Intermittent fasting and bone health: a bone of contention?

Clayton, D.J. ORCID: 0000-0001-5481-0891, Varley, I. ORCID: 0000-0002-3607-8921 and Papageorgiou, M., 2023. Intermittent fasting and bone health: a bone of contention? British Journal of Nutrition. ISSN 0007-1145

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Intermittent fasting (IF) is a promising strategy for weight loss and improving metabolic health, but its effects on bone health are less clear. This review aims to summarize and critically evaluate the preclinical and clinical evidence on IF regimes (the 5:2 diet, alternate-day fasting [ADF] and time-restricted eating/feeding [TRE/TRF]) and bone health outcomes. Animal studies have utilised IF alongside other dietary practices known to elicit detrimental effects on bone health and/or in models mimicking specific conditions, thus, findings from these studies are difficult to apply to humans. Whilst limited in scope, observational studies suggest a link between some IF practices (e.g., breakfast omission) and compromised bone health, although lack of control for confounding factors make these data difficult to interpret. Interventional studies suggest that TRE regimens practiced up to 6 months do not adversely affect bone outcomes and may even slightly protect against bone loss during modest weight loss (<5% of baseline body weight). Most studies on ADF have shown no adverse effects on bone outcomes, while no studies on the "5-2" diet have reported bone outcomes. Available interventional studies are limited by their short duration, small and diverse population samples, assessment of total body bone mass exclusively (by DXA) and inadequate control of factors that may affect bone outcomes, making the interpretation of existing data challenging. Further research is required to better characterise bone responses to various IF approaches using well-controlled protocols of sufficient duration, adequately powered to assess changes in bone outcomes, and designed to include clinically relevant bone assessments.

Item Type: Journal article
Publication Title: British Journal of Nutrition
Creators: Clayton, D.J., Varley, I. and Papageorgiou, M.
Publisher: Cambridge University Press
Date: 6 March 2023
ISSN: 0007-1145
Rights: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Divisions: Schools > School of Science and Technology
Record created by: Jonathan Gallacher
Date Added: 27 Mar 2023 08:29
Last Modified: 27 Mar 2023 08:29

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