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Medical News in Brief
April 12, 2024

Study Examines Intermittent Fasting and Cardiovascular Mortality

JAMA. 2024;331(17):1440. doi:10.1001/jama.2024.5158

Limiting time spent eating to an 8-hour window or less each day—a type of so-called intermittent fasting—was linked with a 91% increased risk of death from cardiovascular disease compared with eating throughout a 12- to 16-hour period, according to presented at an American Heart Association conference.

have found health benefits when people shortened their eating windows. Despite this, time-restricted eating was not associated with a lower risk of death from any cause in the new study.

The study had several major limitations. The researchers analyzed results from about 20 000 US participants who responded to a national survey about health and nutrition. The dietary data came from only 2 self-reported questionnaires, which relied on the participants’ memory. Critically, the researchers also didn’t provide data on other factors that might have affected participants’ health or their decision to engage in time-restricted eating, and instead focused only on the times of day they ate and their cause of death.

“Although the study identified an association between an 8-hour eating window and cardiovascular death, this does not mean that time-restricted eating caused cardiovascular death,” senior study author Victor Wenze Zhong, PhD, cautioned in a .

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Article Information

Published Online: April 12, 2024. doi:10.1001/jama.2024.5158

1 Comment for this article
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More Evidence Needed to Examine the Relationship Between Intermittent Fasting and Cardiovascular Mortality
Xiaohua Liang, PhD, MD | Department of Clinical Epidemiology and Biostatistics, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders
This study found that eight-hour time-restricted eating (TRE) was not associated with a decrease of all-cause or cancer mortality, but was associated with higher risk of cardiovascular mortality in the general U.S. adult population, as well as in individuals with cardiovascular disease or cancer. Eight-hour TRE was not associated with all-cause and cause-specific mortality in individuals with cardiometabolic morbidities. These findings need replication but do not support long-term use of 8-hour TRE for preventing cardiovascular death nor for improving longevity. However, several problems should be addressed, to verify the real relationship between TRE and mortality. First, why the authors set the TRE groups as <8, 8-<10, 10-<12, 12-16 hours (mean duration in US adults), and >16 hours, which needs to be interpreted according to a fitting graph. And this should not just make the mean duration in US adults as reference group, and the lowest risk group should be identified. Second, the sample size in the TRE <8 hours was so small (n=414), and the sample size in this group with cancer, dyslipidemia, hypertension, or diabetes was also limited. Which will not have enough power to provide a valid and correct conclusion. Third, in different populations different TRE should be recommended to realize the greatest health effects. And intervention studies found that 8-10 hours intervention may be effective for BMI control and improve glycolipid abnormality. Therefore, this study should be analyzed basing on obesity subgroups and age groups. The BMI was greatest in TRE<8 hours, therefore the increased CVD may attribute to this reason. Fourth, most information used in this manuscript was self-reported, which may miss undiagnosed new cases, as people in TRE<8 hour may take more consideration about their health status. Therefore, there are more cases will be diagnosed in that group. Moreover, the author introduced “An eating occasion was defined as the consumption of foods or beverages exceeding 5 kcal at any given time”. The definition is inappropriate. As some people unlike to intake so much in the morning, this study may define them as TRE <8 hours. The first and the last meal with calories should be considered as dietary intake. The author may try to do more sensitivity analyses to verify the findings.
CONFLICT OF INTEREST: None Reported
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