Sodiq Ojuroungbe
Though intermittent fasting has been promoted by diet fads and health enthusiasts as one of the best ways to lose weight, a recent study presented at an American Heart Association conference has raised concerns about its potential risks, linking it to a higher likelihood of death from cardiovascular diseases, particularly heart-related conditions.
The findings garnered immediate attention, which was met with scepticism by some medical professionals, who highlighted the study’s limitations.
According to a health website, Mayo Link, intermittent fasting is any of the various meal timing schedules that cycle between voluntary fasting and non-fasting over a given period.
It noted that methods of intermittent fasting include alternate-day fasting, periodic fasting, such as the 16:8 diet, and daily time-restricted eating.
While intermittent fasting has gained popularity as a weight-loss strategy, the new research suggested a potential downside to this dietary approach.
The study revealed that individuals who fasted for extended periods were more prone to cardiovascular-related deaths compared to those who consumed food throughout the day.
The researchers found that people who followed a 16:8 diet or ate only within an eight-hour window had a 91 per cent higher risk of dying from cardiovascular disease compared to people who ate across 12 or 16 hours.
In carrying out the study, the researchers reviewed information from over 20,000 U.S. adults enrolled between 2003 and 2018 in the National Health and Nutrition Examination Survey, a study designed to assess the health and nutritional status of adults and children in the United States.
Participants included a roughly equal number of men and women, with about three-quarters being White, 11 per cent Hispanic, 8 per cent Black and the rest self-identified as another racial category.
Participants reported details about their food consumption and patterns for the survey on two separate days. Researchers followed participants for an average of eight years.
In addition to finding a general link between eating solely within an eight-hour window and a higher risk of dying from cardiovascular disease, researchers also found that people with existing cardiovascular disease, who followed this practice had a 66 per cent increased risk of dying from stroke or heart disease.
Participants with cancer also had a higher chance of dying from heart disease.
The study found no association between time-restricted eating and increased life expectancy.
Reacting to the study’s findings, a registered nutritionist, Odunayo Babatunde cautioned that while intermittent fasting may offer certain metabolic benefits, such as improved cholesterol and blood sugar control, the observed link to cardiovascular risks warrants careful consideration.
Speaking exclusively with PUNCH Healthwise, the expert explained that metabolic changes induced by long fasting periods, including increased insulin resistance and elevated stress hormone levels, could negatively impact heart health over a long period.
Babatunde emphasised the need for cautious consideration of the study’s results, stress the concerning link between extended fasting periods and increased cardiovascular mortality risk.
The food expert pointed out that extended fasting may lead to metabolic changes such as heightened insulin resistance, which can contribute to cardiovascular disease risk over time.
She explained that the surge in the stress hormone, cortisol, during fasting periods could have adverse effects on heart health, and complicate the relationship between fasting and cardiovascular outcomes.
While expressing concern over the possibility of individuals overindulging or binge-eating during meal windows, Babatunde cautioned against the potential offsetting of any benefits associated with intermittent fasting and the subsequent increased risk of heart disease due to weight gain.
The nutritionist also raised concerns about fasting-induced dehydration or electrolyte imbalances, which could strain the cardiovascular system, particularly among individuals who fail to adequately hydrate during fasting periods.
She, however, suggested a reevaluation of intermittent fasting as a long-term dietary strategy, particularly for individuals with existing cardiovascular conditions or risk factors.
Acknowledging the potential metabolic benefits and short-term weight loss advantages of intermittent fasting, Babatunde emphasised the need for longer-term safety data before widespread recommendations can be made.
She further said, “The results of the study should be given careful thought as they are worrying. The study revealed that those who fast for extended periods are more likely to die from cardiovascular disease than those who ate throughout the day.
“Although observational research of this kind should be interpreted cautiously since they don’t establish causation, the link is nevertheless concerning and requires more research.
“Long fasting times may cause metabolic changes, such as higher insulin resistance, which over time is linked to an increased risk of cardiovascular disease.
“Furthermore, the stress hormone cortisol, which can have negative consequences on heart health if it is constantly high, may also surge during fasting.
“Some people who fast may overindulge or binge during meal windows, which would offset any advantages and increase their risk of heart disease by gaining weight.
“There are concerns regarding whether fasting could occasionally result in dehydration or electrolyte imbalances that could tax the cardiovascular system, as many who fast for long periods don’t take enough water to help them hydrate and balance their electrolytes well.
“This latest research makes me think that intermittent fasting should be reevaluated for safety, particularly as a long-term strategy. Although certain research has indicated possible advantages for metabolic health and weight loss, this study indicates that, for certain individuals, there may be significant risks to cardiovascular health that may exceed those advantages.
“Though I believe it should be done carefully and ideally under medical supervision, generally, healthy people can still think about intermittent fasting for short-term weight loss.
“Before we generally suggest it for health improvement, we need longer-term safety data. Those with cardiovascular disease or risk factors should exercise particular caution.”
When asked if intermittent fasting affects the heart, the food expert said, “I think we should put the brakes on encouraging intermittent fasting for heart health at this point. This signal of higher death risk must now be balanced against the possible advantages that have been demonstrated in some studies, such as improvements in cholesterol and blood sugar control.
“Particularly since heart disease is the leading cause of death globally, any rise in risk is quite alarming from the perspective of public health. At least with extended fasting windows, this study suggests that potential risks may exceed the advantages for heart health.
“Anyone considering intermittent fasting as a weight-loss strategy should preferably select time-restricted feeding with shorter fasting periods (maximum of 12–14 hours) over alternate days or extended fasts, ensuring enough food and drink during eating windows.
“Such a person should avoid binging or overeating. The person should be observed for any unfavourable effects and, if any occur, the fasting should be stopped and medical help should be sought immediately. If you have a cardiovascular illness or several risk factors, you should avoid intermittent fasting.
“We definitely need additional excellent, long-term studies on the safety of various intermittent fasting regimens, particularly causally established randomized controlled trials.
“Future research should contrast intermittent fasting to other eating habits and weight management strategies and closely analyse cardiovascular biomarkers, clinical outcomes, and mortality risk. More varied populations should be studied as well because the impacts could differ according to age, sex, health, etc.”
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