5. Types of fasting(Dietary restriction)
• Calorie Restriction - CR:
Chronic reduction of 20-40% of the caloric intake.
• Prolonged Fasting - PF:
which lasts more than 72 hr (4-7 days).
• Fast Mimicking Diet - FMD:
Prolonged and periodic fasting protocol which does not
consider the whole abstinence from food.
• Intermittent Fasting - IF:
Rizza and Wanna, 2017
6. Intermittent fasting
• Switching between fasting states and feeding
states (Switch on: Switch off) or (fast: feed).
• This fasting state can last 16 to 48 hrs and IF can
be combined with any dietary protocol.
10. Insulin Response to Macronutrients
FatStorageFatburning
Hours since last meal
Fat Protein
Fasting
Carbohy
drates
Insulin
11. Ways to undertake Intermittent fasting
Time restricted eating
Alternative day fasting
Weekly IF
Rizza and Wanna, 2017
12. How to get started
How to do IF
“One size doesn’t fit all”
13. Lean gains Daily Intermittent Fasting (TRF)
16–hour fast :
8–hour eating period
14.
15. Weekly Intermittent Fasting
One 24-hour fast each week
In this example, lunch on Monday is your last
meal of the day.
You then fast until lunch on Tuesday.
16.
17. Alternate Day Intermittent Fasting
(Warrior diet)
Fast for alternating 24-hour periods (20:4)
Ori Hofmekler
This style of intermittent fasting is often
used in research studies.
But it is not very popular in the real world.
18.
19.
20.
21. Benefits of IF
Loose weight
Reduces
CVD
Diabetes
Aging process
Cleans cells & Rejuvenate
Induce Autophagy
Eating Disorder
Body Dysmorphia
Type 1 Diabetes
Pregnant or Breastfeeding
Medication
22. Derived from Greek words “auto” meaning self
and “phagy” means eating.
Autophagy is a normal physiological process of
catabolic degradation where protein and organelles
are engulfed into autophagosomes, digested in
lysosomes and recycled to sustain cellular
metabolism during stress.
Survival, Development and Homeostasis
28. • mTOR- protein kinase.
• Links and acts as core
component.
• Central regulator of metabolism
and physiology
• Regulates cell growth,
proliferation, motility, survival,
protein synthesis, transcription
and autophagy.
• mTOR inhibition autophagy.
• AMP-activated protein kinase
• master regulator of cellular energy
homeostasis.
• activated in stresses
• During glucose starvation, the ratio of
AMP :ATP increases, leading to the
activation of AMPK.
• AMPK stimulates the autophagy
Regulation of AP
29. Zhineng et al., 2011 & Eeva et al., 2009
Atg 5-
cardiomyopathy
30. Xie et al., 2017
Calorie restriction mimetics (CRM)
31. • Aging
• High carbohydrates
• Frequent meal consumption
• High Insulin
32.
33. Objective:
Investigate the effect of a modified Intermittent
Fasting protocol (TRF) in healthy resistance trained
males.
Effects of eight weeks of time-restricted feeding (16/8)
on basal metabolism, maximal strength, body composition,
inflammation and cardiovascular risk factors in trained
males
Moro et al., 2016
J. Trans. Med., Italy
34. 34 trained males
ND
Between 8 AM to 8 PM
3 hr/day training
Anthropometric measurements
Hormonal level
TC, HDL, LDL & TG
Divided into 1, 4 & 8 pm
100% in 16:8 window
TRF
Energy:
2828 ± 412.3 kcal/day
CHO- 53.20 ± 1.40%
Fat- 24.70 ± 3.10%
Protein 22.10 ± 2.60%
Energy:
3007 ± 444.70 kcal/day
CHO- 54.70 ± 2.20%
Fat- 23.90 ± 3.50%
Protein 21.40 ± 1.80%
35. Table. 1. Major results of experiments
IF pre IF post ND pre ND post
FFM (kg) 73.0 73.72 73.93 74.41
FM (kg) 10.90 9.28 11.36 11.05
Adiponectin (µg/mL) 11.8 13.9 10.8 10.90
Leptin (ng/mL) 0.21 0.2 0 0.24 0.24
TNF- α(ng/L) 5.58 5.13 5.69 5.68
Testosterone (nmol/L) 21.26 21.23 18.60 18.85
IGF -1 (ng/mL) 216.94 216.12 215.59 215.51
36. IF pre IF post ND pre ND post
Insulin (mU/L) 2.78 1.77 2.56 2.82
TSH (mU/L) 1.28 1.27 1.30 1.31
T3 (ng/dL) 83.21 74.32 81.12 82.35
Glucose (mg/dL) 96.64 85.92 95.21 96.02
Total cholesterol
(mg/dL)
193.45 191.37 196.33 197.12
Cortisol (ng/mL) 174.25 186.05 191.24 185.78
HDL (mg/dL) 54.11 58.06 53.33 54.12
LDL (mg/dL) 114.58 110.26 115.58 116.08
TG (mg/dL) 123.78 115.23 137.10 134.58
REE (kcal/day) 1880 1991 1901 1895
RR 0.83 0.81 0.83 0.83
37. Conclusion
• TRF could be beneficial in resistance trained
individuals to improve health related biomarkers,
also deceases FM & maintain muscle mass.
