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Nutrition and Health (including climate and ecological aspects)

An exploratory investigation of the impact of ‘fast’ and ‘feed’ days during intermittent energy restriction on free-living energy balance behaviours and subjective states in women with overweight/obesity

European Journal of Clinical Nutrition volume 75, pages 430–437 (2021)Cite this article

Subjects

Abstract

Background/objectives

This controlled-feeding randomised controlled trial examined free-living appetite and physical activity (PA) on ‘fast’ and ‘feed’ days during intermittent energy restriction (IER), compared to continuous energy restriction (CER).

Subjects/methods

Forty-six women with overweight/obesity (age = 35 ± 10 years, BMI = 29.1 ± 2.3 kg/m2) were randomised to IER (n = 24; alternate fast days at 25% energy requirements and ad libitum feed days) or CER (n = 22; 75% energy requirements daily) to ≥5% weight loss (WL) or up to 12 weeks. Self-reported energy intake (EI; online food record), objectively measured PA (SenseWear Armband) and retrospective daily hunger and food cravings were measured over 7 days at baseline, week 2 and final week. Intent-to-treat analyses were performed using linear mixed models.

Results

Final WL (MΔ = 4.7 [95% confidence interval 4.2, 5.2] kg, 5.9%) did not differ between IER and CER (interaction P = 0.307). During IER, feed-day EI did not differ from baseline and was lower in the final week compared to week 2 (MΔ = 295 [81, 509] kcal, P = 0.004). Daily hunger was greater on fast compared to feed days (MΔ = 15 [10, 21] mm, P < 0.001), but food cravings did not differ. Light PA was lower on fast relative to feed days (MΔ = 18 [2, 34] min/day, P = 0.024), with no other differences in PA. Compared to CER, IER increased hunger and led to smaller improvements in craving control (both interactions P ≤ 0.034).

Conclusions

IER fast days were associated with increased free-living hunger and lower light PA compared to feed days, but had no impact on food cravings or self-reported ad libitum daily EI. IER may be less favourable than CER for the free-living day-to-day control of hunger and food cravings.

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Fig. 1: Flowchart of particiants screened, enrolled, allocated and included in the analysis.
Fig. 2: Free-living self-reported daily energy intake and hunger during intermittent energy restriction.
Fig. 3: Free-living daily food cravings, physical activity and activity energy expenditure during intermittent energy restriction.

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Acknowledgements

This work was funded by a Research Fellowship awarded to Kristine Beaulieu by the European Society for Clinical Nutrition and Metabolism (ESPEN). We are grateful for in-kind support from LighterLife UK Ltd. The funding sources had no involvement in the conduct of the research and preparation of the article.

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Authors and Affiliations

  1. School of Psychology, University of Leeds, Leeds, UK

    Kristine Beaulieu, Pauline Oustric, Graham Finlayson & Catherine Gibbons

  2. School of Food Science and Nutrition, University of Leeds, Leeds, UK

    Nuno Casanova & Mark Hopkins

  3. Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA

    Krista Varady

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  1. Kristine Beaulieu
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Correspondence to Kristine Beaulieu.

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KV is the author of the book “The Every Other Day Diet” published by the Hachette Book Group. The remaining authors declare that they have no conflicts of interest.

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Beaulieu, K., Casanova, N., Oustric, P. et al. An exploratory investigation of the impact of ‘fast’ and ‘feed’ days during intermittent energy restriction on free-living energy balance behaviours and subjective states in women with overweight/obesity. Eur J Clin Nutr 75, 430–437 (2021). https://doi.org/10.1038/s41430-020-00740-1

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