Effects of Intermittent Fasting in Humans Compared to a Normal Diet and Caloric Restriction: A Meta-analysis of Randomized Controlled Trials

Effects of Intermittent Fasting in Humans Compared to a Normal Diet and Caloric Restriction: A Meta-analysis of Randomized Controlled Trials | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effects of Intermittent Fasting in Humans Compared to a Normal Diet and Caloric Restriction: A Meta-analysis of Randomized Controlled Trials Fei Xie, Rongrong Fu, Jiaze Hong, Haixiang Ni, Kepin Yu, Lihu Gu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1442328/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The popularity of intermittent fasting (IF) has increased as more and more people are trying to avoid or alleviate obesity and metabolic disease. This study aimed to systematically explore the effects of various IF in humans. Methods The randomized controlled trials (RCTs) related to IF versus normal diet (non-intervention diet) or caloric restriction (CR) were retrieved in PubMed, Web of Science, the Cochrane Library database, and Embase. Extraction outcomes included, but not limited to, weight, body mass index (BMI), waist circumference (WC), glucose, and triglyceride (TG). Results Contrasting results showed that, participants had lower weight (WMD = 1.10, 95%CI: 0.09–2.12, p = 0.03) and BMI after IF (WMD = 0.38, 95%CI: 0.08–0.68, p = 0.01). The WC of participants in the IF group decreased significantly compared with the normal diet (WMD = 1.02, 95%CI: 0.06–1.99, p = 0.04). IF regulated fat mass (FM) more effectively than normal diet (WMD = 0.74, 95%CI: 0.17–1.31, p = 0.01). The fat-free mass of people after IF was higher (WMD=-0.73, 95%CI: (-1.45)-(-0.02), p = 0.05). There was no difference in blood glucose fluctuation between participants in the after IF and normal diet groups. The results of insulin and HOMA-IR, though, indicated that IF was significantly more beneficial than normal diet (SMD=-0.21, 95%CI: 0.02–0.40, p = 0.03, and WMD = 0.35, 95%CI: 0.04–0.65, p = 0.03, respectively). Cholesterol and TG levels after IF were also lower than after a normal diet (SMD = 0.22, 95%CI: 0.09–0.35, p = 0.001, and SMD = 0.13, 95%CI: 0.00-0.26, p = 0.05, respectively). Conclusion IF reduced weight, WC, and FM without affecting lean tissue. IF also could improve insulin resistance and blood lipid conditions compared with non-intervention diets. Intermittent fasting non-intervention diet caloric restriction effect meta-analysis. Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction In recent years, the number of patients with metabolic diseases and obesity around the world has increased significantly [ 1 ]. The numerous treatments for these kind of disease are mostly underpinned by diet and exercise [ 2 , 3 ]. Intermittent fasting (IF) has become a popular lifestyle in recent years, though it has existed in religious and cultural contexts for a long time [ 4 , 5 ]. IF is a term that covers several specific patterns [ 6 , 7 ]. Alternate-day fasting (ADF), intermittent energy restriction (IER), time-restricted feeding (TRF), and Ramadan fasting are currently recognized as several types of IF [ 7 , 8 ]. ADF consists of alternating fasting days and eating days, while TRF focuses on the daily free energy intake within a specific time window of 4–12 [ 8 ]. Ramadan Fasting refers to one meal before dawn or after sunset [ 8 , 9 ]. There is also a modified fasting regime that differs from the previous ones in terms of not taking in any energy during the fasting period, and eating extremely low calories food two or three days per week [ 8 ]. IF is a dietary strategy that aims to maintain fasting at periodic fixed time intervals. and it has been used in overweight or obese patients to hopefully achieve weight loss [ 6 ]. Caloric restriction (CR), considered the standard dietary strategy to lose weight or maintain weight, has been discovered as difficult to be maintained for many individuals and possible occurrence of late weight rebound when use in long term. So intermittent CR and a combination with temporal control was proposed to replace simple long-term regimen of CR [ 10 , 11 ]. One study suggested that IF can avoid human suffering from obesity, hypertension, rheumatoid arthritis, and asthma, as well as slow aging [ 12 ]. Also, another study pointed out that, IF may affect the gut microbiome in terms of composition and physiology [ 13 ]. A meta-analysis reported that ADF can result in better patient compliance and reduced fat mass (FM) than CR in patients [ 11 ]. Furthermore, a recent investigation on TRF illustrated its effectiveness in weight loss [ 14 ]. Although some studies have revealed the effects of certain fasting patterns, comprehensive systematic reviews of IF are limited and in need. Therefore, herein, we attempted to explore the effects of IF on humans systematically and comprehensively. Methods Literature search strategy Two researchers independently screened the literature related to IF from PubMed, Web of Science, the Cochrane Library database, and Embase. All selected literature was published before June 2021. The keywords used in the search were ”randomized controlled trial” OR “controlled clinical trial” OR “randomized” OR “placebo” OR “clinical trials as topic OR randomly” OR “trial” AND “fasting” OR “intermittent* fast*” OR “fast* diet*” OR “alternat* fast*” OR “modified fast*” OR “food abstinence” OR “food fast*” OR “diet* restricti*” OR “food restricti*” OR “time restricted feed*” OR “time restricted fast*” OR “one whole day fast*” OR “food tim*” OR “Ramadan” OR “Ramadhan” OR “Ramadan fasting” OR “Islamic fasting” OR “Ramadan intermittent fasting” OR “Ramadan diurnal fasting” OR "Ramadan model of intermittent fasting" OR "intermittent prolonged fasting during Ramadan" OR “Ramadan fast” OR “recurrent circadian fasting”. The references in the relevant literature were screened additionally to expand the library of relevant literature. The study guideline was Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) [ 15 ]. Inclusion criteria and exclusion criteria Literature meeting all the following criteria would be included: (1) The intervention group included but not limited to ADF, TRF, IER, and Ramadan fasting, while the control group was the normal diet or CR. (2) The study provided physical and biochemical parameters of the subjects in both the intervention group and the control group after the intervention. (3) The follow-up time was at least 1 month. (4) Data was available. Study was excluded once it met any of the following criteria: (1) The study was not a randomized controlled trial (RCT). (2) The research individual was not human. (3) The full text of the article was not in English. (4) The literature was duplicated. Quality assessment and data extraction The quality of screened RCTs was evaluated using the Cochrane Collaboration’s tool. Two investigators independently assessed the risk of study bias. Controversies were decided by a third researcher. Study characteristics (author, year, country, trial registration, patient inclusion criteria, intervention, control, and follow-up), physical parameters (weight, body mass index (BMI), waist circumference (WC)), and biochemical parameters (insulin, glucose, total cholesterol (TC), and triglyceride (TG)) were extracted from the included studies. IF patterns were diverse, and current major dietary patterns were ADF, TRF, IER, and Ramadan fasting [ 7 , 8 ]. This study was roughly divided into daily TRF, weekly TRF, ADF, and Ramadan fasting based on the time and frequency of fasting with IF. Of these, daily TRF referred to a feeding window of 4 to 12 hours per day and fasting for the remainder of the day, whereas weekly TRF referred to 2–3 fasting days per week. The energy intake of the participants was not restrict in the intervention group during the intervention period as it may differ under different dietary IF patterns, Statistical analysis Review Manager 5.3 was used for statistical analysis. The weight mean difference (WMD) and the standard mean difference (SMD) were calculated for continuous data. The 95% confidence intervals (CI) for all statistical results were provided. I2 was used to represent the heterogeneity of the results. When I2 > 50, the random-effect model was used, otherwise, the fixed-effect model was used. P < 0.05 was considered as to be statistically significant in the results. Sensitivity analysis was performed by removing the included studies one by one in this statistical analysis. Meanwhile, funnel plots were used to examine publication bias [ 16 ]. Results Study characteristics After retrieval and elimination of duplicates, a total of 24887 articles were screened. Then, 24729 of them were excluded based on their irrelevant title and abstract. After thoroughly viewing the fulltext of the remaining 158 articles, 115 of them were excluded, of which 85 were excluded due to lack of relevant results, 4 exclusions were due to non-RCTs, 2 were excluded due to population duplication, and 24 were excluded due to unavailable data. Finally, 43 RCTs [3, 6, 7, 9, 17–55] were included in our meta-analysis. The detailed retrieval process and elimination reasons are recorded in the flow chart (Fig. 1). Characteristics of included RCTs in the meta-analysis were recorded in Table 1. A total of 2483 participants were enrolled in the study, with 1277 in the intervention group and 1206 in the control group. Interventions included weekly TRF, daily TRF, ADF, as well as Ramadan fasting. Eating patterns in the control group included normal diet and CR. Normal diet lived up to its name, while CR included continuous energy restriction, Mediterranean diet, and Dietary Approaches to Stop Hypertension (DASH). The included studies were followed for at least 1 month, with a median follow-up of 3 months. Participants in this study were came from Brazil, China, Germany, Iran, Italy, Korea, Malaysia, New Zealand, Norway, Spain, Tunisia, Turkey, the UK, and the USA. Table 1 Characteristics of included RCTs in the meta-analysis. Author, year Country Trial registration Patient inclusion criteria Intervention Control Follow-up (month) Fasting patterns N Dietary patterns N Antoni, 2018 UK ISRCTN13687043 BMI > 25kg/m 2 ; Age: 18–65 years IER (2:5 diet) 24 CER 24 16 Beaulieu, 2020 UK NCT03447600 BMI: 25-34.9kg/m 2 ; Age: 18–55 years ADF 24 CER 22 10 Bhutani, 2013 USA NA BMI: 30-39.9kg/m 2 ; Age: 25–65 years ADF 25 Normal diet 16 3 Bowen, 2018 Australia ACTRN12616000110482 BMI > 27kg/m 2 ; Age: 25–60 years ADF + DER 82 DER 81 4 Cai, 2019 China ChiCTR1900024411 BMI > 24kg/m 2 with NAFLD; Age: 18–65 years ADF 95 Normal diet 79 3 TRF (16:8 diet) 97 Carlson, 2007 USA NA BMI: 18-25kg/m 2 ; Age: 40–50 years TRF (20:4 diet) 15 Normal diet 15 4 Catenacci, 2016 USA NA BMI ≥ 30kg/m 2 ; Age: 18–55 years ADF 15 CR 14 8 Chow, 2020 USA NCT03129581 BMI ≥ 25kg/m 2 ; Age: 18–65 years TRF (16:8 diet) 13 Normal diet 9 3 Cienfuegos, 2021 USA NCT03867773 BMI: 30-49.9kg/m 2 ; Age: 18–65 years TRF (20:4 diet) 19 Normal diet 19 2 TRF (18:6 diet) 20 Conley, 2018 Australia ACTRN12614000396628 BMI ≥ 30kg/m 2 ; Age: 55–75 years IER (2:5 diet) 12 CR 12 6 Corley, 2018 New Zealand ACTRN12614000402640 BMI: 30-45kg/m 2 with T2DM; Age > 18 years TRF (2:5 diet) 22 CR 19 4 Correia, 2021 USA NA Age: 18–30 years TRF (16:8 diet) 9 Normal diet 9 1 Coutinho, 2017 Norway NCT02169778 BMI: 30-40kg/m 2 ; Age: 18–65 years IER (3:4 diet) 18 CER 17 3 de Oliveira Maranhão Pureza, 2021 Brazil NA BMI: 30-45kg/m 2 TRF + CR (12:12 diet) 31 CR 27 12 Gabel, 2019 USA NCT00960505 BMI: 25-39.9kg/m 2 ; Age: 18–65 years ADF 34 CR 35 12 Normal diet 31 Guo, 2021 China NCT03608800 Age: 30–50 years with comorbidities IF (2:5 diet) 23 Normal diet 23 2 Harvie, 2011 UK NA BMI: 24-40kg/m 2 ; Age: 30–45 years IER (2:5 diet) 53 CER 54 6 Harvie, 2013 USA ISRCTN52913838 BMI: 24-45kg/m 2 ; Age:20–65 years IECR (2:5 diet) 37 DER 40 16 Headland, 2019 Australia ACTRN12614001041640 BMI ≥ 27kg/m 2 ; Age > 18 years IER (2:5 diet) 82 CER 81 13 Hirsh, 2019 USA NCT03372109 BMI: 25-29.9kg/m 2 ; Age: 21–65 years IF (2:5 diet) 10 Normal diet 12 2 Kotarsky, 2021 USA NCT03823872 BMI: 25-34.9kg/m 2 ; Age: 35–65 years TRF (16:8 diet) 13 Normal diet 10 14 Kunduraci, 2020 Turkey NCT04502329 BMI ≥ 27kg/m 2 with comorbidities; Age: 18–65 years IER (16:8 diet) 35 CER 35 3 Lowe, 2020 USA NCT03393195 Age: 18–64 TRF (16:8 diet) 69 Normal diet 72 3 Martens, 2020 USA NCT02970188 BMI < 40kg/m 2 ; Age: 55–79 years TRF (16:8 diet) 24 CR 24 2 Martínez-Rodríguez, 2021 Spain NCT04404413 NA IF 14 Normal diet 14 4 McAllister, 2019 USA NA NA TRF (16:8 diet) 11 Normal diet 12 1 Moro, 2016 Italy NA NA TRF (16:8 diet) 17 Normal diet 17 2 Moro, 2020 Italy NCT04320784 Age 23kg/m 2 ; Age: 18–64 years ADF + CR 13 CR 10 2 Panizza, 2019 USA NCT03639350 BMI: 25-40kg/m 2 ; Age: 35–55 years IER + MED (2:5 diet) 30 DASH 30 6 Parvaresh, 2019 Iran IRCT201509092395N8 BMI: 25-40kg/m 2 ; Age: 25–60 years ADF 35 CR 35 2 Pureza, 2020 Brazil RBR-387v6v BMI: 30-45kg/m 2 TRF + CR (12:12 diet) 31 CR 27 1 Razavi, 2021 Iran NA BMI: 25-40kg/m 2 with MetS; Age: 25–60 years ADF 40 CR 40 4 Schübel, 2018 Germany NCT02449148 BMI: 25-40kg/m 2 ; Age: 35–65 years ICR (2:5 diet) 45 CR 49 12 Normal diet 52 Stote, 2007 USA NA BMI: 18-25kg/m 2 ; Age: 40–50 years TRF (20:4 diet) 15 Normal diet 15 6 Teng, 2011 Malaysia NA BMI: 23-29.9kg/m 2 ; Age: 50–70 years FCR (2:5 diet) 14 Normal diet 14 3 Teng, 2013 Malaysia NA BMI: 23-29.9kg/m 2 ; Age: 50–70 