• Regimen- adopt by athletes.
38. Objective:
To compare the feasibility & effectiveness of IER /
CER for weight loss, insulin sensitivity & other
metabolic disease risk markers.
The effect of Intermittent fasting or continuous energy
restriction on weight loss and metabolic disease risk markers:
a randomized trail in young overweight women
Harvie et al., 2011
Int. J. Obes., London
39. Changes in dietary intake, weight and also physical activity levels
At 1, 3 and 6 months
6 Months experiment
Analyzed for metabolic disease risk markers
107 Randomized samples
53 assigned to IER 54 assigned to CER
Fig .1. Study design
42. Parameters Base line 1 month 3 month 6 month
Cholesterol (mmol/L)
IER 5.1 4.6 4.8 4.8
CER 5.2 4.8 4.8 4.7
Triglycerides (mmol/L)
IER 1.2 1.0 1.0 1.0
CER 1.3 1.1 1.0 1.0
LDL(mmol/L)
IER 3.1 2.8 2.9 2.8
CER 3.1 2.8 2.8 2.8
BP systolic
IER 115.2 111.6 111.5 110.2
CER 116.8 110.0 110 109.3
BP Diastolic IER 76.7 72.6 72.4 72.4
CER 75.4 71.1 70.5 69.7
Leptin (ng/ml)
IER 28.5 19.4 18.0 17.0
CER 28.2 19.2 19.2 18.0
Leptin/ Adiponectin ratio
ng/μg
IER 1.5 1.4 1.3 1.2
CER 1.5 1.3 1.2 1.2
DHEAS(μmol/L)
Dehydroepi androsterones
IER 3.2 3.4 3.3 3.3
CER 3.4 3.4 3.2 3.3
Table.3 . Changes in risk markers for breast cancer and cardiovascular
diseases over 6 months
Breast cancer risk markers
CVD risk markers
43. Conclusion
IER is as effective as CER in regards to weight loss, insulin sensitivity
and other health biomarkers.
IER can be offered as an alternative equivalent to CER for reducing
obesity and obesity-related disorders .
Psycho studies are required to better understand behavioural factors
which can promote or reduce compliance to IER and CER regimens.
44. Practicality of Intermittent Fasting in Humans
and its effect on Oxidative Stress and Genes
Related to Aging
Objective: Investigate an alternative dietary approach,
i.e. intermittent fasting (IF) and its effect on gene expression
of aging and oxidative stress.
Wegman et al., 2015
Rejuvenation Research, Florida
45. Cohort of 24 healthy individuals -Randomly
3 week treatment periods—IF and IF with anti-oxidant
Supplemented their
diet with placebo
capsules
Supplemented their diet with
Vit C(1g) and E capsules
(400IU)/ orally
Blood samples - beginning and at the end of trial
Gene expression, RNA/ DNA oxidation were measured
Satisfactory survey
Results were
analyzed
Fig. 1. Trial design
49. Conclusion
Detected a marginal increase (2.7%) in SIRT3
expression due to the IF diet, but no change in
expression of other genes or oxidative stress markers.
Additional studies are in need to assess how
oxidative stress and anti-oxidants interplay with
dietary restriction to mediate the potential health
effects.
Although the study suggests that, the IF dieting
paradigm is acceptable in healthy individuals,
additional research is needed to further assess the
potential benefits and risks.
