Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Intermittent energy restriction and weight loss: a systematic review

Subjects

Abstract

Background/Objectives:

Intermittent energy restriction (IER) is an eating pattern of regular daily periods of restricted energy intake followed by periods of unrestricted energy intake. This is gaining prominence as an alternative weight-loss strategy to daily energy restriction (DER). The aim of this systematic review was to determine the effectiveness of IER on weight loss in overweight and obese adults and compare this with DER.

Subjects/Methods:

A systematic literature search was conducted using the CINAHL, Embase, Medline, PsycINFO, Cochrane and Scopus databases. Eight studies that assigned overweight or obese adults to IER or to a DER ‘control’ were deemed eligible for inclusion.

Results:

All studies reported significant weight loss for IER groups. Average weight loss was approximately 0.2–0.8 kg per week. IER resulted in comparable weight loss to DER when overall energy restriction remained similar between diets. The majority of studies that reported body composition outcomes have shown equal efficacy for fat mass, fat-free mass and waist circumference.

Conclusions:

Weight loss was achieved in overweight and obese adults following IER and this loss was comparable to a DER diet. IER may be an effective alternative strategy for health practitioners to promote weight loss for selected overweight and obese people.

Your institute does not have access to this article

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Figure 1

References

  1. Stevens GA, Singh GM, Lu Y, Danaei G, Lin JK, Finucane MM et al. National, regional, and global trends in adult overweight and obesity prevalences. Popul Health Metr 2012; 10: 22.

    Article  Google Scholar 

  2. Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH . The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health 2009; 9: 88.

    Article  Google Scholar 

  3. National Health and Medical Research Council Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. National Health and Medical Research Council: Melbourne, Australia, 2013.

  4. National Health and Medical Research Council Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia - Systematic Review. National Health and Medical Research Council: Melbourne, Australia, 2013.

  5. Varady KA . Intermittent versus daily calorie restriction: Which diet regimen is more effective for weight loss? Obes Rev 2011; 12: e593–e601.

    CAS  Article  Google Scholar 

  6. Horne BD, Muhlestein JB, Anderson JL . Health effects of intermittent fasting: hormesis or harm? A systematic review. Am J Clin Nutr 2015; 102: 464–470.

    CAS  Article  Google Scholar 

  7. Trepanowski JF, Canale RE, Marshall KE, Kabir MM, Bloomer RJ . Impact of caloric and dietary restriction regimens on markers of health and longevity in humans and animals: a summary of available findings. Nutr J 2011; 10: 107.

    CAS  Article  Google Scholar 

  8. Barnosky AR, Hoddy KK, Unterman TG, Varady KA . Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: a review of human findings. Translational Res 2014; 164: 302–311.

    Article  Google Scholar 

  9. Antonio R, Johnston KL, Collins AL, Robertson MD . The effects of intermittent energy restriction on indices of cardiometabolic health. Res Endocrinol 2014.

  10. Harvie MN, Pegington M, Mattson MP, Frystyk J, Dillon B, Evans G et al. The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: a randomized trial in young overweight women. Int J Obes 2011; 35: 714–727.

    CAS  Article  Google Scholar 

  11. Ash S, Reeves MM, Yeo S, Morrison G, Carey D, Capra S . Effect of intensive dietetic interventions on weight and glycaemic control in overweight men with Type II diabetes: a randomised trial. Int J Obes 2003; 27: 797–802.

    CAS  Article  Google Scholar 

  12. Glover R, The Fast Diet author talks to Richard Glover. Available at http://www.abc.net.au/local/stories/2013/02/28/3700802.htm (accessed on 27 October 2013).

  13. Mosley M, Spencer M . The fast diet: the secret of intermittent fasting - lose weight, stay healthy, live longer. Short Books Ltd: London, UK, 2013.

    Google Scholar 

  14. Varady KA, Bhutani S, Church EC, Klempel MC . Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults. Am J Clin Nutr 2009; 90: 1138–1143.

    CAS  Article  Google Scholar 

  15. Johnson JB, Summer W, Cutler RG, Martin B, Hyun DH, Dixit VD et al. Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma. Free Radic Biol Med 2007; 42: 665–674.

    CAS  Article  Google Scholar 

  16. Moher D, Liberati A, Tetzlaff J, Altman DG . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 2010; 8: 336–341.

    Article  Google Scholar 

  17. World Health Organization Obesity: Preventing and Managing the Global Epidemic, Report of a WHO Expert Committee. World Health Organization: Geneva, Switzerland, 2000.

