Misplaced Pages

Revision as of 07:53, 31 October 2019

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Kseses14 (article contribs). Peer reviewers: Taylor O'Neil, Pinecone1500.

Ideal sources for Misplaced Pages's health content are defined in the guideline Misplaced Pages:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Intermittent fasting. PubMed provides review articles from the past five years (limit to free review articles) The TRIP database provides clinical publications about evidence-based medicine. Other potential sources include: Centre for Reviews and Dissemination and CDC

Daily page views Graphs are unavailable due to technical issues. Updates on reimplementing the Graph extension, which will be known as the Chart extension, can be found on Phabricator and on MediaWiki.org.

This is the talk page for discussing improvements to the Intermittent fasting article. This is not a forum for general discussion of the article's subject.

Put new text under old text. Click here to start a new topic. New to Misplaced Pages? Welcome! Learn to edit; get help. Assume good faith Be polite and avoid personal attacks Be welcoming to newcomers Seek dispute resolution if needed Article policies Neutral point of view No original research Verifiability

Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL

Archives: 1, 2Auto-archiving period: 2 months

This article has not yet been rated on Misplaced Pages's content assessment scale. It is of interest to the following WikiProjects:

Please add the quality rating to the {{WikiProject banner shell}} template instead of this project banner. See WP:PIQA for details. Food and drink Low‑importance This article is within the scope of WikiProject Food and drink, a collaborative effort to improve the coverage of food and drink related articles on Misplaced Pages. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.Food and drinkWikipedia:WikiProject Food and drinkTemplate:WikiProject Food and drinkFood and drink Low This article has been rated as Low-importance on the project's importance scale. Food and Drink task list: edit history watch purge To edit this page, select here Here are some tasks you can do for WikiProject Food and drink: Help bring these Top Importance articles currently B Status or below up to GA status: Agaricus bisporus (i.e. mushroom), Beef, Bread, Curry, Drink, Food, Ham and eggs, Soy sauce, Sushi, Yogurt Bring these Top Importance articles currently at GA status up to FA status: Beer, French cuisine, Sugar Bring these High Importance articles currently at GA status up to FA status: Apple, Burger King, Fish Participate in project-related deletion discussions. Delete unrelated trivia sections found in articles. Please review WP:Trivia and WP:Handling trivia to learn how to do this. Add the {{WikiProject Food and drink}} project banner to food and drink related articles and content to help bring them to the attention of members. For a complete list of banners for WikiProject Food and drink and its child projects, select here. Provide photographs and images for Category:Misplaced Pages requested images of food Consider joining this project's Assessment task force. List any project ideas in this section Note: These lists are transcluded from the project's tasks pages. Please add the quality rating to the {{WikiProject banner shell}} template instead of this project banner. See WP:PIQA for details. Health and fitness Low‑importance This article is within the scope of WikiProject Health and fitness, a collaborative effort to improve the coverage of health and physical fitness related articles on Misplaced Pages. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.Health and fitnessWikipedia:WikiProject Health and fitnessTemplate:WikiProject Health and fitnessHealth and fitness Low This article has been rated as Low-importance on the project's importance scale. Please add the quality rating to the {{WikiProject banner shell}} template instead of this project banner. See WP:PIQA for details. Medicine Low‑importance This article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Misplaced Pages talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine Low This article has been rated as Low-importance on the project's importance scale. A dumping ground is available: Talk:Intermittent_fasting/Dumping_ground

The contents of the 5:2 diet page were merged into Intermittent fasting. For the contribution history and old versions of the redirected page, please see its history; for the discussion at that location, see its talk page.

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): JaredWeiss (article contribs). Peer reviewers: Nicolevlad, Emmiesoderstrom, Crb576, Atc424. This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): NelsonL. (article contribs). This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Sl2763, Tcarnella, Heyitsj3 (article contribs). Peer reviewers: Shujins. This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Randy Houghtaling (article contribs). This article was the subject of a Wiki Education Foundation-supported course assignment, between 11 January 2019 and 20 April 2019. Further details are available on the course page. Student editor(s): Krista Georgette Holder (article contribs). Peer reviewers: Vivenso. This article was the subject of a Wiki Education Foundation-supported course assignment, between 22 May 2019 and 28 June 2019. Further details are available on the course page. Student editor(s): Hwainryu (article contribs).

unable to improve article.

I made a few edits and they were just all reverted. Is there some reason this article can't be improved? What is with the Popular Culture section, that doesn't make sense. I'll at least try to fix that again. Volunteer1234 (talk) 01:13, 22 September 2019 (UTC)

There seems to be an anti-fasting editor out there. Some sentences do not reflect at all what the linked sources say (such as the limited efficacy for obese people, what the source says is that it has similar efficiency to calorie restriction, which is what was written before in this WP entry, nothing new). --Signimu (talk) 15:02, 29 September 2019 (UTC)

Disagreement

@Alexbrn: Hello Alex, sorry I saw your revert while I was finishing up a major rewrite, so I committed it nevertheless to keep it in the history, but please feel free to revert it as you primarily intended (edit: reverted it myself until this issue gets resolved by discussion). Now, I would like to discuss your reason for reverting: «unreliable source» for a randomized control study, are you sure you are correct in your endeavor? Could you please clarify what would be a reliable source then, since your definition seems to be outside the boundaries of what is defined in WP:MEDRS? Thank you in advance for discussing this matter. --Signimu (talk) 15:52, 29 September 2019 (UTC)

@Alexbrn: Also please note that half of my changes were about reflecting what the sources, already in the WP entry, says, which is in contradiction to what is written in the entry. Could you please clarify why you would like to maintain a bogus description of the sources? --Signimu (talk) 15:54, 29 September 2019 (UTC)

This is an early-stage research project (30 subjects, 6 months), far from a WP:MEDASSESS "filtered" review. It is unusable as an encyclopedic source. --Zefr (talk) 16:07, 29 September 2019 (UTC)

Quite. And I'm not sure why we're citing the "Harvard health Letter" either. Alexbrn (talk) 16:20, 29 September 2019 (UTC)

I think it's fair to say this topic is more in the lay public eye than it is a focus of well-designed clinical research. I added the Harvard source as a trusted lay source, which was secondary and balanced based on interviews with Harvard faculty members. Not committed that it stays. --Zefr (talk) 16:32, 29 September 2019 (UTC)

I think it's okay so long as it's not used for any novel biomedical claims. Alexbrn (talk) 16:35, 29 September 2019 (UTC)

Hello @Zefr: and @Alexbrn:, thank you for your replies. I have to disagree:

1. yes, the sample size is small, but with now several randomized controlled studies with similar sample sizes all converging to similar findings and conclusions, it's safe to say the scientific evidence is currently in favor of a beneficial effect (here are the additional references I planned to add, I'm still reviewing them: -- not to mention the older references I already added). I am not asking for you to review them -- I'll do it -- but please give me some time to develop. I will start with a meta-analysis if that is more comfortable to you guys.

2. Although I agree that "small" sample size should be accounted for, I can't find where in WP:MEDRS there is a statement about what threshold should be considered too low to be accepted as a reliable source here. I agree we should use our critical thinking, but when so many controlled studies and meta-analyses are pointing in the same direction, the scientific method suggest that this is the one that is the most plausible. Writing otherwise without at least as much scientific evidence can only seem like a personal commentary.

