Impact of Intermittent Fasting on Gut Barrier Function and Inflammation

Abstract

Background: Intermittent fasting (IF) has gained prominence as a metabolic and lifestyle intervention with potential benefits extending beyond weight control. Objective: This study aimed to evaluate the impact of intermittent fasting on gut barrier integrity and inflammatory markers among healthy adults. Methods: A cross-sectional analytical study was conducted at Services Hospital /Services Institute of Medical Sciences Lahore from June 2023 to June 2024. A total of 265 adult participants were enrolled, including 138 individuals practicing intermittent fasting and 127 individuals with normal eating patterns. Non-probability consecutive sampling was employed. Blood samples were analyzed for serum zonulin and lipopolysaccharide (LPS) to assess gut permeability, and for high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) to evaluate systemic inflammation.  Results: The mean zonulin and LPS levels were significantly lower in the IF group (32.4 ± 7.8 ng/mL and 0.38 ± 0.12 EU/mL) compared to controls (40.2 ± 9.5 ng/mL and 0.51 ± 0.15 EU/mL; p < 0.001). Inflammatory markers were also reduced in fasting participants: hs-CRP (1.9 ± 0.7 mg/L vs. 2.8 ± 1.0 mg/L), IL-6 (4.3 ± 1.5 pg/mL vs. 6.2 ± 1.9 pg/mL), and TNF-α (8.6 ± 2.4 pg/mL vs. 10.9 ± 2.8 pg/mL) — all statistically significant (p < 0.001).  Conclusion: It is concluded that intermittent fasting enhances gut barrier function and reduces systemic inflammation by lowering intestinal permeability and inflammatory cytokine levels. These findings suggest that intermittent fasting may serve as an effective, non-pharmacological strategy to improve gut–immune health and prevent inflammation-related disorders.