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Fitzgerald KC, Vizthum D, Henry-Barron B, Schweitzer A, Cassard SD, Kossoff E, Hartman AL, Kapogiannis D, Sullivan P, Baer DJ, Mattson MP, Appel LJ, Mowry EM. Effect of intermittent vs. daily calorie restriction on changes in weight and patient-reported outcomes in people with multiple sclerosis. Mult Scler Relat Disord 2018; 23:33-39. [PMID: 29753994 DOI: 10.1016/j.msard.2018.05.002] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 11/20/2022]
Abstract
An intermittent fasting or calorie restriction diet has favorable effects in the mouse forms of multiple sclerosis (MS) and may provide additional anti-inflammatory and neuroprotective advantages beyond benefits obtained from weight loss alone. We conducted a pilot randomized controlled feeding study in 36 people with MS to assess safety and feasibility of different types of calorie restriction (CR) diets and assess their effects on weight and patient reported outcomes in people with MS. Patients were randomized to receive 1 of 3 diets for 8 weeks: daily CR diet (22% daily reduction in energy needs), intermittent CR diet (75% reduction in energy needs, 2 days/week; 0% reduction, 5 days/week), or a weight-stable diet (0% reduction in energy needs, 7 days/week). Of the 36 patients enrolled, 31 (86%) completed the trial; no significant adverse events occurred. Participants randomized to CR diets lost a median 3.4 kg (interquartile range [IQR]: -2.4, -4.0). Changes in weight did not differ significantly by type of CR diet, although participants randomized to daily CR tended to have greater weight loss (daily CR: -3.6 kg [IQR: -3.0, -4.1] vs. intermittent CR: -3.0 kg [IQR: -1.95, -4.1]; P = 0.15). Adherence to study diets differed significantly between intermittent CR vs. daily CR, with lesser adherence observed for intermittent CR (P = 0.002). Randomization to either CR diet was associated with significant improvements in emotional well-being/depression scores relative to control, with an average 8-week increase of 1.69 points (95% CI: 0.72, 2.66). CR diets are a safe/feasible way to achieve weight loss in people with MS and may be associated with improved emotional health.
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Affiliation(s)
- Kathryn C Fitzgerald
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States.
| | - Diane Vizthum
- Research Nutrition, Institute for Clinical and Translational Research, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Bobbie Henry-Barron
- Research Nutrition, Institute for Clinical and Translational Research, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Amy Schweitzer
- Research Nutrition, Institute for Clinical and Translational Research, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Sandra D Cassard
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Eric Kossoff
- Departments of Neurology and Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Adam L Hartman
- Departments of Neurology and Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Dimitrios Kapogiannis
- Department of Cellular and Molecular Neuroscience, National Institute on Aging, Baltimore, MD, United States
| | - Patrick Sullivan
- Beltsville Human Nutrition Research Center, United States Department of Agriculture, Beltsville, MD, United States
| | - David J Baer
- Beltsville Human Nutrition Research Center, United States Department of Agriculture, Beltsville, MD, United States
| | - Mark P Mattson
- Department of Cellular and Molecular Neuroscience, National Institute on Aging, Baltimore, MD, United States
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Ellen M Mowry
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States
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Santos HO, Macedo RC. Impact of intermittent fasting on the lipid profile: Assessment associated with diet and weight loss. Clin Nutr ESPEN 2018; 24:14-21. [DOI: 10.1016/j.clnesp.2018.01.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 01/08/2018] [Indexed: 01/08/2023]
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354
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Intermittent Fasting with or without Exercise Prevents Weight Gain and Improves Lipids in Diet-Induced Obese Mice. Nutrients 2018. [PMID: 29534545 PMCID: PMC5872764 DOI: 10.3390/nu10030346] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Intermittent fasting (IF) and high intensity interval training (HIIT) are effective lifestyle interventions for improving body composition and overall health. However, the long-term effects of IF and potential synergistic effects of combining IF with exercise are unclear. The purpose of the study was to investigate the long-term effects of IF, with or without HIIT, on body composition and markers of metabolic health in diet-induced obese mice. In a randosmised, controlled design, 8-week-old C57BL/6 mice (males (n = 39) and females (n = 49)) were fed a high fat (HF) and sugar (S) water diet (30% (w/v)) for 24-weeks but were separated into five groups at 12-weeks: (1) 'obese' baseline control (OBC); (2) no intervention (CON); (3) intermittent fasting (IF); (4) high intensity intermittent exercise (HIIT) and (5) combination of dietary and exercise intervention (IF + HIIT). Body composition, strength and blood variables were measured at 0, 10 and/or 12-weeks. Intermittent fasting with or without HIIT resulted in significantly less weight gain, fat mass accumulation and reduced serum low density lipoproteins (LDL) levels compared to HIIT and CON male mice (p < 0.05). The results suggest that IF, with or without HIIT, can be an effective strategy for weight gain prevention despite concurrently consuming a high fat and sugar diet.
