Abstract
It is unknown if time-restricted feeding confers a protective effect on the physical function of older adults. The aim of this study was to assess prolonged nightly fasting in association with performance-based lower-extremity function (LEF) in a large population of community-dwelling older adults. A cross-sectional study was carried out among 1226 individuals ≥64 years from the Seniors-ENRICA-II (Study on Nutrition and Cardiovascular Risk in Spain) cohort. Habitual diet was assessed through a validated diet history. Fasting time was classified into the following categories: ≤9, 10-11 and ≥12 h/d (prolonged nightly fasting). Performance-based LEF was assessed with the Short Physical Performance Battery (SPPB). After adjusting for potential confounders, a longer fasting period was associated with a higher likelihood of impaired LEF (OR for the second and third categories v. ≤ 9 h/d fasting: 2·27 (95 % CI 1·56, 3·33) and 2·70 (95 % CI 1·80, 4·04), respectively; Ptrend < 0·001). Fasting time showed a significant association with the SPPB subtests balance impairment (OR for highest v. shortest fasting time: 2.48; 95 % CI 1·51, 4·08; Ptrend = 0·001) and difficulty to rise from a chair (OR 1·47; 95 % CI 1·05, 2·06; Ptrend = 0·01). The risk associated with ≥12 h fasting among those with the lowest levels of physical activity was three times higher than among those with ≤9 h fasting with the same low level of physical activity. Prolonged nightly fasting was associated with a higher likelihood of impaired LEF, balance impairment, and difficulty to rise from a chair in older adults, especially among those with low levels of physical activity.
Highlights
Several types of intermittent fasting have emerged as an alternative to energetic restriction and to a prolonged period of fasting because this diet strategy is relatively easy to maintain[1] and there is some evidence from studies in animals and humans that it might improve overall health[2] and body composition[3], protects against cardiometabolic risk factors[4,5] and extends life span[6]
Fasting time showed a significant association with balance impairment (OR for longest v. shortest fasting time: 2·48; 95 % CI 1·51, 4·08; Ptrend = 0·001) and difficulty to rise from a chair
Sensitivity analyses by excluding participants with depression yielded similar associations than in the main tables. In this cross-sectional study of community-dwelling older adults, a fasting time of more than 12 h/d was associated with a higher risk of impaired lower-extremity function (ILEF), balance impairment and difficulty to rise from a chair
Summary
Several types of intermittent fasting have emerged as an alternative to energetic restriction and to a prolonged period of fasting because this diet strategy is relatively easy to maintain[1] and there is some evidence from studies in animals and humans that it might improve overall health[2] and body composition[3], protects against cardiometabolic risk factors[4,5] and extends life span[6]. A specific type of intermittent fasting is time-restricted feeding, in which the daily eating period is limited to 12 h or less per d. Studies in humans have shown that time-restricted feeding is associated with weight loss[7], fat mass decrease[8], metabolic disease risk reduction[4] and improvement in glycaemic response[9]. Intermittent fasting may have an impact on the circadian rhythm that regulates metabolism, energetics and sleep–wake cycles[17,18]
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