3. The issue with the Harvard source is not so much the source (we can link to the original paper, but I think also that the Harvard article summarizes nicely and adds additional infos such as limitations and recommendations), but the issue is that it is misused in the entry. For example:

* «As of 2019, there is little high-quality clinical evidence that intermittent fasting provides any benefit for weight loss, and is described as a fad.» --> sources are one opinion paper of 2013 (outdated) and the Harvard article which says otherwise (weight loss is significant and similar to calorie restriction).

* «As of 2019, there is only limited evidence of long-term effectiveness of these fasting methods, preventing conclusions about their relative efficacy for obese people or normal-weight people trying to lose some weight.» --> backed by 2 sources I added that say otherwise + Harvard paper that also says otherwise (for positive effects see the previous point, for negative effects it only says basically that more research is needed and that the drop-out rate for obese individuals is quite high). Plus now there is a whole body of new randomized controlled studies that support the improvement of weight and biomarkers (as previous clinical cases have observed).

So I propose that I review the sources above and start off from at least one meta-analysis, and that the two sentences outlined above are rewritten/moved to adequately reflect what the sources say (as I have done in half of my edits today). Please let me know what you think of this suggestion. --Signimu (talk) 16:52, 29 September 2019 (UTC)

BTW: I can't understand how the 2013 opinion paper could have been accepted as a reliable and quality source, nonetheless in the intro (and solely there BTW), when randomized controlled trials are not? Could you guys explain? Maybe it slipped through? --Signimu (talk) 16:55, 29 September 2019 (UTC)

Your edit looked like really poor POV-pushing to me (e.g. in editorializing to try and downplay the faddish nature of IF). The Harvard Health Letter is not a strong source, so unsuitable for biomedical claims but okay for cultural stuff (like PMC 3652955). Your new source, PMID 31471173, is a weak primary source and so falls afoul of WP:MEDRS. What we have is neutral. Alexbrn (talk) 16:59, 29 September 2019 (UTC)

Signimu: an encyclopedia is not a journal article or textbook where all possible sources might be used to support content, WP:NOTTEXTBOOK, WP:NOTEVERYTHING. That is illustrated by the left pyramid in WP:MEDASSESS where the top kinds of sources are needed (non-existent for this topic). Your sources are primary research and are unencyclopedic. You should pose here on the talk page any potential changes to be reviewed by other editors to reach consensus, WP:CON. --Zefr (talk) 17:04, 29 September 2019 (UTC)

@Zefr: @Alexbrn: 1. neither of you answer why this entry is writing something contradicting the very source it uses (such as the Harvard source -- I remind you that I am not the one adding it) or why a 2013 opinion paper has any validity to be used as a source on WP MED, so please don't accuse others of POV-pushing when you don't even provide a reply and behavior coherent with WP:MEDRS recommendations; 2. as I told you guys, I am in the middle of reviewing the litterature, and it's very exciting :-D Here are some much stronger sources that I plan to use to update this entry: -- bonus, a very interesting commentary on the mechanism, which I think lack from the article, and now that there are some investigations in humans, it would be worth creating a section about it: (this is not the only one I have too :-) ).

So guys, are we going to continue playing cats and mouse or can we agree to further build knowledge by updating this entry? --Signimu (talk) 17:45, 29 September 2019 (UTC)

BTW, the RCT studies I have linked above are indeed not yet included in any meta-review (this is highly likely to change soon given the coverage it had). However, I think it would be interesting to mention 2/3 RCT studies, such as this one and 2 others I have found, that all assess the effects of intermittent fasting in a longer term (6 months to 1 year), which is lacking from currently available meta-reviews. Something like «Long-term effects are currently unknown but a few randomized controlled studies on 6 months to 1 year suggest ADF might have sustained positive effects.», what do you think? --Signimu (talk) 17:49, 29 September 2019 (UTC)

Regarding editing here as a "game of cat and mouse" is not helpful. Adding weak primary sources to the article is not helpful either, and neither are personal attacks. Good edits are always welcome. Alexbrn (talk) 17:55, 29 September 2019 (UTC)

@Alexbrn: May I remind you that you were the one accusing me of POV-pushing (and by the way not assuming good faith as is good usage on WP) when I did nothing of the sort? Your behavior is what I qualified as a "game of cats and mouse", as you clearly did not assume good faith in my contributions. And I am not assuming anything here, you said so yourself above. Also could you please clarify how you can view as "weak primary source" the meta-analyses and systematic reviews, including one solely on randomized clinical trials, that I linked above? Finally, could you please answer why a 2013 opinion paper is in the introduction, and why the Harvard paper has been used as a source for contradictory claims? Thank you. --Signimu (talk) 18:03, 29 September 2019 (UTC)

Please learn to WP:INDENT properly as a courtesy to readers here. Your good faith is not an issue; your POV-pushing is, as is your reference to "an anti-fasting editor out there". The source you actually added to the article, PMID 31471173, is unreliable. WP:MEDRS sources are required for WP:Biomedical information; for lesser matters, such as whether this is faddish or not, lesser sources like opinion pieces are good. Alexbrn (talk) 18:07, 29 September 2019 (UTC)

@Alexbrn: Sorry I did a small mistake with the indent, but the form does not preclude the content. Ok about this source, but I proposed another plan with new references, you do not reply to this proposition (so I assume I just need to be WP:BOLD? But then you might revert again because I did not wait for the end of this discussion, where you avoid answering to concrete propositions?). About your argument that for «"faddish or not", lesser sources like opinion pieces are good»: you are saying that to qualify whether a diet intervention is effective or not, and dangerous or not (these two components being at the core of the definition of fad diet), the source does not need to qualify for WP:MEDRS? Then I wonder why the calorie restriction diet is not a fad diet too, since several such sources claim it does not work! Finally, about my comment of "an anti-fasting editor out there", it was never implicitly nor explicitly targeted at you (I never worked with you yet, I do not know you), but it was quite clear to any reader given the tone the entry turned to have and the mishandling of sources to back up those dubious claims (such as the fad diet). --Signimu (talk) 18:17, 29 September 2019 (UTC)

@Alexbrn: I worked on this entry about a year ago (Zefr knows about it, thank you for your patience ;-) ), it was full of relatively strong sources, all pointing towards quite real beneficial effects, and relatively minor adverse effects except for specific populations that might be at risk. Now, we get a 2013 opinion paper and a Harvard entry that is misused to claim something opposite to what is written in the source. How in the world anybody reading this entry and the sources would not think that the entry is badly reflecting the sources and the current state of knowledge about this diet? --Signimu (talk) 18:20, 29 September 2019 (UTC)

