The promise of intermittent fasting for healthy aging just received its most rigorous examination to date, with important implications for adults over 60 seeking evidence-based approaches to metabolic health. While younger populations have dominated fasting research, this demographic analysis fills a critical knowledge gap for an age group where metabolic interventions carry both greater potential benefits and safety considerations.
This comprehensive network meta-analysis evaluated 31 studies, with seven randomized controlled trials meeting criteria for direct comparison of fasting protocols. Islamic Sunnah fasting emerged as the most potent intervention, producing 2.36 kg weight loss and 0.81 kg/m² BMI reduction. Time-restricted eating with 16-hour fasting windows followed closely, achieving 1.92 kg weight reduction and 1.01 kg/m² BMI decrease. Crucially, neither protocol compromised lean muscle mass, addressing a primary concern in geriatric weight management.
This analysis represents the first systematic comparison of fasting approaches specifically in older adults, where metabolic flexibility and safety profiles differ markedly from younger cohorts. The preservation of lean mass during weight loss is particularly significant, as sarcopenia represents a major health threat in this demographic. However, the limited pool of high-quality trials—just seven RCTs—underscores how underrepresented older adults remain in fasting research. The findings suggest intermittent fasting protocols may offer viable metabolic interventions for healthy aging, though the evidence base requires substantial expansion before clinical recommendations can be definitively established for this vulnerable population.