Meal timing during alternate day fasting: Impact on body weight and cardiovascular disease risk in obese adults

Hoddy, Kristin K.; Kroeger, Cynthia M.; Trepanowski, John F.; Barnosky, Adrienne; Bhutani, Surabhi; Varady, Krista A

doi:10.1002/oby.20909

Cited by 110 publications

(105 citation statements)

References 24 publications

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“…In individuals with T2DM, IER has been shown to improve glycaemic control and lipid profiles (27) . By contrast, many of the IER studies within heterogeneous non-T2DM populations, which have spanned from 4-24 weeks, have failed to show any significant effect on fasting glucose levels (28,34,(37)(38)(39)(40) or glycated Hb (37) ; unsurprising findings given that glucose levels are usually kept under tight physiological control. However, improvements in other indices of insulin sensitivity have been observed, including reductions in fasting insulin (30,37,39,40) and/or HOMA-IR (30,37,40) .…”

Section: Overview and Effects On Body Weightmentioning

confidence: 94%

“…100 % energy restriction) every other day, with fasting intervals ranging between 20 and 36 h. However, the long-term sustainability of this alternate day total fasting approach in human subjects is questionable due to the persistent hunger reported (24) . Subsequently, the IER protocols used by most human studies (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) , and by some rodent studies (11,14,42) , have allowed a small amount of 'fast' day intake, so that energy is substantially (⩾70 %) but not completely restricted. This is often referred to as modified fasting, such that, the term fasting in this IER context denotes periods of severe (total or partial) energy restriction.…”

Section: Overview and Effects On Body Weightmentioning

confidence: 99%

“…The most well-studied examples include alternate day modified fasting and the 5:2 diet, which entails two modified fast days a week (Table 1), although many variations exist. Intakes on non-restricted ('feed') days among these studies have ranged from ad libitum (27)(28)(29)(31)(32)(33)(34)36,38) , hypoenergetic (approximately 15-30 % of energy requirements) (34,41) , isoenergetic (30,37,40) or hyperenergetic (approximately 125-175 % of energy requirements) (35,39) . Compliance is reportedly high (29,37) , with both acute (5) and chronic (29,30,37,40) studies demonstrating a lack of full compensatory hyperphagia following modified fasting days.…”

Section: Overview and Effects On Body Weightmentioning

confidence: 99%

“…Compliance is reportedly high (29,37) , with both acute (5) and chronic (29,30,37,40) studies demonstrating a lack of full compensatory hyperphagia following modified fasting days. In overweight/ obese (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)37,38,40,41) or combined healthy/overweight (36) cohorts, the average reported weight-loss through IER (70-100 % energy restriction) has ranged between approximately 4 and 10 % over dieting periods of 4-24 weeks. There are also some data demonstrating the successful applications of IER as a weight-maintenance strategy following weight-loss for periods of up to 1 year (37,39) .…”

Section: Overview and Effects On Body Weightmentioning

confidence: 99%

“…To date, all IER studies allowing fast day intake have solely measured fasting blood markers of cardiometabolic risk. Some (27,(30)(31)(32)(33)(35)(36)(37)41) but not all of these studies (28,29,34,40) have included CER (standard treatment) or ad libitum (no intervention) control groups, whilst others have compared two or more different IER protocols (35,38,39) . In individuals with T2DM, IER has been shown to improve glycaemic control and lipid profiles (27) .…”