@Alexbrn: About the 2013 opinion paper, this is apparently not the first time you paradoxically advocate strict respect of WP:MEDRS while defending non-scientific sources. Which is BTW against MEDRS since it states that non-scientific sources on medical entries should only be about societal/cultural infos, not about effect or dangerousness (and certainly not in the intro). I propose we stop here this rather sad discussion and let's construct. I propose to **strictly** adhere to WP:MEDRS. This means we will lack cutting edge informations such as long term effects (be it positive or adverse), and opinions such as the 2013 opinion paper, which I nevertheless thought interesting (and in my edit just moved it to a more appropriate place IMO). Following WP:BOLD (and because frankly we are just all losing time here at this point), I will apply right now this new plan and use the references (meta-analyses, not RCT studies) above. I hope this will resolve the issue. --Signimu (talk) 18:39, 29 September 2019 (UTC)

The update is currently done. I expect and am open to some constructive criticism of course . Thank you to everyone who participated in the discussion so far. --Signimu (talk) 20:54, 29 September 2019 (UTC)

Some of the sources you added were good but some were not, what you did was very bold, I don't approve of it entirely but I will not revert. It is a shame you removed two references from the article which described it as a fad diet. It seems there are other negative effects of intermittent fasting and it has been described as a dangerous fad . It seems you want any mention of fad removed from the article? Seems a bit biased to me! I think those references should be put back in but I won't be editing this article. Psychologist Guy (talk) 23:29, 29 September 2019 (UTC)

@Psychologist Guy: These references were removed to strictly adhere to WP:MEDRS. As I said, I was not totally in favor of such a move, but since we had a disagreement on what sources to retain or not, the only coherent thing to do was to raise the quality bar. I have in the latest edit added the recommendation of the NIA, which does not recommend intermittent fasting for non-obese individuals yet, but evaluate it as "promising" and as such has registered a plan for a clinical trial, which suggest they do not consider this intervention as harmful as you do. If you have any high quality source (at least a review) documenting the dangerousness or adverse effects of intermittent fasting, please feel free to add it. I have no vested interest in this procedure, so both are fine to me, as long as it is backed by scientific evidence. --Signimu (talk) 23:41, 29 September 2019 (UTC)

@Zefr and Alexbrn: Thank you both for your edits. However, I am worried to see some kind of war editing happening right now with doubtful arguments. Well, I'll do a last attempt here at reasoning and resolving this peacefully. Here are my arguments against some of the changes that were done (and I appreciate the others, or even these ones as they raise discussion):

* According to fad diet: «Fad diets are generally restrictive, and are characterized by promises of fast weight loss or great physical health,:9 and which are not grounded in sound science.». For IF, that is not at all the case (or please provide an adequate source). I would agree that IF being a weight loss diet trend is worrisome and we should cover that, but 1. it's already covered in the «Fasting trends» section (and my edit left the new edit there), 2. fad diet is not a correct qualification for IF, as it also implies uneffectiveness and/or dangerousness of the diet, which claims should be based on reliable good quality sources. For the moment, all highest quality scientific sources actually claim the opposite. Furthermore, WP:MEDRS states: «Sources about health in the general news media should, in general, not be used to source content about health in Misplaced Pages articles but may be useful for "society and culture" content.». Since fad diet is enclosing health claims, this should be grounded in scientific facts per WP:MEDRS. The categorization too (notice that a similar diet according to ALL good quality scientific evidence, the calorie restriction diet, is not categorized as a fad diet). I will further point at the fact that for simply sourcing aliases, you reverted a source that was from the UK NHS (health regulatory body) itself mentioning a Daily Mail article, but it's still the NHS and for simply an alias! Thus, for aliasing the NHS and public media is not OK, but to qualify a diet as dangerous and uneffective it's ok according to your understanding of WP:MEDRS? Lastly, the 2013 opinion paper might have «fad» in the title (note: not fad diet which is different), but in the article it's clearly stated: «Intermittent fasting can also produce similar effects as intensive exercise, says Mattson, including increasing heart rate variability while reducing resting heart rate and blood pressure. “All of these three changes are exactly what you would see in trained athletes,” he adds. “We are starting to understand some of the underlying mechanisms whereby fasting may benefit animals and possibly humans. We are now moving to testing some of these things in humans.”».

* Mechanism: @Zefr: I believe you too cursorily read the source when doing this revert. The source is a systematic analysis on over a thousand human subjects across different conditions (more than 150 for alternate day fasting), and what was written is exactly what can be found in the article (but rewritten in lay terms). I am open to rewritings, but if the source is not admissible (systematic analyses on human subjects as per WP:MEDRS), would you please explain why?

* Religious fasting: I did not create this section, and I agree that religious fasting should be moved elsewhere as there is a very essential difference: religious fasting involves not drinking any liquid usually, whereas intermittent fasting allows drinking and thus hydration. However, there are now serious research on the topic with several systematic reviews that were linked here. Thus, I find it quite extreme to remove the section altogether. May I suggest we move it to dieting or fasting, cleaned of unreliable sources (see the talk section below)?

* About NIA source: the NIA source clearly indicates that for obese and overweight individuals, there is evidence that theurapeutic IF works: «Many studies have shown that obese and overweight people who lose weight by dieting can improve their health. But scientists still have much to learn about how calorie restriction and fasting affect people who are not overweight, including older adults.» If you so want, we can make a direct citation, but @Alexbrn: reverting as you do here with an edit description of "Not really accurate" is itself not only "not accurate" but contradicting the source. Furthermore, this counters the argument that IF is a fad diet (see first point), and I think we can agree that NIA is a much more reliable source than Medical Daily or a 2013 opinion paper.

To summarize: I thank you guys for your edits, and I know it takes time (it takes me a lot of time too), but please take more time reviewing the sources before using them, as most of your reverts are clearly contradicting the sources. Can we agree to change these information to better reflect the sources? --Signimu (talk) 16:41, 30 September 2019 (UTC)

You need to avoid WP:CHERRYPICKING. When a source says evidence is limited and something is not recommended, you can't present it as saying it finds that thing is effective! Saying that the NIA "recognizes that IF has shown ..." is a skewing of the source. Alexbrn (talk) 16:45, 30 September 2019 (UTC)

@Alexbrn: And now you accuse me of cherrypicking, package that with the pov-pushing... I am certainly NOT cherrypicking: the NIA article is CLEARLY specifying that the inconclusiveness pertains to using IF for non-pathological cases. Heck, that's in the name of the institute: "The National Institute on Ageing", it's NOT on obesity for instance! And when you say it's "skewing the source", I gave you the exact citation above! I proposed that we directly cite the source! So if you want, we do that, and then there'll be no possible skewing whatsoever.

In any case, I agree and I was the FIRST to add limitations on this article about IF, and there was a lot more before the cleaning was done by other editors (because of non high quality source - quite ironic isn't it? Since all high quality sources agree on effectiveness and limited adverse effect, we can't put more warnings here, particularly about dehydration risks...).

