Clinical Epidemiology & Public Health
Public health | Online ISSN 3068-4587
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Volume 3 Number 1 2025
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Intermittent Fasting as a Lifestyle Strategy for Diabetes and Heart Health in the United States: A Systematic Review
Dipongkar Ray Sobuj1, Md. Rokibul Hasan Bhuiyan3*, Tamanna Rashid1, Saiful Islam Arif5, Md Rakib Rased Rana2, Md. Maniruzzaman 2, Sabina Akter3,4, Md. Sadikuj Jaman3
Clinical Epidemiology & Public Health 3 (1) 1-8 https://doi.org/10.25163/health.3110408
Submitted: 30 September 2025 Revised: 12 November 2025 Accepted: 16 November 2025 Published: 18 November 2025
Abstract
Diabetes and cardiovascular disease continue to place a heavy burden on communities across the United States, prompting growing interest in sustainable lifestyle approaches that go beyond traditional dieting. Intermittent fasting (IF)—a pattern of cycling between periods of eating and fasting—has emerged as a promising option that feels more like a rhythm of living than a restrictive diet. This systematic review brings together evidence from clinical trials, observational studies, and public health literature to understand how IF may support metabolic and cardiovascular health. Across the studies examined, IF consistently encourages the body to shift from relying on constant glucose intake to using stored fats and ketone bodies, a transition that appears to improve insulin sensitivity, promote gradual weight loss, and support healthier blood pressure and cholesterol levels. These physiological changes may help explain why IF has gained traction among people seeking more flexible, intuitive eating routines. Yet the findings also remind us that IF is not without concerns—its long-term effects are still uncertain, and certain groups, such as older adults or individuals taking glucose-lowering medications, may face added risks. Overall, the evidence suggests that IF can be a meaningful tool for improving metabolic health when thoughtfully tailored and medically guided. As the U.S. confronts rising rates of diabetes and heart disease, IF offers a simple but potentially powerful shift in eating patterns that could complement existing health strategies. Further long-term, diverse, and culturally responsive studies will be essential to fully understand its safety, accessibility, and real-world impact.
Keywords: Intermittent fasting; metabolic health; diabetes; cardiovascular disease; lifestyle intervention; U.S. public health; time-restricted eating.
References
American Diabetes Association. (2022). Standards of medical care in diabetes—2022. Diabetes Care, 45(Suppl. 1), S1–S264. https://doi.org/10.2337/dc22-SINT
Bhuiyan, M. R. H., Maniruzzaman, M., Akter, S., Rashid, M. H. B., Ehasanullah, M., & Jaman, M. S. (2022). Assessment of antioxidant and antineoplastic activities of Blumea lacera (Burn. F) leaves. International Academic Journal of Applied Bio-Medical Sciences, 3(2), 1–12.
Bhuiyan, M. R. H., Maniruzzaman, M., Akter, S., Mehjabin, S., Rana, M. R. R., & Jaman, M. S. (2022). Drug promising effect for diabetic mice of Carica papaya leaves. European Journal of Pharmaceutical Research, 2(3), 1–5. https://doi.org/10.24018/ejpharma.2022.2.3.47
Bhuiyan, M. R. H., Mamun, A. A., Sharker, B., & Jaman, M. S. (2023). Anticancer activity and therapeutic uses of catechins on breast, prostate and lung cancer: Future perspective and clinical proofs. Journal of Clinical Case Reports, Medical Imaging and Health Sciences, 3(3). https://doi.org/10.55920/JCRMHS.2023.03.001118
Carter, S., Clifton, P. M., & Keogh, J. B. (2018). Effect of intermittent compared with continuous energy restriction on weight loss and metabolic outcomes in patients with type 2 diabetes: A randomized noninferiority trial. JAMA Network Open, 1(3), e180309. https://doi.org/10.1001/jamanetworkopen.2018.0309
