article · Cell Metabolism
Fasting is increasingly used to prevent and treat disease, yet standard terminology across the field has been lacking. To address this, an international panel of thirty-eight clinicians and researchers took part in a Delphi consensus process involving five online surveys and a live digital conference. Twenty-five experts completed the full process. The panel established agreed definitions for core concepts, defining general fasting as the voluntary abstinence from some or all food or beverages. Specific categories were clarified, including modified fasting as limiting energy intake to at most a quarter of requirements, short-term fasting lasting two to three days, and prolonged fasting extending to four or more consecutive days. Intermittent fasting was classified as repetitive fasting episodes lasting forty-eight hours or fewer. These standardised definitions aim to clarify scientific communication and clinical practice in metabolic and dietary interventions.
Clear definitions are essential for comparing dietary trials and prescribing clinical interventions safely. Without consistent language, patients, healthcare providers, and researchers often misunderstand or conflate very different dietary regimens. Standardising terms such as intermittent, modified, and prolonged fasting ensures that research outcomes can be reliably compared, helping to advance evidence-based nutritional strategies for health promotion and disease management.
These standardised definitions provide a foundational reference for clinical practitioners, digital health developers, and clinical trial designers creating dietary protocols or wellness platforms. The guidance is ready for immediate adoption in clinical trial design and product categorisation, although the abstract does not indicate any proprietary technology or direct commercial product development arising from the study.
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Although fasting is increasingly applied for disease prevention and treatment, consensus on terminology is lacking. Using Delphi methodology, an international, multidisciplinary panel of researchers and clinicians standardized definitions of various fasting approaches in humans. Five online surveys and a live online conference were conducted with 38 experts, 25 of whom completed all 5 surveys. Consensus was achieved for the following terms: "fasting" (voluntary abstinence from some or all foods or foods and beverages), "modified fasting" (restriction of energy intake to max. 25% of energy needs), "fluid-only fasting," "alternate-day fasting," "short-term fasting" (lasting 2-3 days), "prolonged fasting" (≥4 consecutive days), and "religious fasting." "Intermittent fasting" (repetitive fasting periods lasting ≤48 h), "time-restricted eating," and "fasting-mimicking diet" were discussed most. This study provides expert recommendations on fasting terminology for future research and clinical applications, facilitating communication and cross-referencing in the field.
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DOI: 10.1016/j.cmet.2024.06.013
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