years FCR (2:5 diet) 28 Normal diet 28 3 Tinsley, 2017 USA NA NA TRF (20:4 diet + 4:3 diet) 14 Normal diet 14 2 Tinsley, 2019 USA NCT03404271 Age: 18–30 years TRF (16:8 diet) 13 Normal diet 14 2 Trabelsi, 2012 Tunisia NA NA Ramadan 10 Normal diet 9 1 Trabelsi, 2013 Tunisia NA NA Ramadan 8 Normal diet 8 1 Varady, 2013 USA NA BMI: 20-29.9kg/m 2 ; Age: 35–65 years ADF 16 Normal diet 16 3 Zouhal, 2020 Tunisia NA BMI: 30-40kg/m 2 Ramadan 14 Normal diet 14 1 RCT, randomized controlled trial; IER, intermittent energy restriction; ADF, alternate day fasting; DER, daily energy restriction; TRF, time-restricted feeding; NAFLD, non-alcoholic fatty liver disease; IF, intermittent fasting; CR, calorie restriction; MED, Mediterranean diet; MetS, Metabolic syndrome; ICR, intermittent calorie restriction; FCR, Muslim sunnah fasting; UK, United Kingdom; USA, the United States; BMI, body mass index; NA, no available; CER, continuous energy restriction; ICER, intermittent energy and carbohydrate restriction; DASH, Dietary Approaches to Stop Hypertension; 2:5 diet, 2-day fasting per week; 16:8 diet, 16-hour fasting per day; 20:8 diet, 20-hour fasting per day; 18:6 diet, 18-hour fasting per day; 3:4 diet, 3-day fasting per week; 12:12 diet, 12-hour fasting per day; 4:3 diet, 4-day fasting per week; N, number of patients. Risk of bias Quality assessment of studies included was shown in Supplementary Table 1. The Cochrane Collaboration’s tool was used to assess the risk of bias in studies. Most studies were at low risk in sequence generation and allocation concealment. Only one study showed unclear risk in sequence generation due to incomplete information. As for blinding of the risk of bias, 10 trials were evaluated as high, 15 were unclear, and the rest 18 studies were low. 43 studies were at low risk for incomplete outcome data and selective outcome reporting. As for free of other bias, 1 was high risk, 15 were unclear risk, and the remaining 27 were low risk. IF vs Normal diet (Non-intervention diet) Nineteen studies reported the weight of participants after their experience of IF or normal diet. The results illustrated that IF was significantly more beneficial to weight loss (WMD = 1.10, 95%CI: 0.09–2.12, p = 0.03) (Supplementary Table 2). For BMI, the statistical result with 9 studies enrolled reported that IF could reduce more BMI compared with the normal diet (WMD = 0.38, 95%CI: 0.08–0.68, p = 0.01)(Fig. 2a). In addition, IF was also associated with a significant reduction in WC among participants who underwent IF (WMD = 1.02, 95%CI: 0.06–1.99, p = 0.04) (Fig. 2b). In terms of body composition, the participants in the IF group had less FM than that in the normal diet group (WMD = 0.74, 95%CI: 0.17–1.31, p = 0.01) (Fig. 3a). The fat-free mass (FFM) of participants who used IF was greater than that in the group of normal diet, demonstrating that IF had less effect on the FFM (WMD=-0.73, 95%CI: (-1.45)-(-0.02), p = 0.05) (Fig. 3b). However, for FM% of the participants, there was no significant difference between IF and normal diet groups (WMD = 0.38, 95%CI: (-0.14)-0.89, p = 0.16) (Supplementary Table 2). Ten studies provided data of systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the participants. The results revealed that neither SBP nor DBP was statistically affected via IF or normal diet (WMD = 1.32, p = 0.33, and WMD = 0.96, p = 0.39, respectively) (Supplementary Table 2). Sixteen studies examined the effects of IF and a normal diet on the glucose level of participants, where no difference was observed (SMD=-0.00, 95%CI: (-0.14)-0.13, p = 0.94) (Fig. 4a). Thirteen studies had investigated the effects of IF and normal diet on insulin in participants. The corelated systematic analysis showed that the insulin levels after IF were significantly lower than that after normal diet (SMD=-0.21, 95%CI: 0.02–0.40, p = 0.03) (Fig. 4b). In addition, the result of homeostasis model assessment insulin resistance (HOMA-IR) from 8 studies showed that IF could reduce insulin resistance more effectively compared to normal diet with a statistically significant difference. (WMD = 0.35, 95%CI: 0.04–0.65, p = 0.03; I2 = 0%) (Fig. 4c). Eighteen studies provided the TG level of participants following IF and the normal diet, and IF was proved to be significantly more effective in reducing TG in participants. (SMD = 0.22, 95%CI: 0.09–0.35, p = 0.001) (Fig. 5a). Eighteen studies reported the TC levels in IF group and a normal diet group, and the results indicated that participants would have significantly lower TC in the former case (SMD = 0.13, 95%CI: 0.00-0.26, p = 0.05; I2 = 26%) (Fig. 5b). In addition, 17 and 16 studies reported statistical results for low-density lipoprotein (LDL) and high-density lipoprotein (HDL), respectively. The statistical difference of those parameters between IF and normal diet was discovered in neither aspect (SMD = 0.10, p = 0.42, and SMD=-0.03, p = 0.63, respectively) (Supplementary Table 2). IF vs CR The physical and biochemical parameters of IF versus CR were analyzed in this study. The result of 10 studies showed that IF reduced more WC in participants. The result was statistically significant with low heterogeneity (WMD = 2.29, 95%CI: 0.57–4.01, p = 0.009; I2 = 35%). Moreover, no difference between IF and CR in terms of weight, glucose, and blood lipids. Details of the results were shown in Table 2. Table 2 Physical and biochemical parameters of IF versus CR. No. of studies SMD/WMD 95%CI p I 2 (%) Effect-model Weight 6 2.08 -0.61-4.77 0.13 22 Fixed BMI 11 0.35 -0.64-1.34 0.49 57 Random WC 10 2.29 0.57–4.01 0.009 35 Fixed FM(kg) 12 1.96 -0.34-4.27 0.09 72 Random FM% 8 0.77 -0.62-2.16 0.28 5 Fixed FFM(kg) 10 0.65 -0.51-1.81 0.27 0 Fixed SBP 9 1.75 -0.41-3.90 0.11 45 Fixed DBP 9 1.06 -0.53-2.65 0.19 0 Fixed Glucose 12 -0.01 -0.16-0.14 0.87 22 Fixed Insulin 10 0.07 -0.09-0.22 0.40 44 Fixed HOMA-IR 7 0.00 -0.31-0.32 0.99 54 Random TG 10 0.03 -0.14-0.19 0.76 20 Fixed TC 10 0.08 -0.09-0.24 0.35 0 Fixed LDL 9 0.06 -0.11-0.23 0.49 0 Fixed CR, calorie restriction; IF, intermittent fasting; BMI: body mass index; WC, waist circumference; FM, fat mass; FFM, fat-free mass; SBP, systolic blood pressure; DBP, diastolic blood pressure; HOMA-IR, homeostasis model assessment insulin resistance; TC, total cholesterol; TG, triglyceride; LDL, low density lipoprotein; SMD, standard mean difference; WMD, weighted mean difference; CI, confidence interval. SMD: Glucose, Insulin, TG, TC, LDL; WMD: Weight, BMI, WC, FM(kg), FM%, FFM(kg), SBP, DBP, HOMA-IR. Subgroup analysis The main pattern of IF in this study was ADF and weekly TRF, so they were enrolled in the comparison with CR separately. The physical and biochemical parameters of participants in ADF and CR groups that were included for the investigation were weight, body composition, glucose, and blood lipids. According to the statistical results, there was no significant difference in all parameters between them. In other words, the effects of ADF and CR on participants were similar (Table 3). In addition, 8 studies compared post-intervention data of weekly TRF versus CR. The statistical result of WC extracted from 6 studies showed that weekly TRF could reduce WC more effectively than CR (WMD = 3.36, 95%CI: 1.24–6.08, p = 0.003; I2 = 38%) (Table 3). Five studies reported the FM of weekly TRF and CR subgroup and more reduced FM was revealed in the weekly TRF group (WMD = 2.58, 95%CI: 0.61–4.55, p = 0.01) (Table 3). Also, weekly TRF was more effective in reducing DBP in participants (WMD = 3.47, 95%CI: (-0.06)-7.00, p = 0.05) (Table 3). More detailed physical and biochemical results are recorded in Table 3. Table 3 Physical and biochemical parameters of ADF versus CR and TRF (week) versus CR. No. of studies SMD/WMD 95%CI p I 2 (%) Effect-model ADF vs CR Weight 6 2.09 -2.91-7.10 0.41 63 Random BMI 5 0.66 -0.24-1.57 0.15 45 Fixed WC 3 1.37 -1.34-4.08 0.32 28 Fixed FM(kg) 6 2.80 -0.74-6.34 0.12 78 Random FM% 3 1.11 -1.00-3.23 0.30 38 Fixed FFM(kg) 4 0.23 -1.64-2.11 0.81 0 Fixed SBP 3 4.34 -5.83-14.50 0.40 79 Random DBP 3 -0.03 -2.47-2.41 0.98 0 Fixed Glucose 4 0.10 -0.32-0.53 0.63 56 Random Insulin 4 0.25 -0.23-0.73 0.31 65 Random TG 4 -0.01 -0.25-0.24 0.96 28 Fixed TC 4 0.04 -0.21-0.28 0.78 0 Fixed LDL 4 0.05 -0.19-0.30 0.68 0 Fixed HDL 4 -0.08 -0.59-0.44 0.77 71 Random TRF(week) vs CR Weight 8 2.41 -0.33-5.14 0.08 42 Fixed BMI 4 0.66 -0.91-2.22 0.41 51 Random WC 6 3.66 1.24–6.08 0.003 38 Fixed FM(kg) 5 2.58 0.61–4.55 0.01 45 Fixed FM% 4 1.42 -0.68-3.53 0.18 0 Fixed FFM(kg) 5 1.27 -0.29-2.82 0.11 2 Fixed SBP 4 3.19 -1.26-7.63 0.16 0 Fixed DBP 4 3.47 -0.06-7.00 0.05 0 Fixed Glucose 6 -0.08 -0.29-0.14 0.49 14 Fixed Insulin 4 0.05 -0.34-0.43 0.81 59 Random TG 5 0.11 -0.14-0.36 0.39 33 Fixed TC 4 0.13 -0.13-0.40 0.33 0 Fixed LDL 4 0.07 -0.20-0.33 0.63 0 Fixed HDL 4 -0.07 -0.34-0.19 0.60 0 Fixed CR, calorie restriction; ADF, alternate day fasting; TRF, time-restricted feeding; BMI: body mass index; WC, waist circumference; FM, fat mass; FFM, fat-free mass; SBP, systolic blood pressure; DBP, diastolic blood pressure; TC, total cholesterol; TG, triglyceride; LDL, low density lipoprotein; HDL, high density lipoprotein; SMD, standard mean difference; WMD, weighted mean difference; CI, confidence interval. SMD: Glucose, Insulin, TG, TC, LDL, HDL; WMD: Weight, BMI, WC, FM(kg), FM%, FFM(kg), SBP, DBP. Subgroup analysis found that, comparing with normal diet and CR, IF had different effects depending on gender. For females, IF was significantly more effective with highly heterogeneous in reducing FM. (WMD = 3.72, 95%CI: 0.56–6.87, p = 0.02; I2 = 67%) (Table 4). However, no advantage was discovered in any other aspects, such as weight, WC, FM%, FFM, glucose, and insulin. When it comes to male population, the statistical results showed that IF could significantly reduce males’ weight and BMI compared with both normal diet and CR, which were supported by 8 and 4 studies, respectively (WMD = 2.16, 95%CI: 0.48–3.85, p = 0.01; I2 = 29%, and WMD = 0.97, 95%CI: 0.23–1.71, p = 0.01; I2 = 0%, respectively) (Table 4). Besides, IF also reduced TG levels more effectively in males (WMD = 0.54, 95%CI: 0.22–0.86, p < 0.001; I2 = 31%). More detailed physical and biochemical results are listed in Table 4. Table 4 Physical and biochemical parameters of IF versus Normal diet/CR in female and male. No. of studies SMD/WMD 95%CI p I 2 (%) Effect-model Female Weight 6 2.08 -0.61-4.77 0.13 22 Fixed WC 5 1.80 -1.53-5.13 0.29 50 Random FM(kg) 5 3.72 0.56–6.87 0.02 67 Random FM% 3 0.68 -1.45-2.80 0.53 0 Fixed FFM(kg) 4 1.10 -0.37-2.57 0.14 0 Fixed Glucose 3 -0.00 -0.17-0.17 1.00 0 Fixed Insulin 3 0.92 -0.21-2.06 0.11 0 Fixed Male Weight 8 2.16 0.48–3.85 0.01 29 Fixed BMI 4 0.97 0.23–1.71 0.01 0 Fixed FM(kg) 4 0.98 -0.38-2.35 0.16 0 Fixed FM% 7 0.40 -0.12-0.92 0.14 0 Fixed FFM(kg) 6 0.37 -0.98-1.72 0.59 0 Fixed Glucose 6 0.09 -0.21-0.40 0.55 0 Fixed TG 6 0.54 0.22–0.86 < 0.001 31 Fixed TC 6 0.15 -0.16-0.45 0.36 0 Fixed LDL 5 0.17 -0.16-0.49 0.32 19 Fixed HDL 5 -0.09 -0.41-0.24 0.60 0 Fixed CR, calorie restriction; IF, intermittent fasting; BMI: body mass index; WC, waist circumference; FM, fat mass; FFM, fat-free mass; TC, total cholesterol; TG, triglyceride; LDL, low density lipoprotein; HDL, high density lipoprotein; SMD, standard mean difference; WMD, weighted mean difference; CI, confidence interval. SMD: Glucose (Male), TG, TC, LDL; WMD: Weight, BMI, WC, FM(kg), FM%, FFM(kg), Glucose (Female), Insulin. According to the International Obesity Task Force (IOTF), for adults, a BMI of 25 ~ 30 is defined as being overweight, while a BMI greater than 30 is considered to be obese [1]. Herein, subgroup analysis was performed specifically on overweight or obese patients (BMI ≥ 25kg/m2) in the included population. The patients’ physical and biochemical parameters of IF versus normal diet were recorded in Table 5. The results showed that IF could significantly reduce insulin resistance compared with a normal diet (HOMA-IR: WMD = 0.43, 95%CI: 0.04–0.83, p = 0.03), but there was no significant difference in weight, body composition, and blood lipids. Moreover, The effectiveness of IF and CR was similar in overweight or obese patients. The correlated physical and biochemical parameters were recorded in Table 6. Table 5 Physical and biochemical parameters of IF versus Normal diet in patients with BMI ≥ 25kg/m 2 . No. of studies WMD 95%CI p I 2 (%) Effect-model Weight 6 3.42 -0.77-7.61 0.11 0 Fixed BMI 3 1.39 -0.12-2.90 0.07 0 Fixed FM(kg) 5 2.52 -1.22-6.26 0.19 0 Fixed FFM(kg) 4 0.72 -2.51-3.94 0.66 0 Fixed SBP 5 1.63 -3.12-6.37 0.50 0 Fixed DBP 5 0.65 -2.52-3.81 0.69 7 Fixed Glucose 4 0.33 -2.36-3.02 0.81 39 Fixed Insulin 6 1.46 -0.36-3.29 0.12 0 Fixed HOMA-IR 5 0.43 0.04–0.83 0.03 0 Fixed TG 5 7.70 -3.85-19.26 0.19 33 Fixed TC 5 2.81 -7.36-12.99 0.59 0 Fixed LDL 5 4.73 -3.32-12.79 0.25 0 Fixed HDL 6 0.40 -3.06-3.86 0.82 49 Fixed IF, intermittent fasting; BMI: body mass index; FM, fat mass; FFM, fat-free mass; SBP, systolic blood pressure; DBP, diastolic blood pressure; HOMA-IR, homeostasis model assessment insulin resistance; TC, total cholesterol; TG, triglyceride; LDL, low density lipoprotein; HDL, high density lipoprotein; WMD, weighted mean difference; CI, confidence interval. Table 6 Physical and biochemical parameters of IF versus CR in patients with BMI ≥ 25kg/m 2 . No. of studies SMD/WMD 95%CI p I 2 (%) Effect-model Weight 13 0.25 -2.88-3.37 0.88 52 Random BMI 11 0.35 -0.64-1.34 0.49 57 Random WC 7 1.58 -0.60-3.76 0.16 36 Fixed FM(kg) 9 1.61 -1.32-4.54 0.28 74 Random FM% 6 0.54 -1.13-2.21 0.53 26 Fixed FFM(kg) 8 -0.13 -1.70-1.44 0.87 0 Fixed SBP 9 1.75 -0.41-3.90 0.11 45 Fixed DBP 9 1.06 -0.53-2.65 0.19 0 Fixed Glucose 10 0.05 -0.12-0.23 0.55 16 Fixed Insulin 9 0.02 -0.15-0.19 0.82 42 Fixed HOMA-IR 6 -0.18 -0.39-0.03 0.10 46 Fixed TG 10 0.03 -0.14-0.19 0.76 20 Fixed TC 9 0.08 -0.09-0.25 0.35 0 Fixed LDL 9 0.06 -0.11-0.23 0.49 0 Fixed HDL 9 0.02 -0.15-0.19 0.79 42 Fixed CR, calorie restriction; IF, intermittent fasting; BMI: body mass index; WC, waist circumference; FM, fat mass; FFM, fat-free mass; SBP, systolic blood pressure; DBP, diastolic blood pressure; HOMA-IR, homeostasis model assessment insulin resistance; TC, total cholesterol; TG, triglyceride; LDL, low density lipoprotein; HDL, high density lipoprotein; SMD, standard mean difference; WMD, weighted mean difference; CI, confidence interval. SMD: Glucose, Insulin, TG, TC, LDL, HDL; WMD: Weight, BMI, WC, FM(kg), FM%, FFM(kg), SBP, DBP, HOMA-IR. Sensitivity analysis and Publication bias analysis After sensitive analysis, we found that the results were stable. Meanwhile, funnel plots were used to examine publication bias. The funnel plots of all statistical results were displayed as to be roughly symmetry, indicating that there was no publication bias. Discussion At present, more and more people in the world are suffering from metabolic diseases and obesity [ 1 ]. IF, a popular dietary strategy, has become increasingly popular among citizens as more and more people around the world are suffering from metabolic diseases and obesity. Although IF was considered to be related to undesired outcomes, such as gout, arrhythmia, and peptic ulcer [ 56 ], it is still widely believed that IF could reduce weight, relive rheumatoid arthritis, and slow down aging [ 57 , 58 ], even if they still disagreed on cancer [ 12 , 59 ]. In this study, IF was compared with normal diet and CR. In addition, subgroup analysis was conducted based on the pattern of IF, gender, and additionally considered the situation of narrowing to overweight or obese population. In our study, IF was found to have significant benefits in regulating weight, FM, insulin, and blood lipids compared to normal diet (non-intervention diet). These results were similar to previous studies [ 6 , 57 , 59 ], indicating that IF can result in desirable weight loss and better health. However, there was no difference in blood glucose level between them in this study. It might be due to the fact that the included population was mostly non-diabetic patients, so the basal glucose level was relatively low, resulting in slight fluctuations in participants. As for the outcomes of insulin and HOMA-IR, IF was proved to be potentially beneficial in reliving insulin resistance. Here, IF was about as effective as CR, only slightly better than CR in reducing WC. Although some researchers believed that, comparing with CR, IF had better compliance and benefited more in the reduction of FM [ 11 , 58 ], other studies showed that long-term compliance of IF was limited due to the high drop-out rate [ 60 ]. As for the comparison between ADF and CR, the subgroup analysis based on the dietary pattern of IF found that ADF showed no differences with CR, but other studies showed a superior compliance, FM, and FFM in the ADF group [ 11 , 61 ]. Furthermore, ADF is more preferable in having no burden of chronic poor feeding and other adverse outcomes compared to CR [ 12 ]. However, some investigators believed that ADF might not be a viable public health intervention because of the considerably and continuously reported hunger by Patterson et al [ 8 , 62 ]. In addition, comparing to ADF, weekly TRF exerted significant advantages on the regulation of WC, FM, and DBP. Another meta-analysis also reported that besides weight, DBP, and insulin regulation, TRF was also more effective in FFM reduction [ 14 ]. In addition, IF might play a small role in women, because FM was the only parameter that was found to be significantly reduced after IF. Comparatively, IF was found to significantly reduce weight and TG in male. The reason for the difference based on gender was still currently not clear. We assumed that it might be related to the gender-depending fat distribution and sex hormones [ 63 ]. Estrogen was considered to suppress appetite and reduce the accumulation of belly fat, while androgen promot food intake. However, research on the relationship between IF and human sex hormones is lacking. Moreover, our subgroup analysis against overweight and obese patients showed that IF could not provide more benefit to this particular population. This was at odds with previous studies by researchers who believed that IF is functional in regulating blood pressure, TC, and TG, especially more than CR did, in overweight or obese patients [ 31 , 64 ]. One theory we speculated was the insufficient quantity of included studies, another might be that the intervention time was relatively short, which is a median follow-up of only 3 months in our study, thus no appearance of IF efficacy. In many ways, the effects of IF and CR overlapped significantly [ 56 ]. The essence of both IF and CR was to reduce energy intake. The difference was that CR maintained a normal eating frequency, while IF was no or small amounts of energy intake during fasting [ 12 ]. In this study, although most of the included studies did not perform energy intake interventions during non-fasting periods, there were still some studies that restricted energy intake during feeding periods, and certain eating patterns of IF also shaped a certain degree of energy restriction [ 19 , 49 ]. Thus, while IF was discovered to be superior to the non-intervention diet here, it was unclear whether time restriction or energy restriction played a greater role. On the other hand, in our study, IF and CR had few differences in their effects on participants, and the previous studies showed that CR could promote weight loss, relive insulin resistance, improve insulin sensitivity, lower TG and TC, and elevate HDL [ 65 ]. Although IF did not restrict calories in some of the included studies [ 37 ], it is suspected here that CR may be dominant as time restriction did not seem to play a role. The researchers suggested that weight loss after CR was due to the adaptation to metabolically induced reductions in FM and FFM [ 65 , 66 ]. The weight loss resulted from IF was also due to the reduction of FM and FFM. However, the difference was that human body, in addition to metabolic adaptations, consumed the stored hepatic glycogen 10–12 hours after fasting, and then generated massive ketone bodies through the oxidation of fatty acids in adipose tissue, which would be used as the energy source of the whole body [ 67 , 68 ]. Therefore, an increase in blood ketones was found after IF, but not after CR alone [ 56 ]. Unfortunately, this investigation was not included in this study. The decrease in blood TG might also be due to the oxidative breakdown of fat and the restriction of fat intake [ 65 ]. Although previous studies attributed weight loss after IF and CR to the reduction of FM and FFM [ 65 , 68 ], it was an important discovery in our study that IF preserved FFM better. This finding contributes to further recognition of IF, which is that IF does not damage lean tissue, dissipating the concern of IF being the potential cause of osteoporosis and sarcopenia [ 14 ]. One of the mechanisms by which CR mediated was that CR could cause decreased levels of anabolic hormones including insulin, leptin, estrogen, and testosterone [ 69 ]. CR in corporating with weight loss can further improve insulin sensitivity, which might lead to decreased insulin secretion [ 70 ]. In addition to the above possible mechanisms, IF might also be due to the ketone produced by fat metabolism acting on the nerve center, enhancing the effect of leptin and insulin on the central nervous system, which normally regulates food intake and insulin sensitivity as well as resistance [ 60 ]. Herein, insulin levels decreased and insulin resistance was relieved after IF with no significance. Both CR and IF lowered TC [ 65 ]. This probably due to the mechanistic target of rapamycin (mTOR) pathway [ 56 , 69 ]. Reduction in TC production was induced by a complex intracellular reaction between mTOR complex 1(mTORC1) and sirtuins [ 56 , 71 ]. IF might lower TC through inhibiting TC production via supressing this pathway. Since this pathway could also be activated by CR, it is resonable to discover no difference in TC levels between the two intervention groups. Researchers have proposed three possible mechanisms for IF: circadian rhythms, gastrointestinal microbiota, and modifiable lifestyle behaviors [ 8 ]. Some researchers argued that the human body clock was affected by, but not limited to, metabolic hormones, nutrients, intracellular metabolism, and intestinal flora [ 71 ]. The human circadian rhythms regulate eating, sleep, hormonal and physiological processes, and coordinated metabolism and energetics. Certain patterns of IF might affect the body clock by revising the time humans eat, thus realigning metabolism and energy allocation to ensure human health [ 8 ]. Sutton's study of daily TRF, a six-hour daily eating during a five-week period, showed that TRF improved cardio-metabolic health [ 72 ]. Unfortunately, due to the limited number of studies, we were unable to conduct a comparative analysis between daily TRF and CR or normal diet. In contrast, the feeding window of the non-fasting period for weekly TRF and ADF was not addressed in the viewed RCTs [ 46 , 73 ], so it was unknown whether circadian rhythms plays a role in these two patterns of IF. Irregular and inappropriate diet might lead to metabolic disorders and other adverse consequences [ 71 ]. Although current IF was actually accompanied with energy restriction, it was undeniable that IF limited daytime hours of feeding, which might contribute to improved parameters [ 8 ]. Both of the two other hypotheses lacked human clinical trials and could not be confirmed in the relation to IF here. So far, this study is the first systematic meta-analysis based on RCTs of IF. However, it must be pointed out that there are still considerable limitations in this study. Firstly, this study mixed various patterns of IF, which might reduce the reliability. Secondly, part of the outcomes such as hip circumference, and waist to hip ratio could not be analysed in this study due to insufficient data, which might produce publication bias. Moreover, although subgroup analysis was conducted, the role of various factors such as the long-term effect of IF was not thoroughly analyzed in detail due to the limited quantity of studies. Finally, only studies that were published in English were included, which might create publication bias. Conclusion In conclusion, in our study, IF was more beneficial in regulating weight, WC, and FM without affecting lean tissue compared to normal diet. IF could also improve the condition of insulin resistance and blood lipid compared with non-intervention diets, but act similarly to CR. Different patterns of IF had different effects on metabolism. Moreover, the effects of IF were not uniform neither across female and male nor in overweight or obese populations. More and larger multi-center studies are needed to evaluate IF, and this study hopes to lay a foundation for follow-up researchin full IF recognition. Abbreviations IF, intermittent fasting, ADF, alternate-day fasting, IER, intermittent energy restriction, TRF, time-restricted feeding, CR, caloric restriction, FM, fat mass, RCT, randomized controlled trial, BMI, body mass index, WC, waist circumference, TC, total cholesterol, TG, triglyceride, WMD, weight mean difference, SMD, the standard mean difference, CI, confidence intervals, FFM, fat-free mass, SBP, systolic blood pressure, DBP, diastolic blood pressure, HOMA-IR, homeostasis model assessment insulin resistance, LDL, low-density lipoprotein, HDL, high-density lipoprotein. Declarations Ethics approval and consent to participate Not applicable Consent for publication Not applicable Availability of data and materials The datasets supporting the conclusions of this article are included within the article. Competing interests The authors declare that they have no competing interests. Funding The authors have no financial support to declare. Authors’ contributions Lihu Gu designed the research process. Fei Xie and Rongrong Fu searched the database for corresponding articles and drafted the meta-analysis. Jiaze Hong extracted useful information from the articles above. Haixiang Ni used statistical software for analysis. Kepin Yu He polished this article. All authors had read and approved the manuscript and ensured that this was the case. Acknowledgments None References Ng M, Fleming T, Robinson M et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014, 384: 766-781. Qasim A, Turcotte M, de Souza RJ et al. On the origin of obesity: identifying the biological, environmental and cultural drivers of genetic risk among human populations. Obes Rev 2018, 19: 121-149. Headland ML, Clifton PM, Keogh JB. 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Obes Sci Pract 2021, 7: 606-618. Luo J, Yang H, Song BL. Mechanisms and regulation of cholesterol homeostasis. Nat Rev Mol Cell Biol 2020, 21: 225-245. Sutton EF, Beyl R, Early KS et al. Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell Metab 2018, 27: 1212-1221.e1213. Stachowicz A, Zabczyk M, Natorska J et al. Differences in plasma fibrin clot composition in patients with thrombotic antiphospholipid syndrome compared with venous thromboembolism. Sci Rep 2018, 8: 17301. Additional Declarations No competing interests reported. Supplementary Files PRISMA2009checklist.doc SupplementaryTable1.docx Supplementary Table 1. Quality assessment of studies included. SupplementaryTable2.docx  Supplementary Table 2. Physical and biochemical parameters of IF versus Normal diet. 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14:14:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1442328/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1442328/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":19298244,"identity":"dc7b28e0-78ba-4e24-b4d2-13899b8e87ac","added_by":"auto","created_at":"2022-03-16 16:11:49","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":350045,"visible":true,"origin":"","legend":"\u003cp\u003eThe flow chart for retrieval process of included studies in this meta-analysis.\u003c/p\u003e","description":"","filename":"Fig.1.png","url":"https://assets-eu.researchsquare.com/files/rs-1442328/v1/a8155334d06ba3cab0a8bed6.png"},{"id":19298242,"identity":"9ab275e6-64a2-4731-9e56-6893f097dfe3","added_by":"auto","created_at":"2022-03-16 16:11:49","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1089321,"visible":true,"origin":"","legend":"\u003cp\u003eForest plots for the BMI and WC of IF versus Normal diet . a, BMI, b, WC.\u003c/p\u003e","description":"","filename":"Fig.2.png","url":"https://assets-eu.researchsquare.com/files/rs-1442328/v1/4e8c8e5a3d07ee4b44407f7c.png"},{"id":19298237,"identity":"ea8ae4e3-0a0f-4664-8faa-33ed2c650d31","added_by":"auto","created_at":"2022-03-16 16:11:48","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":1642305,"visible":true,"origin":"","legend":"\u003cp\u003eForest plots for the FM and FFM of IF versus Normal diet . a, FM, b, FFM.\u003c/p\u003e","description":"","filename":"Fig.3.png","url":"https://assets-eu.researchsquare.com/files/rs-1442328/v1/3fd203fcb23be3eafcfbbc9e.png"},{"id":19298240,"identity":"58bdfb68-93f2-49a8-b2c9-509b45c4970c","added_by":"auto","created_at":"2022-03-16 16:11:48","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":2006512,"visible":true,"origin":"","legend":"\u003cp\u003eForest plots for the glucose, insulin and HOMA-IR of IF versus Normal diet . a, glucose, b, insulin, c, HOMA-IR.\u003c/p\u003e","description":"","filename":"Fig.4.png","url":"https://assets-eu.researchsquare.com/files/rs-1442328/v1/0abb75225d2e89ece329f40e.png"},{"id":19298238,"identity":"cf841713-78c8-489a-8089-ff245fc9e369","added_by":"auto","created_at":"2022-03-16 16:11:48","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":1848667,"visible":true,"origin":"","legend":"\u003cp\u003eForest plots for the TG and TC of IF versus Normal diet . a, TG, b, TC.\u003c/p\u003e","description":"","filename":"Fig.5.png","url":"https://assets-eu.researchsquare.com/files/rs-1442328/v1/743a3ac821e24494e83a3738.png"},{"id":20534249,"identity":"092f97a6-5465-4823-9643-c898fd21b6f5","added_by":"auto","created_at":"2022-04-20 06:14:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2189798,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1442328/v1/4fea0456-be19-4ae3-9bc4-54b23b341b02.pdf"},{"id":19298236,"identity":"7a8f6c8d-c97f-4d64-9726-7e7551ac3868","added_by":"auto","created_at":"2022-03-16 16:11:48","extension":"doc","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":66048,"visible":true,"origin":"","legend":"","description":"","filename":"PRISMA2009checklist.doc","url":"https://assets-eu.researchsquare.com/files/rs-1442328/v1/fae35f43b909dba34e9b7b03.doc"},{"id":19298239,"identity":"f20030ff-59ab-4dbf-b735-6087c7c63334","added_by":"auto","created_at":"2022-03-16 16:11:48","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":19909,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSupplementary Table 1.\u003c/strong\u003e Quality assessment of studies included.\u003c/p\u003e","description":"","filename":"SupplementaryTable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-1442328/v1/c4579fbe81d4d90fa2e7acb1.docx"},{"id":19298241,"identity":"5018ff50-97d3-42ab-bd7c-f37c8c0c2eb8","added_by":"auto","created_at":"2022-03-16 16:11:49","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":15668,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cspan class=\"ql-cursor\"\u003e\u003c/span\u003e\u003cstrong\u003eSupplementary Table 2.\u003c/strong\u003e Physical and biochemical parameters of IF versus Normal diet.\u003c/p\u003e","description":"","filename":"SupplementaryTable2.docx","url":"https://assets-eu.researchsquare.com/files/rs-1442328/v1/451c3e23fefa471640ea9863.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effects of Intermittent Fasting in Humans Compared to a Normal Diet and Caloric Restriction: A Meta-analysis of Randomized Controlled Trials","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn recent years, the number of patients with metabolic diseases and obesity around the world has increased significantly [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The numerous treatments for these kind of disease are mostly underpinned by diet and exercise [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Intermittent fasting (IF) has become a popular lifestyle in recent years, though it has existed in religious and cultural contexts for a long time [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. IF is a term that covers several specific patterns [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Alternate-day fasting (ADF), intermittent energy restriction (IER), time-restricted feeding (TRF), and Ramadan fasting are currently recognized as several types of IF [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. ADF consists of alternating fasting days and eating days, while TRF focuses on the daily free energy intake within a specific time window of 4\u0026ndash;12 [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Ramadan Fasting refers to one meal before dawn or after sunset [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. There is also a modified fasting regime that differs from the previous ones in terms of not taking in any energy during the fasting period, and eating extremely low calories food two or three days per week [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIF is a dietary strategy that aims to maintain fasting at periodic fixed time intervals. and it has been used in overweight or obese patients to hopefully achieve weight loss [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Caloric restriction (CR), considered the standard dietary strategy to lose weight or maintain weight, has been discovered as difficult to be maintained for many individuals and possible occurrence of late weight rebound when use in long term. So intermittent CR and a combination with temporal control was proposed to replace simple long-term regimen of CR [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. One study suggested that IF can avoid human suffering from obesity, hypertension, rheumatoid arthritis, and asthma, as well as slow aging [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Also, another study pointed out that, IF may affect the gut microbiome in terms of composition and physiology [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA meta-analysis reported that ADF can result in better patient compliance and reduced fat mass (FM) than CR in patients [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Furthermore, a recent investigation on TRF illustrated its effectiveness in weight loss [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Although some studies have revealed the effects of certain fasting patterns, comprehensive systematic reviews of IF are limited and in need. Therefore, herein, we attempted to explore the effects of IF on humans systematically and comprehensively.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e \u003cb\u003eLiterature search strategy\u003c/b\u003e \u003c/p\u003e \u003cp\u003eTwo researchers independently screened the literature related to IF from PubMed, Web of Science, the Cochrane Library database, and Embase. All selected literature was published before June 2021. The keywords used in the search were \u0026rdquo;randomized controlled trial\u0026rdquo; OR \u0026ldquo;controlled clinical trial\u0026rdquo; OR \u0026ldquo;randomized\u0026rdquo; OR \u0026ldquo;placebo\u0026rdquo; OR \u0026ldquo;clinical trials as topic OR randomly\u0026rdquo; OR \u0026ldquo;trial\u0026rdquo; AND \u0026ldquo;fasting\u0026rdquo; OR \u0026ldquo;intermittent* fast*\u0026rdquo; OR \u0026ldquo;fast* diet*\u0026rdquo; OR \u0026ldquo;alternat* fast*\u0026rdquo; OR \u0026ldquo;modified fast*\u0026rdquo; OR \u0026ldquo;food abstinence\u0026rdquo; OR \u0026ldquo;food fast*\u0026rdquo; OR \u0026ldquo;diet* restricti*\u0026rdquo; OR \u0026ldquo;food restricti*\u0026rdquo; OR \u0026ldquo;time restricted feed*\u0026rdquo; OR \u0026ldquo;time restricted fast*\u0026rdquo; OR \u0026ldquo;one whole day fast*\u0026rdquo; OR \u0026ldquo;food tim*\u0026rdquo; OR \u0026ldquo;Ramadan\u0026rdquo; OR \u0026ldquo;Ramadhan\u0026rdquo; OR \u0026ldquo;Ramadan fasting\u0026rdquo; OR \u0026ldquo;Islamic fasting\u0026rdquo; OR \u0026ldquo;Ramadan intermittent fasting\u0026rdquo; OR \u0026ldquo;Ramadan diurnal fasting\u0026rdquo; OR \"Ramadan model of intermittent fasting\" OR \"intermittent prolonged fasting during Ramadan\" OR \u0026ldquo;Ramadan fast\u0026rdquo; OR \u0026ldquo;recurrent circadian fasting\u0026rdquo;. The references in the relevant literature were screened additionally to expand the library of relevant literature. The study guideline was Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eInclusion criteria and exclusion criteria\u003c/h2\u003e \u003cp\u003eLiterature meeting all the following criteria would be included: (1) The intervention group included but not limited to ADF, TRF, IER, and Ramadan fasting, while the control group was the normal diet or CR. (2) The study provided physical and biochemical parameters of the subjects in both the intervention group and the control group after the intervention. (3) The follow-up time was at least 1 month. (4) Data was available.\u003c/p\u003e \u003cp\u003eStudy was excluded once it met any of the following criteria: (1) The study was not a randomized controlled trial (RCT). (2) The research individual was not human. (3) The full text of the article was not in English. (4) The literature was duplicated.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eQuality assessment and data extraction\u003c/h2\u003e \u003cp\u003eThe quality of screened RCTs was evaluated using the Cochrane Collaboration\u0026rsquo;s tool. Two investigators independently assessed the risk of study bias. Controversies were decided by a third researcher. Study characteristics (author, year, country, trial registration, patient inclusion criteria, intervention, control, and follow-up), physical parameters (weight, body mass index (BMI), waist circumference (WC)), and biochemical parameters (insulin, glucose, total cholesterol (TC), and triglyceride (TG)) were extracted from the included studies.\u003c/p\u003e \u003cp\u003eIF patterns were diverse, and current major dietary patterns were ADF, TRF, IER, and Ramadan fasting [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. This study was roughly divided into daily TRF, weekly TRF, ADF, and Ramadan fasting based on the time and frequency of fasting with IF. Of these, daily TRF referred to a feeding window of 4 to 12 hours per day and fasting for the remainder of the day, whereas weekly TRF referred to 2\u0026ndash;3 fasting days per week. The energy intake of the participants was not restrict in the intervention group during the intervention period as it may differ under different dietary IF patterns,\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003e Review Manager 5.3 was used for statistical analysis. The weight mean difference (WMD) and the standard mean difference (SMD) were calculated for continuous data. The 95% confidence intervals (CI) for all statistical results were provided. I2 was used to represent the heterogeneity of the results. When I2\u0026thinsp;\u0026gt;\u0026thinsp;50, the random-effect model was used, otherwise, the fixed-effect model was used. P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered as to be statistically significant in the results. Sensitivity analysis was performed by removing the included studies one by one in this statistical analysis. Meanwhile, funnel plots were used to examine publication bias [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv\u003e\n \u003ch2\u003eStudy characteristics\u003c/h2\u003e\n \u003cp\u003eAfter retrieval and elimination of duplicates, a total of 24887 articles were screened. Then, 24729 of them were excluded based on their irrelevant title and abstract. After thoroughly viewing the fulltext of the remaining 158 articles, 115 of them were excluded, of which 85 were excluded due to lack of relevant results, 4 exclusions were due to non-RCTs, 2 were excluded due to population duplication, and 24 were excluded due to unavailable data. Finally, 43 RCTs [3, 6, 7, 9, 17\u0026ndash;55] were included in our meta-analysis. The detailed retrieval process and elimination reasons are recorded in the flow chart (Fig.