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Preferential Metabolic Improvement by Intermittent Fasting in People with Elevated Baseline Red Cell Distribution Width: A Secondary Analysis of the WONDERFUL Randomized Controlled Trial.

Intermountain Medical Center Heart Institute, Salt Lake City, UT 84107, USA. Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA. Cardiology Division, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA. Department of Physician Assistant Studies, College of Medical and Health Professional Science, Rocky Mountain University of Health Professions, Provo, UT 84606, USA. Intermountain Central Laboratory, Intermountain Medical Center, Salt Lake City, UT 84107, USA. Department of Pathology, University of Utah, Salt Lake City, UT 84132, USA. Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, San Diego, CA 92093, USA.

Nutrients. 2021;(12)
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Abstract

Red cell distribution width (RDW) predicts cardiovascular outcomes, but it is unstudied with regard to intermittent fasting. In WONDERFUL trial subjects, the effect of the interaction between baseline RDW and intermittent fasting on changes in insulin and other cardiometabolic endpoints and the effect of fasting on changes in RDW were evaluated. The subjects enrolled were aged 21-70 years and were free of statins, anti-diabetes medications, and chronic diseases, and had ≥1 metabolic syndrome feature, as well as elevated low-density lipoprotein cholesterol. Subjects were randomized to 24-h, water-only fasting (twice per week for 4 weeks, once per week for 22 weeks) or 26 weeks of ad libitum eating. Subjects (N = 71; n = 38 intermittent fasting, n = 33 controls) had more substantial changes in insulin in intermittent fasting vs. controls (-3.45 ± 2.27 vs. 0.48 ± 3.55 mIU/L) when baseline RDW size distribution (RDW-SD) was ≥median (42.6 fL) than