12 posibles beneficios para la salud del ayuno intermitente

Jorge Carlos Fernández Francés El Sardinero
Jorge Carlos Fernández Francés El Sardinero

El ayuno intermitente (AI), una de las dietas de las que más se habla en este momento, es una forma de comer que designa períodos de tiempo para comer y para ayunar. Y no hay señales que sugieran que el interés está disminuyendo. “IF, en sus diferentes formas, mantiene un ritmo constante”, dice Kimberley Rose-Francis, RDN, CDCES, con sede en Sebring, Florida.

Hay algunos enfoques, pero los dos más populares son el 16:8, que exige comprimir todas las comidas del día en un período de ocho horas y ayunar durante las 16 horas restantes, y el 5:2, en el que cinco días de la semana se gastan comiendo normalmente y dos se gastan en ayunas (generalmente se define como comer solo de 500 a 600 calorías por día).

¿Por qué alguien optaría por esta forma de comer en lugar de una dieta estándar, como una dieta baja en carbohidratos o baja en grasas? Algunas personas dicen que el ayuno tiene muchos beneficios para la salud. «Hasta ahora, la investigación demuestra los beneficios de la IF en la medida en que vale la pena como método para perder peso, controlar el azúcar en la sangre y ralentizar el proceso de envejecimiento», dice Sara Gottfried, MD, de Berkeley, California , autora de Las mujeres, los alimentos y las hormonas , La cura hormonal , La dieta de restablecimiento hormonal y La dieta del cerebro y el cuerpo .

Pero no todos están a bordo. “Desde mi punto de vista y el de muchas otras personas, tiende a caer en la siguiente categoría de dieta de moda”, dice Elizabeth Lowden, MD, médica de Warrenville, Illinois, certificada por la junta en medicina de la obesidad; endocrinología, diabetes y metabolismo; y medicina interna. Muchos de los datos están en conflicto, dice, y muchos estudios realizados en animales aún no se han repetido en personas. “Por cada estudio que muestra que no hay cambios, hay algunos estudios que muestran que tal vez hay una mejora”, dice el Dr. Lowden.

Entonces, en lugar de tomar las afirmaciones populares sobre IF al pie de la letra, sumergirnos en ellas y explorar si los 12 beneficios promocionados del enfoque son legítimos o si la ciencia aún no se acumula.

1. Pérdida de peso
La mayoría de las personas comienzan SI para perder peso. Y esa mantuvo parece mantenerse, al menos a corto plazo. Según un artículo publicado en febrero de 2020 en Canadian Family Physician, el IF puede contribuir a la pérdida de peso en personas con sobrepeso u obesidad. Los investigadores analizaron los datos de 27 estudios y encontraron que el IF ayudó a los participantes a perder hasta el 13 por ciento de su peso.

probablemente sea una buena noticia si espera ayunar para perder peso, pero el hecho de que esos estudios arriesgan a corto plazo que no está claro si el IF es sostenible y puede ayudar a evitar los kilos de más a largo plazo.

Es más, no todos los estudios han encontrado que el IF resultó en la pérdida de peso. Un estudio publicado en septiembre de 2020 en JAMA Internal Medicine que involucró a 116 personas con sobrepeso u obesas que comieron entre las 12 y las 8 p. metro. durante 12 semanas encontré que no hubo una pérdida de peso significativamente mayor que el grupo de control.

El otro problema: la cantidad de peso perdido no parece ser más de lo que esperaría de otra dieta restringida en calorías. Una revisión publicada en octubre de 2019 en Nutrients encontró que se lograron cantidades similares de pérdida de peso y grasa a través de IF y restricción continua de energía, como una dieta baja en calorías. Y dependiendo de la cantidad de calorías que coma cada día, incluso podría terminar aumentando de peso. Después de todo, la dieta no restrinja los alimentos ricos en calorías o las calorías totales, solo restrinja cuándo puede comer.

Cuando la dieta se hace correctamente, la IF puede ser tan efectiva como la restricción calórica normal, dice Lowden. Algunas personas, especialmente las personas ocupadas que no tienen tiempo para dedicarse a la planificación de comidas, incluso pueden encontrar una dieta restringida en el tiempo más fácil de seguir que algo como la dieta ceto o la dieta paleo , dice ella.

2. Presión arterial reducida
SI puede ayudar a reducir la presión arterial alta a corto plazo. Un estudio piloto publicado en junio de 2018 en Nutrition and Healthy Aging encontró que 16:8 resultó significativamente la presión arterial sistólica en los 23 participantes del estudio. Como señala la Clínica Mayo, la presión arterial sistólica es el número superior en la lectura de la presión arterial e indica la fuerza del corazón contra las paredes de las arterias cada vez que tarde.

El vínculo entre la presión arterial sistólica más baja y la IF aparece tanto en estudios en animales como en humanos, según una revisión publicada en marzo de 2019 en Nutrients . y un estudio publicado en septiembre de 2020 en el European Journal of Nutrition encontró que el IF condujo a reducciones aún mayores en la presión arterial sistólica que otra dieta que no implicaba horarios definidos para comer.

