argue it IS biomedical information, see the previous section (and please continue the discussion there, thank you). --Signimu (talk) 16:42, 30 September 2019 (UTC)
My spacing is fine. What are you on about? If you think diet classification is biomedical (hint: you're wrong), feel free to seek an opinion at WT:MED. Alexbrn (talk) 16:55, 30 September 2019 (UTC)
@Alexbrn: Yes, because I fixed it. Mind you, it's not just a diet, it's also categorized under Medicine. --Signimu (talk) 17:16, 30 September 2019 (UTC)
@Alexbrn: Thank you for the link, please find the question here[74] (and add your point of view if I misrepresented it -- since you did not accept my requests for clarifications above) --Signimu (talk) 17:28, 30 September 2019 (UTC)

Merge 5:2 diet proposal

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

I propose to merge 5:2 diet into Intermittent fasting. The latter has much more information, has a broader context and better coverage overall (cultural, scientific, historic). I already copied the content from 5:2 diet that was missing but pertinent in Intermittent fasting, the rest that is left consists of commercial or duplicated infos. I thus propose to redirect 5:2 diet to Intermittent fasting. Signimu (talk) 16:15, 4 October 2019 (UTC)

 Done This had already been done after strong consensus at https://en.wikipedia.org/w/index.php?title=Talk:Intermittent_fasting&oldid=792692358#Proposed_merge_with_5:2_diet - it was reversed with no discussion. I have reinstated the redirect. Alexbrn (talk) 06:30, 6 October 2019 (UTC)
The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Fasting mimicking diets (FMDs)

I leave that here in case someone else wonders why it's not in the entry, but Fasting Mimicking Diets (FMDs) is only mentioned (as far as I could see) in Longo's works[75], and he is also involved with ProLon, a commercial product, so it looks more like a commercial plug than a scientifically supported diet as of 2019. A Fasting Mimicking Diet is a diet that supposedly can produce the same beneficial health effects as fasting, but without fasting, by doing a combination of calorie restriction and nutrient composition tweaking (eg, low carbohydrate and high fat), hence the "mimicking". Since there is not much scientific works apart from Longo's on this type of diet, this was left out of the entry (and even if there were other works, I'm not sure whether it should be part of intermittent fasting, since it's not really fasting anymore, as there is no notion of meal timing scheduling anymore). --Signimu (talk) 23:52, 14 October 2019 (UTC)

Addendum: a more concise description of the purpose of FMDs can be found in the Economic Times: «It means eating a special, low-calorie but nutrient-rich diet that the body does not recognise as food for five consecutive days.»[76]. Interesting concept, but sounds like a fad/bad diet red flag, and still only one author with conflicts of interests studying it, and no or little human trials yet. --Signimu (talk) 06:59, 16 October 2019 (UTC)

Disagreement

@Alexbrn: Hello Alex, sorry I saw your revert while I was finishing up a major rewrite, so I committed it nevertheless to keep it in the history, but please feel free to revert it as you primarily intended (edit: reverted it myself until this issue gets resolved by discussion). Now, I would like to discuss your reason for reverting: «unreliable source» for a randomized control study, are you sure you are correct in your endeavor? Could you please clarify what would be a reliable source then, since your definition seems to be outside the boundaries of what is defined in WP:MEDRS? Thank you in advance for discussing this matter. --Signimu (talk) 15:52, 29 September 2019 (UTC)

@Alexbrn: Also please note that half of my changes were about reflecting what the sources, already in the WP entry[77], says, which is in contradiction to what is written in the entry. Could you please clarify why you would like to maintain a bogus description of the sources? --Signimu (talk) 15:54, 29 September 2019 (UTC)
This is an early-stage research project (30 subjects, 6 months), far from a WP:MEDASSESS "filtered" review. It is unusable as an encyclopedic source. --Zefr (talk) 16:07, 29 September 2019 (UTC)
Quite. And I'm not sure why we're citing the "Harvard health Letter" either. Alexbrn (talk) 16:20, 29 September 2019 (UTC)
I think it's fair to say this topic is more in the lay public eye than it is a focus of well-designed clinical research. I added the Harvard source as a trusted lay source, which was secondary and balanced based on interviews with Harvard faculty members. Not committed that it stays. --Zefr (talk) 16:32, 29 September 2019 (UTC)
I think it's okay so long as it's not used for any novel biomedical claims. Alexbrn (talk) 16:35, 29 September 2019 (UTC)
Hello @Zefr: and @Alexbrn:, thank you for your replies. I have to disagree:
1. yes, the sample size is small, but with now several randomized controlled studies with similar sample sizes all converging to similar findings and conclusions, it's safe to say the scientific evidence is currently in favor of a beneficial effect (here are the additional references I planned to add, I'm still reviewing them: [78][79][80][81][82][83][84][85][86][87] -- not to mention the older references I already added). I am not asking for you to review them -- I'll do it -- but please give me some time to develop. I will start with a meta-analysis if that is more comfortable to you guys.
2. Although I agree that "small" sample size should be accounted for, I can't find where in WP:MEDRS there is a statement about what threshold should be considered too low to be accepted as a reliable source here. I agree we should use our critical thinking, but when so many controlled studies and meta-analyses are pointing in the same direction, the scientific method suggest that this is the one that is the most plausible. Writing otherwise without at least as much scientific evidence can only seem like a personal commentary.
3. The issue with the Harvard source is not so much the source (we can link to the original paper, but I think also that the Harvard article summarizes nicely and adds additional infos such as limitations and recommendations), but the issue is that it is misused in the entry. For example:
* «As of 2019, there is little high-quality clinical evidence that intermittent fasting provides any benefit for weight loss, and is described as a fad.» --> sources are one opinion paper of 2013 (outdated) and the Harvard article which says otherwise (weight loss is significant and similar to calorie restriction).
* «As of 2019, there is only limited evidence of long-term effectiveness of these fasting methods, preventing conclusions about their relative efficacy for obese people or normal-weight people trying to lose some weight.» --> backed by 2 sources I added that say otherwise + Harvard paper that also says otherwise (for positive effects see the previous point, for negative effects it only says basically that more research is needed and that the drop-out rate for obese individuals is quite high). Plus now there is a whole body of new randomized controlled studies that support the improvement of weight and biomarkers (as previous clinical cases have observed).
So I propose that I review the sources above and start off from at least one meta-analysis, and that the two sentences outlined above are rewritten/moved to adequately reflect what the sources say (as I have done in half of my edits today). Please let me know what you think of this suggestion. --Signimu (talk) 16:52, 29 September 2019 (UTC)
BTW: I can't understand how the 2013 opinion paper [88] could have been accepted as a reliable and quality source, nonetheless in the intro (and solely there BTW), when randomized controlled trials are not? Could you guys explain? Maybe it slipped through? --Signimu (talk) 16:55, 29 September 2019 (UTC)
Your edit looked like really poor POV-pushing to me (e.g. in editorializing to try and downplay the faddish nature of IF). The Harvard Health Letter is not a strong source, so unsuitable for biomedical claims but okay for cultural stuff (like PMC 3652955). Your new source, PMID 31471173, is a weak primary source and so falls afoul of WP:MEDRS. What we have is neutral. Alexbrn (talk) 16:59, 29 September 2019 (UTC)

Signimu: an encyclopedia is not a journal article or textbook where all possible sources might be used to support content, WP:NOTTEXTBOOK, WP:NOTEVERYTHING. That is illustrated by the left pyramid in WP:MEDASSESS where the top kinds of sources are needed (non-existent for this topic). Your sources are primary research and are unencyclopedic. You should pose here on the talk page any potential changes to be reviewed by other editors to reach consensus, WP:CON. --Zefr (talk) 17:04, 29 September 2019 (UTC)