Thus, let me make this straight: I don't care about what effects IF is described to have, as long as it is grounded by high quality scientific sources when we follow strict WP:MEDRS compliance. I added only scientific sources of the highest quality (systematic reviews) since the first warning by Zefr. These sources show only positive effects and limited adverse effects. If you want to put more warning, please find sources of similar quality. Mind you, I have searched for ANYTHING about intermittent fasting, not just the positive ones (as I said, I don't care, I am interested in the scientific findings!). --Signimu (talk) 16:54, 30 September 2019 (UTC)

PS: look, here's the proof in NIA article: «There's insufficient evidence to recommend **any type of calorie-restriction or fasting diet**. A lot more needs to be learned about their effectiveness and safety, **especially in older adults**.» --> This clearly is a statement about using these diets for ageing. For instance, calorie-restriction is already recommended as therapies for obese and overweight individuals by US official guidelines since 2014 (see the source about weight loss that was reverted). IF as far as I know is NOT yet recommended, that's true, but writing that any weight loss inducing therapy is not recommended for obese and overweight is utterly false! Please read the full content of the sources, and not just the conclusion! --Signimu (talk) 17:02, 30 September 2019 (UTC)

BTW, how could weight loss be off-topic (the reason for the revert) since it's one of the two main pursued and confirmed therapeutic effects of IF? I agree it shouldn't be long and additional material should be placed there, but seriously how can we write about the therapeutic effects of a treatment if there is no background about its end goals? --Signimu (talk) 17:04, 30 September 2019 (UTC)

Holy WP:WALLOFTEXT! To be clear: we follow what good sources say, faithfully and without spin. We don't use sources that don't even mention IF to make points about IF. These are very basic concepts for encylopedia editing. Alexbrn (talk) 17:07, 30 September 2019 (UTC)

@Alexbrn: Using WP:Walloftext to avoid answering to a sourced argumentation is cheap, and questions your good faith. Let's cut the chase, let's try one last time to find a common ground:

From my understanding of reading all the systematic review sources and official health content like NIA, here's my summary: IF induces weight loss and has a specific effect on insulin for obese and overweight individuals, and thus is a promising therapy (not my words, it's in the conclusions of literally each systematic review and even NIA). IF is similar to calorie restriction diet, except for the effect on insulin. For non-overweight individuals pursing a goal of improving general health or ageing, it's an interesting approach but there is not enough evidence as NIA summarizes. The parameters (eating schedule, conditions, amount of calories, gender, long-term maintenance, tolerance, etc) can of course change the outcome and thus they have to be clarified, hence the trending use of IF by non trained health professionals should be disadvised. @Zefr and Alexbrn: Do you both agree with this being a good summary of the current state of knowledge about IF? If not, why? Do you have sources (or give citations)? Thank you. --Signimu (talk) 17:13, 30 September 2019 (UTC)

@Zefr and Alexbrn: Thank you both for responding to my invitation to discuss with 2 edit war warnings. This forces me to stop contributing to this article temporarily. --Signimu (talk) 18:18, 30 September 2019 (UTC)

That seems a partial summary, omitting for example any mention of possible adverse effects, and containing factual inaccuracies (NIA do not "literally" say IF is a "promising therapy", but they do literally recommend against it - at least in the document we cite). It illustrates I think your POV approach to the topic. But I don't see the point of agreeing or disagreeing with your summary: our editing need to follow the WP:PAGs so we need decent sources as the direct basis of our article. Alexbrn (talk) 03:01, 1 October 2019 (UTC)

Just saw this comment... Well, I won't dwell in uncivil behaviors that are not useful for the content, but I'd just like to clarify that I (inaccurately) wrote that "NIA recommends against intermittent fasting" when I added the NIA source, when in fact the NIA says literally that it "can't recommend yet intermittent fasting due to lack of evidence on long term outcomes". I clarified this in the entry a few days ago anyway. --Signimu (talk) 01:51, 17 October 2019 (UTC)

Long-term effect of intermittent fasting

A slew of recent randomized controlled trials were very recently conducted on both obese and non-obese volunteers, for duration between 6 months to 1 year: (see in particular the CALERIE study on 2 years), and particularly new developments for metabolic syndrome diseases that are known to be associated with insulin resistance: (and a plan for a clinical trial by NIA). Also, see in particular the HELENA trial, which investigated the 5:2 scheme for in a real-life scenario for 150 overweight or obese individuals with cardiovascular risk and measuring the adipose tissue transcription over 1 year. It will be interesting to monitor them, as I am confident a meta-analysis will probably pick up on these new developments in the field in the upcoming year, given the high coverage some of them had: . This will allow us to develop the sections about long-term effects (be it positive or adverse) of intermittent fasting (and hopefully shed some additional light in the conditions for these effects). Likewise, the mechanisms behind intermittent fasting's effects on animal models are seeing interesting developments: , with preliminary evidence from non-controlled clinical trials on humans (increase in ketone body production). An excellent mini-review in a proceedings highlight the currently known differences between the variants of intermittent fasting, and suggest that there should be investigations into the possible "regularly protracted post-absorptive periods", in other words any specific health effects appearing after sustained periods of complete fasting (16 hours reported in current trials). Furthermore, intermittent fasting (and other approaches) might be effective for cancer patients doing immunotherapy by targeting glucose metabolism, but more research is needed. Neuroplasticity promotion (including for traumatic brain injury protection) and pain relief is also investigated. Interventions in obese adolescents is investigated. A non-randomized study suggest that alternate day supplementation of iron in anemic women might be more efficient than continuous administration. --Signimu (talk) 22:11, 29 September 2019 (UTC)

There are some systematic reviews I did not include in the entry: . --Signimu (talk) 22:26, 29 September 2019 (UTC)

Addendum: a great study on adverse effects of therapeutic fasting (including periodic fasting): and a study on "who is fasting?" in Germany, finding that its practice is more correlated with other factors such as higher education than the real benefits: . --Signimu (talk) 02:04, 6 October 2019 (UTC)

Above you wrote "I propose to **strictly** adhere to WP:MEDRS". This does not appear to be the case sadly because on MEDRS, it says "Primary sources should generally not be used for medical content". Practically everything you link to is a primary source or taken from dubious open access journals. You did not link to any reliable systematic reviews. This which you link to is hardly reliable. Cureus is an open access journal and its founder created the journal because he was "dissatisfied with the existing world of medical journals, which have become increasingly preoccupied with tenure and prestige" Psychologist Guy (talk) 23:14, 29 September 2019 (UTC)

@Psychologist Guy: Thank you for your feedback. Please do not misunderstand what I am writing in this section: the references here are solely as a future reminder, they do not appear anywhere on the main entry (only reviews, and foremost systematic reviews on RCTs, were used). I hope this clarifies the misunderstanding, if there is any other issue, please let me know. --Signimu (talk) 23:34, 29 September 2019 (UTC)

Ok my misunderstanding you are just collecting material here for future reference. On the article itself you have done some good edits with reliable sources but also some not so good edits, I am very tired to point out what is good and what is bad. I will leave that to another experienced editor :) This involves going through each of the sources you added. A few of them looked good but there are critics of intermittent fasting that characterise it as a fad diet, I don't think those criticisms should be removed entirely, it can't be denied that the link is there. I have studied the history of fasting and it is associated with quackery. A lot of these fad diets like low-carb or paleolithic diet are now promoting intermittent fasting programmes. Psychologist Guy (talk) 23:43, 29 September 2019 (UTC)

@Psychologist Guy: Thank you for pointing that out. As I wrote above, I am in favor of adding critics. And I think we should differenciate therapeutic intermittent fasting (as is done explicitly by some sources but only implicitly by most) from commercial/fad intermittent fasting, these are two very different things, and the edits I've done are mostly pertaining to the first (as I have no intellectual interest in the latter ). So I would like to do so but I fear that writing everywhere "therapeutic intermittent fasting" might be too verbose and be reverted. Do you have any suggestion? About adding critical sources about the adverse effects of intermittent fasting, please free to do so, but note that so far (and I am searching ANY review on therapeutic intermittent fasting), I have found no scientific evidence of adverse effects apart from the ones already written in the article (but keep in mind this pertains to scientifically controlled therapeutic fasting, not the fad diet ones -- although the 5:2 seems to be more and more used, and is the one investigated by NIA).