Tener una presión arterial saludable es importante: los niveles no saludables pueden dañar el corazón, el cerebro, los riñones y los ojos, según los Centros para el Control y la Prevención de Enfermedades (CDC) .

Pero hasta ahora, la investigación muestra que estos beneficios de la presión arterial duran solo mientras alguien está haciendo IF. Una vez que terminó la dieta y las personas volvieron a comer normalmente, los investigadores encontraron que las lecturas de la presión arterial volvieron a sus niveles iniciales.

3. Inflamación reducida
Los estudios en animales sugieren que tanto la IF como la restricción calórica general pueden reducir los niveles de inflamación, aunque los ensayos clínicos son pocos y esporádicos. Los autores de la investigación publicada en Nutrition Research Querían saber si ese también existía entre los humanos, por lo que analizaron un grupo de 50 participantes que estaban ayunando durante el Ramadán, la festividad musulmana, que implica ayunar desde el amanecer hasta el atardecer y comer durante la noche. El estudio mostró que durante el período de ayuno, los marcadores proinflamatorios eran más bajos de lo habitual, al igual que la presión arterial, el peso corporal y la grasa corporal.

4. Reducir el colesterol
Según una revisión publicada en octubre de 2021 en el Annual Review of Nutrition, varias formas de IF, incluido el ayuno en días alternos y 5:2, pueden ayudar a reducir el colesterol LDL («malo»), entre otros marcadores de la salud cardiometabólica, como la presión arterial.

El colesterol LDL puede aumentar el riesgo de enfermedad cardíaca o accidente cerebrovascular, según los CDC. Los investigadores también notaron que el IF redujo la presencia de triglicéridos, que son grasas que se encuentran en la sangre y que pueden provocar un derrame cerebral, un ataque cardíaco o una enfermedad cardíaca, según la Clínica Mayo.

Sin embargo, no todos los investigadores están de acuerdo en que el SI reduce significativamente los niveles de colesterol. Una revisión publicada en la edición de verano de 2020 del Journal of Patient-Centered Research and Reviews concluyó que no había una diferencia en los niveles de colesterol entre quienes hicieron IF y quienes lograron una dieta baja en calorías.

5. Mejores resultados para los sobrevivientes de accidentes cerebrovasculares
Los niveles de colesterol más saludables y la presión arterial más baja (dos beneficios mencionados anteriormente) juegan un papel importante para ayudar a reducir el riesgo de accidente cerebrovascular. Pero ese no es el único posible beneficio de la IF relacionado con el accidente cerebrovascular. Un artículo publicado en octubre de 2019 en Nutrients encontró que el ayuno puede proporcionar un mecanismo de protección para el cerebro y mejorar la recuperación de un accidente cerebrovascular , en parte debido al efecto antiinflamatorio de IF. Esa fue la conclusión basada en estudios en animales: los investigadores notaron que faltaban estudios en humanos sobre los efectos de IF en el accidente cerebrovascular.

6. Función cerebral potenciada
El Dr. Gottfried dice que la FI puede mejorar la agudeza mental y la concentración. Y hay algunas investigaciones iniciales que respaldan esa idea: un estudio publicado en noviembre de 2021 en Molecular Psychiatry descubrió que ayunar cada dos días puede mejorar la memoria. Sin embargo, este estudio se realizó solo en animales. Una revisión publicada en de 2021 en Nutrients analizó cómo la IF afecta los cerebros humanos y descubrió que no parece conducir a beneficios cognitivos a corto plazo entre las personas sanas, pero puede proteger contra el desarrollo de un trastorno neurológico.

7. Protección contra el cáncer
Una dieta en ayunas puede reducir el riesgo de cáncer al disminuir la capacidad de las células cancerosas para adaptarse y propagarse y al mejorar los efectos del tratamiento del cáncer , según una revisión publicada en noviembre de 2018 en Nature Reviews: Cancer. Esta es otra área donde se necesita más investigación: un artículo publicado en noviembre de 2021 en CA: A Cancer Journal for Clinicians señala que se necesitan más ensayos clínicos ocasionales de alta calidad para confirmar esta asociación. Por supuesto, también es importante que las personas que se someten a un tratamiento contra el cáncer consulten a su equipo de atención médica antes de realizar cambios en su dieta.

8. Aumento de la rotación celular
Gottfried dice que el período de descanso involucrado en el ayuno intermitente aumenta la autofagia, que es «una importante función de desintoxicación en el cuerpo para limpiar las células dañadas», dice ella. Dicho de otra manera, un descanso de la comida y la digestión le da al cuerpo la oportunidad de sanar y deshacerse de la basura dentro de las células que pueden acelerar el envejecimiento, explica.