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355
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Nicoll R, Henein MY. Caloric Restriction and Its Effect on Blood Pressure, Heart Rate Variability and Arterial Stiffness and Dilatation: A Review of the Evidence. Int J Mol Sci 2018; 19:E751. [PMID: 29518898 PMCID: PMC5877612 DOI: 10.3390/ijms19030751] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 02/27/2018] [Accepted: 03/02/2018] [Indexed: 02/07/2023] Open
Abstract
Essential hypertension, fast heart rate, low heart rate variability, sympathetic nervous system dominance over parasympathetic, arterial stiffness, endothelial dysfunction and poor flow-mediated arterial dilatation are all associated with cardiovascular mortality and morbidity. This review of randomised controlled trials and other studies demonstrates that caloric restriction (CR) is capable of significantly improving all these parameters, normalising blood pressure (BP) and allowing patients to discontinue antihypertensive medication, while never becoming hypotensive. CR appears to be effective regardless of age, gender, ethnicity, weight, body mass index (BMI) or a diagnosis of metabolic syndrome or type 2 diabetes, but the greatest benefit is usually observed in the sickest subjects and BP may continue to improve during the refeeding period. Exercise enhances the effects of CR only in hypertensive subjects. There is as yet no consensus on the mechanism of effect of CR and it may be multifactorial. Several studies have suggested that improvement in BP is related to improvement in insulin sensitivity, as well as increased nitric oxide production through improved endothelial function. In addition, CR is known to induce SIRT1, a nutrient sensor, which is linked to a number of beneficial effects in the body.
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Affiliation(s)
- Rachel Nicoll
- Department of Public Health and Clinical Medicine and Heart Centre, Umea University, 901 87 Umea, Sweden.
| | - Michael Y Henein
- Department of Public Health and Clinical Medicine and Heart Centre, Umea University, 901 87 Umea, Sweden.
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356
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Intermittentv. continuous energy restriction: differential effects on postprandial glucose and lipid metabolism following matched weight loss in overweight/obese participants. Br J Nutr 2018; 119:507-516. [DOI: 10.1017/s0007114517003890] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe intermittent energy restriction (IER) approach to weight loss involves short periods of substantial (>70 %) energy restriction (ER) interspersed with normal eating. Studies to date comparing IER to continuous energy restriction (CER) have predominantly measured fasting indices of cardiometabolic risk. This study aimed to compare the effects of IER and CER on postprandial glucose and lipid metabolism following matched weight loss. In all, twenty-seven (thirteen male) overweight/obese participants (46 (sem3) years, 30·1 (sem1·0) kg/m2) who were randomised to either an IER intervention (2638 kJ for 2 d/week with an overall ER of 22 (sem0·3) %,n15) or a CER intervention (2510 kJ below requirements with overall ER of 23 (sem0·8) %) completed the study. Postprandial responses to a test meal (over 360 min) and changes in anthropometry (fat mass, fat-free mass, circumferences) were assessed at baseline and upon attainment of 5 % weight loss, following a 7-d period of weight stabilisation. The study found no statistically significant difference in the time to attain a 5 % weight loss between groups (median 59 d (interquartile range (IQR) 41–80) and 73 d (IQR 48–128), respectively,P=0·246), or in body composition (P≥0·437). For postprandial measures, neither diet significantly altered glycaemia (P=0·266), whereas insulinaemia was reduced comparatively (P=0·903). The reduction in C-peptide tended (P=0·057) to be greater following IER (309 128 (sem23 268) to 247781 (sem20 709) pmol×360 min/l)v. CER (297 204 (sem25 112) to 301 655 (sem32 714) pmol×360 min/l). The relative reduction in TAG responses was greater (P=0·045) following IER (106 (sem30) to 68 (sem15) mmol×360 min/l) compared with CER (117 (sem43) to 130 (sem31) mmol×360 min/l). In conclusion, these preliminary findings highlight underlying differences between IER and CER, including a superiority of IER in reducing postprandial lipaemia, which now warrant targeted mechanistic evaluation within larger study cohorts.