Carter, S., Clifton, P. M., & Keogh, J. B. (2018). The 5:2 diet vs daily calorie restriction for type 2 diabetes: A randomized controlled trial. JAMA Network Open, 1(3), e180309. https://doi.org/10.1001/jamanetworkopen.2018.0309
Carnethon, M. R., Pu, J., Howard, G., et al. (2019). Cardiometabolic health in racial/ethnic minority populations: A scientific statement from the American Heart Association. Circulation, 140(23), e644–e672. https://doi.org/10.1161/CIR.0000000000000701
Direito, A., Jiang, Y., Whittaker, R., & Maddison, R. (2020). Apps for improving adherence to intermittent fasting and dietary interventions: Systematic review. Journal of Medical Internet Research, 22(6), e18098. https://doi.org/10.2196/18098
Frieden, T. R., Dietz, W. H., & Collins, J. (2021). Reducing premature mortality from non-communicable diseases: The role of public health policy. Lancet, 398(10296), 986–1007. https://doi.org/10.1016/S0140-6736(21)01296-2
Gabel, K., Cienfuegos, S., Kalam, F., Ezpeleta, M., & Varady, K. A. (2019). Time-restricted feeding in weight loss and cardiometabolic health: A review of human and animal studies. Nutrients, 11(8), 1906. https://doi.org/10.3390/nu11081906
Heald, A. H., Stedman, M., Davies, M., Livingston, M., Alshames, R., Lunt, M., Rayman, G., & Gadsby, R. (2020). Estimating life years lost to diabetes: Outcomes from analysis of National Diabetes Audit and Office of National Statistics data. Cardiovascular Endocrinology & Metabolism, 9(4), 183–185. https://doi.org/10.1097/XCE.0000000000000210
Harris, L., Hamilton, S., Azevedo, L. B., et al. (2018). Intermittent fasting interventions for treatment of overweight and obesity in adults: A systematic review and meta-analysis. Nutrition Reviews, 76(9), 657–681. https://doi.org/10.1093/nutrit/nuy042
Jaman, M. S., & Sayeed, M. A. (2018). Ellagic acid, sulforaphane, and ursolic acid in the prevention and therapy of breast cancer: Current evidence and future perspectives. Breast Cancer, 25(5), 517–528. https://doi.org/10.1007/s12282-018-0866-4
Jaman, M. S., Rahman, M. S., Swarna, R. R., Mahato, J., Miah, M. M., et al. (2018). Diabetes and red blood cell parameters. Annals of Clinical Endocrinology & Metabolism, 2, 001–009. https://doi.org/10.29328/journal.acem.1001004
Jaman, S., & Sawgat, R. (2017). Association of mean platelet volume and platelet distribution width with HbA1c. Journal of Endocrinology and Diabetes, 4(4), 1–6. http://dx.doi.org/10.15226/2374-6890/4/4/00183
Jaman, S., Islam, N. M., Maniruzzaman, H., Hossain, F., Bhuiyan, R. H., & Emaul, N. (2023). Preventive and therapeutic effect of ellagic acid, sulforphane and ursolic acid on colon cancer: From cellular response to molecular mechanism of action with future perspectives. International Journal of Clinical and Medical Case Reports, 1–13. http://www.IJCMCR.com
Jaman, M. S., Alam, M. S., Rezwan, M. S., Islam, M. R., Husna, A. U., & Sayeed, M. A. (2017). Comparison of total antioxidant activity between fresh and commercial mango juices available in Bangladesh. GSC Biological and Pharmaceutical Sciences, 1(2), 26–33. https://doi.org/10.30574/gscbps.2017.1.2.0045
Jaman, M. S., Mamun, A. A., Sharker, B., Maniruzzaman, M., Rana, M. R. R., Hasan, M. N., & Bhuiyan, M. R. H. (2023). Curcumin, diallyl sulphide, quercetin and gallic acid uses as anticancer and therapeutic agents for breast cancer: Current strategies and future perspectives. European Journal of Medical and Health Sciences, 5(3), 32–48. https://doi.org/10.24018/ejmed.2023.5.3.1699
Jamshed, H., Beyl, R. A., Della Manna, D. L., Yang, E. S., Ravussin, E., & Peterson, C. M. (2019). Early time-restricted feeding improves 24-hour glucose levels and markers of the circadian clock in humans. Nutrients, 11(6), 1234. https://doi.org/10.3390/nu11061234
Jaman, M. S., Maniruzzaman, M., Rana, M. R. R., Bhuyan, M. R. H., Akter, L., Ahmad, S., Ullah, M. N., & Saifujjaman, M. (2024). Overall summary of Gulf country employees from Bangladesh, preliminary evaluation for abnormal kidney, liver, and virally infected individuals using low-cost tests like CBC parameters. Chemical Science International Journal, 33(4), 19–33. https://doi.org/10.9734/CSJI/2024/v33i4903