Un estudio publicado en mayo de 2019 en Nutrients encontró que la alimentación restringida en el tiempo, que los investigadores definieron como comer entre las 8 a. metro. y las 2 p. m., aumenta la expresión del gen de autofagia LC3A y la proteína MTOR, que regula el crecimiento celular. Este estudio fue pequeño, con solo 11 participantes durante cuatro días.

9. Resistencia a la insulina reducida
Gottfried propone que el ayuno intermitente puede ayudar a estabilizar los niveles de azúcar en la sangre en personas con diabetes porque «restablece la insulina», aunque se necesita más investigación. La idea es que reducir las calorías puede mejorar la resistencia a la insulina , que es un marcador de la diabetes tipo 2, según un estudio publicado en abril de 2019 en Nutrients . El ayuno, como el tipo de ayuno asociado con la IF, fomenta la caída de los niveles de insulina, lo que puede desempeñar un papel en la reducción del riesgo de diabetes tipo 2, señala el estudio. “Tengo colegas en otras instalaciones que han visto resultados positivos, especialmente en mejoras en las necesidades de insulina [medicamento] para diabéticos”, dice Lowden.

El estudio Nutrición y Envejecimiento Saludable investigó este efecto en humanos, y aunque un enfoque 16:8 resultó en reducciones en la resistencia a la insulina, los resultados no fueron significativamente diferentes del grupo de control. Y nuevamente, este estudio fue pequeño.

Los dietistas registrados aconsejan a las personas con diabetes que se acerquen al ayuno intermitente con precaución. Las personas que toman ciertos medicamentos para la diabetes tipo 2 o las que usan insulina (ya sea para controlar el azúcar en la sangre para la diabetes tipo 2 o tipo 1) pueden correr un mayor riesgo de tener un nivel bajo de azúcar en la sangre , lo que puede poner en peligro la vida. Consulte con su médico antes de probar el ayuno intermitente si tiene algún tipo de diabetes, aconsejan.

10. Menor riesgo de problemas cardiovasculares
Según el estudio de Nutrients , cuando los niveles de insulina caen, también lo hace el riesgo de eventos cardiovasculares peligrosos, como insuficiencia cardíaca congestiva , que es importante que las personas con diabetes tipo 2 consideren porque tienen el doble de probabilidades de desarrollar y morir a causa de una enfermedad cardíaca que adultos sin diabetes, según la American Heart Association.

El estudio de Nutrients dijo que, si bien no hay estudios prospectivos en humanos que demuestren este efecto, los estudios observacionales han demostrado que los IF pueden brindar beneficios tanto cardiovasculares como metabólicos. Lowden sospecha que los cambios en los parámetros metabólicos, como niveles más bajos de triglicéridos y una disminución en los niveles de azúcar en la sangre, son el resultado de perder peso y se lograrían sin importar cómo se haya perdido el peso, ya sea a través de IF o una dieta baja en carbohidratos . por ejemplo.

Por ejemplo, una revisión publicada en enero de 2021 en la base de datos Cochrane de revisiones sistemáticas encontró que no había una diferencia significativa entre el IF y la ingesta reducida de calorías en la reducción de los factores de riesgo de enfermedad cardiovascular.

11. Mayor longevidad
Ha habido algunos estudios en animales que han demostrado que el IF puede prolongar la vida útil, posiblemente porque el ayuno parece desarrollar resistencia a las enfermedades relacionadas con la edad. Un estudio publicado en septiembre de 2021 en Nature descubrió que el IF ralentizaba el proceso de envejecimiento dentro de las células de las moscas de la fruta, lo que ayudaba a que las mentiras de la fruta vivieran más tiempo. Una revisión publicada en junio de 2018 en Current Obesity Reports indicó que, si bien estos hallazgos son prometedores, no se han replicado en estudios con humanos. Hasta que eso suceda, es mejor ser escéptico acerca de este beneficio potencial.

12. Una mejor noche de sueño
Si alguna vez sintió que entró en un coma alimentario después de una gran comida, sabe que la dieta puede tener un impacto en la vigilia y la somnolencia. Algunos seguidores de IF informan que pueden dormir mejor como resultado de seguir esta forma de comer. “El IF y las comidas pueden tener un impacto en el sueño”, dice Rose-Francis.

¿Por qué? Una teoría es que la FI regula el ritmo circadiano, que determina los patrones de sueño. Un ritmo circadiano regulado significa que te dormirás fácilmente y te despertarás sintiéndote renovado, aunque la investigación que respalda esta teoría es limitada, según un artículo publicado en 2018 en Nature and Science of Sleep .

La otra teoría se centra en el hecho de que tener tu última comida más temprano en la noche significa que habrás digerido la comida para cuando toques la almohada. De acuerdo con Sleep Foundation , irse a dormir con el estómago lleno (especialmente si la última comida involucró alimentos pesados ​​o picantes) puede interferir con la digestión o provocarle acidez estomacal , lo que puede dificultar conciliar el sueño.

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