Biology:Calorie restriction

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Short description: Dietary regime

Calorie restriction (caloric restriction or energy restriction) is a dietary regimen that reduces the energy intake from foods and beverages without incurring malnutrition.[1][2] The possible effect of calorie restriction on body weight management, longevity, and aging-associated diseases has been an active area of research.[1]


Dietary guidelines

Caloric intake control, and reduction for overweight individuals, is recommended by US dietary guidelines and science-based societies.[3][4][5][6][7][8]

Calorie restriction is recommended for people with diabetes[9][10] and prediabetes,[10] in combination with physical exercise and a weight loss goal of 5-15% for diabetes and 7-10% for prediabetes to prevent progression to diabetes.[10] Mild calorie restriction may be beneficial for pregnant women to reduce weight gain (without weight loss) and reduce perinatal risks for both the mother and child.[11][12] For overweight or obese individuals, calorie restriction may improve health through weight loss, although a gradual weight regain of 1–2 kg (2.2–4.4 lb) per year may occur.[4][6]

Risks of malnutrition

The term "calorie restriction" as used in the study of aging refers to dietary regimens that reduce calorie intake without incurring malnutrition.[1] If a restricted diet is not designed to include essential nutrients, malnutrition may result in serious deleterious effects, as shown in the Minnesota Starvation Experiment.[13] This study was conducted during World War II on a group of lean men, who restricted their calorie intake by 45%[14] for six months and composed roughly 77% of their diet with carbohydrates.[13] As expected, this malnutrition resulted in metabolic adaptations, such as decreased body fat, improved lipid profile, and decreased resting heart rate. The experiment also caused negative effects, such as anemia, edema, muscle wasting, weakness, dizziness, irritability, lethargy, and depression.[13]

Typical low-calorie diets may not supply sufficient nutrient intake that is typically included in a calorie restriction diet.[15][16][17]

Possible side effects

People losing weight during calorie restriction risk developing side effects, such as cold sensitivity, menstrual irregularities, infertility, or hormonal changes.[18]

Research

Humans

Decreasing caloric intake by 20-30%, while fulfilling nutrient requirements, has been found to remedy diseases of aging, including cancer, cardiovascular disease, dementia, and diabetes in humans, and result in an average loss of 7.9 kilograms (17 lb) in body weight, but because of the long lifespan of humans, evidence that calorie restriction could prevent age-related disease in humans remains under preliminary research.[1][19] While calorie restriction leads to weight and fat loss, the precise amount of calorie intake and associated fat mass for optimal health in humans is not known.[1] Moderate amounts of calorie restriction may have harmful effects on certain population groups, such as lean people with low body fat.[1]

Life extension

As of 2021, intermittent fasting and calorie restriction remain under preliminary research to assess the possible effects on disease burden and increased lifespan during aging, although the relative risks associated with long-term fasting or calorie restriction remain undetermined.[1]

Intermittent fasting refers to periods with intervals during which no food but only clear fluids are ingested – such as a period of daily time-restricted eating with a window of 8 to 12 hours for any caloric intake – and could be combined with overall calorie restriction and variants of the Mediterranean diet which may contribute to long-term cardiovascular health and longevity.[20]

Minnesota Starvation Experiment

The Minnesota Starvation Experiment examined the physical and psychological effects of extreme calorie restriction on 32 young and lean 24-year-old men during a 40% reduction in energy intake for 6 months. The study was designed to mimic dietary conditions during World War II. Participants could only eat 1800 kcal per day, but were required to walk 5 km per day and expend 3000 calories.[21] The men lost about 25% of their body weight of which 67% was fat mass and 17% fat-free mass.[21] The quality of the diet was insufficient to accurately represent the diet during war due to the inadequate consumption of protein, and a lack of fruits and vegetables. Despite the extreme calorie restriction, the experiment was not representative of true calorie-restrictive diets, which adhere to intake guidelines for macronutrients and micronutrients.[21] Chronic weakness, decreased aerobic capacity, and painful lower limb edema was caused by the malnourished calorie restrictive diet.[21][22] Emotional distress, confusion, apathy, depression, hysteria, hypochondriasis, suicidal thoughts, and loss of sex drive were among the abnormal psychological behaviors that occurred within six weeks.[21]

