Intermittent fasting is a non-pharmacological dietary approach to management of obesity and metabolic syndrome, involving periodic intervals of complete or near-complete abstinence from food and energy-containing fluids. This dietary strategy has recently gained significant popularity in mainstream culture and has been shown to induce weight loss in humans, reduce gut and systemic inflammation, and improve gut microbial diversity and dysbiosis (largely in animal models). It has been hypothesized that intermittent fasting could be beneficial in the management of nonalcoholic fatty liver disease, given the condition’s association with obesity. This review summarizes protocols, potential mechanisms of action, and evidence for intermittent fasting in nonalcoholic fatty liver disease. It also highlights practical considerations for implementing intermittent fasting in clinical practice. A search of the literature for English-language articles related to intermittent fasting or time-restricted feeding and liver disease was completed in PubMed and Google Scholar. Potential mechanisms of action for effects of intermittent fasting included modulation of circadian rhythm, adipose tissue and adipokines, gut microbiome, and autophagy. Preclinical, epidemiological, and clinical trial data suggested clinical benefits of intermittent fasting on metabolic and inflammatory markers in humans. However, there was a paucity of evidence of its effects in patients with nonalcoholic fatty liver disease. More clinical studies are needed to determine mechanisms of action and to evaluate safety and efficacy of intermittent fasting in this population.

Purpose.: To determine the associations of daily pedometer steps with health-related quality of life (HRQoL) and psychosocial health. Design.: Cross-sectional. Setting.: Alberta, Canada. Subjects.: Three hundred eighty-five older-aged men 55 years of age and older. Measures.: Subjects completed a mailed survey that assessed HRQoL (RAND-12 Health Status Inventory [RAND-12]), depression, anxiety, and satisfaction with life. Steps/day were assessed with a pedometer via a 3-day step-monitoring period. Analysis.: Average pedometer steps/d were categorized into quartiles (Qs). The primary model assessed the association between average pedometer steps/d as the independent variable of interest and our dependent variables of interest (physical, mental, and global health component scores of the RAND-12). Results.: For HRQoL, all three adjusted models (i.e., physical, mental, and global health) indicated a significant linear trend between HRQoL indices across pedometer step Qs, with participants in Q3 and Q4 demonstrating higher physical, mental, and global health compared to participants in the lowest Q of pedometer steps (Q1) (all p < .05). For depression, significant differences were observed between Q1 and Q3 (M _diff = 3.3, p = .006, η ² = .019) and Q1 and Q4 (M _diff = 2.7, p = .025, η ² = .013). Conclusion.: Higher average steps/d were significantly associated with HRQoL across all domains. Older men in the higher Qs of pedometer steps/d reported less depressive symptoms compared to those in the lowest Q of pedometer steps/d.

Background: Patients with inflammatory bowel diseases (IBD) experience anxiety, depression, and decreased quality of life (QoL), even when in remission. Mobile health apps with online health coaching focusing on self-management could help reduce mental health burden and improve QoL. Methods: In this real-world, patient-centered study, patients with IBD chose conventional management (CM) alone or with the intervention (INT), which included the use of a mobile health app with online coaching. Changes in anxiety, depression, and QoL were assessed after 12 weeks using the Generalized Anxiety Disorder 7-item scale, the 9-item Patient Health Questionnaire, and the 12-item Short-Form Scale. Physical activity, stress, sleep, and diet were secondary outcomes. Results: Of 65 adult participants, 45 (14 with ulcerative colitis and 31 with Crohn’s disease) completed the study; 21 in the CM group and 24 in the INT group. In the INT compared to CM group from baseline to week 12, the risk of anxiety decreased (P = .002) and QoL improved (P <.001 and P = .007 for physical and mental health summary scores, respectively). Risk of depression decreased significantly in both groups, but not between groups (P = .28). Physical activity, stress, and sleep significantly improved within both groups, but changes were not significant between groups. The INT group increased intakes of vitamin C, folate, total fruit, and legumes by a greater magnitude than the CM group (P< .04). Conclusions: Integrating a mobile app with online health coaching into IBD management is an effective strategy for improving mental health and QoL.