Intermittent fasting and cardiovascular health: What the research says

Intermittent fasting is a popular dietary pattern gaining attention for its potential role in cardiovascular health. While much of the focus we hear in the media has been around weight loss, emerging evidence suggests intermittent fasting may also support improvements in key cardiovascular risk factors, particularly in individuals with prediabetes or type 2 diabetes.

Intermittent fasting and cardiovascular risk

Intermittent fasting typically involves alternating periods of eating and fasting such as Time-Restricted Eating (TRE) or Alternate-Day Fasting (ADF). For example, a popular type of time-restricted eating involves fasting for a period of 16 hours and eating within an 8-hour window.

A 2019 review highlighted multiple physiological benefits of intermittent fasting, including improvements in blood pressure, lipid levels, insulin sensitivity, and inflammation [1]. The authors proposed several mechanisms through which intermittent fasting may exert these effects, including reduced oxidative stress, enhanced ketone production, and improved circadian rhythm alignment.

Current human studies suggest:

• Mild to moderate reductions in body weight with intermittent fasting protocols [2]
• Lower blood pressure, especially in individuals with hypertension or metabolic syndrome [3]
• Variable improvements in cholesterol and triglycerides, with some positive findings [2,3]
• Improved insulin sensitivity and reduced glucose levels, particularly in those with prediabetes or type 2 diabetes [4]

Clinical outcomes and limitations

Despite these promising metabolic changes, there is currently no strong evidence that intermittent fasting reduces major cardiovascular events such as heart attacks, stroke, or cardiovascular mortality [5].

Most studies remain short-term and focus on surrogate outcomes. Importantly, research indicates that intermittent fasting appears to be about as effective as continuous calorie restriction for improving cardiometabolic markers, with no clear superior effect [6].

There are also some factors to consider within these research findings. A small number of observational studies have raised concerns around loss of lean mass and disruption to circadian rhythms with long-term or poorly structured fasting regimens [6]. While not conclusive, these findings highlight the importance of individualising dietary advice, as intermittent fasting may not be suitable for all individuals.

Intermittent fasting is a safe and potentially beneficial option for cardiometabolic risk reduction in adults with type 2 diabetes. However, like any dietary intervention, it should be personalised and monitored. If a patient is considering intermittent fasting, it’s important to ensure fasting protocols include nutrient-dense foods during eating windows to prevent nutritional deficiencies. Intermittent fasting may offer a practical approach to improving cardiovascular risk markers in the right patient population, but long-term outcome data is still emerging.

– Sarah Marko, Accredited Practising Dietitian

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References

[1] Malinowski B, Zalewska K, Węsierska A, Sokołowska MM, Socha M, Liczner G, Pawlak-Osińska K, Wiciński M. Intermittent Fasting in Cardiovascular Disorders-An Overview. Nutrients. 2019 Mar 20;11(3):673. doi: 10.3390/nu11030673. PMID: 30897855; PMCID: PMC6471315.

[2] Varady KA, Cienfuegos S, Ezpeleta M, Gabel K. Cardiometabolic Benefits of Intermittent Fasting. Annu Rev Nutr. 2021 Oct 11;41:333-361. doi: 10.1146/annurev-nutr-052020-041327. PMID: 34633860.

[3] Muhammad Naif Hafizin Afdzal Rasif, Amirah Farhana Nazri and May Khin Soe, The Effects of Intermittent Fasting on Cardiovascular Health of Prediabetes and Type 2 Diabetes Mellitus (T2DM) Patients: A Systematic Review. Malaysian Journal of Pharmacy (MJP). 2023;2(9):1-19.

[4] Cheung, K., Chan, V., Chan, S., Wong, M., Chung, G., Cheng, W., Lo, K., & Zeng, F. (2024). Effect of Intermittent Fasting on Cardiometabolic Health in the Chinese Population: A Meta-Analysis of Randomized Controlled Trials. Nutrients, 16. https://doi.org/10.3390/nu16030357.

[5] Allaf, M., Elghazaly, H., Mohamed, O., Fareen, M., Zaman, S., Salmasi, A., Tsilidis, K., & Dehghan, A. (2019). Intermittent fasting for the prevention of cardiovascular disease.. The Cochrane database of systematic reviews, 1, CD013496 . https://doi.org/10.1002/14651858.cd013496.

[6] Eliopoulos, A., Gkouskou, K., Tsioufis, K., & Sanoudou, D. (2025). A perspective on intermittent fasting and cardiovascular risk in the era of obesity pharmacotherapy. Frontiers in Nutrition, 12. https://doi.org/10.3389/fnut.2025.1524125.