\u0026nbsp;1).\u003c/p\u003e\n \u003cp\u003eCharacteristics of included RCTs in the meta-analysis were recorded in Table\u0026nbsp;1. A total of 2483 participants were enrolled in the study, with 1277 in the intervention group and 1206 in the control group. Interventions included weekly TRF, daily TRF, ADF, as well as Ramadan fasting. Eating patterns in the control group included normal diet and CR. Normal diet lived up to its name, while CR included continuous energy restriction, Mediterranean diet, and Dietary Approaches to Stop Hypertension (DASH). The included studies were followed for at least 1 month, with a median follow-up of 3 months. Participants in this study were came from Brazil, China, Germany, Iran, Italy, Korea, Malaysia, New Zealand, Norway, Spain, Tunisia, Turkey, the UK, and the USA.\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 1\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eCharacteristics of included RCTs in the meta-analysis.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eAuthor, year\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eCountry\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eTrial registration\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePatient inclusion criteria\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eIntervention\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eFollow-up (month)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFasting patterns\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDietary patterns\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAntoni, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eISRCTN13687043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u0026thinsp;\u0026gt;\u0026thinsp;25kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 18\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIER (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBeaulieu, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT03447600\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 25-34.9kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 18\u0026ndash;55 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eADF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBhutani, 2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 30-39.9kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 25\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eADF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBowen, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAustralia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eACTRN12616000110482\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u0026thinsp;\u0026gt;\u0026thinsp;27kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 25\u0026ndash;60 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eADF\u0026thinsp;+\u0026thinsp;DER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eCai, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\"\u003eChina\u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eChiCTR1900024411\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eBMI\u0026thinsp;\u0026gt;\u0026thinsp;24kg/m\u003csup\u003e2\u003c/sup\u003e with NAFLD; Age: 18\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eADF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"2\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCarlson, 2007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 18-25kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 40\u0026ndash;50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (20:4 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCatenacci, 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u0026thinsp;\u0026ge;\u0026thinsp;30kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 18\u0026ndash;55 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eADF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChow, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT03129581\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u0026thinsp;\u0026ge;\u0026thinsp;25kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 18\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eCienfuegos, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eNCT03867773\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eBMI: 30-49.9kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 18\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (20:4 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"2\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (18:6 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eConley, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAustralia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eACTRN12614000396628\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u0026thinsp;\u0026ge;\u0026thinsp;30kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 55\u0026ndash;75 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIER (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCorley, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNew Zealand\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eACTRN12614000402640\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 30-45kg/m\u003csup\u003e2\u003c/sup\u003e with T2DM; Age\u0026thinsp;\u0026gt;\u0026thinsp;18 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCorreia, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge: 18\u0026ndash;30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCoutinho, 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNorway\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT02169778\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 30-40kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 18\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIER (3:4 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ede Oliveira Maranh\u0026atilde;o Pureza, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBrazil\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 30-45kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF\u0026thinsp;+\u0026thinsp;CR (12:12 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eGabel, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eNCT00960505\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eBMI: 25-39.9kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 18\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eADF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"2\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"2\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGuo, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT03608800\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge: 30\u0026ndash;50 years with comorbidities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIF (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHarvie, 2011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 24-40kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 30\u0026ndash;45 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIER (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHarvie, 2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eISRCTN52913838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 24-45kg/m\u003csup\u003e2\u003c/sup\u003e; Age:20\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIECR (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHeadland, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAustralia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eACTRN12614001041640\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u0026thinsp;\u0026ge;\u0026thinsp;27kg/m\u003csup\u003e2\u003c/sup\u003e; Age\u0026thinsp;\u0026gt;\u0026thinsp;18 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIER (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHirsh, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT03372109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 25-29.9kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 21\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIF (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKotarsky, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT03823872\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 25-34.9kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 35\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKunduraci, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTurkey\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT04502329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u0026thinsp;\u0026ge;\u0026thinsp;27kg/m\u003csup\u003e2\u003c/sup\u003e with comorbidities; Age: 18\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIER (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLowe, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT03393195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge: 18\u0026ndash;64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMartens, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT02970188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u0026thinsp;\u0026lt;\u0026thinsp;40kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 55\u0026ndash;79 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMart\u0026iacute;nez-Rodr\u0026iacute;guez, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT04404413\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMcAllister, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMoro, 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eItaly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMoro, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eItaly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT04320784\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u0026thinsp;\u0026lt;\u0026thinsp;23 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOh, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKorea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT03652532\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u0026thinsp;\u0026gt;\u0026thinsp;23kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 18\u0026ndash;64 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eADF\u0026thinsp;+\u0026thinsp;CR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePanizza, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT03639350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 25-40kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 35\u0026ndash;55 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIER\u0026thinsp;+\u0026thinsp;MED (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDASH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eParvaresh, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIran\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIRCT201509092395N8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 25-40kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 25\u0026ndash;60 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eADF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePureza, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBrazil\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRBR-387v6v\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 30-45kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF\u0026thinsp;+\u0026thinsp;CR (12:12 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRazavi, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIran\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 25-40kg/m\u003csup\u003e2\u003c/sup\u003e with MetS; Age: 25\u0026ndash;60 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eADF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eSch\u0026uuml;bel, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eGermany\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eNCT02449148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eBMI: 25-40kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 35\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eICR (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"2\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"2\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStote, 2007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 18-25kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 40\u0026ndash;50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (20:4 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTeng, 2011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMalaysia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 23-29.9kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 50\u0026ndash;70 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFCR (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTeng, 2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMalaysia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 23-29.9kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 50\u0026ndash;70 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFCR (2:5 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTinsley, 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (20:4 diet\u0026thinsp;+\u0026thinsp;4:3 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTinsley, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNCT03404271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge: 18\u0026ndash;30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTRF (16:8 diet)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTrabelsi, 2012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTunisia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRamadan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTrabelsi, 2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTunisia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRamadan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVarady, 2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 20-29.9kg/m\u003csup\u003e2\u003c/sup\u003e; Age: 35\u0026ndash;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eADF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eZouhal, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTunisia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI: 30-40kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRamadan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\"\u003eRCT, randomized controlled trial; IER, intermittent energy restriction; ADF, alternate day fasting; DER, daily energy restriction; TRF, time-restricted feeding; NAFLD, non-alcoholic fatty liver disease; IF, intermittent fasting; CR, calorie restriction; MED, Mediterranean diet; MetS, Metabolic syndrome; ICR, intermittent calorie restriction; FCR, Muslim sunnah fasting; UK, United Kingdom; USA, the United States; BMI, body mass index; NA, no available; CER, continuous energy restriction; ICER, intermittent energy and carbohydrate restriction; DASH, Dietary Approaches to Stop Hypertension; 2:5 diet, 2-day fasting per week; 16:8 diet, 16-hour fasting per day; 20:8 diet, 20-hour fasting per day; 18:6 diet, 18-hour fasting per day; 3:4 diet, 3-day fasting per week; 12:12 diet, 12-hour fasting per day; 4:3 diet, 4-day fasting per week; N, number of patients.