@Zefr: @Alexbrn: 1. neither of you answer why this entry is writing something contradicting the very source it uses (such as the Harvard source -- I remind you that I am not the one adding it) or why a 2013 opinion paper has any validity to be used as a source on WP MED, so please don't accuse others of POV-pushing when you don't even provide a reply and behavior coherent with WP:MEDRS recommendations; 2. as I told you guys, I am in the middle of reviewing the litterature, and it's very exciting :-D Here are some much stronger sources that I plan to use to update this entry: [89][90][91][92] -- bonus, a very interesting commentary on the mechanism, which I think lack from the article, and now that there are some investigations in humans, it would be worth creating a section about it: [93] (this is not the only one I have too :-) ).
So guys, are we going to continue playing cats and mouse or can we agree to further build knowledge by updating this entry? --Signimu (talk) 17:45, 29 September 2019 (UTC)
BTW, the RCT studies I have linked above are indeed not yet included in any meta-review (this is highly likely to change soon given the coverage it had). However, I think it would be interesting to mention 2/3 RCT studies, such as this one and 2 others I have found, that all assess the effects of intermittent fasting in a longer term (6 months to 1 year), which is lacking from currently available meta-reviews. Something like «Long-term effects are currently unknown but a few randomized controlled studies on 6 months to 1 year suggest ADF might have sustained positive effects.», what do you think? --Signimu (talk) 17:49, 29 September 2019 (UTC)

Regarding editing here as a "game of cat and mouse" is not helpful. Adding weak primary sources to the article is not helpful either, and neither are personal attacks. Good edits are always welcome. Alexbrn (talk) 17:55, 29 September 2019 (UTC)

@Alexbrn: May I remind you that you were the one accusing me of POV-pushing (and by the way not assuming good faith as is good usage on WP) when I did nothing of the sort? Your behavior is what I qualified as a "game of cats and mouse", as you clearly did not assume good faith in my contributions. And I am not assuming anything here, you said so yourself above. Also could you please clarify how you can view as "weak primary source" the meta-analyses and systematic reviews, including one solely on randomized clinical trials, that I linked above? Finally, could you please answer why a 2013 opinion paper is in the introduction, and why the Harvard paper has been used as a source for contradictory claims? Thank you. --Signimu (talk) 18:03, 29 September 2019 (UTC)
Please learn to WP:INDENT properly as a courtesy to readers here. Your good faith is not an issue; your POV-pushing is, as is your reference to "an anti-fasting editor out there". The source you actually added to the article, PMID 31471173, is unreliable. WP:MEDRS sources are required for WP:Biomedical information; for lesser matters, such as whether this is faddish or not, lesser sources like opinion pieces are good. Alexbrn (talk) 18:07, 29 September 2019 (UTC)
@Alexbrn: Sorry I did a small mistake with the indent, but the form does not preclude the content. Ok about this source, but I proposed another plan with new references, you do not reply to this proposition (so I assume I just need to be WP:BOLD? But then you might revert again because I did not wait for the end of this discussion, where you avoid answering to concrete propositions?). About your argument that for «"faddish or not", lesser sources like opinion pieces are good»: you are saying that to qualify whether a diet intervention is effective or not, and dangerous or not (these two components being at the core of the definition of fad diet), the source does not need to qualify for WP:MEDRS? Then I wonder why the calorie restriction diet is not a fad diet too, since several such sources claim it does not work! Finally, about my comment of "an anti-fasting editor out there", it was never implicitly nor explicitly targeted at you (I never worked with you yet, I do not know you), but it was quite clear to any reader given the tone the entry turned to have and the mishandling of sources to back up those dubious claims (such as the fad diet). --Signimu (talk) 18:17, 29 September 2019 (UTC)
@Alexbrn: I worked on this entry about a year ago (Zefr knows about it, thank you for your patience ;-) ), it was full of relatively strong sources, all pointing towards quite real beneficial effects, and relatively minor adverse effects except for specific populations that might be at risk. Now, we get a 2013 opinion paper and a Harvard entry that is misused to claim something opposite to what is written in the source. How in the world anybody reading this entry and the sources would not think that the entry is badly reflecting the sources and the current state of knowledge about this diet? --Signimu (talk) 18:20, 29 September 2019 (UTC)
@Alexbrn: About the 2013 opinion paper, this is apparently not the first time you paradoxically advocate strict respect of WP:MEDRS while defending non-scientific sources[94]. Which is BTW against MEDRS since it states that non-scientific sources on medical entries should only be about societal/cultural infos, not about effect or dangerousness (and certainly not in the intro). I propose we stop here this rather sad discussion and let's construct. I propose to **strictly** adhere to WP:MEDRS. This means we will lack cutting edge informations such as long term effects (be it positive or adverse), and opinions such as the 2013 opinion paper, which I nevertheless thought interesting (and in my edit just moved it to a more appropriate place IMO). Following WP:BOLD (and because frankly we are just all losing time here at this point), I will apply right now this new plan and use the references (meta-analyses, not RCT studies) above. I hope this will resolve the issue. --Signimu (talk) 18:39, 29 September 2019 (UTC)

The update is currently done. I expect and am open to some constructive criticism of course . Thank you to everyone who participated in the discussion so far. --Signimu (talk) 20:54, 29 September 2019 (UTC)