Kahleova, H., Fleeman, R., Hlozkova, A., Holubkov, R., & Barnard, N. D. (2019). Effect of intermittent fasting on use of medication in type 2 diabetes. Nutrients, 11(11), 2517. https://doi.org/10.3390/nu11112517
Kumanyika, S. K. (2019). A framework for culturally relevant dietary interventions to reduce disparities in obesity and diabetes. Annual Review of Public Health, 40, 305–330. https://doi.org/10.1146/annurev-publhealth-040218-044047
Longo, V. D., & Panda, S. (2016). Fasting, circadian rhythms, and time-restricted feeding in healthy lifespan. Cell Metabolism, 23(6), 1048–1059. https://doi.org/10.1016/j.cmet.2016.06.001
Levitsky, D. A., & Pacanowski, C. R. (2020). Effect of intermittent fasting on disordered eating behaviors: A review. Appetite, 151, 104711. https://doi.org/10.1016/j.appet.2020.104711
Lowe, D. A., Wu, N., Rohdin-Bibby, L., et al. (2020). Effects of time-restricted eating on weight loss and metabolic health: A randomized clinical trial. JAMA Internal Medicine, 180(11), 1491–1499. https://doi.org/10.1001/jamainternmed.2020.4153
Mozaffarian, D., Rosenberg, I., & Uauy, R. (2019). History of modern nutrition science—Implications for current research, dietary guidelines, and food policy. The New England Journal of Medicine, 381(18), 1773–1781. https://doi.org/10.1056/NEJMra1906035
Maniruzzaman, M., Bhuiyan, M. R. H., Jaman, M. S., & Haque, M. S. (2025). MicroRNA dynamics, PTEN/PI3K/AKT signaling, and their relationship to breast cancer: Prospects for pharmaceuticals and natural product application. Breast Cancer Research and Treatment, 209(3), 467–485. https://doi.org/10.1007/s10549-024-07600-7
Patterson, R. E., & Sears, D. D. (2017). Metabolic effects of intermittent fasting. Annual Review of Nutrition, 37, 371–393. https://doi.org/10.1146/annurev-nutr-071816-064634
Patterson, R. E., Laughlin, G. A., Sears, D. D., et al. (2017). Intermittent fasting and human metabolic health. Annual Review of Nutrition, 37, 371–393. https://doi.org/10.1146/annurev-nutr-071816-064634
Sutton, E. F., Beyl, R. A., Peterson, C. M., & Ravussin, E. (2018). Intermittent fasting improves glycemic control and HbA1c in prediabetes. Cell Metabolism, 27(6), 1212–1221.e3. https://doi.org/10.1016/j.cmet.2018.04.010
Trepanowski, J. F., Kroeger, C. M., Barnosky, A., et al. (2017). Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults: A randomized clinical trial. JAMA Internal Medicine, 177(7), 930–938. https://doi.org/10.1001/jamainternmed.2017.0936
Varady, K. A., Bhutani, S., Klempel, M. C., & Kroeger, C. M. (2019). Improvements in LDL particle size and distribution by intermittent fasting. Nutrients, 11(4), 911. https://doi.org/10.3390/nu11040911
Virani, S. S., Alonso, A., Aparicio, H. J., et al. (2023). Heart disease and stroke statistics—2023 update: A report from the American Heart Association. Circulation, 147(8), e93–e621. https://doi.org/10.1161/CIR.0000000000001123
Varady, K. A. (2019). Intermittent fasting and lipid metabolism: An update. Nutrients, 11(4), 873. https://doi.org/10.3390/nu11040873
Woodruff, R. C., Tong, X., Khan, S. S., Shah, N. S., Jackson, S. L., Loustalot, F., & Vaughan, A. S. (2024). Trends in cardiovascular disease mortality rates and excess deaths, 2010–2022. American Journal of Preventive Medicine, 66(4), 582–589. https://doi.org/10.1016/j.amepre.2023.11.009
Wilkinson, M. J., Zadourian, A., Ostler, J., et al. (2020). Blood pressure improvements with time-restricted feeding in metabolic syndrome. Hypertension, 76(1), 107–116. https://doi.org/10.1161/HYPERTENSIONAHA.120.14759
Zarrinpar, A., Chaix, A., & Panda, S. (2018). Circadian regulation of metabolism and the gut microbiome: Implications for intermittent fasting. Cell Metabolism, 27(6), 1212–1226. https://doi.org/10.1016/j.cmet.2018.04.019