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Dietary adherence, weight loss comparable between alternate day fasting, calorie restriction
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Patients with obesity demonstrated comparable dietary adherence and weight loss between alternate day fasting and daily calorie restriction, according to research presented at Obesity Week 2014.
“Adherence, as objectively measured by doubly-labeled water, is similar between alternate day fasting and calorie restriction,” John F. Trepanowski, a PhD candidate in the department of kinesiology and nutrition at the University of Illinois in Chicago, told Endocrine Today. “This translated into similar weight loss, total fat mass reduction and particularly similar visceral fat mass reduction. It did not translate, in our study, to improvements in blood lipids and blood pressure.”
John F. Trepanowski
Trepanowski, along with Krista A. Varady, PhD, associate professor in the department, and colleagues assessed adherence and changes to cardiovascular disease (CVD) biomarkers in a randomized controlled feeding trial involving 102 sedentary adults with overweight or obesity (BMI, 25.0-39.9); patients with history of CVD or diabetes were excluded.
Patients were assigned to one of three groups: alternate day fasting (ADF; 24-hour energy intake = 125% of needs, rotated with 24-hour energy intake = 25% of needs); calorie restriction (CR; energy intake = 75% of needs every day); or control (energy intake = 100% of needs every day).
Both intervention groups were prescribed the same average daily energy restriction (25%). Dietary adherence was defined as actual energy restriction; it was calculated based on change in energy expenditure, measured via doubly-labeled water, and changes in body composition.
The intervention groups similar showed similar actual energy restriction (ADF, 21 ± 4% vs. CR, 24 ± 4%; P=.89) that was greater compared with the control group (8 ± 5%, P<.03).
Similar results were seen for weight loss (ADF, -6.9 ± 0.8 kg vs. CR, -7.6 ± 1.0 kg; P=.79) and total fat mass reduction (ADF, -4.5 ± 0.6 kg vs. CR, -5.6 ± 0.7 kg; P=.33), both also greater compared with reductions seen in the control group (-0.7 ± 0.5 kg, P<.001 and -0.6 ± 0.3 kg, respectively; P<.001). No changes were observed among any of the groups for visceral fat mass, blood lipids or blood pressure (P>.05 for all comparisons).
“Clinicians can now tell their patients alternate day fasting and calorie restriction work equally well, so choose the diet you think works best for you,”
The study broadened research on ADF in patients with obesity already conducted at the lab — the longest over 12 weeks, Trepanowski said. Previous trials did not compare ADF to a positive control group, include a negative control group or objectively measure energy intake, he said.
“Previously we had relied on dietary records and food frequency questionnaires; we wanted a more objective measurement.”
Trepanowski said the ultimate goal of weight loss research is to come up with an alternative diet that is superior to the standard care method, which made this comparison much needed. The next stage in the research would be identifying whether ADF can help patients who have not been helped by CR.
“Right now, we don’t know that answer,” Trepanowski said. “The findings from my research offer some hope that there might be individuals identified who could do better with ADF, but that has not been formally tested.” — by Allegra Tiver
For More Information: Trepanowski JF. Abstract T-3108-OR. Presented at: Obesity Week; Nov 2-7, 2014; Boston.
Disclosures: Trepanowski reports no relevant disclosures.