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv\u003e\n \u003ch2\u003eRisk of bias\u003c/h2\u003e\n \u003cp\u003eQuality assessment of studies included was shown in Supplementary Table\u0026nbsp;1. The Cochrane Collaboration\u0026rsquo;s tool was used to assess the risk of bias in studies. Most studies were at low risk in sequence generation and allocation concealment. Only one study showed unclear risk in sequence generation due to incomplete information. As for blinding of the risk of bias, 10 trials were evaluated as high, 15 were unclear, and the rest 18 studies were low. 43 studies were at low risk for incomplete outcome data and selective outcome reporting. As for free of other bias, 1 was high risk, 15 were unclear risk, and the remaining 27 were low risk.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv\u003e\n \u003ch2\u003eIF vs Normal diet (Non-intervention diet)\u003c/h2\u003e\n \u003cp\u003eNineteen studies reported the weight of participants after their experience of IF or normal diet. The results illustrated that IF was significantly more beneficial to weight loss (WMD\u0026thinsp;=\u0026thinsp;1.10, 95%CI: 0.09\u0026ndash;2.12, p\u0026thinsp;=\u0026thinsp;0.03) (Supplementary Table\u0026nbsp;2). For BMI, the statistical result with 9 studies enrolled reported that IF could reduce more BMI compared with the normal diet (WMD\u0026thinsp;=\u0026thinsp;0.38, 95%CI: 0.08\u0026ndash;0.68, p\u0026thinsp;=\u0026thinsp;0.01)(Fig.\u0026nbsp;2a). In addition, IF was also associated with a significant reduction in WC among participants who underwent IF (WMD\u0026thinsp;=\u0026thinsp;1.02, 95%CI: 0.06\u0026ndash;1.99, p\u0026thinsp;=\u0026thinsp;0.04) (Fig.\u0026nbsp;2b).\u003c/p\u003e\n \u003cp\u003eIn terms of body composition, the participants in the IF group had less FM than that in the normal diet group (WMD\u0026thinsp;=\u0026thinsp;0.74, 95%CI: 0.17\u0026ndash;1.31, p\u0026thinsp;=\u0026thinsp;0.01) (Fig.\u0026nbsp;3a). The fat-free mass (FFM) of participants who used IF was greater than that in the group of normal diet, demonstrating that IF had less effect on the FFM (WMD=-0.73, 95%CI: (-1.45)-(-0.02), p\u0026thinsp;=\u0026thinsp;0.05) (Fig.\u0026nbsp;3b). However, for FM% of the participants, there was no significant difference between IF and normal diet groups (WMD\u0026thinsp;=\u0026thinsp;0.38, 95%CI: (-0.14)-0.89, p\u0026thinsp;=\u0026thinsp;0.16) (Supplementary Table\u0026nbsp;2). Ten studies provided data of systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the participants. The results revealed that neither SBP nor DBP was statistically affected via IF or normal diet (WMD\u0026thinsp;=\u0026thinsp;1.32, p\u0026thinsp;=\u0026thinsp;0.33, and WMD\u0026thinsp;=\u0026thinsp;0.96, p\u0026thinsp;=\u0026thinsp;0.39, respectively) (Supplementary Table\u0026nbsp;2).\u003c/p\u003e\n \u003cp\u003eSixteen studies examined the effects of IF and a normal diet on the glucose level of participants, where no difference was observed (SMD=-0.00, 95%CI: (-0.14)-0.13, p\u0026thinsp;=\u0026thinsp;0.94) (Fig.\u0026nbsp;4a). Thirteen studies had investigated the effects of IF and normal diet on insulin in participants. The corelated systematic analysis showed that the insulin levels after IF were significantly lower than that after normal diet (SMD=-0.21, 95%CI: 0.02\u0026ndash;0.40, p\u0026thinsp;=\u0026thinsp;0.03) (Fig.\u0026nbsp;4b). In addition, the result of homeostasis model assessment insulin resistance (HOMA-IR) from 8 studies showed that IF could reduce insulin resistance more effectively compared to normal diet with a statistically significant difference. (WMD\u0026thinsp;=\u0026thinsp;0.35, 95%CI: 0.04\u0026ndash;0.65, p\u0026thinsp;=\u0026thinsp;0.03; I2\u0026thinsp;=\u0026thinsp;0%) (Fig.\u0026nbsp;4c).\u003c/p\u003e\n \u003cp\u003eEighteen studies provided the TG level of participants following IF and the normal diet, and IF was proved to be significantly more effective in reducing TG in participants. (SMD\u0026thinsp;=\u0026thinsp;0.22, 95%CI: 0.09\u0026ndash;0.35, p\u0026thinsp;=\u0026thinsp;0.001) (Fig.\u0026nbsp;5a). Eighteen studies reported the TC levels in IF group and a normal diet group, and the results indicated that participants would have significantly lower TC in the former case (SMD\u0026thinsp;=\u0026thinsp;0.13, 95%CI: 0.00-0.26, p\u0026thinsp;=\u0026thinsp;0.05; I2\u0026thinsp;=\u0026thinsp;26%) (Fig.\u0026nbsp;5b). In addition, 17 and 16 studies reported statistical results for low-density lipoprotein (LDL) and high-density lipoprotein (HDL), respectively. The statistical difference of those parameters between IF and normal diet was discovered in neither aspect (SMD\u0026thinsp;=\u0026thinsp;0.10, p\u0026thinsp;=\u0026thinsp;0.42, and SMD=-0.03, p\u0026thinsp;=\u0026thinsp;0.63, respectively) (Supplementary Table\u0026nbsp;2).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv\u003e\n \u003ch2\u003eIF vs CR\u003c/h2\u003e\n \u003cp\u003eThe physical and biochemical parameters of IF versus CR were analyzed in this study. The result of 10 studies showed that IF reduced more WC in participants. The result was statistically significant with low heterogeneity (WMD\u0026thinsp;=\u0026thinsp;2.29, 95%CI: 0.57\u0026ndash;4.01, p\u0026thinsp;=\u0026thinsp;0.009; I2\u0026thinsp;=\u0026thinsp;35%). Moreover, no difference between IF and CR in terms of weight, glucose, and blood lipids. Details of the results were shown in Table\u0026nbsp;2.\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 2\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ePhysical and biochemical parameters of IF versus CR.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth\u003e\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo. of studies\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSMD/WMD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eI\u003csup\u003e2\u003c/sup\u003e (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eEffect-model\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.61-4.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.64-1.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.57\u0026ndash;4.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.34-4.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.62-2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.51-1.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.41-3.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.53-2.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGlucose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.16-0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.09-0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHOMA-IR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.31-0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.14-0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.09-0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.11-0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eCR, calorie restriction; IF, intermittent fasting; BMI: body mass index; WC, waist circumference; FM, fat mass; FFM, fat-free mass; SBP, systolic blood pressure; DBP, diastolic blood pressure; HOMA-IR, homeostasis model assessment insulin resistance; TC, total cholesterol; TG, triglyceride; LDL, low density lipoprotein; SMD, standard mean difference; WMD, weighted mean difference; CI, confidence interval.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eSMD: Glucose, Insulin, TG, TC, LDL; WMD: Weight, BMI, WC, FM(kg), FM%, FFM(kg), SBP, DBP, HOMA-IR.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv\u003e\n \u003ch2\u003eSubgroup analysis\u003c/h2\u003e\n \u003cp\u003eThe main pattern of IF in this study was ADF and weekly TRF, so they were enrolled in the comparison with CR separately. The physical and biochemical parameters of participants in ADF and CR groups that were included for the investigation were weight, body composition, glucose, and blood lipids. According to the statistical results, there was no significant difference in all parameters between them. In other words, the effects of ADF and CR on participants were similar (Table\u0026nbsp;3). In addition, 8 studies compared post-intervention data of weekly TRF versus CR. The statistical result of WC extracted from 6 studies showed that weekly TRF could reduce WC more effectively than CR (WMD\u0026thinsp;=\u0026thinsp;3.36, 95%CI: 1.24\u0026ndash;6.08, p\u0026thinsp;=\u0026thinsp;0.003; I2\u0026thinsp;=\u0026thinsp;38%) (Table\u0026nbsp;3). Five studies reported the FM of weekly TRF and CR subgroup and more reduced FM was revealed in the weekly TRF group (WMD\u0026thinsp;=\u0026thinsp;2.58, 95%CI: 0.61\u0026ndash;4.55, p\u0026thinsp;=\u0026thinsp;0.01) (Table\u0026nbsp;3). Also, weekly TRF was more effective in reducing DBP in participants (WMD\u0026thinsp;=\u0026thinsp;3.47, 95%CI: (-0.06)-7.00, p\u0026thinsp;=\u0026thinsp;0.05) (Table\u0026nbsp;3). More detailed physical and biochemical results are recorded in Table\u0026nbsp;3.\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 3\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ePhysical and biochemical parameters of ADF versus CR and TRF (week) versus CR.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth\u003e\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo. of studies\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSMD/WMD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eI\u003csup\u003e2\u003c/sup\u003e (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eEffect-model\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eADF vs CR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.91-7.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.24-1.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.34-4.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.74-6.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.00-3.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.64-2.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-5.83-14.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.47-2.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGlucose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.32-0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.23-0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.25-0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.21-0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.19-0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.59-0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eTRF(week) vs CR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.33-5.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.91-2.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.24\u0026ndash;6.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.61\u0026ndash;4.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.68-3.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.29-2.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.26-7.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.06-7.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGlucose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.29-0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.34-0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.14-0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.13-0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.20-0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.34-0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eCR, calorie restriction; ADF, alternate day fasting; TRF, time-restricted feeding; BMI: body mass index; WC, waist circumference; FM, fat mass; FFM, fat-free mass; SBP, systolic blood pressure; DBP, diastolic blood pressure; TC, total cholesterol; TG, triglyceride; LDL, low density lipoprotein; HDL, high density lipoprotein; SMD, standard mean difference; WMD, weighted mean difference; CI, confidence interval.