  18. National Health and Medical Research Council NHMRC additional levels of evidence and grades for recommendations for developers of guidelines. National Health and Medical Research Council: Melbourne, Australia, 2009.

  19. De Groot LCPGM, Van Es AJH, Van Raaij JMA, Vogt JE, Hautvast JGAJ . Adaptation of energy metabolism of overweight women to alternating and continuous low energy intake. Am J Clin Nutr 1989; 50: 1314–1323.

    CAS  Article  Google Scholar 

  20. Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Canada: Available at http://www.ephpp.ca/tools.html (accessed on 27 October 2013).

  21. Armijo-Olivo S, Stiles CR, Hagen NA, Biondo PD, Cummings GG . Assessment of study quality for systematic reviews: a comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment Tool: methodological research. J Eval Clin Pract 2012; 18: 12–18.

    Article  Google Scholar 

  22. Bhutani S, Klempel MC, Berger RA, Varady KA . Improvements in coronary heart disease risk indicators by alternate-day fasting involve adipose tissue modulations. Obesity 2010; 18: 2152–2159.

    Article  Google Scholar 

  23. Varady KA, Bhutani S, Klempel MC, Lamarche B . Improvements in LDL particle size and distribution by short-term alternate day modified fasting in obese adults. Br J Nutr 2011; 105: 580–583.

    CAS  Article  Google Scholar 

  24. Klempel MC, Bhutani S, Fitzgibbon M, Freels S, Varady KA . Dietary and physical activity adaptations to alternate day modified fasting: implications for optimal weight loss. Nutr J 2010; 9: 35.

    Article  Google Scholar 

  25. Eshghinia S, Mohammadzadeh F . The effects of modified alternate-day fasting diet on weight loss and CAD risk factors in overweight and obese women. J Diabetes Metab Disord 2013; 12: 4.

    Article  Google Scholar 

  26. Arguin H, Dionne IJ, Sénéchal M, Bouchard DR, Carpentier AC, Ardilouze JL et al. Short- and long-term effects of continuous versus intermittent restrictive diet approaches on body composition and the metabolic profile in overweight and obese postmenopausal women: a pilot study. Menopause 2012; 19: 870–876.

    Article  Google Scholar 

  27. Harvie M, Wright C, Pegington M, McMullan D, Mitchell E, Martin B et al. The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women. Br J Nutr 2013; 110: 1534–1547.

    CAS  Article  Google Scholar 

  28. Keogh JB, Pedersen E, Petersen KS, Clifton PM . Effects of intermittent compared to continuous energy restriction on short-term weight loss and long-term weight loss maintenance. Clin Obes 2014; 4: 150–156.

    CAS  Article  Google Scholar 

  29. Williams KV, Mullen ML, Kelley DE, Wing RR . The effect of short periods of caloric restriction on weight loss and glycemic control in type 2 diabetes. Diabetes Care 1998; 21: 2–8.

    CAS  Article  Google Scholar 

  30. Varady KA, Bhutani S, Klempel MC, Kroeger CM . Comparison of effects of diet versus exercise weight loss regimens on LDL and HDL particle size in obese adults. Lipids Health Dis 2011; 10: 119.

    Article  Google Scholar 

  31. Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care 2011; 34: 1481–1486.

    CAS  Article  Google Scholar 

  32. Lau DCW, Teoh H . Benefits of modest weight loss on the management of type 2 diabetes mellitus. Can J Diabetes 2013; 37: 128–134.

    Article  Google Scholar 

  33. Sparti A, DeLany JP, de la Bretonne JA, Sander GE, Bray GA . Relationship between resting metabolic rate and the composition of the fat-free mass. Metabolism 1997; 46: 1225–1230.

    CAS  Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to L Ryan.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Author contributions

Study conception and design: LR. Collection of data: CSD, REC, SNC, KNR, REW and CER. Analysis and interpretation of data: LR, CSD, REC, SNC, KNR, REW and CER. Paper preparation CSD, LR and CEH. Revision of manuscript CSD and LR. All authors have actively contributed, read and approved the final manuscript.

Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Davis, C., Clarke, R., Coulter, S. et al. Intermittent energy restriction and weight loss: a systematic review. Eur J Clin Nutr 70, 292–299 (2016). https://doi.org/10.1038/ejcn.2015.195

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2015.195

Further reading

Search

Quick links