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Bariatric Surgery

Network meta-analysis of three different forms of intermittent energy restrictions for overweight or obese adults

Abstract

This network meta-analysis aimed to compare the efficacy of three forms of intermittent energy restriction (IER), including alternate-day fasting (ADF), the 5:2 diet, and time-restricted feeding (TRF), in overweight or obese adults. A literature search was conducted in PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI) to find relevant randomized controlled trials (RCTs) until August 10, 2022. The modified Cochrane risk of bias assessment tool was applied to assess the methodological quality of eligible studies. Random network meta-analysis was conducted using STATA 14.0. Sixteen RCTs were included, with 1228 patients. Overall, the methodological quality ranged from low to moderate. ADF was superior to CER and 5:2 diet in reducing waist circumference, whereas 5:2 diet was superior to CER in reducing BMI. Regarding fat mass and drop-out, all forms of IER were comparable. Sensitivity analyses indicated that the type of individuals had no influence on the pooled results; nevertheless, ADF significantly reduced weight compared to CER and achieved significant waist circumference reduction compared to CER, 5:2 diet, and TRF. ADF may be preferentially prescribed for overweight or obese adults. More large-scale and high-quality studies are required, however, to investigate the effect of TRF on overweight and obesity.

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Fig. 1
Fig. 2: Network maps.
Fig. 3: Network meta-analysis.
Fig. 4: SUCRA plots.

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All data generated or analyzed during this study are included in this published article/as supplementary information files.

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Acknowledgements

We would like to deeply appreciate all authors who performed all eligible studies that have been included in the present network meta-analysis.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Conceptualization: YM; Methodology: YM and LS; Formal analysis and investigation: ZM and LS; Writing - original draft preparation: YM; Writing - review and editing: YM; Funding acquisition: All authors; Resources: All authors; Supervision: ZM.

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Correspondence to Yahui Ma.

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Ma, Y., Sun, L. & Mu, Z. Network meta-analysis of three different forms of intermittent energy restrictions for overweight or obese adults. Int J Obes 48, 55–64 (2024). https://doi.org/10.1038/s41366-023-01416-z

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