Some of the sources you added were good but some were not, what you did was very bold, I don't approve of it entirely but I will not revert. It is a shame you removed two references from the article which described it as a fad diet. It seems there are other negative effects of intermittent fasting and it has been described as a dangerous fad [95]. It seems you want any mention of fad removed from the article? Seems a bit biased to me! I think those references should be put back in but I won't be editing this article. Psychologist Guy (talk) 23:29, 29 September 2019 (UTC)
@Psychologist Guy: These references were removed to strictly adhere to WP:MEDRS. As I said, I was not totally in favor of such a move, but since we had a disagreement on what sources to retain or not, the only coherent thing to do was to raise the quality bar. I have in the latest edit added the recommendation of the NIA, which does not recommend intermittent fasting for non-obese individuals yet, but evaluate it as "promising" and as such has registered a plan for a clinical trial[96], which suggest they do not consider this intervention as harmful as you do. If you have any high quality source (at least a review) documenting the dangerousness or adverse effects of intermittent fasting, please feel free to add it. I have no vested interest in this procedure, so both are fine to me, as long as it is backed by scientific evidence. --Signimu (talk) 23:41, 29 September 2019 (UTC)
@Zefr and Alexbrn: Thank you both for your edits. However, I am worried to see some kind of war editing happening right now with doubtful arguments[97][98]. Well, I'll do a last attempt here at reasoning and resolving this peacefully. Here are my arguments against some of the changes that were done (and I appreciate the others, or even these ones as they raise discussion):
* According to fad diet: «Fad diets are generally restrictive, and are characterized by promises of fast weight loss[2][4] or great physical health,[6]:9 and which are not grounded in sound science.». For IF, that is not at all the case (or please provide an adequate source). I would agree that IF being a weight loss diet trend is worrisome and we should cover that, but 1. it's already covered in the «Fasting trends» section (and my edit left the new edit there), 2. fad diet is not a correct qualification for IF, as it also implies uneffectiveness and/or dangerousness of the diet, which claims should be based on reliable good quality sources. For the moment, all highest quality scientific sources actually claim the opposite. Furthermore, WP:MEDRS states: «Sources about health in the general news media should, in general, not be used to source content about health in Wikipedia articles but may be useful for "society and culture" content.». Since fad diet is enclosing health claims, this should be grounded in scientific facts per WP:MEDRS. The categorization too (notice that a similar diet according to ALL good quality scientific evidence, the calorie restriction diet, is not categorized as a fad diet). I will further point at the fact that for simply sourcing aliases, you reverted[99] a source that was from the UK NHS (health regulatory body) itself mentioning a Daily Mail article, but it's still the NHS and for simply an alias! Thus, for aliasing the NHS and public media is not OK, but to qualify a diet as dangerous and uneffective it's ok according to your understanding of WP:MEDRS? Lastly, the 2013 opinion paper[100] might have «fad» in the title (note: not fad diet which is different), but in the article it's clearly stated: «Intermittent fasting can also produce similar effects as intensive exercise, says Mattson, including increasing heart rate variability while reducing resting heart rate and blood pressure. “All of these three changes are exactly what you would see in trained athletes,” he adds. “We are starting to understand some of the underlying mechanisms whereby fasting may benefit animals and possibly humans. We are now moving to testing some of these things in humans.”».
* Mechanism: @Zefr: I believe you too cursorily read the source when doing this revert[101]. The source is a systematic analysis on over a thousand human subjects across different conditions (more than 150 for alternate day fasting), and what was written is exactly what can be found in the article (but rewritten in lay terms). I am open to rewritings, but if the source is not admissible (systematic analyses on human subjects as per WP:MEDRS), would you please explain why?
* Religious fasting: I did not create this section, and I agree that religious fasting should be moved elsewhere as there is a very essential difference: religious fasting involves not drinking any liquid usually, whereas intermittent fasting allows drinking and thus hydration. However, there are now serious research on the topic with several systematic reviews that were linked here. Thus, I find it quite extreme to remove the section altogether[102]. May I suggest we move it to dieting or fasting, cleaned of unreliable sources (see the talk section below)?
* About NIA source: the NIA source clearly indicates that for obese and overweight individuals, there is evidence that theurapeutic IF works: «Many studies have shown that obese and overweight people who lose weight by dieting can improve their health. But scientists still have much to learn about how calorie restriction and fasting affect people who are not overweight, including older adults.» If you so want, we can make a direct citation, but @Alexbrn: reverting as you do here [103] with an edit description of "Not really accurate" is itself not only "not accurate" but contradicting the source. Furthermore, this counters the argument that IF is a fad diet (see first point), and I think we can agree that NIA is a much more reliable source than Medical Daily or a 2013 opinion paper.
To summarize: I thank you guys for your edits, and I know it takes time (it takes me a lot of time too), but please take more time reviewing the sources before using them, as most of your reverts are clearly contradicting the sources. Can we agree to change these information to better reflect the sources? --Signimu (talk) 16:41, 30 September 2019 (UTC)
You need to avoid WP:CHERRYPICKING. When a source says evidence is limited and something is not recommended, you can't present it as saying it finds that thing is effective! Saying that the NIA "recognizes that IF has shown ..." is a skewing of the source. Alexbrn (talk) 16:45, 30 September 2019 (UTC)
@Alexbrn: And now you accuse me of cherrypicking, package that with the pov-pushing... I am certainly NOT cherrypicking: the NIA article is CLEARLY specifying that the inconclusiveness pertains to using IF for non-pathological cases. Heck, that's in the name of the institute: "The National Institute on Ageing", it's NOT on obesity for instance! And when you say it's "skewing the source", I gave you the exact citation above! I proposed that we directly cite the source! So if you want, we do that, and then there'll be no possible skewing whatsoever.
In any case, I agree and I was the FIRST to add limitations on this article about IF, and there was a lot more before the cleaning was done by other editors (because of non high quality source - quite ironic isn't it? Since all high quality sources agree on effectiveness and limited adverse effect, we can't put more warnings here, particularly about dehydration risks...).
Thus, let me make this straight: I don't care about what effects IF is described to have, as long as it is grounded by high quality scientific sources when we follow strict WP:MEDRS compliance. I added only scientific sources of the highest quality (systematic reviews) since the first warning by Zefr. These sources show only positive effects and limited adverse effects. If you want to put more warning, please find sources of similar quality. Mind you, I have searched for ANYTHING about intermittent fasting, not just the positive ones (as I said, I don't care, I am interested in the scientific findings!). --Signimu (talk) 16:54, 30 September 2019 (UTC)
PS: look, here's the proof in NIA article: «There's insufficient evidence to recommend **any type of calorie-restriction or fasting diet**. A lot more needs to be learned about their effectiveness and safety, **especially in older adults**.» --> This clearly is a statement about using these diets for ageing. For instance, calorie-restriction is already recommended as therapies for obese and overweight individuals by US official guidelines since 2014 (see the source about weight loss that was reverted). IF as far as I know is NOT yet recommended, that's true, but writing that any weight loss inducing therapy is not recommended for obese and overweight is utterly false! Please read the full content of the sources, and not just the conclusion! --Signimu (talk) 17:02, 30 September 2019 (UTC)
BTW, how could weight loss be off-topic (the reason for the revert) since it's one of the two main pursued and confirmed therapeutic effects of IF? I agree it shouldn't be long and additional material should be placed there, but seriously how can we write about the therapeutic effects of a treatment if there is no background about its end goals? --Signimu (talk) 17:04, 30 September 2019 (UTC)
Holy WP:WALLOFTEXT! To be clear: we follow what good sources say, faithfully and without spin. We don't use sources that don't even mention IF to make points about IF. These are very basic concepts for encylopedia editing. Alexbrn (talk) 17:07, 30 September 2019 (UTC)
@Alexbrn: Using WP:Walloftext to avoid answering to a sourced argumentation is cheap, and questions your good faith. Let's cut the chase, let's try one last time to find a common ground:
From my understanding of reading all the systematic review sources and official health content like NIA, here's my summary: IF induces weight loss and has a specific effect on insulin for obese and overweight individuals, and thus is a promising therapy (not my words, it's in the conclusions of literally each systematic review and even NIA). IF is similar to calorie restriction diet, except for the effect on insulin. For non-overweight individuals pursing a goal of improving general health or ageing, it's an interesting approach but there is not enough evidence as NIA summarizes. The parameters (eating schedule, conditions, amount of calories, gender, long-term maintenance, tolerance, etc) can of course change the outcome and thus they have to be clarified, hence the trending use of IF by non trained health professionals should be disadvised. @Zefr and Alexbrn: Do you both agree with this being a good summary of the current state of knowledge about IF? If not, why? Do you have sources (or give citations)? Thank you. --Signimu (talk) 17:13, 30 September 2019 (UTC)
@Zefr and Alexbrn: Thank you both for responding to my invitation to discuss with 2 edit war warnings. This forces me to stop contributing to this article temporarily. --Signimu (talk) 18:18, 30 September 2019 (UTC)

That seems a partial summary, omitting for example any mention of possible adverse effects, and containing factual inaccuracies (NIA do not "literally" say IF is a "promising therapy", but they do literally recommend against it - at least in the document we cite). It illustrates I think your POV approach to the topic. But I don't see the point of agreeing or disagreeing with your summary: our editing need to follow the WP:PAGs so we need decent sources as the direct basis of our article. Alexbrn (talk) 03:01, 1 October 2019 (UTC)

Just saw this comment... Well, I won't dwell in uncivil behaviors that are not useful for the content, but I'd just like to clarify that I (inaccurately) wrote that "NIA recommends against intermittent fasting" when I added the NIA source, when in fact the NIA says literally that it "can't recommend yet intermittent fasting due to lack of evidence on long term outcomes". I clarified this in the entry a few days ago anyway. --Signimu (talk) 01:51, 17 October 2019 (UTC)

Disagreement 2

@Zefr: Hello, I would like to discuss your latest revert[104], which points were not discussed before, so let's do it point-by-boint:

  1. About IGF-1 effects: previous history[105][106][107]. This is a 2019 systematic review on humans, published in Ageing Research Reviews (impact factor 10.390[108]), and is covering both intermittent fasting and calorie restriction. The review is new and not covered by AHA (2017). This looks both pertinent and of high quality per WP:MEDRS. Could you explain why you reject it?
  2. About NIA sentence: «Intermittent fasting and calorie restriction diets, although under active research, are not recommended for non-obese or non-overweight individuals.» --> This is inaccurate and misleading, for two reasons: 1. for calorie restriction, it is already recommended for the whole population by US dietary guidelines (see Calorie restriction), 2. for intermittent fasting, it contradicts the AHA Scientific Statement[109] (peer-reviewed, authority), which recommends to «include intermittent fasting approaches as an option to help lower calorie intake and to reduce body weight» for cardiovascular disease prevention (not necessarily obesity!), whereas NIA is kind of a "news" article (apriori non peer-reviewed and certainly not of the same quality as AHA process for scientific statements). Per WP:MEDRS, the AHA scientific statement should supercede the NIA in case they contradict as to not WP:UNDUE. That is not to say that there should be no mention of NIA position, it's written in the lede, but this sentence is inaccurate and misleading.
  3. the "flip switch": it's one of the two major theories for explaining intermittent fasting effects, it's covered by nearly all serious papers and reviews in some form, even if I only selected the 3 most pertinent as refs for this sentences, most other refs also mention it. This IS very fundamental for this section. Why wouldn't we be describing the two major theories that are reflected in the whole academic literature on the topic?
  4. about the therapeutic targets, I found the review was nice with a good figure differentiating what was found in humans from what was on animals, but if you don't like it I won't fight for it.
  5. for Varady in History, I fail to understand why you would not allow its inclusion, given it's a statement from The Times in UK, it seems certainly notable (furthermore since modern interest was first fostered in UK). (/EDIT: moot point, see below, it's in fact the whole History section that was emptied).

Could you please clarify your rationale behind your revert? Thank you :-) --Signimu (talk) 20:43, 6 October 2019 (UTC)

Ah, I did not see that you emptied most of the History content[110]. Why did you do that? I think it is pertinent to describe both the antique practices up to how the first modernized variants came to be. In fact, we could even further develop the antique part using Hart2018 ref (I didn't because I'm more interested in the scientific parts, but the cultural part certainly has its place). --Signimu (talk) 01:01, 7 October 2019 (UTC)
@Zefr: Since you are choosing since a few weeks to avoid replying to me (except in reverts), I have requested a 3O in the hope this can help us get unstuck from this situation without continuous reverting :-) --Signimu (talk) 15:55, 8 October 2019 (UTC)

@Zefr: Hello Let's try one last time to discuss about a few of these edits (I reduce to the 2 most important points to me, consider the rest dropped ):

  • About the IGF-1 factor, I think the info is very important and pertinent, it should be included. However, I propose to move it, at least separate it from the first paragraph, as the influence IGF-1 can be ambivalent (both good and bad), and the study does not conclude anything about that, it only shows evidence that IGF-1 levels can be modified by at least a 50% average daily caloric restriction or alternate day fasting. For a reminder, here is the sentence I wrote:

«IGF-1 decreases are observed only with at least 50% average daily caloric restriction.[1]»

  • About the "flip switch", there are 3 strong sources (including NIA) who mention it, it's clearly one of the main hypothesis (this and the hypothesis that effects are only due to caloric reduction), so I think it's important both are mentioned in the "mechanism" section. The point is not to declare which one is valid, we don't know at this point (and it can be another hypothesis noone thought of yet ;-) ), but since they are widely considered in this scientific community, I think they should be mentioned (with the adequate uncertainty - they are just hypothesis). For a reminder, here is what I wrote:

«It remains unclear whether the beneficial effects are due solely to weight loss or to an additional "flip switch" mechanism specific to intermittent fasting.[2][3][4]

Would you agree to add these two lines in the entry's content, or do you have any suggestion of modification, or if you are against please tell me why so I can understand, thank you --Signimu (talk) 21:45, 14 October 2019 (UTC)

Addendum: Found a new notable source (UPDATE: and another one) for 2nd point (flip switch vs simple weight loss consequences), which prompts me to suggest a new formulation for the proposed addition:
«It remains unclear whether the beneficial effects are due solely to weight loss or to an additional "flip switch" mechanism specific to intermittent fasting,[2][3][4] but a review of a wide variety of diets, including alternate day fasting, show they all provide similar weight loss and cardiovascular benefits, with more adherence and weight loss predicting more benefits.[5] Another review did not find evidence of a reduction of adaptive responses, except maybe appetite, when using intermittent fasting, although most studies were underpowered to assess this.[6]» --Signimu (talk) 01:44, 17 October 2019 (UTC)

References

  1. ^ Rahmani J, Kord Varkaneh H, Clark C, Zand H, Bawadi H, Ryan PM, et al. (August 2019). "The influence of fasting and energy restricting diets on IGF-1 levels in humans: A systematic review and meta-analysis". Ageing Research Reviews. 53: 100910. doi:10.1016/j.arr.2019.100910. PMID 31116995.
  2. ^ a b "Calorie restriction and fasting diets: What do we know?". National Institute on Aging, US National Institutes of Health. 2018-08-14. Retrieved 29 September 2019.
  3. ^ a b Cioffi I, Evangelista A, Ponzo V, Ciccone G, Soldati L, Santarpia L, et al. (December 2018). "Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials". Journal of Translational Medicine. 16 (1): 371. doi:10.1186/s12967-018-1748-4. PMC 6304782. PMID 30583725.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  4. ^ a b Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG, et al. (February 2018). "Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting". Obesity. 26 (2): 254–268. doi:10.1002/oby.22065. PMC 5783752. PMID 29086496. Cite error: The named reference "Anton2018" was defined multiple times with different content (see the help page).
  5. ^ Thom G, Lean M (May 2017). "Is There an Optimal Diet for Weight Management and Metabolic Health?". Gastroenterology (Review). 152 (7): 1739–1751. doi:10.1053/j.gastro.2017.01.056. PMID 28214525.
  6. ^ Seimon RV, Roekenes JA, Zibellini J, Zhu B, Gibson AA, Hills AP, et al. (December 2015). "Do intermittent diets provide physiological benefits over continuous diets for weight loss? A systematic review of clinical trials". Molecular and Cellular Endocrinology. 418 Pt 2: 153–72. doi:10.1016/j.mce.2015.09.014. PMID 26384657.

Zefr, proposing new good-faith edits that attempts to fix previous (vague) issues is not WP:DE, whereas reverting with no discussion[111] is (per the same guideline). I am reasonable, and more concise. Could you please explain 1- why you revert reviews and write they are not primary studies as your diff comment incorrectly states[112], 2- and what's the difference between this addition that makes it unencyclopedic for you whereas a similar section Calorie_restriction#Research you recently copy-edited was deemed encyclopedic (and it contains animal research, whereas my addition does not)? Thank you in advance. --Signimu (talk) 19:46, 28 October 2019 (UTC)