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357
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Kroeger CM, Trepanowski JF, Klempel MC, Barnosky A, Bhutani S, Gabel K, Varady KA. Eating behavior traits of successful weight losers during 12 months of alternate-day fasting: An exploratory analysis of a randomized controlled trial. Nutr Health 2018; 24:5-10. [PMID: 29353535 PMCID: PMC7183822 DOI: 10.1177/0260106017753487] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Alternate-day fasting (ADF) has gained popularity in recent years. The diet consists of a "fast day" where an individual consumes 0-25% of their energy needs, alternated with a "feast day" where a person is permitted to eat ad libitum. AIM This study examined eating behavior traits of successful weight losers during alternate day fasting. METHODS Obese participants ( n = 34) took part in 12 months of ADF and were grouped into a high (≥5%) or low-weight-loss (<5%) group post-treatment. RESULTS The high-weight-loss group demonstrated increased ( p = 0.04) fullness, decreased ( p = 0.03) hunger, increased dietary protein intake (15% to 20% of kcal, p = 0.04), and better adherence to fast-day calorie goals. CONCLUSIONS Thus, individuals who achieve clinically significant weight loss with ADF demonstrate improved satiety, increased protein intake, and better adherence to fast-day calorie goals.
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Affiliation(s)
- Cynthia M Kroeger
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, USA
- Nutrition Obesity Research Center, University of Alabama at Birmingham, USA
| | - John F Trepanowski
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, USA
| | - Monica C Klempel
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, USA
| | - Adrienne Barnosky
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, USA
| | - Surabhi Bhutani
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, USA
| | - Kelsey Gabel
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, USA
| | - Krista A Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, USA
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358
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Templeman I, Thompson D, Gonzalez J, Walhin JP, Reeves S, Rogers PJ, Brunstrom JM, Karagounis LG, Tsintzas K, Betts JA. Intermittent fasting, energy balance and associated health outcomes in adults: study protocol for a randomised controlled trial. Trials 2018; 19:86. [PMID: 29394908 PMCID: PMC5797418 DOI: 10.1186/s13063-018-2451-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/04/2018] [Indexed: 12/03/2022] Open
Abstract
Background Prior studies have shown that intermittent fasting is capable of producing improvements in body weight and fasted health markers. However, the extent to which intermittent fasting incurs compensatory changes in the components of energy balance and its impact on postprandial metabolism are yet to be ascertained. Methods A total of 30–36 lean participants and 30–36 overweight/obese participants will be recruited to provide two separate study groups who will undergo the same protocol. Following an initial assessment of basic anthropometry and key health markers, measurements of habitual energy intake (weighed food and fluid intake) and physical activity energy expenditure (combined heart rate and accelerometry) will be obtained over 4 weeks under conditions of energy balance. Participants will then be randomly allocated to one of three experimental conditions for 20 days, namely (1) daily calorie restriction (reduce habitual daily energy intake by 25%), (2) intermittent fasting with calorie restriction (alternate between 24-hour periods of fasting and feeding to 150% of habitual daily energy intake), (3) intermittent fasting without calorie restriction (alternate between 24-hour periods of fasting and feeding to 200% of habitual daily energy intake). In addition to continued monitoring of energy intake and physical activity during the intervention, participants will report for laboratory-based assessments of various metabolic parameters both before and after the intervention. Specifically, fasting and postprandial measurements of resting metabolic rate, substrate oxidation, appetite, food preference, and plasma concentrations of key metabolites and hormones will be made, in addition to subcutaneous abdominal adipose tissue biopsies in the fasted state and an assessment of body composition via dual-energy x-ray absorptiometry. Discussion Comparing observed changes in these measures across the three intervention arms in each group will establish the impact of intermittent fasting on postprandial metabolism and the components of energy balance in both lean and overweight/obese populations. Furthermore, this will be benchmarked against current nutritional interventions for weight management and the relative contributions of negative energy balance and fasting-dependent mechanisms in inducing any observed effects will be elucidated. Trial registration Trial retrospectively registered at clinicaltrials.gov under reference number NCT02498002 (version: IMF-02, date: July 6, 2015). Electronic supplementary material The online version of this article (10.1186/s13063-018-2451-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Iain Templeman
- Department for Health, University of Bath, Bath, BA2 7AY, UK.
