The effect of intermittent energy and carbohydrate restriction<i>v</i>. daily energy restriction on weight loss and metabolic disease risk markers in overweight women

Harvie, Michelle; Wright, Claire; Pegington, Mary; McMullan, Debbie; Mitchell, Ellen Sullivan; Martin, Bronwen; Cutler, Roy G.; Evans, D. Gareth; Whiteside, Sigrid; Maudsley, Stuart; Camandola, Simonetta; Wang, Rui; Carlson, Olga D.; Egan, Josephine M.; Mattson, Mark P.; Howell, Anthony

doi:10.1017/s0007114513000792

Cited by 377 publications

(543 citation statements)

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“…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%

“…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. 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.…”

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%

“…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) . IER additionally elicits favourable alterations in fasted lipid profiles (28)(29)(30)(31)(32)(33)(35)(36)(37)(38)41) including shifts in LDL sub-fraction distribution and/or size towards larger less atherogenic particles (31)(32)(33)36,38) , even in the absence of overall change in total LDL (38) . Glycaemic and lipaemic outcomes do not appear to be influenced by meal timing on modified fast days (38) , or by dietary composition on feed days, although in this particular study vascular function worsened slightly when a high-fat (45 % total energy) diet was consumed (35) .…”

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: 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%

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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Effectiveness of Early Time-Restricted Eating for Weight Loss, Fat Loss, and Cardiometabolic Health in Adults With Obesity

et al. 2022

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IMPORTANCEIt is unclear how effective intermittent fasting is for losing weight and body fat, and the effects may depend on the timing of the eating window. This randomized trial compared time-restricted eating (TRE) with eating over a period of 12 or more hours while matching weight-loss counseling across groups.OBJECTIVE To determine whether practicing TRE by eating early in the day (eTRE) is more effective for weight loss, fat loss, and cardiometabolic health than eating over a period of 12 or more hours. DESIGN, SETTING, AND PARTICIPANTSThe study was a 14-week, parallel-arm, randomized clinical trial conducted between August 2018 and April 2020. Participants were adults aged 25 to 75 years with obesity and who received weight-loss treatment through the Weight Loss Medicine Clinic at the University of Alabama at Birmingham Hospital.INTERVENTIONS All participants received weight-loss treatment (energy restriction [ER]) and were randomized to eTRE plus ER (8-hour eating window from 7:00 to 15:00) or control eating (CON) plus ER (Ն12-hour window). MAIN OUTCOMES AND MEASURESThe co-primary outcomes were weight loss and fat loss. Secondary outcomes included blood pressure, heart rate, glucose levels, insulin levels, and plasma lipid levels.RESULTS Ninety participants were enrolled (mean [SD] body mass index, 39.6 [6.7]; age, 43 [11] years; 72 [80%] female). The eTRE+ER group adhered 6.0 (0.8) days per week. The eTRE+ER intervention was more effective for losing weight (−2.3 kg; 95% CI, −3.7 to −0.9 kg; P = .002) but did not affect body fat (−1.4 kg; 95% CI, −2.9 to 0.2 kg; P = .09) or the ratio of fat loss to weight loss (−4.2%; 95% CI, −14.9 to 6.5%; P = .43). The effects of eTRE+ER were equivalent to reducing calorie intake by an additional 214 kcal/d. The eTRE+ER intervention also improved diastolic blood pressure (−4 mm Hg; 95% CI, −8 to 0 mm Hg; P = .04) and mood disturbances, including fatigue-inertia, vigor-activity, and depression-dejection. All other cardiometabolic risk factors, food intake, physical activity, and sleep outcomes were similar between groups. In a secondary analysis of 59 completers, eTRE+ER was also more effective for losing body fat and trunk fat than CON+ER. CONCLUSIONS AND RELEVANCEIn this randomized clinical trial, eTRE was more effective for losing weight and improving diastolic blood pressure and mood than eating over a window of 12 or more hours at 14 weeks.TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03459703

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