Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial

Abstract

Background Although preliminary evidence suggests that intermittent calorie restriction (ICR) exerts stronger effects on metabolic parameters, which may link obesity and major chronic diseases, compared with continuous calorie restriction (CCR), there is a lack of well-powered intervention studies. Objective We conducted a randomized controlled trial to test whether ICR, operationalized as the “5:2 diet,” has stronger effects on adipose tissue gene expression, anthropometric and body composition measures, and circulating metabolic biomarkers than CCR and a control regimen. Design One hundred and fifty overweight and obese nonsmokers [body mass index (kg/m2) ≥25 to <40, 50% women], aged 35–65 y, were randomly assigned to an ICR group (5 d without energy restriction and 2 d with 75% energy deficit, net weekly energy deficit ∼20%), a CCR group (daily energy deficit ∼20%), or a control group (no advice to restrict energy) and participated in a 12-wk intervention phase, a 12-wk maintenance phase, and a 26-wk follow-up phase. Results Loge relative weight change over the intervention phase was −7.1% ± 0.7% (mean ± SEM) with ICR, −5.2% ± 0.6% with CCR, and −3.3% ± 0.6% with the control regimen (Poverall < 0.001, PICR vs. CCR = 0.053). Despite slightly greater weight loss with ICR than with CCR, there were no significant differences between the groups in the expression of 82 preselected genes in adipose tissue implicated in pathways linking obesity to chronic diseases. At the final follow-up assessment (week 50), weight loss was −5.2% ± 1.2% with ICR, −4.9% ± 1.1% with CCR, and −1.7% ± 0.8% with the control regimen (Poverall = 0.01, PICR vs. CCR = 0.89). These effects were paralleled by proportional changes in visceral and subcutaneous adipose tissue volumes. There were no significant differences between ICR and CCR regarding various circulating metabolic biomarkers. Conclusion Our results on the effects of the “5:2 diet” indicate that ICR may be equivalent but not superior to CCR for weight reduction and prevention of metabolic diseases. This trial was registered at clinicaltrials.gov as NCT02449148.

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

“…Furthermore, two studies related to ICR and Ramadan fasting found no changes in lipid metabolism in obese and overweight subjects. 29,37 However, this was not the case for ADF where some changes were measured. 18,32,40 There may be a number of reasons for the differences reported on the effects of IF.…”

Dietary Factors in Relation to Liver Fat Content: A Cross-sectional Study

“…Considering the limited evidence from human studies, it was the aim of this cross-sectional study to evaluate associations between food consumption and liver fat content. We used baseline data from the Healthy Nutrition and Energy Restriction as Cancer Prevention Strategies: A Randomized Controlled Intervention Trial (HELENA Trial) [15], a randomized controlled intervention study, in a post-hoc manner to evaluate food frequency questionnaire-(FFQ-) derived dietary items (47 food groups and two diet quality scores, the MED diet and DASH scores) in relation to liver fat content measured by magnetic resonance imaging (MRI) among 136 overweight or obese individuals.…”

Ketogenic diets: Opportunities and limitations in practical application (LITERATURE REVIEW)

“…Intermittent fasting helps reduce weight and can contribute to good health, but not better than regular diets (116). This is the conclusion reached by the scientists from the German Cancer Research Centre (DKFZ) and the Heidelberg University Hospital (Deutsches Krebsforschungszentrum und das Universitätsklinikum Heidelberg) in the HELENA study (HELENA-Studie) (116), the largest study in this area to date. It is obvious to researchers that there are many different ways to reduce weight, but it is important to select the right option for each patient.…”

“…Due to the high hopes that some dieticians and sports physicians have today for the intermittent fasting, it is of great interest to researchers to compare different forms of diet in terms of the weight loss (116,117,118).…”