This whole paragraph and its sources explain nothing encyclopedically - they're "if" this, and "may" that. An hypothesis about a "metabolic switch" is not encyclopedic, as it can't be studied in humans. The article and talk page histories show you have repeatedly tried to have this content inserted, with no agreement from other editors. This 'wall-texting' is highly disruptive, as your edits require checking for grammar and misunderstandings of medical science. This is WP:DE behavior for which you have been warned several times by other editors and me. Please take a break. --Zefr (talk) 19:58, 28 October 2019 (UTC)
Thank you for your reply! I truly appreciate it. I auto-reverted and won't restore as promised, as long as you reply on this point you did not answer: if hypothetical mechanisms aren't fit for an encyclopedic article, why do you accept them in Calorie restriction#Research? And why then other editors seem to not share your position[113]? But I'd like to reach a consensus with you, since only us edit this page currently. About the side-note you raise: yes the metabolic switch is testable, just ensure the same total caloric intake in a IER group vs a CER group. If IER has more/different effects, then it's not solely due to caloric restriction. Some studies already did that, but there's just not enough to have a clear cut answer yet. But that has no pertinence to whether we add this paragraph or not, else there would be no theories on WP at all. --Signimu (talk) 20:08, 28 October 2019 (UTC)
Zefr, please reply. It's not OK to ignore parts of the initial question[114], particularly when I shown my good faith by autoreverting. This is no WP:MWOT. Please just say how my proposition[115] differs with what you accepted in Calorie restriction#Research? --Signimu (talk) 02:50, 29 October 2019 (UTC)

PS: please be precise, a vague reason is not sufficientWP:SUMMARYNO[116]. --Signimu (talk) 19:51, 28 October 2019 (UTC)

Zefr Same proposition as before: if you discuss here, I'll auto-revert and stop from restoring. As long as your answer is honest and your reason accurate enough (no "unencyclopedic" please). --Signimu (talk) 19:58, 28 October 2019 (UTC)

Zefr is not encyclopedic, as it can't be studied in humans That argument is nonsense. The sources provided are clearly based on human data. I support reintroduction of the text. Boghog (talk) 05:56, 30 October 2019 (UTC)
Boghog: the removed paragraph was based on Signimu's WP:SYNTH about a "metabolic switch mechanism". Among all the sources in the reverted paragraph, only this one (Anton) addresses a metabolic switch, presented as a single hypothesis which cannot be evaluated in humans from clinical trials or otherwise as a metabolic mechanism in vivo. Assessing the tables, sources, and discussion in the Anton article shows preliminary, short-term, small subject number studies (or from lab animals), none of which defined a switch in vivo. So the whole content of the paragraph was conjecture from an untestable hypothesis. I call this unencyclopedic editing because it was based on synthesis of sources and a weak concept from just one hypothesis. The Anton article 'Future Directions' section shows the incomplete status of science on this topic. Outside of the Anton "flipping the switch" article, no authors of other sources used in the contested paragraph went to a "flipping the switch" conclusion. It was just synthesized by Signimu. WP:CIR requires editors to be competent in the discipline of the article, understand source quality and specificity, and in this case, know what can be determined from preliminary human studies and what is pure, unencyclopedic speculation. The paragraph mostly was not about a mechanism, but was synthesized to support an undefinable one, and so is unusable. --Zefr (talk) 15:07, 30 October 2019 (UTC)
Proposed text

IF may affect several cardiometabolic systems in humans, such as the cardiovascular system by effecting blood pressure, metabolic profiles by reducing lipid, glucose, insulin levels[1][2] and reducing IGF-1 levels,[3] enhance autophagy, reduce levels of advanced glycation end-products and increase adiponectin levels.[4] It remains unclear whether these changes are due solely to weight loss or to a "metabolic switch" mechanism activating only during fasting periods,[1][5][6] which consists in shifting the body from lipogenesis and fat storage to the mobilization of fat.[5] A review of a wide variety of diets, including alternate day fasting, show they all produce similar weight loss and cardiometabolic changes, with adherence and weight loss being better predictors than the type of diet.[6] Another systematic review did not find evidence of a reduction of adaptive responses, except maybe appetite, when using intermittent fasting, although most studies were under-powered to assess this.[7]

References

  1. ^ a b Cioffi I, Evangelista A, Ponzo V, Ciccone G, Soldati L, Santarpia L, et al. (December 2018). "Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials". Journal of Translational Medicine. 16 (1): 371. doi:10.1186/s12967-018-1748-4. PMC 6304782. PMID 30583725.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  2. ^ Harris L, Hamilton S, Azevedo LB, Olajide J, De Brún C, Waller G, Whittaker V, Sharp T, Lean M, Hankey C, Ells L (February 2018). "Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis" (PDF). JBI Database System Rev Implement Rep. 16 (2): 507–547. doi:10.11124/JBISRIR-2016-003248. PMID 29419624.
  3. ^ Rahmani J, Kord Varkaneh H, Clark C, Zand H, Bawadi H, Ryan PM, et al. (August 2019). "The influence of fasting and energy restricting diets on IGF-1 levels in humans: A systematic review and meta-analysis". Ageing Research Reviews (Meta-analysis). 53: 100910. doi:10.1016/j.arr.2019.100910. PMID 31116995.
  4. ^ Papamichou D, Panagiotakos DB, Itsiopoulos C (June 2019). "Dietary patterns and management of type 2 diabetes: A systematic review of randomised clinical trials". Nutrition, Metabolism, and Cardiovascular Diseases (Systematic review). 29 (6): 531–543. doi:10.1016/j.numecd.2019.02.004. PMID 30952576.
  5. ^ a b Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG, et al. (February 2018). "Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting". Obesity. 26 (2): 254–268. doi:10.1002/oby.22065. PMC 5783752. PMID 29086496.
  6. ^ a b Thom G, Lean M (May 2017). "Is There an Optimal Diet for Weight Management and Metabolic Health?" (PDF). Gastroenterology (Review). 152 (7): 1739–1751. doi:10.1053/j.gastro.2017.01.056. PMID 28214525.
  7. ^ Seimon RV, Roekenes JA, Zibellini J, Zhu B, Gibson AA, Hills AP, et al. (December 2015). "Do intermittent diets provide physiological benefits over continuous diets for weight loss? A systematic review of clinical trials" (PDF). Molecular and Cellular Endocrinology (Systematic review). 418 Pt 2: 153–72. doi:10.1016/j.mce.2015.09.014. PMID 26384657.

Zefr The metabolic switch mechanism is one sentence out of an entire paragraph. So you delete the entire paragraph because of one sentence? hypothesis which cannot be evaluated in humans[citation needed] More nonsense. It is pretty obvious that all animals including humans have a metabolic switch between fasting and fed states and this can easily be demonstrated in humans by what happens with blood lipids and insulin senstivity after fasting for example. It is one thing to state that a particular source does not support a hypothesis but to state it is impossible to demonstrate this is ridiculous. Proving a negative is really hard. Boghog (talk) 19:07, 30 October 2019 (UTC)

