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Open AccessArticle

Effects of Periodic Fasting on Fatty Liver Index—A Prospective Observational Study

Buchinger Wilhelmi Clinic, 88662 Überlingen, Germany
Clinic St. Katharinental, Department of Rheumatology, 8253 Diessenhofen, Switzerland
Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt–Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany
Division of Rheumatology, Immunology and Rehabilitation, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland
Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, 07743 Jena, Germany
Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, 14109 Berlin, Germany
Author to whom correspondence should be addressed.
Nutrients 2019, 11(11), 2601;
Received: 19 September 2019 / Revised: 24 October 2019 / Accepted: 28 October 2019 / Published: 30 October 2019
This prospective observational trial investigated effects and safety of periodic fasting in subjects with and without type 2 diabetes mellitus (T2DM). The primary end point was set as the change of fatty liver index (FLI) as a surrogate parameter of non-alcoholic fatty liver disease (NAFLD). Six-hundred and ninety-seven subjects (38 with T2DM) were enrolled. A baseline FLI ≥ 60 (the threshold for fatty liver) was found in 264 subjects (37.9%). The mean duration of fasting was 8.5 ± 4.0 days (range 6–38). FLI decreased significantly (−14.02 ± 11.67; p < 0.0001), with a larger effect in individuals with T2DM (−19.15 ± 11.0; p < 0.0001; p = 0.002 compared to non-diabetic subjects). Body mass index (BMI) decreased by −1.51 ± 0.82 kg/m2, and 49.9% of the subjects lost ≥5% body weight. After fasting, nearly half of the 264 subjects with FLI ≥ 60 (highest risk category) shifted to a lower category. The improvement of FLI correlated with the number of fasting days (r = −0.20, p < 0.0001) and with the magnitude of BMI reduction (r = 0.14, p = 0.0001). Periodic fasting with concomitant weight reduction leads to significant rapid improvement of FLI in subjects with and without T2DM. View Full-Text
Keywords: periodic fasting; obesity; overweight; fatty liver index; diabetes periodic fasting; obesity; overweight; fatty liver index; diabetes
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Drinda, S.; Grundler, F.; Neumann, T.; Lehmann, T.; Steckhan, N.; Michalsen, A.; Wilhelmi de Toledo, F. Effects of Periodic Fasting on Fatty Liver Index—A Prospective Observational Study. Nutrients 2019, 11, 2601.

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