Khalafi · Nutrients 2025 · systematic review and network meta-analysis · n=21 studies (839 participants)

The Effects of Intermittent Fasting on Inflammatory Markers in Adults: A Systematic Review and Pairwise and Network Meta-Analyses.

Cited 12 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review and network meta-analysis of randomized and non-randomized controlled trials

PubMed 40805975 · doi:10.3390/nu17152388 · record verified 2026-08-30

What was done

Authors conducted a systematic review, pairwise meta-analysis, and network meta-analysis of studies indexed in PubMed, Scopus, and Web of Science through June 2024. They evaluated randomized and non-randomized trials examining the impact of intermittent fasting (IF) modes (such as time-restricted feeding [TRF] and the 5:2 diet) on inflammatory and adipokine markers (IL-6, TNF-α, CRP, leptin, and adiponectin) in adults. Standardized mean differences (SMDs) were pooled using random-effects models.

What was found

Across 21 studies with 839 participants, IF significantly reduced TNF-α (SMD: -0.31, p = 0.009), CRP (SMD: -0.19, p = 0.04), and leptin (SMD: -0.57, p = 0.005) compared to controls. IF did not significantly alter IL-6 or adiponectin. In network analysis, TRF led to the largest reduction in TNF-α (SMD: -0.39, p = 0.001) and ranked highest for probability of benefit across TNF-α, IL-6, leptin, and adiponectin, though effects for IL-6 and adiponectin remained statistically non-significant. The 5:2 diet ranked highest for CRP reduction.

Why it matters

This study provides comparative evidence that intermittent fasting regimens can lower specific systemic inflammatory markers, pointing to time-restricted feeding as potentially the most effective fasting modality for reducing TNF-α.

Limits

The total sample size across 21 studies was small (averaging ~40 participants per trial), and non-randomized studies were included alongside randomized trials. The abstract does not report intervention durations, participant baseline health status, caloric intake control, or long-term clinical endpoints.

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