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eSMD: Glucose, Insulin, TG, TC, LDL, HDL; WMD: Weight, BMI, WC, FM(kg), FM%, FFM(kg), SBP, DBP.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eSubgroup analysis found that, comparing with normal diet and CR, IF had different effects depending on gender. For females, IF was significantly more effective with highly heterogeneous in reducing FM. (WMD\u0026thinsp;=\u0026thinsp;3.72, 95%CI: 0.56\u0026ndash;6.87, p\u0026thinsp;=\u0026thinsp;0.02; I2\u0026thinsp;=\u0026thinsp;67%) (Table\u0026nbsp;4). However, no advantage was discovered in any other aspects, such as weight, WC, FM%, FFM, glucose, and insulin. When it comes to male population, the statistical results showed that IF could significantly reduce males\u0026rsquo; weight and BMI compared with both normal diet and CR, which were supported by 8 and 4 studies, respectively (WMD\u0026thinsp;=\u0026thinsp;2.16, 95%CI: 0.48\u0026ndash;3.85, p\u0026thinsp;=\u0026thinsp;0.01; I2\u0026thinsp;=\u0026thinsp;29%, and WMD\u0026thinsp;=\u0026thinsp;0.97, 95%CI: 0.23\u0026ndash;1.71, p\u0026thinsp;=\u0026thinsp;0.01; I2\u0026thinsp;=\u0026thinsp;0%, respectively) (Table\u0026nbsp;4). Besides, IF also reduced TG levels more effectively in males (WMD\u0026thinsp;=\u0026thinsp;0.54, 95%CI: 0.22\u0026ndash;0.86, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; I2\u0026thinsp;=\u0026thinsp;31%). More detailed physical and biochemical results are listed in Table\u0026nbsp;4.\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 4\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ePhysical and biochemical parameters of IF versus Normal diet/CR in female and male.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth\u003e\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo. of studies\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSMD/WMD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eI\u003csup\u003e2\u003c/sup\u003e (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eEffect-model\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.61-4.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.53-5.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.56\u0026ndash;6.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.02\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.45-2.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.37-2.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGlucose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.17-0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.21-2.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.48\u0026ndash;3.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.23\u0026ndash;1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.38-2.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.12-0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.98-1.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGlucose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.21-0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.22\u0026ndash;0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;\u0026thinsp;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.16-0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.16-0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.41-0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eCR, calorie restriction; IF, intermittent fasting; BMI: body mass index; WC, waist circumference; FM, fat mass; FFM, fat-free mass; TC, total cholesterol; TG, triglyceride; LDL, low density lipoprotein; HDL, high density lipoprotein; SMD, standard mean difference; WMD, weighted mean difference; CI, confidence interval.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eSMD: Glucose (Male), TG, TC, LDL; WMD: Weight, BMI, WC, FM(kg), FM%, FFM(kg), Glucose (Female), Insulin.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eAccording to the International Obesity Task Force (IOTF), for adults, a BMI of 25\u0026thinsp;~\u0026thinsp;30 is defined as being overweight, while a BMI greater than 30 is considered to be obese [1]. Herein, subgroup analysis was performed specifically on overweight or obese patients (BMI\u0026thinsp;\u0026ge;\u0026thinsp;25kg/m2) in the included population. The patients\u0026rsquo; physical and biochemical parameters of IF versus normal diet were recorded in Table\u0026nbsp;5. The results showed that IF could significantly reduce insulin resistance compared with a normal diet (HOMA-IR: WMD\u0026thinsp;=\u0026thinsp;0.43, 95%CI: 0.04\u0026ndash;0.83, p\u0026thinsp;=\u0026thinsp;0.03), but there was no significant difference in weight, body composition, and blood lipids. Moreover, The effectiveness of IF and CR was similar in overweight or obese patients. The correlated physical and biochemical parameters were recorded in Table\u0026nbsp;6.\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 5\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ePhysical and biochemical parameters of IF versus Normal diet in patients with BMI\u0026thinsp;\u0026ge;\u0026thinsp;25kg/m\u003csup\u003e2\u003c/sup\u003e.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth\u003e\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo. of studies\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eWMD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eI\u003csup\u003e2\u003c/sup\u003e (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eEffect-model\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.77-7.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.12-2.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.22-6.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.51-3.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.12-6.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.52-3.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGlucose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.36-3.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.36-3.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHOMA-IR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.04\u0026ndash;0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.85-19.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-7.36-12.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.32-12.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.06-3.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eIF, intermittent fasting; BMI: body mass index; FM, fat mass; FFM, fat-free mass; SBP, systolic blood pressure; DBP, diastolic blood pressure; HOMA-IR, homeostasis model assessment insulin resistance; TC, total cholesterol; TG, triglyceride; LDL, low density lipoprotein; HDL, high density lipoprotein; WMD, weighted mean difference; CI, confidence interval.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cdiv\u003e\n \u003ctable border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 6\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ePhysical and biochemical parameters of IF versus CR in patients with BMI\u0026thinsp;\u0026ge;\u0026thinsp;25kg/m\u003csup\u003e2\u003c/sup\u003e.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth\u003e\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo. of studies\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSMD/WMD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eI\u003csup\u003e2\u003c/sup\u003e (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eEffect-model\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-2.88-3.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.64-1.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.60-3.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-1.32-4.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRandom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFM%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-1.13-2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFFM(kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-1.70-1.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.41-3.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.53-2.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGlucose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.12-0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.15-0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHOMA-IR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.39-0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.14-0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.09-0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.11-0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.15-0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eCR, calorie restriction; IF, intermittent fasting; BMI: body mass index; WC, waist circumference; FM, fat mass; FFM, fat-free mass; SBP, systolic blood pressure; DBP, diastolic blood pressure; HOMA-IR, homeostasis model assessment insulin resistance; TC, total cholesterol; TG, triglyceride; LDL, low density lipoprotein; HDL, high density lipoprotein; SMD, standard mean difference; WMD, weighted mean difference; CI, confidence interval.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eSMD: Glucose, Insulin, TG, TC, LDL, HDL; WMD: Weight, BMI, WC, FM(kg), FM%, FFM(kg), SBP, DBP, HOMA-IR.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv\u003e\n \u003ch2\u003eSensitivity analysis and Publication bias analysis\u003c/h2\u003e\n \u003cp\u003eAfter sensitive analysis, we found that the results were stable. Meanwhile, funnel plots were used to examine publication bias. The funnel plots of all statistical results were displayed as to be roughly symmetry, indicating that there was no publication bias.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eAt present, more and more people in the world are suffering from metabolic diseases and obesity [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. IF, a popular dietary strategy, has become increasingly popular among citizens as more and more people around the world are suffering from metabolic diseases and obesity. Although IF was considered to be related to undesired outcomes, such as gout, arrhythmia, and peptic ulcer [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], it is still widely believed that IF could reduce weight, relive rheumatoid arthritis, and slow down aging [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e], even if they still disagreed on cancer [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. In this study, IF was compared with normal diet and CR. In addition, subgroup analysis was conducted based on the pattern of IF, gender, and additionally considered the situation of narrowing to overweight or obese population.\u003c/p\u003e \u003cp\u003eIn our study, IF was found to have significant benefits in regulating weight, FM, insulin, and blood lipids compared to normal diet (non-intervention diet). These results were similar to previous studies [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e], indicating that IF can result in desirable weight loss and better health. However, there was no difference in blood glucose level between them in this study. It might be due to the fact that the included population was mostly non-diabetic patients, so the basal glucose level was relatively low, resulting in slight fluctuations in participants. As for the outcomes of insulin and HOMA-IR, IF was proved to be potentially beneficial in reliving insulin resistance. Here, IF was about as effective as CR, only slightly better than CR in reducing WC. Although some researchers believed that, comparing with CR, IF had better compliance and benefited more in the reduction of FM [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e], other studies showed that long-term compliance of IF was limited due to the high drop-out rate [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs for the comparison between ADF and CR, the subgroup analysis based on the dietary pattern of IF found that ADF showed no differences with CR, but other studies showed a superior compliance, FM, and FFM in the ADF group [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. Furthermore, ADF is more preferable in having no burden of chronic poor feeding and other adverse outcomes compared to CR [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. However, some investigators believed that ADF might not be a viable public health intervention because of the considerably and continuously reported hunger by Patterson et al [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e]. In addition, comparing to ADF, weekly TRF exerted significant advantages on the regulation of WC, FM, and DBP. Another meta-analysis also reported that besides weight, DBP, and insulin regulation, TRF was also more effective in FFM reduction [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn addition, IF might play a small role in women, because FM was the only parameter that was found to be significantly reduced after IF. Comparatively, IF was found to significantly reduce weight and TG in male. The reason for the difference based on gender was still currently not clear. We assumed that it might be related to the gender-depending fat distribution and sex hormones [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]. Estrogen was considered to suppress appetite and reduce the accumulation of belly fat, while androgen promot food intake. However, research on the relationship between IF and human sex hormones is lacking. Moreover, our subgroup analysis against overweight and obese patients showed that IF could not provide more benefit to this particular population. This was at odds with previous studies by researchers who believed that IF is functional in regulating blood pressure, TC, and TG, especially more than CR did, in overweight or obese patients [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e]. One theory we speculated was the insufficient quantity of included studies, another might be that the intervention time was relatively short, which is a median follow-up of only 3 months in our study, thus no appearance of IF efficacy.