A Six-Week Follow-Up Study on the Sustained Effects of Prolonged Water-Only Fasting and Refeeding on Markers of Cardiometabolic Risk.

(1) Background: Chronic inflammation and insulin resistance are associated with cardiometabolic diseases, such as cardiovascular disease, type 2 diabetes mellitus, and non-alcoholic fatty liver disease. Therapeutic water-only fasting and whole-plant-food refeeding was previously shown to improve markers of cardiometabolic risk and may be an effective preventative treatment but sustained outcomes are unknown. We conducted a single-arm, open-label, observational study with a six-week post-treatment follow-up visit to assess the effects of water-only fasting and refeeding on markers of cardiometabolic risk. (2) Methods: Patients who had voluntarily elected and were approved to complete a water-only fast were recruited from a single-center residential medical facility. The primary endpoint was to describe changes to Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) scores between the end-of-refeed visit and the six-week follow-up visit. Additionally, we report on changes in anthropometric measures, blood lipids, high-sensitivity C-reactive protein (hsCRP), and fatty liver index (FLI). Observations were made at baseline, end-of-fast (EOF), end-of-refeed (EOR), and six-week follow-up (FU). (3) Results: The study enrolled 40 overweight/obese non-diabetic participants, of which 33 completed the full study protocol. Median fasting, refeeding, and follow-up lengths were 14, 6, and 45 days, respectively. At the FU visit, body weight (BW), body mass index (BMI), abdominal circumference (AC), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein (LDL), hsCRP, and FLI were significantly decreased from baseline. Triglycerides (TG) and HOMA-IR scores, which had increased at EOR, returned to baseline values at the FU visit. (4) Conclusion: Water-only fasting and whole-plant-food refeeding demonstrate potential for long-term improvements in markers of cardiovascular risk including BW, BMI, AC, SBP, DBP, blood lipids, FLI, and hsCRP.

Potential Effects of Prolonged Water-Only Fasting Followed by a Whole-Plant-Food Diet on Salty and Sweet Taste Sensitivity and Perceived Intensity, Food Liking, and Dietary Intake.

The overconsumption of calorie-dense foods high in added salt, sugar, and fat is a major contributor to current rates of obesity, and methods to reduce consumption are needed. Prolonged water-only fasting followed by an exclusively whole-plant-food diet free of added salt, oil, and sugar may reduce the consumption of these hyper-palatable foods, but such effects have not been quantified. Therefore, we conducted a preliminary study to estimate the effects of this intervention on salty and sweet taste detection and recognition thresholds and perceived taste intensity after at least five days of fasting and at refeed day three. We also assessed the effects on sweet, salty, and fatty food preference and overall dietary consumption 30 days after the day three refeed visit. Based on this data, we estimated that 10 days after the start of the fasting, salty taste recognition, sweet taste detection, and sweet taste recognition thresholds decreased significantly, salty taste intensity ratings increased significantly, and sweet taste intensity ratings decreased significantly. We also have preliminary data that prolonged water-only fasting followed by refeeding on an exclusively whole-food-plant diet may reduce salty/fatty and sweet/fatty food liking, reduce sugar intake, and increase vegetable intake. These results support further research into the effects of fasting and diet on taste function and food likability and consumption.

The Effects of Prolonged Water-Only Fasting and Refeeding on Markers of Cardiometabolic Risk.

(1) Background: Cardiometabolic disease, including insulin resistance, hyperlipidemia, and hypertension, are major contributors to adverse health outcomes. Fasting has gained interest as a nonpharmacological therapeutic adjunct for these disorders. (2) Methods: We conducted a prospective, single-center study on the effects of prolonged water-only fasting followed by an exclusively whole-plant-food refeeding diet on accepted measures of cardiovascular risk and metabolic health. Participants were recruited from patients who had voluntarily elected to complete a water-only fast in order to improve their overall health according to an established protocol at an independent, residential medical center. Median fasting and refeed lengths were 17 and 8 days, respectively. The primary endpoint was to describe the mean glucose tolerance as indicated by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) scores at baseline, end-of-fast (EOF), and end-of-refeed (EOR) visits. Secondary endpoints were to describe the mean weight, body mass index (BMI), abdominal circumference (AC), systolic blood pressure (SBP), diastolic blood pressure (DBP), lipid panel, and high-sensitivity C-reactive protein (hsCRP) at the same time points. (3) Results: The study enrolled 48 overweight/obese non-diabetic participants, of which 26 completed the full study protocol. At the EOF visit, the median SBP, AC, low-density lipoprotein (LDL), and hsCRP were decreased and triglycerides (TG) and HOMA-IR scores were increased. Conclusion: Prolonged water-only fasting and whole-plant-food refeeding holds potential as a clinical therapy for cardiometabolic disease but increased TG and HOMA-IR values after refeeding necessitate further inquiry.

