Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial
Trepanowski JF, Kroeger CM, Barnosky A, Klempel MC, Bhutani S, Hoddy KK, Gabel K, Freels S, Rigdon J, Rood J, Ravussin E, Varady KA
JAMA internal medicine · 479 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- National Institute of Diabetes and Digestive and Kidney Diseases
- Gobierno
- NIDDK NIH HHS
- Gobierno
- NHLBI NIH HHS
- Subvenciones
- National Institute of Diabetes and Digestive and Kidney Diseases (F32DK107157); National Heart, Lung, and Blood Institute (R01 HL106228); National Institute of Diabetes and Digestive and Kidney Diseases (P30 DK-072476)
Según 4 financiadores declarados.
Publicación
- Publicado
- 2017-05-01 · JAMA Intern Med · vol. 177 · número 7 · pág. 930
- Editorial
- American Medical Association
- Citado
- 648 citas · más que el 100% de estudios similares · 24.7× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 32 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Dietary Effects on Health · Diet and metabolism studies · Genetics, Aging, and Longevity in Model Organisms
- Palabras clave
- Medicine, Weight loss, Calorie restriction, Intermittent fasting, Body mass index, Randomized controlled trial, Weight change, Calorie, Obesity, Internal medicine, Very low calorie diet, Hazard ratio, Physical therapy, Gerontology, Confidence interval
- MeSH
- humans, cardiovascular diseases, obesity, weight loss, insulin, blood glucose, diet therapy, caloric restriction, fasting, risk factors, feeding behavior, patient compliance, adult, middle aged, female, male, outcome and process assessment, health care
12 autores
- John F. Trepanowski🇺🇸University of Illinois Chicago
- Cynthia M. Kroeger🇺🇸University of Alabama at Birmingham; University of Illinois Chicago
- Adrienne Barnosky🇺🇸University of Illinois Chicago
- Monica C Klempel🇺🇸University of Illinois Chicago
- Surabhi Bhutani🇺🇸University of Illinois Chicago
- Kristin K. Hoddy🇺🇸University of Illinois Chicago
- Kelsey Gabel🇺🇸University of Illinois Chicago
- Sally A. Freels🇺🇸University of Illinois Chicago
- Joseph Rigdon🇺🇸Stanford University
- Jennifer Carlton Rood🇺🇸Pennington Biomedical Research Center
- Éric Ravussin🇺🇸Pennington Biomedical Research Center
- Krista A Varady🇺🇸 · autor de correspondenciaUniversity of Illinois Chicago
Resumen
El texto original del estudio, en el idioma en que se publicó.
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 participants
A 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 measures
The 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.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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