Funded in part by A.P. Møller og Hustru Chastine Mc-Kinney Møllers Fond til almene Formaal, Novo Nordisk Fonden, Novo Nordisk Foundation, A.P. Møller Fonden
Three-week Alternate-day Fasting Improves Myocardial Flow Reserve and Reduces Oxygen Use in Overweight Individuals
Kjærulff MLG, Luong TV, Munk OL, Tolbod LP, Cunnane SC, Nielsen EN, Berg-Hansen K, Wiggers H, Søndergaard E, Møller N, Møller N, Gormsen LC
The Journal of clinical endocrinology and metabolism · 3 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Industry funded
- Nonprofit
- Dagmar Marshalls Fond
- Nonprofit
- Arvid Nilssons Fond
- University or hospital
- Aarhus Universitetshospital
- Nonprofit
- Savvaerksejer Jeppe Juhl og Hustru Ovita Juhls Mindelegat
- Nonprofit
- Snedkermester Sophus Jacobsen og Hustru Astrid Jacobsens Fond
- Company
- A.P. Møller og Hustru Chastine Mc-Kinney Møllers Fond til almene Formaal
- Nonprofit
- Helsefonden
- Nonprofit
- Direktør Emil C. Hertz og Hustru Inger Hertz Fond
- Nonprofit
- Helga og Peter Kornings Fond
- Nonprofit
- Eva og Henry Frænkels Mindefond
- Nonprofit
- Frimodt-Heineke Fonden
- Company
- Novo Nordisk Fonden
- Nonprofit
- Raimond og Dagmar Ringgård-Bohns Fond
- Nonprofit
- Direktør Emil C. Hertz og hustru Inger Hertz’ Fond
- Company
- Novo Nordisk Foundation
- University or hospital
- Aarhus University Hospital
- Nonprofit
- Henry og Astrid Møllers Fond
- Nonprofit
- Savværksejer Jeppe Juhls og hustru Ovita Juhls Mindelegat
- Nonprofit
- Direktør Emil C. Hertz og hustru Inger Hertz' Fond
- Company
- A.P. Møller Fonden
- Nonprofit
- Jens Anker Andersen Fonden
- Nonprofit
- Snedkermester Sophus Jacobsen og hustru Astrid Jacobsens Fond
- Grants
- Novo Nordisk Fonden (NNF19OC0058872); Novo Nordisk Fonden (NNF23OC0085664)
Based on 22 listed funder(s).
Publication
- Published
- 2025-08-26 · J Clin Endocrinol Metab · vol. 111 · issue 3 · pp. 744–756
- Publisher
- Oxford University Press
- Cited
- 2 citations · more than 78% of similar papers · 1.1× the field average
- References
- 0 works
- Access
- Paywalled
- Research areas
- Dietary Effects on Health · Diet and metabolism studies · Cardiovascular Function and Risk Factors
- Keywords
- Internal medicine, Medicine, Endocrinology, Context (archaeology), Perfusion, Overweight, Blood pressure, Cardiology, Ejection fraction, Cardiac output, Blood flow, Obesity, Biology
- MeSH
- myocardium, humans, positron-emission tomography, fasting, cross-over studies, oxygen consumption, coronary circulation, adult, middle aged, female, male, overweight, fractional flow reserve, myocardial
11 authors
From DK, CA
- Mette Louise Gram Kjærulff · correspondingSteno Diabetes Centers; Aarhus University; Aarhus University Hospital; Steno Diabetes Center Aarhus
- Thien Vinh LuongSteno Diabetes Centers; Aarhus University; Aarhus University Hospital; Steno Diabetes Center Aarhus
- Ole Lajord MunkAarhus University; Aarhus University Hospital
- Lars Poulsen TolbodAarhus University; Aarhus University Hospital
- Stephen C. CunnaneUniversité de Sherbrooke
- Erik Nguyen NielsenAarhus University Hospital
Abstract
Context
Alternate-day fasting (ADF) is a dietary regimen with prolonged fasting periods associated with metabolic and cardiovascular benefits. It remains unclear if ADF improves cardiac function and metabolism to explain these benefits.
Objective
This study aimed to investigate the effects of a 3-week ADF intervention on myocardial efficiency, perfusion, and substrate metabolism in overweight/obese individuals.
Methods
Sixteen participants with overweight (body mass index: 32 ± 1.9 kg/m2) completed this randomized crossover study comparing ADF with a standard diet. Dynamic cardiac positron emission tomography scans were performed using 5 tracers: [15O]water to assess myocardial blood flow and flow reserve (MFR), [11C]acetate to measure myocardial oxygen consumption (MVO2) and myocardial external efficiency (MEE), and [11C]β-hydroxybutyrate, [11C]palmitate, and [18F]fluorodeoxyglucose to assess metabolism of β-hydroxybutyrate (OHB), free fatty acid (FFA), and glucose, respectively. Blood samples were analyzed for OHB, FFA, glucose, lactate, and insulin. Blood pressure, heart rate, cardiac output, and left ventricular mass, ejection fraction, and volumes were assessed.
Results
ADF increased circulating ketones on fasting days (peak: 0.67 ± 0.09 mmol/L), which remained elevated on eating days (0.20 ± 0.03 mmol/L). However, myocardial substrate metabolism remained unaltered following ADF. Blood pressure and cardiac output significantly decreased after ADF (systolic/diastolic: 13/9 mmHg and 0.5 L/min, respectively; P < .001). MVO2 decreased by 10% (P = .01) and total left ventricular energy use by 19% (P < .01). Resting myocardial perfusion decreased by 9% (P < .05), and MFR increased by 34% (P < .01).
Conclusion
A 3-week ADF regimen reduced blood pressure and MVO2, and improved MFR, suggesting ADF may provide a nonpharmacological strategy to improve cardiovascular health in individuals with overweight.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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