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Javier Gonzalez
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | | | - Sue Reeves
- Department of Life Sciences, University of Roehampton, London, SW15 4JD, UK
| | - Peter J Rogers
- School of Experimental Psychology, University of Bristol, Bristol, BS8 1TU, UK
| | - Jeffrey M Brunstrom
- School of Experimental Psychology, University of Bristol, Bristol, BS8 1TU, UK
| | - Leonidas G Karagounis
- Faculty of Sport and Health Sciences, University of St Mark and St John, Plymouth, PL6 8BH, UK
| | - Kostas Tsintzas
- School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - James A Betts
- Department for Health, University of Bath, Bath, BA2 7AY, UK
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359
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Anton SD, Moehl K, Donahoo WT, Marosi K, Lee S, Mainous AG, Leeuwenburgh C, Mattson MP. Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting. Obesity (Silver Spring) 2018; 26:254-268. [PMID: 29086496 PMCID: PMC5783752 DOI: 10.1002/oby.22065] [Citation(s) in RCA: 340] [Impact Index Per Article: 56.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/14/2017] [Accepted: 09/26/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Intermittent fasting (IF) is a term used to describe a variety of eating patterns in which no or few calories are consumed for time periods that can range from 12 hours to several days, on a recurring basis. This review is focused on the physiological responses of major organ systems, including the musculoskeletal system, to the onset of the metabolic switch: the point of negative energy balance at which liver glycogen stores are depleted and fatty acids are mobilized (typically beyond 12 hours after cessation of food intake). RESULTS AND CONCLUSIONS Emerging findings suggest that the metabolic switch from glucose to fatty acid-derived ketones represents an evolutionarily conserved trigger point that shifts metabolism from lipid/cholesterol synthesis and fat storage to mobilization of fat through fatty acid oxidation and fatty acid-derived ketones, which serve to preserve muscle mass and function. Thus, IF regimens that induce the metabolic switch have the potential to improve body composition in overweight individuals. Moreover, IF regimens also induce the coordinated activation of signaling pathways that optimize physiological function, enhance performance, and slow aging and disease processes. Future randomized controlled IF trials should use biomarkers of the metabolic switch (e.g., plasma ketone levels) as a measure of compliance and of the magnitude of negative energy balance during the fasting period.
