OBJECTIVES:According to most guidelines, dietary interventions are essential in the management of diabetes. Fasting has emerged as potential therapeutic regimes for diabetes. The proof-of-concept study and the fasting in diabetes treatment trial are the first to explore the clinical impact of the Fasting Mimicking Diet (FMD) in patients with type 2 diabetes mellitus. Their results showed that FMD cycles improve glycemic management and can be integrated into usual care complementary to current guidelines. This economic evaluation aims to assess the 10-year quality-of-life effects, cost implications, and cost-effectiveness of adding a 3-year FMD program to diabetes standard care in diabetic population on dual or triple medications at baseline from the perspective of the US payer. METHODS:We constructed a microsimulation model in TreeAge using a published US-specific diabetes model. The model was populated using FMD effectiveness outcomes and publicly available clinical and economic data associated with diabetes complications, use of diabetes medications, hypoglycemia incidence, direct medical costs in 2021 USD, quality of life, and mortality. All benefits were discounted by 3%. RESULTS:This cost-utility analysis showed that the FMD program was associated with 11.4% less diabetes complications, 67.2% less overall diabetes medication use, and 45.0% less hypoglycemia events over the 10-year simulation period. The program generated an additional effectiveness benefit of 0.211 quality-adjusted life year and net monetary benefit of 41 613 USD per simulated patient. Thus, the FMD program is cost saving. CONCLUSIONS:These results indicate that the FMD program is a beneficial first-line strategy in T2DM management.

Diet and nutrition have been shown to impact dermatological conditions. This has increased attention toward integrative and lifestyle medicine in the management of skin health. Emerging research around fasting diets, specifically the fasting-mimicking diet (FMD), has provided clinical evidence for chronic inflammatory, cardiometabolic, and autoimmune diseases. In this randomized controlled trial, we evaluated the effects of a five-day FMD protocol, administrated once a month for three months, on facial skin parameters, including skin hydration and skin roughness, in a group of 45 healthy women between the ages of 35 to 60 years old over the course of 71 days. The results of the study revealed that the three consecutive monthly cycles of FMD resulted in a significant percentage increase in skin hydration at day 11 (p = 0.00013) and at day 71 (p = 0.02) relative to baseline. The results also demonstrated maintenance of skin texture in the FMD group compared to an increase in skin roughness in the control group (p = 0.032). In addition to skin biophysical properties, self-reported data also demonstrated significant improvement in components of mental states such as happiness (p = 0.003) and confidence (0.039). Overall, these findings provide evidence for the potential use of FMD in improving skin health and related components of psychological well-being.

Intermittent fasting has gained popularity in promoting health and been proposed to combat metabolic diseases. The study aimed to evaluate the effects of consuming a Fast BarTM (FB) with coffee or tea in extending physiological ketosis associated with time-restricted eating (Clinicaltrial.gov: NCT04790552). We conducted the study remotely during the COVID-19 pandemic with healthy adults. Participants were randomized into 4 groups: water-only fast (overnight for 15 hours), FB as a nighttime snack, FB + coffee or FB + tea in the morning. Blood ketone (BHB) and glucose levels were measured hourly for 4 hours (Precision Xtra Blood Ketone & Glucose Monitoring System, Abbott) after consuming study foods. Subjects also completed a satiety and mood survey. 84 of the 89 enrolled participants completed the study. There was no postprandial glucose increase after consuming the Fast Bar with either black coffee or tea. The mean (SD) BHB AUC0–4 for nighttime FB, FB + coffee, FB + tea, or water-only fast were 1.40 (0.81), 1.22 (0.73), 1.11 (0.45), 1.36 (0.78) mM∙h, respectively. Despite a delay in BHB increase 1 hour after consuming the Fast Bar, the 4-h ketone and glucose AUCs of the Fast Bar groups were similar to those of subjects water-fasted for 19 hours (one-way ANOVA with Dunn's multiple comparison test). Fast BarTM can be used as a nighttime snack, or with coffee or tea in the morning, to extend physiologic fasting state comparable to a 19-h water fasting. Fast BarTM may be used to support intermittent fasting or time-restricted eating pattern while providing satiety. Fully funded by L-Nutra, Inc.

There has been increasing interest in time-restricted eating to attain intermittent fasting’s metabolic benefits. However, a more extended daily fast poses many challenges. This study was designed to evaluate the effects of a 200-calorie fasting-mimicking diet (FMD) energy bar formulated to prolong ketogenesis and mitigate fasting-associated side effects. A randomized, controlled study was conducted comparing the impact of consuming an FMD bar vs. continued water fast, after a 15-h overnight fast. Subjects in the FMD group showed a 3-h postprandial beta-hydroxybutyrate (BHB) level and 4-h postprandial BHB area under the curve (AUC0–4) that were non-inferior to those who continued with the water fast (p = 0.891 and p = 0.377, respectively). The postprandial glucose AUC0–4 in the FMD group was non-inferior to that in the water fast group (p = 0.899). A breakfast group served as a control, which confirmed that the instrument used in home glucose and ketone monitoring functioned as expected. The results indicate that FMD bar consumption does not interfere with the physiological ketogenesis associated with overnight fasting and could be used to facilitate the practice of time-restricted eating or intermittent fasting.