Effects of alternate day calorie restriction and exercise on cardio-metabolic risk factors in overweight and obese adults: an exploratory randomized controlled study

Abstract

BackgroundIt has been recognized that alternate day calorie restriction (ADCR) or exercise has positive effects on cardio-metabolic risk factors. It is unclear whether the combined effect of ADCR and exercise (aerobic + resistance training) influences risk. We investigated effects of an 8-week ADCR and exercise program (aerobic + resistance training) on cardio-metabolic risk factors in overweight and obese adults.MethodsThis study randomized 45 overweight or obese but healthy adults (F = 26, M = 19; aged about 32 to 40 years) into 4 groups: ADCR (n = 13), exercise (n = 10), exercise plus ADCR (n = 12), and control (n = 10) for 8 weeks. Body composition, blood lipids profile, and insulin resistance were measured. The intention to treat (ITT) method was used to analyze all participants that were randomized.ResultsA total of 35 participants completed the trial (78%). Body weight, body mass index, waist circumference, fat mass and percent body fat were reduced in the exercise plus ADCR group (− 3.3 ± 2.4 kg, p < 0.01; − 1.3 ± 1.0 kg/m2, p < 0.01; − 4.1 ± 3.9 cm, p < 0.01; − 2.7 ± 2.0 kg, p < 0.01; − 2. 5 ± 2.2%, p < 0.01). Insulin, glucose, homeostasis model assessment insulin resistance and triglyceride (− 2.9 ± 4.1 μIU/ml, p < 0.05; − 10.9 ± 16.9 mg/dl, p < 0.05; − 0.9 ± 1.3, p < 0.05; − 43.8 ± 41.9 mg/dl, p < 0.01) decreased in the exercise plus ADCR group only.ConclusionsADCR and exercise both proved to be beneficial, but the combined intervention was most effective at inducing beneficial changes in body weight, body composition, glucose, insulin, insulin resistance and triglyceride in overweight and obese adults.Trial registrationClinicalTrials.gov: NCT03652532, Registered August 28, 2018, ‘retrospectively registered’.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6009-1) contains supplementary material, which is available to authorized users.

<p>Exercise Training and Fasting: Current Insights</p>

“…Additional confounding factors included age, weight and gender, as ICR studies generally included middle-aged or older adults. 15 The data in Table 4 show that body weight, 30,31 fat mass, 32,33 and also fat free mass, 32 are significantly lowered by ADF. Moreover, ADF-mediated weight loss occurred in obese and overweight individuals, 30,34 and also in normalweight persons.…”

“…15 The data in Table 4 show that body weight, 30,31 fat mass, 32,33 and also fat free mass, 32 are significantly lowered by ADF. Moreover, ADF-mediated weight loss occurred in obese and overweight individuals, 30,34 and also in normalweight persons. 35 Variations in results may be related to differences in study design, duration of fasting, subject characteristics, as well as differences in weight (normal weight, overweight, obese), age, and gender.…”

“…As summarized in were no significant changes in blood glucose levels of obese individuals after intermittent fasting. 18,30,32 However, some studies found that highly trained athletes displayed improved glucose metabolism after intermittent fasting, 58 while other studies failed to confirm this. 67,76 Changes in protein metabolism during IF are not as well studied.…”

Weight Loss after 12 Weeks of Exercise and/or Nutritional Guidance Is Not Obligatory for Induced Changes in Local Fat/Lean Mass Indexes in Adults with Excess of Adiposity

“…Due to the cost to both physical (i.e., metabolic and/or biomechanical disorders) [ 14 , 15 ] and psychological health (i.e., depression, dementia, and cognitive/skills process) [ 16 , 17 ], many clinical studies have been conducted on various interventions to improve body weight and composition [ 18 , 19 ]. A growing body of literature demonstrates that in comparison with dietary restriction alone, exercise, either accompanied by weight loss or not, can lead to favorable changes in body composition/function, including a reduction in metabolic abnormalities and abdominal adiposity, and improves the fat free mass to total mass ratio [ 20 , 21 , 22 , 23 , 24 ]. However, only one study to our knowledge [ 22 ] has tested whether nutritional guidance (NG) in conjunction with different exercise training modalities—including high-intensity interval training (HIIT), resistance training (RT), or combined training (CT = HIIT + RT)—might be more effective and provide additional improvements on body composition in overweight and obese adults.…”

“…However, in human trials, the veracity of the approach to determine the existence of individual variability has been questioned [ 25 ]. In adults, interindividual variability in health biomarker responses to exercise training, such as blood pressure, insulin resistance parameters, lipids profile, muscle strength, and cardiorespiratory fitness (CRF), have not been fully clarified [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], while there is scarce evidence in the physically inactive/overweight adults [ 26 , 27 , 28 ]. Recently, statistical approaches use cut-off points for identifying responders/non-responders considering both biological and TE measurement [ 29 ].…”