PS: please also note that English is not my primary language so I may well have inelegantly written some parts (but the sense should always be correct), so I am honestly sorry about the time it may take to other editors and I am actively and continuously working on it (wink to Zefr ). --Signimu (talk) 23:57, 29 September 2019 (UTC)

I have restored the faddism content, which was completely removed! Also, this article is not about religious fasting, so I have removed content about that as off-topic. Alexbrn (talk) 03:38, 30 September 2019 (UTC)

@Alexbrn: Thank you for your edits, please continue the discussion in the previous section, this one was never meant as anything else than a future reminder to ease updates --Signimu (talk) 16:08, 30 September 2019 (UTC)

And now Signimu is trying to remove the fad categorization again, invoking WP:MEDRS. This is exactly the kind of misapplication of MEDRS which had caused community concern. To be clear: whether something is (or is not) a "fad diet" is not WP:Biomedical information and so MEDRS does not apply. Alexbrn (talk) 16:36, 30 September 2019 (UTC)

@Alexbrn: Please use correct indentation/spacing I argue it IS biomedical information, see the previous section (and please continue the discussion there, thank you). --Signimu (talk) 16:42, 30 September 2019 (UTC)

My spacing is fine. What are you on about? If you think diet classification is biomedical (hint: you're wrong), feel free to seek an opinion at WT:MED. Alexbrn (talk) 16:55, 30 September 2019 (UTC)

@Alexbrn: Yes, because I fixed it. Mind you, it's not just a diet, it's also categorized under Medicine. --Signimu (talk) 17:16, 30 September 2019 (UTC)

@Alexbrn: Thank you for the link, please find the question here (and add your point of view if I misrepresented it -- since you did not accept my requests for clarifications above) --Signimu (talk) 17:28, 30 September 2019 (UTC)

Sources checking

Hello everyone, I have checked the impact factor/SJR of all the recently added sources, and I found that the one using "Eastern Mediterranean health journal" has a very low impact factor (0.663 in 2016). Should we keep or remove it? Thank you for your feedback. --Signimu (talk) 01:35, 30 September 2019 (UTC)

Planned changes

Here are the sources of the changes I plan to add later:

• AHA 2017 scientific statement
• Fad diet stronger source (fasting might be the oldest fad): Advanced Nutrition and Dietetics in Obesity (Wiley, 2018) p. 180, Hart, K. (2018). Fad diets and fasting for weight loss in obesity. Advanced Nutrition and Dietetics in Obesity, 177.
• (Dropped, unreliable) Fad v2: some quantitative measures on Google Trends:
• Lean body mass might be reduced (so we have both systematic reviews that do not find any effect and one that does find, how to write that?)
• IF vs CER direct comparison: systematic review, simple review
• Confirmation for mechanism interpretation: (simple study, will only be used for talk)

--Signimu (talk) 19:04, 1 October 2019 (UTC)

Addendum: IF vs CER another direct comparison (was added in the past, not sure why it was removed?): systematic review --Signimu (talk) 08:53, 2 October 2019 (UTC)

Medium.com is not a usable source. Alexbrn (talk) 19:12, 1 October 2019 (UTC)

@Alexbrn: Errr why is that so? Is there a specific WP rule regarding Medium? --Signimu (talk) 19:23, 1 October 2019 (UTC)

WP:SPS's are generally questionable. What is effectively a blog post by an advertising executive is unlikely to be considered a worthwhile source here, especially when there are plenty of better sources to hand. Alexbrn (talk) 19:33, 1 October 2019 (UTC)

@Alexbrn: Ok for the self-publishing part, that makes sense. However I did not find other sources giving quantitative estimates of the trend (although I did not really look for that kind of info, I'm more interested in the science than the cultural aspects of diets). Dropping the source, thanks for your feedback (and copyvio fix). (Please can you ping me so I get a notification of your replies?). --Signimu (talk) 19:45, 1 October 2019 (UTC)

@Zefr: Could you please check (if you don't have access I can send you the doc) about the interpretation of the "Mechanism" section and tell me what you think about it? --Signimu (talk) 19:45, 1 October 2019 (UTC)

It's a loosely-designed (interviews, unreliable), preliminary research study (n=47) far from defining a 'mechanism', and is unusable as medical content for an encyclopedia. See MEDMOS, writing for the wrong audience. --Zefr (talk) 20:10, 1 October 2019 (UTC)

@Zefr: You are correct, but as I said it was not meant to add in the article. Notice it cites ref 35 that is currently in the entry, with this description: «All of these strategies are effective because humans do not completely compensate for the lost energy. After any of these changes, they will finish the day with a negative energy balance and will lose tissue.» --> Do you agree with this depiction of ? --Signimu (talk) 20:29, 1 October 2019 (UTC)

@Zefr: To clarify context: we have a disagreement of my addition. Two reasons you gave: 1. WP:OR, which it is not, all infos written (including about Set Point Theory, its date, its widespread acceptance) are in the source, I thought it gave a meaningful context (biggest theory of body weight homeostasis), but if you find it too verbose it's certainly shortenable, 2. the interpretation of the results, this being your version. To solve the latter, I tried to find a third-party view depicting the source, and the study above is what I found. Could we agree on using this 3rd-party as an indication on how to write the results? If not, could you please explain your rationale? Thank you. --Signimu (talk) 08:42, 2 October 2019 (UTC)

The set point theory is impossible to analyze experimentally even in a rigorous clinical setting, which your source did not establish. Speculating in this section about a psychophysiological mechanism for why weight loss is not sustainable after long-term fasting would be original research, and is unencyclopedic. The section content as stated is concise, accurate, and sufficient with the source used. --Zefr (talk) 14:27, 3 October 2019 (UTC)

@Zefr: Please, stop with the weaseling... Your version states that "ADF cannot work because of energy errors", whereas the source says "ADF (and overnutrition and exercise etc) work because the body cannot compensate for energy errors" (I paraphrase, not citing here). You simply can't say that your version is reflecting the source... About your opinion on set point theory, that may very well be perfectly valid, but isn't that WP:OR? Or can you provide a secondary source that describe what you say? --Signimu (talk) 17:48, 3 October 2019 (UTC)

No, WP:BURDEN on you - you have to show the source proving SPT is a thing, which science says it isn't. --Zefr (talk) 22:52, 3 October 2019 (UTC)