Boghog: So go ahead and explain to us the biochemical mechanisms of weight loss from fasting. That's what the section is supposed to discuss. You're talking about biomarkers, not mechanisms of weight loss. The mechanisms of weight loss have not and cannot be determined in humans at present (there are no reviews to cite; who would pay the tens of $ millions for such large-scale randomized controlled trials?), and were not studied in vivo in any source used in the removed paragraph, so were deleted as WP:OFFTOPIC. The one sentence and source remaining, PMID 30476522 - a review of 739 studies - provides only a vague conclusion that people who lost weight by fasting misjudge energy intake and loss, then gain weight again. Addressing a section on 'Mechanism' is futile and misleading because there are no good sources to identify a mechanism, other than an untestable hypothesis, PMID 29086496, which is conjecture and unencyclopedic. --Zefr (talk) 21:41, 30 October 2019 (UTC)
Zefr No problem. Energy expenditure exceeds energy intake. Boghog (talk) 21:56, 30 October 2019 (UTC) PMID 29086496 is solid science, WP:MEDRS compliant, common sense, and clearly encyclopedic. Boghog (talk) 22:02, 30 October 2019 (UTC)
Zefr You seem to have a fundamental misunderstanding of the purpose of clinical trials. Clinical trials are not to determine mechanism, but rather to see if a particular treatment has a desirable effect (see for example "Mechanism matters". Nature Medicine. April 2010.). If a treatment mechanism has been worked out in animals and the treatment effects can be reproduced in humans and biomarkers in animals and humans are affected in the same way, that provides strong evidence that the same mechanism is also operative in humans. Your extreme views on evidence have not gained consensus (see for example here and here). Boghog (talk) 07:53, 31 October 2019 (UTC)
The Nature Medicine article substantiates my point: a reputable review of conclusive clinical research defines the efficacy of an intervention (such as a drug successfully completing Phase III trials) on a target organ or disease condition, providing evidence for the drug's mechanism of action. There is no reputable review on the mechanism for how intermittent fasting affects body weight because no comprehensive clinical research has been done, no specific target organ known, and therefore no mechanism revealed. The 'Mechanism' section is futile without a foundation of scientific evidence to substantiate the subheading. The new content and sources added today are a synthesis of off-topic research (WP:SYNTH and WP:OFFTOPIC apply): the studies cited were not specifically about intermittent fasting, and were not about discerning a 'mechanism', but rather were about effects of sustained fasting on biomarkers (perhaps more appropriate for the fasting article). The sentence about sirtuin is only conjecture from lab research, and again off-topic synthesis. --Zefr (talk) 23:42, 31 October 2019 (UTC)
Zefr Good, then we agree that a successful clinical trial together with supporting preclinical studies provide evidence of mechanism. Just to be clear, clinical trials alone cannot establish mechanism because they are not designed for that purpose. The whole point of the Nature Medicine article is that one needs to determine the mechanism before clinical trials. The emphasis on a single target organ is misplaced as many organs and tissues are likely involved (liver, adipose tissue, skeletal muscle, etc.). Finally the underlying mechanism for fasting induced weight loss is blindingly obvious: catabolism of energy depots, primarily fat in adipose tissue. Boghog (talk) 06:45, 1 November 2019 (UTC)
Zefr, the section is not about the efficacy, there is only one sentence as whether the mechanisms of fasting is pertinent for human health, and the conclusion is that we don't know, which reflects the opinion of all serious sources. The rest is about the metabolic changes induced by intermittent fasting, which includes changes induced by fasting. All sources are about human studies. As I noted below, there are more than 50 years of clinical human studies of the effect of fasting during various timescales (see PMID 16848698 Fig.1 and [117]), all these states are well-known and well-accepted by the scientific and medical fields. These facts about fasting were never contradicted since 1965 at least and get regularly cited, so you need to provide sources if you disagree. About whether this is pertinent here: do you really argue whether intermittent fasting, which cycles between fed and fasted periods, produces a fasted state? The whole premisse of IF is to fast, so fasting mechanism is obviously of pertinence and interest. This also for sure is of interest for the Fasting entry, but overlap does not mean the pertinent info should be removed when pertinent. Finally, please refrain from reverting again, there are 3 editors who have expressed a consensus for this content to be insertedlocal consensus on this specific matter[118][119][120][121], and previous community consensus supporting this type of content[122][123][124], not to mention your agreement on a similar type of content[125]. If you still disagree, please follow WP:BRD by seeking a different consensus first, here or on WT:MED, thank you. --Signimu (talk) 02:55, 1 November 2019 (UTC)
Zefr again shows a misunderstanding of the source PMID 30476522 he cites (is that why you trimmed down so much this sentence?). If you would read what I write, you would not make this mistake. Here is what another paper PMID 31561967 writes about the source: "Researchers observed that in a self-weighing for weight-gain prevention study, as many strategies for weight control emerged as there were participants in the study. Some reduced portion sizes, others omitted desserts or snacks, and others increased exercise. All of these strategies are effective because humans do not completely compensate for the lost energy." How can you understand this as being "a vague conclusion that people who lost weight by fasting misjudge energy intake and loss, then gain weight again", the source, and the other paper mentioning the source, are clearly writing the opposite, that calorie restriction works because the body cannot correct for energetic unbalances, if you restrict calories, you lose weight, even in the long-term! Now instead of moving the goal post, can we go back to why the metabolic pathways are not acceptable to you? --Signimu (talk) 00:42, 31 October 2019 (UTC)
Zefr You may try to ignore what I write, but you can't ignore the fact that there is a recent consensus on WP:MED[126] that this kind of source is acceptable and "not entirely clear" results are encyclopedic content, as long as they are correctly described and reflecting the sources' POVs and not ours. --Signimu (talk) 00:53, 31 October 2019 (UTC)
The Anton "metabolic switch" review already has a lot of citations, I may update further the proposed addition. I've found other authors confirm the accuracy of the wording I proposed, here's what PMID 31023390 write for instance: "Further progress will require such models to be tested with appropriate controls to isolate whether any possible health effects of intermittent fasting are primarily attributable to regularly protracted post-absorptive periods, or simply to the net negative energy balance indirectly elicited by any form of dietary restriction." - in addition, these authors do consider it's possible to test the hypothesis in humans. --Signimu (talk) 03:52, 31 October 2019 (UTC)
Here's a well-designed RCT study on 88 women, PMID 30569640, testing the metabolic switch hypothesis. So it is possible to test. It's considered a seminal study by the commentary PMID 30569643 which also mentions the "two competing hypotheses". PS: this is not meant to be added in the article, but just for discussion here. Reviews are necessary to make any conclusion. --Signimu (talk) 08:26, 31 October 2019 (UTC)
I have dived deeper in the biological mechanisms of fast states and rewrote the proposition to be more accurate[127]. There is a whole body of research since more than 50 years on fed state, fast state and starvation state, in humans. Hence, the metabolic switch (which is just a fancy name for lipolysis and ketogenesis) existence leaves no doubt. What is unclear is whether IF, via this metabolic switch, can produce effects regardless of weight loss. If there is no objection, I'll add it in the article late this evening or tomorrow. Feel free also to edit it. --Signimu (talk) 12:58, 31 October 2019 (UTC)
Added the first part right now, I left the refquotes and duplicated references, I will clean up the refs order and quotes after some time to let other editors more easily check. --Signimu (talk) 21:35, 31 October 2019 (UTC)
What Zefr says is utterly false. All sources used in this sentence either mention the metabolic switch hypothesis in some form, or in addition it cites it directly (such as Cioffi). In addition, there was a 4th ref, Zubrinski, that you deleted Zefr[128] and its ref quote[129] which clearly mentions the metabolic switch (and cite Anton). All the other refs have adequate quotes on WT:MED[130]. For ease, please find below the full paragraph with the adequate refquotes to save you time:
Extended content
IF may affect several cardiometabolic systems in humans, such as the cardiovascular system by effecting blood pressure, metabolic profiles by reducing lipid, glucose, insulin levels[1][2] and reducing IGF-1 levels,[3] enhance autophagy, reduce levels of advanced glycation end-products and increase adiponectin levels.[4] It remains unclear whether these changes are due solely to weight loss or to a "metabolic switch" mechanism activating only during fasting periods,[5][1][6][7] which consists in shifting the body from lipogenesis and fat storage to the mobilization of fat.[5][8][6] A review of a wide variety of diets, including alternate day fasting, show they all produce similar weight loss and cardiometabolic changes, with adherence and weight loss being better predictors than the type of diet.[7] Another systematic review did not find evidence of a reduction of adaptive responses, except maybe appetite, when using intermittent fasting, although most studies were under-powered to assess this.[9]

