Several new clinical studies provide evidence for the potential of specific intermittent and periodic fasting interventions to decrease adiposity and HbA1c in patients with obesity and/or type 2 diabetes mellitus, while also reducing drug use, adverse effects and risk factors for other diseases.
Key advances
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Ten to eleven-hour time-restricted eating (TRE) requires a daily commitment but might be effective in reducing HbA1c, weight and other cardiometabolic risk factors after several months4,5,6.
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Modified fasting interventions for 2 days per week (5:2) with additional daily restrictions might be effective in reducing HbA1c and weight but are difficult to implement in the short term and long term7.
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Fasting-mimicking diet (FMD) cycles that last 5 days adopted once a month or less are effective at reducing HbA1c, weight, drug use and other disease risk factors in patients with obesity and/or type 2 diabetes mellitus after 6 cycles but a proportion of patients will not be able to follow this regimen in the long term8,9.
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The activation of polyamine signalling and autophagy might be important in mediating the metabolic effects of fasting interventions, particularly those lasting more than several continuous days10.
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V.D.L. has equity interest in L-Nutra, a company making medical food. He also has filed patents related to fasting-mimicking diets and their medical use.
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Longo, V.D. Intermittent and periodic fasting in the treatment of obesity and type 2 diabetes mellitus. Nat Rev Endocrinol 21, 73–74 (2025). https://doi.org/10.1038/s41574-024-01078-5
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DOI: https://doi.org/10.1038/s41574-024-01078-5