@Zefr: I'm not sure of your argument here? The systematic review does exactly that: it reminds that SPT was only just a theory, with some evidence (potentially due to simple measurement errors), and it tests a hypothesis that if true would not fit with SPT theory: if energetic errors (a quantification of body weight loss/gain) are not autocorrected, then this is an argument against SPT. Anyway, SPT is a theoretical framework for introducing the review, but the review itself does not rely on SPT for its analysis nor conclusion. So if anything, what you say here is totally in line with the conclusions of the review, and in contradiction to what is currently written (that ADF does not work because SPT does in fact exist). --Signimu (talk) 23:31, 3 October 2019 (UTC)

@Zefr: PS: about the IGF ref, you're right, it should be separated as it does not mention insulin concentration, I probably decided to mix both to save space but that's an amalgam. Anyway I'll do that when rewriting the article with the stronger refs above because they also talk about it, finishing Ghrelin now. --Signimu (talk) 23:36, 3 October 2019 (UTC)

Update done. Cleared IGF issue among other things I hope :-) --Signimu (talk) 03:01, 4 October 2019 (UTC)

@Alexbrn and Zefr: I just discovered the issue on faddism was already raised just a few months agoTalk:Intermittent_fasting/Archive_1#Fad_diet, with similar arguments. Why none of you did notify me of that? First, this shows that it has been a point of contention with no clear consensus and it would have saved a lot of time from arguing the same thing over again, but also Alexbrn you hid the fact that one of the two sources, the Collier paper, had an update! The older ref should have been replaced. Anyway, I've found a better academic source that takes a much less sensationalist stance, but seriously that's not cool. I honestly do want to work constructively with you, I expect the same honesty in return. I hope we can move forward towards making a better article together. --Signimu (talk) 05:14, 4 October 2019 (UTC)

Better watch out with the accusations. It's not my job to direct other editors to previous discussions (which I had forgotten anyway - with 568 articles on my watch list including many fad diet ones it is not possible to keep all historical discussions in mind). Alexbrn (talk) 05:32, 4 October 2019 (UTC)

@Alexbrn: Ok, agreed, but still you could have updated the Collier ref, but please accept my sincere apologies for asking you to remind of this past discussion, I agree you're not a robot, I was simply frustrated that we endured such a bad discussion that was just redundant. Thank you for your edits. About , there is literally a ref titled "Intermittent Fasting is Not A Fad". So maybe "sometimes" is not the best formulation, but "is" lacks nuance. I would propose "IF is also a fad diet" (and remove "popular" since it's redundant with the definition of fad diet). Thank you, I'll leave you free room for editing now. --Signimu (talk) 05:45, 4 October 2019 (UTC)

Since we now have the excellent source you found (the Wiley textbook) which flat out puts these IF diets in a table of fad diets, I don't think there's any doubt. We could trim away some of the other sources on this as redundant (the one mentioning celebrity endorsement adds something extra). Alexbrn (talk) 05:48, 4 October 2019 (UTC)

@Alexbrn: Agreed, thank you for your edits and your patience I did not know it was a "gold standard", I thought it was a simple academic monograph, why is it so good? Is it because it's part of the BDA series? --Signimu (talk) 13:30, 4 October 2019 (UTC)

@Zefr: My last proposition for the "mechanism" issue: . --Signimu (talk) 16:57, 4 October 2019 (UTC)

Merge 5:2 diet proposal

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

I propose to merge 5:2 diet into Intermittent fasting. The latter has much more information, has a broader context and better coverage overall (cultural, scientific, historic). I already copied the content from 5:2 diet that was missing but pertinent in Intermittent fasting, the rest that is left consists of commercial or duplicated infos. I thus propose to redirect 5:2 diet to Intermittent fasting. Signimu (talk) 16:15, 4 October 2019 (UTC)

 Done This had already been done after strong consensus at https://en.wikipedia.org/search/?title=Talk:Intermittent_fasting&oldid=792692358#Proposed_merge_with_5:2_diet - it was reversed with no discussion. I have reinstated the redirect. Alexbrn (talk) 06:30, 6 October 2019 (UTC)

Disagreement 2

@Zefr: Hello, I would like to discuss your latest revert, which points were not discussed before, so let's do it point-by-boint:

1. About IGF-1 effects: previous history. This is a 2019 systematic review on humans, published in Ageing Research Reviews (impact factor 10.390), and is covering both intermittent fasting and calorie restriction. The review is new and not covered by AHA (2017). This looks both pertinent and of high quality per WP:MEDRS. Could you explain why you reject it?
2. About NIA sentence: «Intermittent fasting and calorie restriction diets, although under active research, are not recommended for non-obese or non-overweight individuals.» --> This is inaccurate and misleading, for two reasons: 1. for calorie restriction, it is already recommended for the whole population by US dietary guidelines (see Calorie restriction), 2. for intermittent fasting, it contradicts the AHA Scientific Statement (peer-reviewed, authority), which recommends to «include intermittent fasting approaches as an option to help lower calorie intake and to reduce body weight» for cardiovascular disease prevention (not necessarily obesity!), whereas NIA is kind of a "news" article (apriori non peer-reviewed and certainly not of the same quality as AHA process for scientific statements). Per WP:MEDRS, the AHA scientific statement should supercede the NIA in case they contradict as to not WP:UNDUE. That is not to say that there should be no mention of NIA position, it's written in the lede, but this sentence is inaccurate and misleading.
3. the "flip switch": it's one of the two major theories for explaining intermittent fasting effects, it's covered by nearly all serious papers and reviews in some form, even if I only selected the 3 most pertinent as refs for this sentences, most other refs also mention it. This IS very fundamental for this section. Why wouldn't we be describing the two major theories that are reflected in the whole academic literature on the topic?
4. about the therapeutic targets, I found the review was nice with a good figure differentiating what was found in humans from what was on animals, but if you don't like it I won't fight for it.
5. for Varady in History, I fail to understand why you would not allow its inclusion, given it's a statement from The Times in UK, it seems certainly notable (furthermore since modern interest was first fostered in UK). (/EDIT: moot point, see below, it's in fact the whole History section that was emptied).

Could you please clarify your rationale behind your revert? Thank you :-) --Signimu (talk) 20:43, 6 October 2019 (UTC)

Ah, I did not see that you emptied most of the History content. Why did you do that? I think it is pertinent to describe both the antique practices up to how the first modernized variants came to be. In fact, we could even further develop the antique part using Hart2018 ref (I didn't because I'm more interested in the scientific parts, but the cultural part certainly has its place). --Signimu (talk) 01:01, 7 October 2019 (UTC)

@Zefr: Since you are choosing since a few weeks to avoid replying to me (except in reverts), I have requested a 3O in the hope this can help us get unstuck from this situation without continuous reverting :-) --Signimu (talk) 15:55, 8 October 2019 (UTC)

@Zefr: Hello Let's try one last time to discuss about a few of these edits (I reduce to the 2 most important points to me, consider the rest dropped ):

• About the IGF-1 factor, I think the info is very important and pertinent, it should be included. However, I propose to move it, at least separate it from the first paragraph, as the influence IGF-1 can be ambivalent (both good and bad), and the study does not conclude anything about that, it only shows evidence that IGF-1 levels can be modified by at least a 50% average daily caloric restriction or alternate day fasting. For a reminder, here is the sentence I wrote:

«IGF-1 decreases are observed only with at least 50% average daily caloric restriction.»