References

  1. ^ a b Cioffi I, Evangelista A, Ponzo V, Ciccone G, Soldati L, Santarpia L, et al. (December 2018). "Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials". Journal of Translational Medicine (Systematic review). 16 (1): 371. doi:10.1186/s12967-018-1748-4. PMC 6304782. PMID 30583725. This latter choice derived from the idea of studying conditions simulating as much as possible a condition of fasting, whose benefits, proven by animal studies, seem to depend on the shift in metabolism from glucose utilization and fat synthesis/storage towards reduced insulin secretion and fat mobilization/oxidation [30, 31]. [...] The hypothesized benefits of IER, extensively studied in animal models, included the use of fats during severe energy restriction with preferential reduction of adipose mass, the stimulation of browning in white adipose tissue, increased insulin sensitivity, lowering of leptin and increased human growth hormone, ghrelin and adiponectin circulating levels, reduced inflammation and oxidative stress [30]. The trigger of adaptive cell response leading to enhanced ability to cope with stress [...] At present, many of these adaptive mechanisms have been demonstrated in animal experimental models but not in humans, thus more research is still needed. [NB: refs 30 & 31 refers to the metabolic switch hypothesis]{{cite journal}}: CS1 maint: unflagged free DOI (link)
  2. ^ Harris L, Hamilton S, Azevedo LB, Olajide J, De Brún C, Waller G, et al. (February 2018). "Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis" (PDF). JBI Database of Systematic Reviews and Implementation Reports. 16 (2): 507–547. doi:10.11124/JBISRIR-2016-003248. PMID 29419624.
  3. ^ Rahmani J, Kord Varkaneh H, Clark C, Zand H, Bawadi H, Ryan PM, et al. (August 2019). "The influence of fasting and energy restricting diets on IGF-1 levels in humans: A systematic review and meta-analysis". Ageing Research Reviews (Meta-analysis). 53: 100910. doi:10.1016/j.arr.2019.100910. PMID 31116995.
  4. ^ Papamichou D, Panagiotakos DB, Itsiopoulos C (June 2019). "Dietary patterns and management of type 2 diabetes: A systematic review of randomised clinical trials". Nutrition, Metabolism, and Cardiovascular Diseases (Systematic review). 29 (6): 531–543. doi:10.1016/j.numecd.2019.02.004. PMID 30952576.
  5. ^ a b Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG, et al. (February 2018). "Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting". Obesity (Review). 26 (2): 254–268. doi:10.1002/oby.22065. PMC 5783752. PMID 29086496. {{cite journal}}: Unknown parameter |lay-url= ignored (help)
  6. ^ a b Zubrzycki A, Cierpka-Kmiec K, Kmiec Z, Wronska A (October 2018). "The role of low-calorie diets and intermittent fasting in the treatment of obesity and type-2 diabetes". Journal of Physiology and Pharmacology (Review). 69 (5). doi:10.26402/jpp.2018.5.02. PMID 30683819. These beneficial effects arise not only from the loss of body mass, but also from the activation of metabolic pathways specific to fasting conditions. IF interventions induce a metabolic shift that has the potential to positively alter body composition. This switch represents a shift from preferential lipid synthesis and fat storage to the mobilization of fat. It typically occurs in the third phase of fasting (i.e., 12 – 36 hours after the last meal) when glycogen in the hepatocytes (though not in muscles) becomes depleted. Around that time, accelerated lipolysis in adipose tissue produces increased plasma levels of FFAs, which contribute to the increased synthesis of fatty acid-derived ketones in the liver, kidney, astrocytes, and enterocytes. IF regimens are a potential method of treatment for obesity and related metabolic conditions, including T2D and metabolic syndrome.
  7. ^ a b Thom G, Lean M (May 2017). "Is There an Optimal Diet for Weight Management and Metabolic Health?". Gastroenterology (Review). 152 (7): 1739–1751. doi:10.1053/j.gastro.2017.01.056. PMID 28214525. The principle for it providing health benefit independent of body weight loss is that regularly inducing a mild stressor such as fasting increases resistance against a number of degenerative age-related problems. [...] It would seem plausible that the unfavorable physiological changes synonymous with energy restriction and weight loss could be offset by intermittently raising energy intake to meet weight maintenance energy requirements, rather than a continuous and ongoing energy restriction. However, a systematic review of clinical trials was unable to find any evidence that IER reduced adaptive responses when compared with CER.
  8. ^ Cite error: The named reference Tinsley2015 was invoked but never defined (see the help page).
  9. ^ Seimon RV, Roekenes JA, Zibellini J, Zhu B, Gibson AA, Hills AP, et al. (December 2015). "Do intermittent diets provide physiological benefits over continuous diets for weight loss? A systematic review of clinical trials". Molecular and Cellular Endocrinology (Systematic review). 418 Pt 2: 153–72. doi:10.1016/j.mce.2015.09.014. PMID 26384657.
Furthermore, your criticism pertains only to the metabolic switch hypothesis, and this paragraph does not pretend the hypothesis is proven, it only present it as a current research direction. All the infos, especially the metabolic pathways ones, are only from human studies, even if some studies also mix animal studies as you say, I selected only human-related info. So if you have a problem with the metabolic switch, fine, let's discuss that, but you can't revert a whole paragraph because of one sentence as Boghog says WP:PRESERVE.
Zefr, you can't constantly disregard my explanations and then repeatedly make false claims of SYNTH to discredit me and misuse policies such as constantly qualifying me as incompetent, please stop. I'm more than willing to discuss and honestly advance on this issue if you do, otherwise I will have to seek other resolution methods to make this stop. You are not required to like me, but WP is not place for WP:GRUDGE, if we work on the same entry, we have to discuss and work together. --Signimu (talk) 21:25, 30 October 2019 (UTC)

Maybe a source we can exploit?

This news says that in 2017 people tended to abuse intermittent fasting by extending it into prolonged periodic fasting. Maybe this can be used? [131]. --Signimu (talk) 12:52, 8 November 2019 (UTC)

Where we stand about meal skipping (and more specifically breakfast skipping) and type 2 diabetes, it's only a commentary so can't be added but it's a good recap, we need to wait for >6 months trials: PMID 30624661. --Signimu (talk) 16:03, 24 November 2019 (UTC)

Point of contention RE: disambiguation vs eating disorders

It's intellectually dishonest and factually inaccurate for the redirect subheader to say that "eating disorder" and "involuntary fasting" are equivalent phrases. They are not. Anyone who has anorexia will tell you as much. As a psychotherapist who works with ED populations, there needs to be a more responsible phrasing on this page. Perhaps something along the lines of "psychologically motivated intentional fasting" would work better. Please adjust accordingly. --A Passing Therapist, 05:28 25 November 2019 (UTC)

Hello, to clarify, it's not meant to be equivalent, but for "involuntary fasting" to be a subtype of "eating disorder", but I see what you mean. I have tried to track down where this comes from (I have added it myself but we can't leave a ref in the subheaders), I think it indirectly comes from PMID 25540982, PMID 25857868, PMID 28715993 and PMID 31210344 (and certainly other refs), where intermittent fasting is defined as a "voluntary period of abstinence from food", but I can't find any mention of involuntary fasting. This indeed merits deeper inspection, I'll read the literature on intermittent fasting and anorexia. For the moment, I found this PhD thesis that tackles directly the issue[132], not sure if this is usable on Wikipedia? --Signimu (talk) 14:01, 25 November 2019 (UTC)
Hello again, I tried to search the literature for anything relating intermittent fasting and eating disorders or anorexia nervosa, and found no review or monograph on the topic, and only very few primary research studies, such as the PhD thesis above, and this other study with similar conclusions[133]. I also had a look at DSM IV and DSM V, and although some authors proposed to include intermittent fasting as one of the criteria[134], this suggestion did not make it there yet, and in fact the DSM V mention "extended periods of food restriction", which sounds contrary to the concept of intermittent fasting. So if you have other sources that relate IF and eating disorders, please provide them. Meanwhile, I'm not sure we should change, maybe we can redirect involuntary fasting to starvation, and mention eating disorders somewhere in the entry? --Signimu (talk) 19:22, 25 November 2019 (UTC)

"Scientists who study intermittent fasting"?