Intensive care

(As of 2019), current clinical guidelines recommend that hospitals ensure that the patients get fed with 80–100% of energy expenditure, the normocaloric feeding. A systematic review investigated whether people in intensive care units have different outcomes with normocaloric feeding or hypocaloric feeding, and found no difference.[23] However, a comment criticized the inadequate control of protein intake, and raised concerns that hypocaloric feeding safety should be further assessed with underweight critically ill people.[24]

Non-human primates

A calorie restriction study started in 1987 by the National Institute on Aging showed that calorie restriction did not extend years of life or reduce age-related deaths in non-obese rhesus macaques.[25] It did improve certain measures of health, however.[26] These results were publicized as being different from the Wisconsin rhesus macaque calorie restriction study, which also started in 1987 and showed an increase in the lifespan of rhesus macaques following calorie restriction.[25]

In a 2017 report on rhesus monkeys, caloric restriction in the presence of adequate nutrition was effective in delaying the effects of aging.[27][28] Older age of onset, female sex, lower body weight and fat mass, reduced food intake, diet quality, and lower fasting blood glucose levels were factors associated with fewer disorders of aging and with improved survival rates.[27] Specifically, reduced food intake was beneficial in adult and older primates, but not in younger monkeys.[27] The study indicated that caloric restriction provided health benefits with fewer age-related disorders in elderly monkeys and, because rhesus monkeys are genetically similar to humans, the benefits and mechanisms of caloric restriction may apply to human health during aging.[29][30]

Activity levels

Calorie restriction preserves muscle tissue in nonhuman primates[31][32] and rodents.[33] Muscle tissue grows when stimulated, so it has been suggested that the calorie-restricted test animals exercised more than their companions on higher calories, perhaps because animals enter a foraging state during calorie restriction. However, studies show that overall activity levels are no higher in calorie restriction than ad libitum animals in youth.[34]

Sirtuin-mediated mechanism

Preliminary research indicates that sirtuins are activated by fasting and serve as "energy sensors" during metabolism.[35] Sirtuins, specifically Sir2 (found in yeast) have been implicated in the aging of yeast,[36] and are a class of highly conserved, NAD+-dependent histone deacetylase enzymes.[37] Sir2 homologs have been identified in a wide range of organisms from bacteria to humans.[36][38]

See also

  • CR Society International
  • Fasting
  • Intermittent fasting
  • List of diets
  • Okinawa diet
  • Very low calorie diet