• About the "flip switch", there are 3 strong sources (including NIA) who mention it, it's clearly one of the main hypothesis (this and the hypothesis that effects are only due to caloric reduction), so I think it's important both are mentioned in the "mechanism" section. The point is not to declare which one is valid, we don't know at this point (and it can be another hypothesis noone thought of yet ;-) ), but since they are widely considered in this scientific community, I think they should be mentioned (with the adequate uncertainty - they are just hypothesis). For a reminder, here is what I wrote:

«It remains unclear whether the beneficial effects are due solely to weight loss or to an additional "flip switch" mechanism specific to intermittent fasting.

Would you agree to add these two lines in the entry's content, or do you have any suggestion of modification, or if you are against please tell me why so I can understand, thank you --Signimu (talk) 21:45, 14 October 2019 (UTC)

Addendum: Found a new notable source (UPDATE: and another one) for 2nd point (flip switch vs simple weight loss consequences), which prompts me to suggest a new formulation for the proposed addition:

«It remains unclear whether the beneficial effects are due solely to weight loss or to an additional "flip switch" mechanism specific to intermittent fasting, but a review of a wide variety of diets, including alternate day fasting, show they all provide similar weight loss and cardiovascular benefits, with more adherence and weight loss predicting more benefits. Another review did not find evidence of a reduction of adaptive responses, except maybe appetite, when using intermittent fasting, although most studies were underpowered to assess this.» --Signimu (talk) 01:44, 17 October 2019 (UTC)

References

1. Rahmani J, Kord Varkaneh H, Clark C, Zand H, Bawadi H, Ryan PM, et al. (August 2019). "The influence of fasting and energy restricting diets on IGF-1 levels in humans: A systematic review and meta-analysis". Ageing Research Reviews. 53: 100910. doi:10.1016/j.arr.2019.100910. PMID 31116995.
2. ^ "Calorie restriction and fasting diets: What do we know?". National Institute on Aging, US National Institutes of Health. 2018-08-14. Retrieved 29 September 2019.
3. ^ Cioffi I, Evangelista A, Ponzo V, Ciccone G, Soldati L, Santarpia L, et al. (December 2018). "Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials". Journal of Translational Medicine. 16 (1): 371. doi:10.1186/s12967-018-1748-4. PMC 6304782. PMID 30583725.{{cite journal}}: CS1 maint: unflagged free DOI (link)
4. ^ Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG, et al. (February 2018). "Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting". Obesity. 26 (2): 254–268. doi:10.1002/oby.22065. PMC 5783752. PMID 29086496. Cite error: The named reference "Anton2018" was defined multiple times with different content (see the help page).
5. Thom G, Lean M (May 2017). "Is There an Optimal Diet for Weight Management and Metabolic Health?". Gastroenterology (Review). 152 (7): 1739–1751. doi:10.1053/j.gastro.2017.01.056. PMID 28214525.
6. Seimon RV, Roekenes JA, Zibellini J, Zhu B, Gibson AA, Hills AP, et al. (December 2015). "Do intermittent diets provide physiological benefits over continuous diets for weight loss? A systematic review of clinical trials". Molecular and Cellular Endocrinology. 418 Pt 2: 153–72. doi:10.1016/j.mce.2015.09.014. PMID 26384657.

Zefr, proposing new good-faith edits that attempts to fix previous (vague) issues is not WP:DE, whereas reverting with no discussion is (per the same guideline). I am reasonable, and more concise. Could you please explain 1- why you revert reviews and write they are not primary studies as your diff comment incorrectly states, 2- and what's the difference between this addition that makes it unencyclopedic for you whereas a similar section Calorie_restriction#Research you recently copy-edited was deemed encyclopedic (and it contains animal research, whereas my addition does not)? Thank you in advance. --Signimu (talk) 19:46, 28 October 2019 (UTC)

This whole paragraph and its sources explain nothing encyclopedically - they're "if" this, and "may" that. An hypothesis about a "metabolic switch" is not encyclopedic, as it can't be studied in humans. The article and talk page histories show you have repeatedly tried to have this content inserted, with no agreement from other editors. This 'wall-texting' is highly disruptive, as your edits require checking for grammar and misunderstandings of medical science. This is WP:DE behavior for which you have been warned several times by other editors and me. Please take a break. --Zefr (talk) 19:58, 28 October 2019 (UTC)

Thank you for your reply! I truly appreciate it. I auto-reverted and won't restore as promised, as long as you reply on this point you did not answer: if hypothetical mechanisms aren't fit for an encyclopedic article, why do you accept them in Calorie restriction#Research? And why then other editors seem to not share your position? But I'd like to reach a consensus with you, since only us edit this page currently. About the side-note you raise: yes the metabolic switch is testable, just ensure the same total caloric intake in a IER group vs a CER group. If IER has more/different effects, then it's not solely due to caloric restriction. Some studies already did that, but there's just not enough to have a clear cut answer yet. But that has no pertinence to whether we add this paragraph or not, else there would be no theories on WP at all. --Signimu (talk) 20:08, 28 October 2019 (UTC)

Zefr, please reply. It's not OK to ignore parts of the initial question, particularly when I shown my good faith by autoreverting. This is no WP:MWOT. Please just say how my proposition differs with what you accepted in Calorie restriction#Research? --Signimu (talk) 02:50, 29 October 2019 (UTC)

PS: please be precise, a vague reason is not sufficientWP:SUMMARYNO. --Signimu (talk) 19:51, 28 October 2019 (UTC)

Zefr Same proposition as before: if you discuss here, I'll auto-revert and stop from restoring. As long as your answer is honest and your reason accurate enough (no "unencyclopedic" please). --Signimu (talk) 19:58, 28 October 2019 (UTC)

Zefr is not encyclopedic, as it can't be studied in humans That argument is nonsense. The sources provided are clearly based on human data. I support reintroduction of the text. Boghog (talk) 05:56, 30 October 2019 (UTC)

Boghog: the removed paragraph was based on Signimu's WP:SYNTH about a "metabolic switch mechanism". Among all the sources in the reverted paragraph, only this one (Anton) addresses a metabolic switch, presented as a single hypothesis which cannot be evaluated in humans from clinical trials or otherwise as a metabolic mechanism in vivo. Assessing the tables, sources, and discussion in the Anton article shows preliminary, short-term, small subject number studies (or from lab animals), none of which defined a switch in vivo. So the whole content of the paragraph was conjecture from an untestable hypothesis. I call this unencyclopedic editing because it was based on synthesis of sources and a weak concept from just one hypothesis. The Anton article 'Future Directions' section shows the incomplete status of science on this topic. Outside of the Anton "flipping the switch" article, no authors of other sources used in the contested paragraph went to a "flipping the switch" conclusion. It was just synthesized by Signimu. WP:CIR requires editors to be competent in the discipline of the article, understand source quality and specificity, and in this case, know what can be determined from preliminary human studies and what is pure, unencyclopedic speculation. The paragraph mostly was not about a mechanism, but was synthesized to support an undefinable one, and so is unusable. --Zefr (talk) 15:07, 30 October 2019 (UTC)