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Affiliation(s)
- Stephen D. Anton
- Department of Aging and Geriatric Research, Institute on Aging, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL 32610
| | - Keelin Moehl
- Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21224
| | - William T. Donahoo
- Division of Endocrinology, Diabetes and Metabolism, University of Florida College of Medicine, Gainesville, FL 32610
| | - Krisztina Marosi
- Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21224
| | - Stephanie Lee
- Department of Aging and Geriatric Research, Institute on Aging, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL 32610
| | - Arch G. Mainous
- Department of Health Services Research, Management and Policy; Department of Community Health and Family Medicine, University of Florida, Gainesville, FL 32610
| | - Christiaan Leeuwenburgh
- Department of Aging and Geriatric Research, Institute on Aging, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL 32610
| | - Mark P. Mattson
- Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21224
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205
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360
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Botchlett R, Wu C. Diet Composition for the Management of Obesity and Obesity-related Disorders. JOURNAL OF DIABETES MELLITUS AND METABOLIC SYNDROME 2018; 3:10-25. [PMID: 30972384 PMCID: PMC6452864 DOI: 10.28967/jdmms.2018.01.18002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Healthy nutrition is essential for prevention of disease and for maintenance or promotion of health; although healthy nutrition remains to be precisely defined. Over the past several decades, various types of nutrients have been functionally validated and considered as critical components of healthy nutrition, which commonly include fiber-enriched carbohydrates, mono- or poly-unsaturated fatty acids, essential amino acids, and certain micronutrients. When managing obesity and obesity-associated metabolic diseases, much attention has been paid to the content of nutrients that is considered as healthy nutrition. Accumulating evidence also suggests that nutrient composition could be more important than the content of individual nutrients in the context of reducing body weight and obesity-associated risk for metabolic diseases. Consistently, it would be more important to focus on diet with differences in nutrient ratios rather than individual type(s) of nutrients in terms of managing obesity and metabolic diseases. In this review, recent advances in dietary management of obesity and obesity-related metabolic diseases have been discussed. This review also has highlighted several specific diet compositions and their differences in managing hypertension, type 2 diabetes, and non-alcoholic fatty liver disease.
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Affiliation(s)
- Rachel Botchlett
- Pinnacle Clinical Research, Live Oak, TX, 78233, USA
- For Correspondence Rachel Botchlett, Pinnacle Clinical Research, Live Oak, TX, 78233, USA, , Fax: 210 572 5766
| | - Chaodong Wu
- Department of Nutrition and Food Science, Texas A&M University, College Station, TX, 77843, USA
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361
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Tinsley GM, Horne BD. Intermittent fasting and cardiovascular disease: current evidence and unresolved questions. Future Cardiol 2018; 14:47-54. [DOI: 10.2217/fca-2017-0038] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Intermittent fasting has produced a variety of beneficial health effects in animal models, although high-quality research in humans has been limited. This special report examines current evidences for intermittent fasting in humans, discusses issues that require further examination, and recommends new research that can improve the knowledge base in this emerging research area. While potentially useful for health improvement, intermittent fasting requires further study prior to widespread implementation for health purposes. Randomized, longer-term studies are needed to determine whether using intermittent fasting as a lifestyle rather than a diet is feasible and beneficial for the health of some members of the human population.
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Affiliation(s)
- Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA
| | - Benjamin D Horne
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT 84107, USA
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362
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Affiliation(s)
- Leonie K Heilbronn
- Adelaide Medical School, The University of Adelaide And Nutrition and Metabolism Theme, SAHMRI
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363
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Barnosky A, Kroeger CM, Trepanowski JF, Klempel MC, Bhutani S, Hoddy KK, Gabel K, Shapses SA, Varady KA. Effect of alternate day fasting on markers of bone metabolism: An exploratory analysis of a 6-month randomized controlled trial. NUTRITION AND HEALTHY AGING 2017; 4:255-263. [PMID: 29276795 PMCID: PMC5734119 DOI: 10.3233/nha-170031] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Alternate day fasting (ADF) is a novel diet therapy that reduces body weight, but its effect on bone health remains unknown. OBJECTIVE This study examined the impact of ADF versus traditional daily calorie restriction (CR) on markers of bone metabolism in a 6-month randomized controlled trial. METHODS Overweight and obese subjects (n = 100) were randomized to 1 of 3 groups for 6 months: 1) ADF (25% energy intake fast day, alternated with 125% intake feast day; 2) CR (75% intake every day); or 3) control (usual intake every day). RESULTS Body weight decreased similarly (P < 0.001) by ADF (-7.8±1.2%) and CR (-8.8±1.5%), relative to controls by month 6. Lean mass, total body bone mineral content and total body bone mineral density remained unchanged in all groups. Circulating osteocalcin, bone alkaline phosphatase, and C-terminal telopeptide type I collagen (CTX) did not change in any group. IGF-1 increased (P < 0.01) in the CR group, with no change in the ADF or control group. When the data were sub-analyzed according to menopausal status, there were no differences between premenopausal or postmenopausal women for any marker of bone metabolism. CONCLUSION These findings suggest that 6 months of ADF does not have any deleterious impact on markers of bone metabolism in obese adults with moderate weight loss.
