Metabolic effects of alternate-day fasting in males with obesity with or without type 2 diabetes.

Alternate-day fasting induces oscillations in energy stores. We hypothesized that repeated oscillations increases insulin secretion and sensitivity, and improve metabolic health in patients with obesity with or without type 2 diabetes (T2DM). Twenty-three male patients fasted every other day for 30 h for 6 weeks. Experiments included resting energy expenditure, continuous glucose monitoring, intravenous glucose tolerance test, euglycemic hyperinsulinemic clamp, body composition, hepatic triglyceride content, muscle biopsies which were performed at baseline, during 3 weeks without allowed weight loss, and after additional 3 weeks with weight loss. Bodyweight decreased ∼1% and further ∼3% during weeks one to three and four to six, respectively (p < 0.05). Only minor changes in fat mass occurred in weeks 1-3. With weight loss, visceral fat content decreased by 13 ± 3% and 12 ± 2% from baseline in patients with and without T2DM, respectively (p < 0.05). Hepatic triglyceride content decreased by 17 ± 9% and 36 ± 9% (with diabetes) and 27 ± 8% and 40 ± 8% (without diabetes) from baseline to week 3 and week 6, respectively (all p < 0.05). Muscle lipid and glycogen content oscillated with the intervention. Glucose homeostasis, insulin secretion and sensitivity was impaired in patients with T2DM and did not change without weight loss, but improved (p < 0.05) when alternate day fasting was combined with weight loss. In conclusion, alternate-day fasting is feasible in patients with obesity and T2DM, and decreases visceral fat and liver fat deposits. Energy store oscillations by alternate-day fasting do not improve insulin secretion or sensitivity per se. Clinical Trial registration: (ClinicalTrials.gov), (ID NCT02420054).

The Association Between Season of Birth and Atopic Dermatitis in the Northern Hemisphere: A Systematic Review and Meta-Analysis.

BACKGROUND: Cold and dry climate negatively affects skin barrier functions. This could explain the higher incidence of atopic dermatitis (AD) in Northern countries distant from the equator, as well as the general worsening of AD in Northern European winter months. Although it has been suggested that fall and winter birth is associated with AD, this remains unknown. OBJECTIVES: To examine whether the prevalence of AD is associated with season of birth. METHODS: We conducted a systematic review and meta-analysis. Two reviewers independently searched 3 databases. Study quality was assessed using a Newcastle-Ottawa scale. Study heterogeneity was assessed with Cochrane Q and I2 statistics. Odds ratios with 95% CIs were calculated. Publication bias was assessed using funnel plots. RESULTS: The systematic review identified 23 relevant articles of which 9 articles were included in the meta-analysis. Among a total of 726,378 children aged 0 to 12 years, the overall pooled prevalence of AD was 12.9%. The pooled prevalence of AD was 15.4% (95% CI, 12.1%-19.1%), 14.9% (95% CI, 12.0%-18.1%), 12.7% (95% CI, 10.2%-15.4%), and 13.7% (95% CI, 10.8%-17.0%), among children born in the fall, winter, spring, and summer, respectively. AD was significantly associated with fall (odds ratio, 1.16; 95% CI, 1.06-1.28; P = .0018) and winter (odds ratio, 1.15; 95% CI, 1.04-1.27; P = .0076) birth compared with spring birth. CONCLUSIONS: Although a positive and significant association was observed between being born in fall and winter and developing AD on the Northern hemisphere, there is a need for additional and better-designed studies to understand the effect of seasonal changes on the risk of AD.

Prevalence of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational and clinical studies.

BACKGROUND: Wide-ranging prevalence estimates of psoriatic arthritis (PsA) in patients with psoriasis have been reported. OBJECTIVES: To assess the prevalence and incidence of PsA in patients with psoriasis. METHODS: Two authors independently searched 3 databases for studies reporting on the prevalence or incidence of PsA in patients with psoriasis. A proportion meta-analysis was performed to calculate the pooled proportion estimates of PsA in patients with psoriasis. RESULTS: A total of 266 studies examining 976,408 patients with psoriasis were included. Overall, the pooled proportion (95% confidence interval [CI]) of PsA among patients with psoriasis was 19.7% (95% CI, 18.5%-20.9%). In children and adolescents (<18 years of age), the pooled prevalence was 3.3% (95% CI, 2.1%-4.9%). The PsA prevalence was 22.7% (95% CI, 20.6%-25.0%) in European patients with psoriasis, 21.5% (95% CI, 15.4%-28.2%) in South American patients with psoriasis, 19.5% (95% CI, 17.1%-22.1%) in North American patients with psoriasis, 15.5% (95% CI, 0.009%-51.5%) in African patients with psoriasis, and 14.0% (95% CI, 95% CI, 11.7%-16.3%) in Asian patients with psoriasis. The prevalence of PsA was 23.8% (95% CI, 20.1%-27.6%) in studies in which the Classification Criteria for Psoriatic Arthritis were applied. The incidence of PsA among patients with psoriasis ranged from 0.27 to 2.7 per 100 person-years. LIMITATIONS: Between-study heterogeneity may have affected the estimates. CONCLUSIONS: We found that 1 in 4 patients with psoriasis have PsA. With the growing recognition of the Classification Criteria for Psoriatic Arthritis, more homogenous and comparable prevalence estimates are expected to be reported.