This sounds more like Everipedia, than Wikipedia. Since when have there been sections about investigators in a field, with biographies? Do these people meet notability guidelines? JuanTamad (talk) 03:10, 3 January 2020 (UTC)

It reads as promotion, I have removed that material twice. This is likely a single purpose account [135] Psychologist Guy (talk) 04:47, 7 January 2020 (UTC)

Mechanism split

With the publication of a new review [136] on this phenomenon, it seems like its time to split this section out into its own article, say Metabolism switching. Comments encouraged! Lfstevens (talk) 21:57, 5 January 2020 (UTC)

Although a review in a respected journal, the NEJM source is a review of preliminary research and conjecture about mechanisms. What new information in it is encyclopedic? The whole mechanism section of the article is based on lab research, inconclusive early-stage clinical trials, and conjecture. We have the sentence: Whether repeatedly triggering this transition between fed, fasted and starvation states, as does intermittent fasting, may produce meaningful health benefits regardless of weight loss and caloric restriction has not yet been determined. That is where the section should end; WP:NOTTEXTBOOK, #6,7. --Zefr (talk) 00:50, 6 January 2020 (UTC)
Thanks for your response. Reviews aren't supposed to add new info. They're supposed to assess the state of knowledge and give a basis for a consensus (which may or may not yet exist.) I'd appreciate your thoughts on the idea of a split. Lfstevens (talk) 05:45, 7 January 2020 (UTC)
When the state of knowledge is based only on primary research, my opinion is that this is too much speculation, and is unencyclopedic per WP:MEDREV. You're proposing a new article, as opposed to revising this one. I suggest you introduce the idea at WT:MED for community discussion. --Zefr (talk) 17:09, 7 January 2020 (UTC)

Fact or non-neutral statement

Please consider this edit/revert. history link. What say the consensus. Needed neutral statement or unnecessary warning? —¿philoserf? (talk) 23:57, 20 April 2020 (UTC)

It's good per the source. Statements are "neutral" if they mirror good sourcing. Alexbrn (talk) 05:01, 21 April 2020 (UTC)

Here's also a good recent article talking about the new finding of IF and how for instance time of day matters a lot vs control groups. — Preceding unsigned comment added by Juha-jarmo.heinonen (talk • contribs) 14:09, 30 May 2020 (UTC)

That's not WP:MEDRS. Sourcing standards for health content are way higher. Alexbrn (talk) 14:28, 30 May 2020 (UTC)

Copy edit tag removed

Greetings everyone! I am removing the {{copyedit section|date=July 2020}} tag from the section named "Research". I have signed up for the July 2020 drive of GOCE and taking this article for copy editing. Kindly note that even if the copy edit tag was for only one section, I may copy edit the whole article. When I will be completed working woth this article, I will update it here only. Good day all of you! :) Red Pen (talk) 07:07, 8 July 2020 (UTC)

@Vr parashar: your edits are a mixed bag, introducing some grammar errors and errors of idiom. This is going to create work for other editors. Alexbrn (talk) 09:14, 8 July 2020 (UTC)
@Alexbrn: I understand, I am a new editor with almost nil experience, so inconveniences caused by me are regretted :) you can help me to do this job better :) please guide as to what are the areas in which this article requires copy edit (you can better give examples instead of using technical terms alone, as I am not a language graduate and may not understand every technical term), and what (and also how/approach/procedure) I should be doing exactly, to copy edit this article correctly. cheers! :) Red Pen (talk) 09:24, 8 July 2020 (UTC)
@Alexbrn: I would also like you to please mention exactly the errors I have introduced, so that I may not repeat them again while I copy edit other articles in future. Thanks for your efforts :) Red Pen (talk) 09:39, 8 July 2020 (UTC)
Alexbrn, I am halting my ce work on the article till your replies/explanations/guidance/explanations come, as I dont want to rather add errors in an otherwise fine text, than to fix some. Also I dont want to appear as a vandal or something, and I also dont want to irritate/burden other people xD haha
Also it would be nice if you reply with your guidance and pin-point examples (including errors I introduced) on my talk page, so that I will be able to use them easily in future. Good day bro :) Red Pen (talk) 09:54, 8 July 2020 (UTC)
Generally, copy editing requires a firm grasp of English so I'm not sure it's the best way to contribute to Wikipedia if you are unsure. Some examples:
  • In this edit
    • such as continuous feeling of hunger | "feelings of hunger" was idiomatic English (just "hunger" would be better still)
    • data remains sparse | "remain" was technically correct since data is a Latin plural
    • within a month from | "month of" was idiomatic English
  • And in this edit
    • a determinant of it's potential | "its potential" was correct; "it's" with an apostophe is only ever used when it's a contraction of "it is" or "it has". Possessive forms are always "its".
    • You wikilinked weight loss which was already wikilinked in the body. See MOS:DL.
Alexbrn (talk) 11:34, 8 July 2020 (UTC)
@Alexbrn: I see, I also searched for errors of idiom on internet and went through some articles about idiomatic English. Honestly though, the books I read dont have such exact language use and thus I could not see that my edits were erroneous. Also I am not a native speaker of English, but yes I do believe that I have good enough grasp of English usage :)
The errors introduced by me must be reverted so you are free to do that :) I can reduce such errors basically by learning everytime I make them and to not repeat them in further edits. Thus I will keep in mind the points you have mentioned, so I can assure that the exact mistake will not be repeated :) with time, I shall be improving my editing and also English language usage :) thanks for your cooperation and efforts :) Good day! :) Red Pen (talk) 04:00, 9 July 2020 (UTC)

Remove statement about intensive care.

"Given the lack of advantage and the increased incidence of diarrhea, European guidelines do not recommend intermittent feeding."

This statment is tottally without context. Nutrition in Intensive Care patients has nothing to do with the Intermittent fasting. — Preceding unsigned comment added by 87.103.13.66 (talk) 19:50, 8 September 2020 (UTC)

Recent revert

Zefr, I made that change because someone had added a link to this article from the AFD disambiguation page. The change was to properly format the 3 types of fasting for targets as redirect pages, and to add the abbreviation AFD. I only looked for a source for the abbreviation as an afterthought and took the first one I saw - I'm sure there are others - the existing sources cover the name and the rest. Your revert took the good with the questionable (I would question whether a MEDRS is necessary for a possibly colloquial usage that might not appear in the studies). Laterthanyouthink (talk) 23:14, 10 February 2021 (UTC)

If a MEDRS source used the abbreviation routinely, or if it was supported by several good WP:RS sources as a replacement term for "alternate-day fasting", then that would be enough to highlight it, but never with Healthline (which is written mainly by non-experts). WP:MOS states under 'Do not use unwarranted abbreviations' that an obscure term may confuse a typical user - it's unlikely a common encyclopedia user would know what I'm discussing if I used 'AFD' in a conversation about intermittent fasting. Zefr (talk) 23:43, 10 February 2021 (UTC)

Minor Distraction in the Article

The last sentence in the introductory portion "Fasting exists in various religious practices, including Buddhism, Christianity, Hinduism, Islam, Jainism, and Judaism.[3][14][15]." Takes away from the importance of contacting a physician before changing eating habits. It caught me off guard as to why it was located after such an important statement. It just seems irrelevant to mention at this point when there is an entire section devoted to the religious fasting trends. Ddotdalllas (talk) 14:15, 10 October 2021 (UTC)

Ddotdalllas - all articles are open to editing that will improve the presentation. See MOS:LEAD and consider if what is covered in the lead section represents the whole article, then feel free to edit. Zefr (talk) 15:34, 10 October 2021 (UTC)

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