Evidence map›Paper›PMID 41994097›Full record

SynthesisFrontiers in nutrition2026

Duration-dependent effects of water-only fasting on blood lipids: a systematic review, meta-analysis, and threshold meta-regression.

Ayşe Çamli, İzzet Ülker, Merve Terzi, Edanur Yağan, Serhat Özbay, Süleyman Ulupınar

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ayşe ÇamliDepartment of Nutrition and Dietetics, Faculty of Health Sciences, Erzurum Technical University, Erzurum, Türkiye.
İzzet ÜlkerDepartment of Nutrition and Dietetics, Faculty of Health Sciences, Erzurum Technical University, Erzurum, Türkiye.
Merve TerziDepartment of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Yeni Yuzyil University, Istanbul, Türkiye.
Edanur YağanFaculty of Sports Sciences, Erzurum Technical University, Erzurum, Türkiye.
Serhat ÖzbayFaculty of Sports Sciences, Erzurum Technical University, Erzurum, Türkiye.
Süleyman UlupınarFaculty of Sports Sciences, Erzurum Technical University, Erzurum, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background/objectives: Water-only fasting is practiced for metabolic and therapeutic purposes, yet its specific effects on lipid fractions remain inconsistently reported. This systematic review and meta-analysis evaluated lipid responses to water-only fasting across varying durations and fasting protocols. Methods: PubMed, Scopus, and Web of Science (2000-2025) were searched for human studies reporting pre-post lipid measurements under water-only fasting. Thirty-two studies met eligibility criteria. Effect sizes were calculated as Hedges' g using random-effects models. Duration-dependent responses were evaluated through subgroup analyses (≤3 days, >3 days) and piecewise threshold meta-regression. Publication bias was assessed via funnel plots and Egger's tests. Results: Water-only fasting produced lipid-specific and duration-dependent adaptations. HDL decreased significantly overall (g = -0.233), with no change in ≤3-day fasts but clear reductions in >3-day fasts; threshold analysis identified an early decline within the first ~3 days. LDL increased significantly (g = 0.489) and across all duration subgroups, showing a biphasic trajectory with progressive elevation up to ~10 days followed by attenuation or partial reversal. Total cholesterol also increased (g = 0.343), with the largest effects in >3--day fasts and a nonlinear threshold at ~5 days marking stabilization or modest decline thereafter. Triglycerides showed no significant overall effect (g = -0.039), characterized by reductions in ≤3-day fasts, increases in >3-day fasts; a marked early-phase threshold was observed at ~2.5 days. VLDL exhibited small, non-significant changes (g = 0.203) with substantial heterogeneity and limited data. Evidence of publication bias was detected for LDL and total cholesterol but not for HDL, triglycerides, or VLDL. Conclusion: Water-only fasting induces distinct, duration-dependent lipid adaptations. LDL and total cholesterol demonstrate early increases followed by stabilization, HDL decreases mainly during multi-day fasts, while triglycerides and VLDL show no uniform pattern. These findings highlight the importance of considering fasting duration when evaluating cardiometabolic effects and underscore the need for rigorously controlled, longer-term clinical trials.

Indexed as

blood lipidsHDL cholesterolLDL cholesterolmeta-analysistotal cholesteroltriglyceridesVLDL cholesterolwater-only fasting

Identifiers

PMID41994097
PMCPMC13079636

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.