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Affiliation(s)
- Adrienne Barnosky
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
- Endocrinology, Diabetes and Metabolism, Wheaton Franciscan Healthcare, Ascension, Wauwatosa, WI, USA
| | - Cynthia M. Kroeger
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - John F. Trepanowski
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
- Stanford Prevention Research Center, Stanford University, Stanford, CA, USA
| | - Monica C. Klempel
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Surabhi Bhutani
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Kristin K. Hoddy
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Kelsey Gabel
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Sue A. Shapses
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Krista A. Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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364
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Trepanowski JF, Kroeger CM, Barnosky A, Klempel M, Bhutani S, Hoddy KK, Rood J, Ravussin E, Varady KA. Effects of alternate-day fasting or daily calorie restriction on body composition, fat distribution, and circulating adipokines: Secondary analysis of a randomized controlled trial. Clin Nutr 2017; 37:1871-1878. [PMID: 29258678 DOI: 10.1016/j.clnu.2017.11.018] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/16/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND & AIMS Indirect comparisons suggest that alternate-day fasting (ADF) may produce greater improvements in body composition, fat distribution, and/or the adipokine profile compared to daily calorie restriction (CR), but this has not been tested directly. In a pre-planned secondary analysis of a randomized controlled trial, we compared changes in the VAT:SAT ratio, FFM:total mass ratio, and the adipokine profile between ADF and CR. METHODS Overweight and obese participants (n = 100) were randomized to 1) ADF (alternating every 24-h between consuming 25% or 125% of energy needs); 2) CR (consuming 75% of needs every day); or 3) control (consuming 100% of needs every day) for 24 wk. RESULTS The VAT:SAT ratio did not change in any group. The FFM:total mass ratio increased in both ADF (0.03 ± 0.00) and CR (0.03 ± 0.01) compared to the control group (P < 0.01), with no differences between the intervention groups. Circulating leptin decreased in both the ADF group (-18 ± 6%) and CR group (-31 ± 10%) relative to the control group (P < 0.05), with no differences between the intervention groups. Circulating levels of adiponectin, resistin, IL-6, and TNF-α did not change in either intervention group relative to the control group. CONCLUSION ADF and CR similarly improve the FFM:total mass ratio and reduce leptin after a 24-wk intervention. TRIAL REGISTRATION Clinicaltrials.gov, number NCT00960505.
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Affiliation(s)
- John F Trepanowski
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA; Stanford Prevention Research Center, Stanford University, Stanford, CA, USA.
| | - Cynthia M Kroeger
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA; Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Adrienne Barnosky
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Monica Klempel
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Surabhi Bhutani
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Kristin K Hoddy
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Jennifer Rood
- Nutrition and Obesity Division, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Eric Ravussin
- Nutrition and Obesity Division, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Krista A Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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Byrne NM, Sainsbury A, King NA, Hills AP, Wood RE. Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study. Int J Obes (Lond) 2017; 42:129-138. [PMID: 28925405 PMCID: PMC5803575 DOI: 10.1038/ijo.2017.206] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/02/2017] [Accepted: 08/06/2017] [Indexed: 11/09/2022]
Abstract
Background/Objectives: The MATADOR (Minimising Adaptive Thermogenesis And Deactivating Obesity Rebound) study examined whether intermittent energy restriction (ER) improved weight loss efficiency compared with continuous ER and, if so, whether intermittent ER attenuated compensatory responses associated with ER. Subjects/Methods: Fifty-one men with obesity were randomised to 16 weeks of either: (1) continuous (CON), or (2) intermittent (INT) ER completed as 8 × 2-week blocks of ER alternating with 7 × 2-week blocks of energy balance (30 weeks total). Forty-seven participants completed a 4-week baseline phase and commenced the intervention (CON: N=23, 39.4±6.8 years, 111.1±9.1 kg, 34.3±3.0 kg m−2; INT: N=24, 39.8±9.5 years, 110.2±13.8 kg, 34.1±4.0 kg m−2). During ER, energy intake was equivalent to 67% of weight maintenance requirements in both groups. Body weight, fat mass (FM), fat-free mass (FFM) and resting energy expenditure (REE) were measured throughout the study. Results: For the N=19 CON and N=17 INT who completed the intervention per protocol, weight loss was greater for INT (14.1±5.6 vs 9.1±2.9 kg; P<0.001). INT had greater FM loss (12.3±4.8 vs 8.0±4.2 kg; P<0.01), but FFM loss was similar (INT: 1.8±1.6 vs CON: 1.2±2.5 kg; P=0.4). Mean weight change during the 7 × 2-week INT energy balance blocks was minimal (0.0±0.3 kg). While reduction in absolute REE did not differ between groups (INT: -502±481 vs CON: −624±557 kJ d−1; P=0.5), after adjusting for changes in body composition, it was significantly lower in INT (INT: −360±502 vs CON: −749±498 kJ d−1; P<0.05). Conclusions: Greater weight and fat loss was achieved with intermittent ER. Interrupting ER with energy balance ‘rest periods’ may reduce compensatory metabolic responses and, in turn, improve weight loss efficiency.
