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Intermittent fasting, Paleolithic, or Mediterranean diets in the real world: exploratory secondary analyses of a weight-loss trial that included choice of diet and exercise

Jospe MR, Roy M, Brown RC, Haszard JJ, Meredith-Jones K, Fangupo LJ, Osborne H, Fleming EA, Taylor RW

The American journal of clinical nutrition · 49 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
Universidad u hospital
University of Otago
Organización sin fines de lucro
Karitane Fellowship

Según 2 financiadores declarados.

Publicación

Publicado
2019-12-12 · Am J Clin Nutr · vol. 111 · número 3 · págs. 503–514
Editorial
Elsevier BV
Citado
64 citas · más que el 95% de estudios similares · 4.4× el promedio de su campo
Impacto
Entre el 10 % más citado de su campo
Referencias
55 trabajos
Acceso
Lectura gratuita
Áreas de investigación
Dietary Effects on Health · Nutritional Studies and Diet · Diet and metabolism studies
Palabras clave
intermittent fasting, Paleolithic diet, Mediterranean diet, weight loss, dietary adherence, overweight adults, high-intensity interval training, physical activity, self-selected diet, self-monitoring, body composition, systolic blood pressure, HbA1c, free-living conditions, long-term efficacy, weight loss maintenance, self-efficacy
MeSH
humans, weight loss, exercise, exercise therapy, fasting, diet, mediterranean, blood pressure, adult, middle aged, australia, female, male, overweight, young adult, diet, paleolithic

9 autores

  • Michelle Rose Jospe🇳🇿University of Otago
  • Melyssa Roy🇳🇿University of Otago
  • Rachel Clare Brown🇳🇿University of Otago
  • Jillian Joy Haszard🇳🇿University of Otago
  • Kim Meredith-Jones🇳🇿University of Otago
  • Louise J. Fangupo🇳🇿University of Otago
  • Hamish Osborne🇳🇿University of Otago
  • Elizabeth Fleming🇳🇿University of Otago
  • Rachael Waring Taylor🇳🇿 · autor de correspondenciaUniversity of Otago

Resumen

El texto original del estudio, en el idioma en que se publicó.

Background

Intermittent fasting (IF) and Paleolithic (Paleo) diets produce weight loss in controlled trials, but minimal evidence exists regarding long-term efficacy under free-living conditions without intense dietetic support.

Objectives

This exploratory, observational analysis examined adherence, dietary intake, weight loss, and metabolic outcomes in overweight adults who could choose to follow Mediterranean, IF, or Paleo diets, and standard exercise or high-intensity interval training (HIIT) programs, as part of a 12-mo randomized controlled trial investigating how different monitoring strategies influenced weight loss (control, daily self-weighing, hunger training, diet/exercise app, brief support).

Methods

A total of 250 overweight [BMI (in kg/m2) ≥27] healthy adults attended an individualized dietary education session (30 min) relevant to their self-selected diet. Dietary intake (3-d weighed diet records), weight, body composition, blood pressure, physical activity (0, 6, and 12 mo), and blood indexes (0 and 12 mo) were assessed. Mean (95% CI) changes from baseline were estimated using regression models. No correction was made for multiple tests.

Results

Although 54.4% chose IF, 27.2% Mediterranean, and 18.4% Paleo diets originally, only 54% (IF), 57% (Mediterranean), and 35% (Paleo) participants were still following their chosen diet at 12 mo (self-reported). At 12 mo, weight loss was -4.0 kg (95% CI: -5.1, -2.8 kg) in IF, -2.8 kg (-4.4, -1.2 kg) in Mediterranean, and -1.8 kg (-4.0, 0.5 kg) in Paleo participants. Sensitivity analyses showed that, due to substantial dropout, these may be overestimated by ≤1.2 kg, whereas diet adherence increased mean weight loss by 1.1, 1.8, and 0.3 kg, respectively. Reduced systolic blood pressure was observed with IF (-4.9 mm Hg; -7.2, -2.6 mm Hg) and Mediterranean (-5.9 mm Hg; -9.0, -2.7 mm Hg) diets, and reduced glycated hemoglobin with the Mediterranean diet (-0.8 mmol/mol; -1.2, -0.4 mmol/mol). However, the between-group differences in most outcomes were not significant and these comparisons may be confounded due to the nonrandomized design.

Conclusions

Small differences in metabolic outcomes were apparent in participants following self-selected diets without intensive ongoing dietary support, even though dietary adherence declined rapidly. However, results should be interpreted with caution given the exploratory nature of analyses. This trial was registered with the Australian New Zealand Clinical Trials Registry as ACTRN12615000010594 at https://www.anzctr.org.au.

Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.

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