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preLekára.sk / Journals / Forum Diabetologicum / 2026 - 1

The power of starvation: metabolic, hormonal, and psychological effects of intermittent fasting

Czech version

Authors: Emil Martinka
Authors‘ workplace: Diabetologické oddelenie NEDÚ n. o., Ľubochňa
Published in: Forum Diab 2026; 15(1): 26-35
Category: Topic

Overview

Available clinical evidence suggests that intermittent fasting (IF), including time-restricted eating, may improve certain parameters of metabolic health in selected patients (body weight, glycemia/insulin sensitivity, and some cardiometabolic risk markers). The effect is often also related to energy deficit, diet quality, and circadian timing of meals. Data on the reduction of “subclinical” inflammation are heterogeneous (changes in some biomarkers are observed, but not consistently across studies). IF may induce a physiological “metabolic switch” toward increased fat oxidation/ketosis; however, preservation of muscle mass is not automatic and requires adequate protein intake and resistance training. Mechanistically, IF activates pathways associated with stress adaptation and autophagy, but direct clinical evidence of tissue autophagy in humans is limited. Evidence regarding neuroprotection, mood, and sleep is promising but currently inconclusive and highly individual. IF is not a universal solution; the choice of protocol, goals, and safety precautions should be individualized, with increased caution and often medical supervision in high-risk groups (especially in patients on antidiabetic therapy with risk of hypoglycemia, during pregnancy, in individuals with eating disorders, and in frail underweight patients).

Keywords:

Starvation – autophagy – fasting – intermittent fasting – metabolic effects

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