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Clinical Research

Impact of intermittent vs. continuous energy restriction on weight and cardiometabolic factors: a 12-month follow-up

International Journal of Obesity volume 44, pages 1236–1242 (2020)Cite this article

Subjects

Abstract

Background and objective

Intermittent energy restriction continues to gain popularity as a weight loss strategy; however, data assessing it’s long-term viability is limited. The objective of this study was to follow up with participants 12 months after they had completed a 12-month dietary intervention trial involving continuous energy restriction and two forms of intermittent energy restriction; a week-on-week-off energy restriction and a 5:2 programme, assessing long-term changes on weight, body composition, blood lipids and glucose.

Subjects and methods

109 overweight and obese adults, aged 18–72 years, attended a 12-month follow-up after completing a 12-month dietary intervention involving three groups: continuous energy restriction (1000 kcal/day for women and 1200 kcal/day for men), week-on-week-off energy restriction (alternating between the same energy restriction as the continuous group for one week and one week of habitual diet), or 5:2 (500 kcal/day on modified fast days each week for women and 600 kcal/day for men). The primary outcome was weight change at 24 months from baseline, with secondary outcomes of change in body composition, blood lipids and glucose.

Results

For the 109 individuals who completed the 12-month follow-up (82 female, 15 male, mean BMI 33 kg/m2), weight decreased over time with no differences between week-on and week-off and continuous energy restriction or 5:2 and continuous energy restriction with −4.5 ± 4.9 kg for continuous energy restriction, −2.8 ± 6.5 kg for week-on, week-off and −3.5 ± 5.1 kg for 5:2. Total cholesterol reduced over time and glucose, HDL, LDL and triglycerides were unchanged.

Discussion and conclusion

Intermittent energy restriction was as successful in achieving modest weight loss over a 24-month period as continuous energy restriction.

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References

  1. Varady KA. Intermittent versus daily calorie restriction: which diet regimen is more effective for weight loss? Obes Rev. 2011;12:e593–601.

    CAS  PubMed  Google Scholar 

  2. Wing RR, Jeffery RW. Prescribed “breaks” as a means to disrupt weight control efforts. Obes Res. 2003;11:287–91.

    PubMed  Google Scholar 

  3. Harvie M, Pegington M. 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;35:714–27.

    CAS  Google Scholar 

  4. 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;110:1534–47.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Conley M, Le Fevre L, Haywood C, Proietto J. Is two days of intermittent energy restirction per week a feasible weight loss approach in obese males? A randomsied pilot study. Nutr Diet. 2017;75:65–72.

    Google Scholar 

  6. 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;4:150–6.

    CAS  PubMed  Google Scholar 

  7. Byrne NM, Sainsbury A, King NA, Hills AP, Wood RE. Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study. Int J Obes. 2017;42:129–38.

    PubMed  Google Scholar 

  8. Headland M, Clifton PM, Carter S, Keogh JB. Weight loss outcomes: a systematic review and meta-analysis of intermittent energy restriction trials lasting a minimum of 6 months. Nutrients. 2015;8:1–12.

    Google Scholar 

  9. Trepanowski JF, Kroeger CM, Barnosky AR, Klempel M, Bhutani S, Hoddy KK, et al. Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults a randomized clinical trial. JAMA Intern Med. 2017;177:930–8.

    PubMed  PubMed Central  Google Scholar 

  10. Sundfor T, Svendsen M, Tonstad S. Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: a randomized 1-year trial. Nutr Metab Cardio Dis. 2018;28:698–706.

    CAS  Google Scholar 

  11. Headland ML, Clifton PM, Keogh JB. Effect of intermittent compared to continuous energy restriction on weight loss and weight maintenance after 12 months in healthy overweight or obese adults. Int J Obes. 2019;43:2028–36.

    PubMed  Google Scholar 

  12. Noakes M, Keogh JB, Foster PR, Clifton PM. Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional high-carbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. Am J Clin Nutr. 2005;81:1298–306.

    CAS  PubMed  Google Scholar 

  13. Anastasiou CA, Karfopoulou E, Yannakoulia M. Weight regaining: from statistics and behaviours to physiology and metabolism. Metabolism. 2015;64:1395–407.

    CAS  PubMed  Google Scholar 

  14. Harvie M, Howell A. Potential benefits and harms of intermittent energy restriction and intermittent fasting amongst obese, overweight and normal weight subjects—a narrative review of human and animal evidence. Behav Sci. 2017;7:1–22.