\u003c/p\u003e \u003cp\u003eIn many ways, the effects of IF and CR overlapped significantly [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]. The essence of both IF and CR was to reduce energy intake. The difference was that CR maintained a normal eating frequency, while IF was no or small amounts of energy intake during fasting [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. In this study, although most of the included studies did not perform energy intake interventions during non-fasting periods, there were still some studies that restricted energy intake during feeding periods, and certain eating patterns of IF also shaped a certain degree of energy restriction [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Thus, while IF was discovered to be superior to the non-intervention diet here, it was unclear whether time restriction or energy restriction played a greater role. On the other hand, in our study, IF and CR had few differences in their effects on participants, and the previous studies showed that CR could promote weight loss, relive insulin resistance, improve insulin sensitivity, lower TG and TC, and elevate HDL [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]. Although IF did not restrict calories in some of the included studies [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], it is suspected here that CR may be dominant as time restriction did not seem to play a role.\u003c/p\u003e \u003cp\u003eThe researchers suggested that weight loss after CR was due to the adaptation to metabolically induced reductions in FM and FFM [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e]. The weight loss resulted from IF was also due to the reduction of FM and FFM. However, the difference was that human body, in addition to metabolic adaptations, consumed the stored hepatic glycogen 10\u0026ndash;12 hours after fasting, and then generated massive ketone bodies through the oxidation of fatty acids in adipose tissue, which would be used as the energy source of the whole body [\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]. Therefore, an increase in blood ketones was found after IF, but not after CR alone [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]. Unfortunately, this investigation was not included in this study. The decrease in blood TG might also be due to the oxidative breakdown of fat and the restriction of fat intake [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]. Although previous studies attributed weight loss after IF and CR to the reduction of FM and FFM [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e], it was an important discovery in our study that IF preserved FFM better. This finding contributes to further recognition of IF, which is that IF does not damage lean tissue, dissipating the concern of IF being the potential cause of osteoporosis and sarcopenia [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOne of the mechanisms by which CR mediated was that CR could cause decreased levels of anabolic hormones including insulin, leptin, estrogen, and testosterone [\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e]. CR in corporating with weight loss can further improve insulin sensitivity, which might lead to decreased insulin secretion [\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e]. In addition to the above possible mechanisms, IF might also be due to the ketone produced by fat metabolism acting on the nerve center, enhancing the effect of leptin and insulin on the central nervous system, which normally regulates food intake and insulin sensitivity as well as resistance [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]. Herein, insulin levels decreased and insulin resistance was relieved after IF with no significance. Both CR and IF lowered TC [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]. This probably due to the mechanistic target of rapamycin (mTOR) pathway [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e]. Reduction in TC production was induced by a complex intracellular reaction between mTOR complex 1(mTORC1) and sirtuins [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]. IF might lower TC through inhibiting TC production via supressing this pathway. Since this pathway could also be activated by CR, it is resonable to discover no difference in TC levels between the two intervention groups.\u003c/p\u003e \u003cp\u003eResearchers have proposed three possible mechanisms for IF: circadian rhythms, gastrointestinal microbiota, and modifiable lifestyle behaviors [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Some researchers argued that the human body clock was affected by, but not limited to, metabolic hormones, nutrients, intracellular metabolism, and intestinal flora [\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]. The human circadian rhythms regulate eating, sleep, hormonal and physiological processes, and coordinated metabolism and energetics. Certain patterns of IF might affect the body clock by revising the time humans eat, thus realigning metabolism and energy allocation to ensure human health [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Sutton's study of daily TRF, a six-hour daily eating during a five-week period, showed that TRF improved cardio-metabolic health [\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e]. Unfortunately, due to the limited number of studies, we were unable to conduct a comparative analysis between daily TRF and CR or normal diet. In contrast, the feeding window of the non-fasting period for weekly TRF and ADF was not addressed in the viewed RCTs [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e], so it was unknown whether circadian rhythms plays a role in these two patterns of IF. Irregular and inappropriate diet might lead to metabolic disorders and other adverse consequences [\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]. Although current IF was actually accompanied with energy restriction, it was undeniable that IF limited daytime hours of feeding, which might contribute to improved parameters [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Both of the two other hypotheses lacked human clinical trials and could not be confirmed in the relation to IF here.\u003c/p\u003e \u003cp\u003eSo far, this study is the first systematic meta-analysis based on RCTs of IF. However, it must be pointed out that there are still considerable limitations in this study. Firstly, this study mixed various patterns of IF, which might reduce the reliability. Secondly, part of the outcomes such as hip circumference, and waist to hip ratio could not be analysed in this study due to insufficient data, which might produce publication bias. Moreover, although subgroup analysis was conducted, the role of various factors such as the long-term effect of IF was not thoroughly analyzed in detail due to the limited quantity of studies. Finally, only studies that were published in English were included, which might create publication bias.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, in our study, IF was more beneficial in regulating weight, WC, and FM without affecting lean tissue compared to normal diet. IF could also improve the condition of insulin resistance and blood lipid compared with non-intervention diets, but act similarly to CR. Different patterns of IF had different effects on metabolism. Moreover, the effects of IF were not uniform neither across female and male nor in overweight or obese populations. More and larger multi-center studies are needed to evaluate IF, and this study hopes to lay a foundation for follow-up researchin full IF recognition.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eIF, intermittent fasting, ADF, alternate-day fasting, IER, intermittent energy restriction, TRF, time-restricted feeding, CR, caloric restriction, FM, fat mass, RCT, randomized controlled trial, BMI, body mass index, WC, waist circumference, TC, total cholesterol, TG, triglyceride, WMD, weight mean difference, SMD, the standard mean difference, CI, confidence intervals, FFM, fat-free mass, SBP, systolic blood pressure, DBP, diastolic blood pressure, HOMA-IR, homeostasis model assessment insulin resistance, LDL, low-density lipoprotein, HDL, high-density lipoprotein.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets supporting the conclusions of this article are included within the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no financial support to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLihu Gu designed the research process. Fei Xie and Rongrong Fu searched the database for corresponding articles and drafted the meta-analysis. Jiaze Hong extracted useful information from the articles above. Haixiang Ni used statistical software for analysis. Kepin Yu He polished this article. All authors had read and approved the manuscript and ensured that this was the case.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNg M, Fleming T, Robinson M et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014, 384: 766-781.\u003c/li\u003e\n\u003cli\u003eQasim A, Turcotte M, de Souza RJ et al. On the origin of obesity: identifying the biological, environmental and cultural drivers of genetic risk among human populations. 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Sci Rep 2018, 8: 17301.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Intermittent fasting, non-intervention diet, caloric restriction, effect, meta-analysis.","lastPublishedDoi":"10.21203/rs.3.rs-1442328/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1442328/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe popularity of intermittent fasting (IF) has increased as more and more people are trying to avoid or alleviate obesity and metabolic disease. This study aimed to systematically explore the effects of various IF in humans.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe randomized controlled trials (RCTs) related to IF versus normal diet (non-intervention diet) or caloric restriction (CR) were retrieved in PubMed, Web of Science, the Cochrane Library database, and Embase. Extraction outcomes included, but not limited to, weight, body mass index (BMI), waist circumference (WC), glucose, and triglyceride (TG).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eContrasting results showed that, participants had lower weight (WMD\u0026thinsp;=\u0026thinsp;1.10, 95%CI: 0.09\u0026ndash;2.12, p\u0026thinsp;=\u0026thinsp;0.03) and BMI after IF (WMD\u0026thinsp;=\u0026thinsp;0.38, 95%CI: 0.08\u0026ndash;0.68, p\u0026thinsp;=\u0026thinsp;0.01). The WC of participants in the IF group decreased significantly compared with the normal diet (WMD\u0026thinsp;=\u0026thinsp;1.02, 95%CI: 0.06\u0026ndash;1.99, p\u0026thinsp;=\u0026thinsp;0.04). IF regulated fat mass (FM) more effectively than normal diet (WMD\u0026thinsp;=\u0026thinsp;0.74, 95%CI: 0.17\u0026ndash;1.31, p\u0026thinsp;=\u0026thinsp;0.01). The fat-free mass of people after IF was higher (WMD=-0.73, 95%CI: (-1.45)-(-0.02), p\u0026thinsp;=\u0026thinsp;0.05). There was no difference in blood glucose fluctuation between participants in the after IF and normal diet groups. The results of insulin and HOMA-IR, though, indicated that IF was significantly more beneficial than normal diet (SMD=-0.21, 95%CI: 0.02\u0026ndash;0.40, p\u0026thinsp;=\u0026thinsp;0.03, and WMD\u0026thinsp;=\u0026thinsp;0.35, 95%CI: 0.04\u0026ndash;0.65, p\u0026thinsp;=\u0026thinsp;0.03, respectively). Cholesterol and TG levels after IF were also lower than after a normal diet (SMD\u0026thinsp;=\u0026thinsp;0.22, 95%CI: 0.09\u0026ndash;0.35, p\u0026thinsp;=\u0026thinsp;0.001, and SMD\u0026thinsp;=\u0026thinsp;0.13, 95%CI: 0.00-0.26, p\u0026thinsp;=\u0026thinsp;0.05, respectively).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eIF reduced weight, WC, and FM without affecting lean tissue. IF also could improve insulin resistance and blood lipid conditions compared with non-intervention diets.\u003c/p\u003e","manuscriptTitle":"Effects of Intermittent Fasting in Humans Compared to a Normal Diet and Caloric Restriction: A Meta-analysis of Randomized Controlled Trials","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-03-16 16:11:46","doi":"10.21203/rs.3.rs-1442328/v1","editorialEvents":[{"type":"communityComments","content":1}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"de3130dd-14ee-41ba-96f5-e77acd0ead99","owner":[],"postedDate":"March 16th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2022-04-20T06:14:19+00:00","versionOfRecord":[],"versionCreatedAt":"2022-03-16 16:11:46","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1442328","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1442328","identity":"rs-1442328","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}