Zefr The metabolic switch mechanism is one sentence out of an entire paragraph. So you delete the entire paragraph because of one sentence? hypothesis which cannot be evaluated in humans More nonsense. It is pretty obvious that all animals including humans have a metabolic switch between fasting and fed states and this can easily be demonstrated in humans by what happens with blood lipids and insulin senstivity after fasting for example. It is one thing to state that a particular source does not support a hypothesis but to state it is impossible to demonstrate this is ridiculous. Proving a negative is really hard. Boghog (talk) 19:07, 30 October 2019 (UTC)

Boghog: So go ahead and explain to us the biochemical mechanisms of weight loss from fasting. That's what the section is supposed to discuss. You're talking about biomarkers, not mechanisms of weight loss. The mechanisms of weight loss have not and cannot be determined in humans at present (there are no reviews to cite; who would pay the tens of $ millions for such large-scale randomized controlled trials?), and were not studied in vivo in any source used in the removed paragraph, so were deleted as WP:OFFTOPIC. The one sentence and source remaining, PMID 30476522 - a review of 739 studies - provides only a vague conclusion that people who lost weight by fasting misjudge energy intake and loss, then gain weight again. Addressing a section on 'Mechanism' is futile and misleading because there are no good sources to identify a mechanism, other than an untestable hypothesis, PMID 29086496, which is conjecture and unencyclopedic. --Zefr (talk) 21:41, 30 October 2019 (UTC)

Zefr No problem. Energy expenditure exceeds energy intake. Boghog (talk) 21:56, 30 October 2019 (UTC) PMID 29086496 is solid science, WP:MEDRS compliant, common sense, and clearly encyclopedic. Boghog (talk) 22:02, 30 October 2019 (UTC)

Zefr You seem to have a fundamental misunderstanding of the purpose of clinical trials. Clinical trials are not to determine mechanism, but rather to see if a particular treatment has a desirable effect (see for example "Mechanism matters". Nature Medicine. April 2010.). If a treatment mechanism has been worked out in animals and the treatment effects can be reproduced in humans and biomarkers in animals and humans are affected in the same way, that provides strong evidence that the same mechanism is also operative in humans. Your extreme views on evidence have not gained consensus (see for example here and here). Boghog (talk) 07:53, 31 October 2019 (UTC)

Zefr again shows a misunderstanding of the source PMID 30476522 he cites (is that why you trimmed down so much this sentence?). If you would read what I write, you would not make this mistake. Here is what another paper PMID 31561967 writes about the source: "Researchers observed that in a self-weighing for weight-gain prevention study, as many strategies for weight control emerged as there were participants in the study. Some reduced portion sizes, others omitted desserts or snacks, and others increased exercise. All of these strategies are effective because humans do not completely compensate for the lost energy." How can you understand this as being "a vague conclusion that people who lost weight by fasting misjudge energy intake and loss, then gain weight again", the source, and the other paper mentioning the source, are clearly writing the opposite, that calorie restriction works because the body cannot correct for energetic unbalances, if you restrict calories, you lose weight, even in the long-term! Now instead of moving the goal post, can we go back to why the metabolic pathways are not acceptable to you? --Signimu (talk) 00:42, 31 October 2019 (UTC)

Zefr You may try to ignore what I write, but you can't ignore the fact that there is a recent consensus on WP:MED that this kind of source is acceptable and "not entirely clear" results are encyclopedic content, as long as they are correctly described and reflecting the sources' POVs and not ours. --Signimu (talk) 00:53, 31 October 2019 (UTC)

The Anton "metabolic switch" review already has a lot of citations, I may update further the proposed addition. I've found other authors confirm the accuracy of the wording I proposed, here's what PMID 31023390 write for instance: "Further progress will require such models to be tested with appropriate controls to isolate whether any possible health effects of intermittent fasting are primarily attributable to regularly protracted post-absorptive periods, or simply to the net negative energy balance indirectly elicited by any form of dietary restriction." - in addition, these authors do consider it's possible to test the hypothesis in humans. --Signimu (talk) 03:52, 31 October 2019 (UTC)

Here's a well-designed RCT study on 88 women, with both longitudinal and against control results, testing the metabolic switch hypothesis. So it is possible to test. PS: this is not meant to be added in the article, but just for discussion here. Reviews are necessary to make any conclusion. --Signimu (talk) 06:58, 31 October 2019 (UTC)

What Zefr says is utterly false. All sources used in this sentence either mention the metabolic switch hypothesis in some form, or in addition it cites it directly (such as Cioffi). In addition, there was a 4th ref, Zubrinski, that you deleted Zefr and its ref quote which clearly mentions the metabolic switch (and cite Anton). All the other refs have adequate quotes on WT:MED. For ease, please find below the full paragraph with the adequate refquotes to save you time:

Furthermore, your criticism pertains only to the metabolic switch hypothesis, and this paragraph does not pretend the hypothesis is proven, it only present it as a current research direction. All the infos, especially the metabolic pathways ones, are only from human studies, even if some studies also mix animal studies as you say, I selected only human-related info. So if you have a problem with the metabolic switch, fine, let's discuss that, but you can't revert a whole paragraph because of one sentence as Boghog says WP:PRESERVE.

Zefr, you can't constantly disregard my explanations and then repeatedly make false claims of SYNTH to discredit me and misuse policies such as constantly qualifying me as incompetent, please stop. I'm more than willing to discuss and honestly advance on this issue if you do, otherwise I will have to seek other resolution methods to make this stop. You are not required to like me, but WP is not place for WP:GRUDGE, if we work on the same entry, we have to discuss and work together. --Signimu (talk) 21:25, 30 October 2019 (UTC)

Fasting mimicking diets (FMDs)

I leave that here in case someone else wonders why it's not in the entry, but Fasting Mimicking Diets (FMDs) is only mentioned (as far as I could see) in Longo's works, and he is also involved with ProLon, a commercial product, so it looks more like a commercial plug than a scientifically supported diet as of 2019. A Fasting Mimicking Diet is a diet that supposedly can produce the same beneficial health effects as fasting, but without fasting, by doing a combination of calorie restriction and nutrient composition tweaking (eg, low carbohydrate and high fat), hence the "mimicking". Since there is not much scientific works apart from Longo's on this type of diet, this was left out of the entry (and even if there were other works, I'm not sure whether it should be part of intermittent fasting, since it's not really fasting anymore, as there is no notion of meal timing scheduling anymore). --Signimu (talk) 23:52, 14 October 2019 (UTC)

Addendum: a more concise description of the purpose of FMDs can be found in the Economic Times: «It means eating a special, low-calorie but nutrient-rich diet that the body does not recognise as food for five consecutive days.». Interesting concept, but sounds like a fad/bad diet red flag, and still only one author with conflicts of interests studying it, and no or little human trials yet. --Signimu (talk) 06:59, 16 October 2019 (UTC)

• All unassessed articles
• Start-Class Food and drink articles
• Low-importance Food and drink articles
• WikiProject Food and drink articles
• Start-Class Health and fitness articles
• Low-importance Health and fitness articles
• WikiProject Health and fitness articles
• Start-Class medicine articles
• Low-importance medicine articles
• All WikiProject Medicine pages