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 "Antiaging diets: Separating fact from fiction". Science 374 (6570): eabe7365. November 2021. doi:10.1126/science.abe7365. PMID 34793210. 
  2. ↑ "Calorie Restriction and Aging in Humans". Annual Review of Nutrition 40: 105–133. September 2020. doi:10.1146/annurev-nutr-122319-034601. PMID 32559388. 
  3. ↑ "2015–2020 Dietary Guidelines for Americans - health.gov". Skyhorse Publishing Inc.. 2017. https://health.gov/dietaryguidelines/2015/. 
  4. ↑ 4.0 4.1 "2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". Circulation 140 (11): e596–e646. September 2019. doi:10.1161/CIR.0000000000000678. PMID 30879355. 
  5. ↑ "Obesity: maintaining a healthy weight and preventing excess weight gain". https://pathways.nice.org.uk/pathways/obesity/obesity-maintaining-a-healthy-weight-and-preventing-excess-weight-gain#content=view-node%3Anodes-diet. 
  6. ↑ 6.0 6.1 "2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society". Circulation 129 (25 Suppl 2): S102–S138. June 2014. doi:10.1161/01.cir.0000437739.71477.ee. PMID 24222017. 
  7. ↑ "Diet - NICE Pathways". https://pathways.nice.org.uk/pathways/diet#path=view%3A/pathways/diet/dietary-interventions-and-advice-for-adults.xml&content=view-node%3Anodes-reducing-calorie-intake. 
  8. ↑ "American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity". Endocrine Practice 22 (Suppl 3): 1–203. July 2016. doi:10.4158/EP161365.GL. PMID 27219496. 
  9. ↑ American Diabetes Association (January 2019). "5. Lifestyle Management: Standards of Medical Care in Diabetes-2019". Diabetes Care 42 (Suppl 1): S46–S60. doi:10.2337/dc19-S005. PMID 30559231. 
  10. ↑ 10.0 10.1 10.2 "Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report". Diabetes Care 42 (5): 731–754. May 2019. doi:10.2337/dci19-0014. PMID 31000505. 
  11. ↑ "The effect of Ramadan fasting during pregnancy on perinatal outcomes: a systematic review and meta-analysis". BMC Pregnancy and Childbirth 18 (1): 421. October 2018. doi:10.1186/s12884-018-2048-y. PMID 30359228. 
  12. ↑ "Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence". BMJ 344: e2088. May 2012. doi:10.1136/bmj.e2088. PMID 22596383. 
  13. ↑ 13.0 13.1 13.2 Keys A, Brozek J, Henschels A & Mickelsen O & Taylor H. The Biology of Human Starvation, 1950. University of Minnesota Press, Minneapolis
  14. ↑ Keys A 1950, p. 114.
  15. ↑ "Dietary protein and weight reduction: a statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association". Circulation 104 (15): 1869–1874. October 2001. doi:10.1161/hc4001.096152. PMID 11591629. 
  16. ↑ "Alternatives for macronutrient intake and chronic disease: a comparison of the OmniHeart diets with popular diets and with dietary recommendations". The American Journal of Clinical Nutrition 88 (1): 1–11. July 2008. doi:10.1093/ajcn/88.1.1. PMID 18614716. 
  17. ↑ "A dietary quality comparison of popular weight-loss plans". Journal of the American Dietetic Association 107 (10): 1786–1791. October 2007. doi:10.1016/j.jada.2007.07.013. PMID 17904938. 
  18. ↑ "Cellular mechanisms of cardioprotection by calorie restriction: state of the science and future perspectives". Clinics in Geriatric Medicine 25 (4): 715–32, ix. November 2009. doi:10.1016/j.cger.2009.07.002. PMID 19944269. 
  19. ↑ "Is Caloric Restriction Associated with Better Healthy Aging Outcomes? A Systematic Review and Meta-Analysis of Randomized Controlled Trials". Nutrients 12 (8): 2290. July 2020. doi:10.3390/nu12082290. PMID 32751664. 
  20. ↑ "A pesco-Mediterranean diet with intermittent fasting: JACC Review Topic of the Week". Journal of the American College of Cardiology 76 (12): 1484–1493. September 2020. doi:10.1016/j.jacc.2020.07.049. PMID 32943166. 
  21. ↑ 21.0 21.1 21.2 21.3 21.4 "Calorie restriction in humans: An update". Ageing Research Reviews. Nutritional interventions modulating aging and age-associated diseases 39: 36–45. October 2017. doi:10.1016/j.arr.2016.08.005. PMID 27544442. 