What are the effects of Teach For America on Math, English Language Arts, and Science outcomes of K-12 students in the USA?

This Campbell systematic review examines the impact of Teach For America (TFA) on learning outcomes. Four studies were included in the review. Studies had to be a quantitative evaluation of the effects of TFA on K-12 student academic outcomes. Studies also had to use a research design which: 1. allowed valid causal inferences about TFA's effects, 2. targeted participants K-12 students taught by TFA corps members or TFA alumni in the USA, 3. compared TFA corps members to novice teachers, or compared TFA alumni with veteran teachers, and 4. reported at least one academic student outcome in math, ELA, or science domains. A total of 919 citations were retrieved on TFA, of which 24 studies were eligible for review. However, when the research design and study quality along with types of TFA corps members and non-TFA teachers compared were reviewed, the evidence base for estimating the effects of TFA on student academic outcomes was reduced to just four studies. There is no significant effect on reading from teaching by TFA corps members in their first or second year of teaching elementary-grade students (PreK - grade 5) compared to non-TFA teachers who are also in their first or second year of teaching elementary-grade students. There is a small positive effect for early elementary-grade students (PreK to grade 2) in reading but not in math. However, given the small evidence base, these findings should be treated with caution. Plain language summary: There are too few well-designed studies to know the effects of Teach For America on Math, English Language Arts, and Science outcomes of K-12 students in the USA: Teach For America (TFA) is an alternate route teacher preparation program that aims to address the decades-long shortage of effective teachers in many rural and urban public schools for kindergarten through 12th grade (K-12), that serve the highest proportions of high-poverty students across the USA. This review finds that there are very few studies - just four - which reliably measure the effects of TFA on learning outcomes, so that no firm conclusions may be drawn.What is this review about?: This systematic review evaluated the impact of TFA prepared teachers (corps members) relative to novice teachers and alumni relative to veteran teachers on K-12 student outcomes in math, English Language Arts (ELA), and science.What are the main findings of this review?: Studies had to be a quantitative evaluation of the effects of TFA on K-12 student academic outcomes. Studies also had to use a research design which: 1. allowed valid causal inferences about TFA's effects, 2. targeted participants K-12 students taught by TFA corps members or TFA alumni in the USA, 3. compared TFA corps members to novice teachers, or compared TFA alumni with veteran teachers, and 4. reported at least one academic student outcome in math, ELA, or science domains.A total of 919 citations were retrieved on TFA, of which 24 studies were eligible for review. However, when the research design and study quality along with types of TFA corps members and non-TFA teachers compared were reviewed, the evidence base for estimating the effects of TFA on student academic outcomes was reduced to just four studies.There is no significant effect on reading from teaching by TFA corps members in their first or second year of teaching elementary-grade students (PreK - grade 5) compared to non-TFA teachers who are also in their first or second year of teaching elementary-grade students. There is a small positive effect for early elementary-grade students (PreK to grade 2) in reading but not in math.However, given the small evidence base, these findings should be treated with caution.What do the findings of this review mean?: TFA is the most evaluated program of its kind. Multiple quasi-experimental and experimental studies have been conducted on its effectiveness in improving student outcomes. However, this systematic review found that only a small number of these studies (1) met the evidence review standards and (2) compared the same type of TFA corps members and non-TFA teachers. So it is not possible to draw firm policy conclusions.Future research can contribute to this evidence base by designing, implementing, and reporting experiments and quasi-experiments to meet objective extant evidence standards and by comparing the same types of TFA and non-TFA teachers so that effect sizes can be included in a future systematic review and meta-analysis.How up-to-date is this review?: The review authors searched for studies published up to January 2015. This Campbell systematic review was published in June 2018.