    Google Scholar 

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

  16. Wadden T, Butryn ML, Byrne KJ. Efficacy of lifestyle modification for long-term weight control. Obes Res. 2012;12 S12:151S–62S.

    Google Scholar 

  17. Botoseneanu A, Liang J. Social stratification of body-weight trajectory in middle age and older americans: results from a 14-year longitudinal study. J Aging Health. 2011;23:454–80.

    PubMed  Google Scholar 

  18. Gomersall SR, Dobson AJ, Brown WJWeightGain. Overweight, and obesity: determinants and health outcomes from the Australian Longitudinal Study on women’s health. Curr Obes Rep. 2014;3:46–53.

    CAS  PubMed  Google Scholar 

  19. Anderson KM, Castelli WP, Levy D. Cholesterol and mortality 30 years of follow-up from the Framingham Study. JAMA. 1987;257:2176–80.

    CAS  PubMed  Google Scholar 

  20. Thomas JG, Bond DS, Phelan S, Hill JO, Wing RR. Weight-loss maintenance for 10 years in the National Weight Control Registry. Am J Prev Med. 2014;46:17–23.

    PubMed  Google Scholar 

  21. Keller KL, Kral TVE, Rolls BJ. Impacts of energy density and portion size on satiation and satiety. In: Blundell JE, Bellisle F, editors. Oxford, UK: Woodhead Publishing; 2013.

  22. Tremblay A, Bellisle F. Nutrients, satiety, and control of energy intake. Appl Physiol Nutr Metab. 2015;40:971–9.

    PubMed  Google Scholar 

  23. Chapelot D, Aubert R, Mamonier C, Chabert M, Louis-Sylvestre J. An endocrine and metabolic definition of the intermeal interval in humans: evidence for a role of leptin on the prandial pattern through fatty acid disposal. Am J Clin Nutr. 2000;72:421–31.

    CAS  PubMed  Google Scholar 

  24. Melanson K, Westerterp-Plantenga MS, Sarris WH, Smith FJ, Campfield LA. Blood glucose patterns and appetite in time-blinded humans: carbohydrate versus fat. Am J Physiol. 1999;277:R337–45.

    CAS  PubMed  Google Scholar 

  25. Cummings DE, Frayo RS, Marmonier C, Aubert R, Chapelot D. Plasma ghrelin levels and hunger scores in humans initiating meals voluntarily without time—and food-related cues. Am J Physiol Endocrinol Metab. 2004;287:E297–304.

    CAS  PubMed  Google Scholar 

  26. Blom WA, de Graaf C, Lluch A, Stafleu A, Schaafsma G, Hendriks HF. Postprandial ghrelin responses are associated with the intermeal interval in time-blinded normal weight men, but not in obese men. Physiol Behav. 2009;96:742–48.

    CAS  PubMed  Google Scholar 

  27. Callahan HS, Cummings DE, Pepe MS, Breen PA, Matthys CC, Weigle DS. Postprandial suppression of plasma ghrelin level is proportional to ingested caloric load but does not predict intermeal interval in humans. J Clin Endocrinol Metab. 2004;89:1319–24.

    CAS  PubMed  Google Scholar 

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Acknowledgements

We would like to thank Louise Massie for her assistance with study organisation and study participants, as well as the study participants for their willingness to participate in the trial. The authors’ responsibilities were as follows: PMC and JBK designed the research, MLH conducted the research and had primary responsibility for the final content of the manuscript, MLH and PMC analysed the data and all the authors revised the manuscript, and read and approved the final manuscript.

Funding

MLH was supported by a University of South Australia Postgraduate Award, funded jointly by the University of South Australia and the Research Training Program. The University of South Australia funded the study.

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Authors and Affiliations

  1. School of Pharmacy and Medical Sciences, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia

    Michelle Louise Headland, Peter Marshall Clifton & Jennifer Beatrice Keogh

  2. Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, SA, Australia

    Michelle Louise Headland, Peter Marshall Clifton & Jennifer Beatrice Keogh

  3. Sansom Institute for Health Research, Adelaide, SA, Australia

    Michelle Louise Headland, Peter Marshall Clifton & Jennifer Beatrice Keogh

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  1. Michelle Louise Headland
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Correspondence to Jennifer Beatrice Keogh.

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Headland, M.L., Clifton, P.M. & Keogh, J.B. Impact of intermittent vs. continuous energy restriction on weight and cardiometabolic factors: a 12-month follow-up. Int J Obes 44, 1236–1242 (2020). https://doi.org/10.1038/s41366-020-0525-7

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