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Affiliation(s)
- N M Byrne
- School of Health Sciences, Faculty of Health, University of Tasmania, Launceston, Tasmania, Australia.,Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
| | - A Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown New South Wales, Australia
| | - N A King
- Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
| | - A P Hills
- School of Health Sciences, Faculty of Health, University of Tasmania, Launceston, Tasmania, Australia.,Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
| | - R E Wood
- School of Health Sciences, Faculty of Health, University of Tasmania, Launceston, Tasmania, Australia.,Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
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Hoddy KK, Bhutani S, Phillips SA, Varady KA. Effects of different degrees of insulin resistance on endothelial function in obese adults undergoing alternate day fasting. ACTA ACUST UNITED AC 2016; 4:63-71. [PMID: 28035343 PMCID: PMC5166513 DOI: 10.3233/nha-1611] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND: Obesity can have deleterious effects on insulin sensitivity leading to endothelial dysfunction. Whether alternate day fasting (ADF) can ameliorate insulin sensitivity in a way that improves endothelial function remains unknown. OBJECTIVE: This study examined the impact of ADF on endothelium dependent flow mediated dilation (FMD) in obese subjects with different degrees of insulin resistance. METHODS: Obese non-diabetic adults (n = 54) participated in an 8-week ADF protocol (25% energy intake "fast day", alternated with ad libitum intake "feast day"). Subjects were divided into tertiles according to degree of insulin resistance based on HOMA-IR (Homeostatic model assessment-Insulin resistance): tertile 1 (0.8-2.4), tertile 2 (2.5-3.6), tertile 3 (3.7-12.4). RESULTS: Body weight decreased (P < 0.001) by 4% in each tertile. Fat mass, lean mass, and visceral fat mass also decreased (P < 0.001) similarly in each tertile. After 8 weeks of ADF, FMD and adiponectin differed (P < 0.05) between tertile 1 (3±0%; 26±23%) versus tertile 3 (-3±0%; -13±10%). Changes in leptin did not differ between tertiles (tertile 1: -23±7%; tertile 2: -20±7%; tertile 3: -9±7%). Fasting glucose did not change in any tertile. Fasting insulin and HOMA-IR differed (P < 0.05) between tertile 1 (10±11%; 11±11%) versus tertile 3 (-27±8%; -30±9%). Plasma lipids, blood pressure and heart rate did not change in any tertile. CONCLUSION: Our data suggest that ADF may be effective for decreasing insulin resistance in insulin resistant subjects, but these changes have no effect on endothelial function.
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Affiliation(s)
- Kristin K Hoddy
- Department of Kinesiology and Nutrition, University of Illinois at Chicago , Chicago, IL, USA
| | - Surabhi Bhutani
- Department of Kinesiology and Nutrition, University of Illinois at Chicago , Chicago, IL, USA
| | - Shane A Phillips
- Department of Physical Therapy, University of Illinois at Chicago , Chicago, IL, USA
| | - Krista A Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago , Chicago, IL, USA
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