50. Objective:
To know whether IF enhance Beta cell survival
through Autophagy – lysosomal pathway
Intermittent fasting preserves beta-cell mass on Obesity –
induced Diabetes via the Autophagy lysosomal pathway
Liu et al., 2017
Autophagy, Germany
51. • 8 weeks old mice: N= 86 (wild & lab mices )
• Divided into two groups
• Chow diet (lab diet): 12 weeks
• High fat diet
• randomized into 2
• IF group & Ad- lib- fed (control): 6 weeks
• 12.00PM to 12.00PM alternate 24hr fasting &
feeding
• Ad- lib- fed was access to water
• Mices were weighed at weekly intervals
• After 6 weeks the animals were sacrificed for
further analysis
Fig.1 . Study design
52. Figure . 2. Prevention of beta cell loss in mice with diet-induced obesity
54. Conclusion
Intermittent fasting/ APD preserves
organelle quality via the autophagy-
lysosome pathway to enhance beta cell
survival and stimulates markers of
regeneration in obesity-induced diabetes.
55. Differential Roles of Unsaturated and Saturated Fatty
Acids on Autophagy and Apoptosis in Hepatocytes
Determine the effects of saturated and
unsaturated fatty acids on autophagy and
apoptosis in hepatocytes.
.
Objective:
Mei, et al., 2011
The J. Phar. and Exptl. Thera
56. Hep G2 cells
Control
diet
Western diet
(40 % of calorie from milk)
Then treated with- 6hr
Vehicle control OA OA+CQ CQ
(5%BSA) (500µm) (20µm ) (20µm alone)
Fig.1 . Study design
Cell lysates were subjected to Immunoblot analysis
Induction of AP, No. of autosomes were recorded
For 3 months
Then treated with- 6hr
Vehicle control PA PA+CQ PQ
(5%BSA) (500µm) (20µm ) (20µm alone)
59. Fig. 4. OA but not PA increases the number of autophagosomes and
lipid droplets in HepG2 cells.
A
CB
D
60. • OA treated cells tend to increase the LC3 puncta levels in the
presence of CQ and induce autophagy.
• No. of lipid droplets and level of triglycerides were
significantly higher in OA treated HepG2 cells than in PA
treated cells.
• Impaired autophagy in PA-treated cells may increase
mitochondrial damage and further increase apoptosis.
CONCLUSION
61. Objective: to know the changes in hormones when body knows that it
will be hungry until sunset during RAMDAN & NON- RAMDAN fasting.
62. Material and methods
30 participants= 19 males + 11 females
Two phase
Blood samples in the noon
Study protocol repeated.
1st phase- skip- Suhur 2nd phase- after 6 months
65. Conclusion
Significant differences in leptin, ghrelin, and GLP-
1 levels between Ramadan fasting and non-
Ramadan fasting.
Nervous and Gastro intestinal system may behave
differently in religious than in non- religious
fasting.
66. IF is an dietary approach, which Switches between fasting
states and feeding states (Switch on: Switch off) or (fast: feed).
TRF could be beneficial in resistance trained individuals to
improve health related biomarkers, by decreasing FM &
maintain muscle mass.
TRF Regimen-could be adopted by athletes.
Intermittent energy restriction is as effective as Continuous
energy restriction in regards to weight loss, insulin sensitivity
and other health biomarkers.
IER can be offered as an alternative equivalent to CER for
reducing obesity and obesity-related disorders.
67. Intermittent fasting preserves organelle quality via the
autophagy-lysosome pathway to enhance beta cell survival and
stimulates markers of regeneration in obesity-induced diabetes.
Impaired autophagy in saturated fatty acid (Palmitic acid)-treated
cells may increase mitochondrial damage and further increase
apoptosis.
Unsaturated fatty acid (Oleic acid) treated cells tend to increase
the LC3 puncta levels, which induces autophagy.
No. of lipid droplets and level of triglycerides were significantly
higher in OA treated HepG2 cells than in PA treated cells.
Impaired autophagy in saturated fatty acid (Palmitic acid) treated
cells may increase mitochondrial damage and further increase
apoptosis.
68. There was a marginal increase (2.7%) in SIRT3 expression due to the
IF diet, but no change in expression of other genes or oxidative
stress markers analyzed.
Significant difference's in Leptin, Ghrelin, and GLP-1 levels between
Ramadan fasting and non-Ramadan fasting.
Nervous and Gastro intestinal system may behave differently in
religious than in non- religious fasting.
Although IF dieting paradigm is acceptable in healthy individuals,
additional research is needed to further assess the potential
benefits and risks.
69.
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