Section: Overview and Effects On Body Weightmentioning

confidence: 99%

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Effects of intermittent fasting on glucose and lipid metabolism

et al. 2017

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Two intermittent fasting variants, intermittent energy restriction (IER) and time-restricted feeding (TRF), have received considerable interest as strategies for weight-management and/or improving metabolic health. With these strategies, the pattern of energy restriction and/or timing of food intake are altered so that individuals undergo frequently repeated periods of fasting. This review provides a commentary on the rodent and human literature, specifically focusing on the effects of IER and TRF on glucose and lipid metabolism. For IER, there is a growing evidence demonstrating its benefits on glucose and lipid homeostasis in the short-to-medium term; however, more long-term safety studies are required. Whilst the metabolic benefits of TRF appear quite profound in rodents, findings from the few human studies have been mixed. There is some suggestion that the metabolic changes elicited by these approaches can occur in the absence of energy restriction, and in the context of IER, may be distinct from those observed following similar weight-loss achieved via modest continuous energy restriction. Mechanistically, the frequently repeated prolonged fasting intervals may favour preferential reduction of ectopic fat, beneficially modulate aspects of adipose tissue physiology/morphology, and may also impinge on circadian clock regulation. However, mechanistic evidence is largely limited to findings from rodent studies, thus necessitating focused human studies, which also incorporate more dynamic assessments of glucose and lipid metabolism. Ultimately, much remains to be learned about intermittent fasting (in its various forms); however, the findings to date serve to highlight promising avenues for future research.

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Section: Overview and Effects On Body Weightmentioning

confidence: 94%

Section: Overview and Effects On Body Weightmentioning

confidence: 99%

Section: Overview and Effects On Body Weightmentioning

confidence: 99%

Section: Overview and Effects On Body Weightmentioning

confidence: 99%

Section: Overview and Effects On Body Weightmentioning

confidence: 99%

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Effects of intermittent fasting on glucose and lipid metabolism

et al. 2017

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Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults

et al. 2017

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IMPORTANCE Alternate-day fasting has become increasingly popular, yet, to date, no long-term randomized clinical trials have evaluated its efficacy.OBJECTIVE To compare the effects of alternate-day fasting vs daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease. DESIGN, SETTING, AND PARTICIPANTSA single-center randomized clinical trial of obese adults (18 to 64 years of age; mean body mass index, 34) was conducted between October 1, 2011, and January 15, 2015, at an academic institution in Chicago, Illinois.INTERVENTIONS Participants were randomized to 1 of 3 groups for 1 year: alternate-day fasting (25% of energy needs on fast days; 125% of energy needs on alternating "feast days"), calorie restriction (75% of energy needs every day), or a no-intervention control. The trial involved a 6-month weight-loss phase followed by a 6-month weight-maintenance phase. MAIN OUTCOMES AND MEASURESThe primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease. RESULTS Among the 100 participants (86 women and 14 men; mean [SD] age, 44 [11] years), the dropout rate was highest in the alternate-day fasting group (13 of 34 [38%]), vs the daily calorie restriction group (10 of 35 [29%]) and control group (8 of 31 [26%]). Mean weight loss was similar for participants in the alternate-day fasting group and those in the daily calorie restriction group at month 6 (-6.8% [95% CI, -9.1% to -4.5%] vs -6.8% [95% CI, -9.1% to -4.6%]) and month 12 (-6.0% [95% CI, -8.5% to -3.6%] vs -5.3% [95% CI, -7.6% to -3.0%]) relative to those in the control group. Participants in the alternate-day fasting group ate more than prescribed on fast days, and less than prescribed on feast days, while those in the daily calorie restriction group generally met their prescribed energy goals. There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C-reactive protein, or homocysteine concentrations at month 6 or 12. Mean high-density lipoprotein cholesterol levels at month 6 significantly increased among the participants in the alternate-day fasting group (6.2 mg/dL [95% CI, 0.1-12.4 mg/dL]), but not at month 12 (1.0 mg/dL [95% CI, -5.9 to 7.8 mg/dL]), relative to those in the daily calorie restriction group. Mean low-density lipoprotein cholesterol levels were significantly elevated by month 12 among the participants in the alternate-day fasting group (11.5 mg/dL [95% CI, 1.9-21.1 mg/dL]) compared with those in the daily calorie restriction group.CONCLUSIONS AND RELEVANCE Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00960505

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