  22. ↑ The biology of human starvation (2 vols).. Univ. of Minnesota Press. 1950. 
  23. ↑ "Normocaloric versus hypocaloric feeding on the outcomes of ICU patients: a systematic review and meta-analysis". Intensive Care Medicine 42 (3): 316–323. March 2016. doi:10.1007/s00134-015-4131-4. PMID 26556615. 
  24. ↑ "Comments on Marik and Hooper: Normocaloric versus hypocaloric feeding on the outcomes of ICU patients: a systematic review and meta-analysis". Intensive Care Medicine 42 (4): 628–629. April 2016. doi:10.1007/s00134-016-4248-0. PMID 26880090. 
  25. ↑ 25.0 25.1 National Institutes of Health (2012-08-29). "NIH study finds calorie restriction does not affect survival". https://www.nih.gov/news-events/news-releases/nih-study-finds-calorie-restriction-does-not-affect-survival. 
  26. ↑ Nicholas Wade (April 1, 2014). "Diet's Link to Longevity: After 2 Studies Diverge, a Search for Consensus". https://www.nytimes.com/2014/04/02/science/a-new-salvo-in-debate-over-caloric-restrictions-and-longevity.html. 
  27. ↑ 27.0 27.1 27.2 "Caloric restriction improves health and survival of rhesus monkeys". Nature Communications 8 (1): 14063. January 2017. doi:10.1038/ncomms14063. PMID 28094793. Bibcode: 2017NatCo...814063M. 
  28. ↑ "Calorie restriction lets monkeys live long and prosper". ScienceDirect. 17 January 2017. https://www.sciencedaily.com/releases/2017/01/170117140105.htm. 
  29. ↑ "Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study". Nature 489 (7415): 318–321. September 2012. doi:10.1038/nature11432. PMID 22932268. Bibcode: 2012Natur.489..318M. 
  30. ↑ "Caloric Restriction Study Design Limitations in Rodent and Nonhuman Primate Studies". The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 73 (1): 48–53. December 2017. doi:10.1093/gerona/glx088. PMID 28977341. 
  31. ↑ "Cellular adaptation contributes to calorie restriction-induced preservation of skeletal muscle in aged rhesus monkeys". Experimental Gerontology 47 (3): 229–236. March 2012. doi:10.1016/j.exger.2011.12.009. PMID 22226624. 
  32. ↑ "Attenuation of sarcopenia by dietary restriction in rhesus monkeys". The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 63 (6): 556–559. June 2008. doi:10.1093/gerona/63.6.556. PMID 18559628. 
  33. ↑ "Sarcopenia: the role of apoptosis and modulation by caloric restriction". Exercise and Sport Sciences Reviews 36 (1): 19–24. January 2008. doi:10.1097/jes.0b013e31815ddd9d. PMID 18156949. https://journals.lww.com/acsm-essr/Fulltext/2008/01000/Sarcopenia__The_Role_of_poptosis_and_Modulation_by.5.aspx. 
  34. ↑ "Calorie restriction in mice: effects on body composition, daily activity, metabolic rate, mitochondrial reactive oxygen species production, and membrane fatty acid composition". The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 61 (8): 781–794. August 2006. doi:10.1093/gerona/61.8.781. PMID 16912094. 
  35. ↑ "SIRT1 and other sirtuins in metabolism". Trends in Endocrinology and Metabolism 25 (3): 138–145. March 2014. doi:10.1016/j.tem.2013.12.001. PMID 24388149. 
  36. ↑ 36.0 36.1 "Sirtuins in aging and disease". Cold Spring Harbor Symposia on Quantitative Biology 72: 483–488. 2007. doi:10.1101/sqb.2007.72.024. PMID 18419308. 
  37. ↑ "Calorie restriction extends yeast life span by lowering the level of NADH". Genes & Development 18 (1): 12–16. January 2004. doi:10.1101/gad.1164804. PMID 14724176. 
  38. ↑ "The SIR2/3/4 complex and SIR2 alone promote longevity in Saccharomyces cerevisiae by two different mechanisms". Genes & Development 13 (19): 2570–2580. October 1999. doi:10.1101/gad.13.19.2570. PMID 10521401. 

Further reading

  • "Food Intake, Life Style, Aging and Human Longevity". Calorie Restriction, Aging and Longevity. New York: Springer. 2010. ISBN 978-90-481-8555-9. 
  • The Biology of Human Starvation. I. University of Minnesota Press. 1950. ISBN 978-0-8166-7234-9. 



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