Article Synopsis
- A randomized trial compared the effects of a 4:3 intermittent fasting (IMF) approach versus daily caloric restriction (DCR) on weight loss over 12 months among overweight adults.
- Both groups received comprehensive behavioral support and increased physical activity, with the IMF group fasting 80% of their caloric intake on three nonconsecutive days, while the DCR group reduced daily intake by 34%.
- Results showed the IMF group experienced a greater average weight loss of 2.89 kg compared to the DCR group, although the findings may not be widely applicable to the general population.
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Article Abstract
Background: Long-term (≥12 months) randomized trials evaluating the efficacy of intermittent fasting (IMF) as a dietary weight loss strategy are limited. Furthermore, no studies have compared IMF versus daily caloric restriction (DCR) when both interventions are provided in the context of a guidelines-based behavioral weight loss program.
Objective: To compare the effects of 4:3 IMF versus DCR on changes in weight at 12 months, with comprehensive behavioral support provided to both groups.
Design: Randomized clinical trial. (ClinicalTrials.gov: NCT03411356).
Setting: Denver, Colorado, and surrounding metropolitan area.
Participants: Adults aged 18 to 60 years with body mass index (BMI) of 27 to 46 kg/m.
Intervention: The IMF group was instructed to restrict energy intake by 80% on 3 nonconsecutive days per week, with ad libitum intake (no restriction) the other 4 days (4:3 IMF). The DCR group was instructed to reduce daily energy intake by 34% to match the weekly energy deficit of 4:3 IMF. Both groups received a high-intensity comprehensive behavioral weight loss program that included group-based behavioral support and a recommendation to increase moderate-intensity physical activity to 300 minutes per week.
Measurements: The primary outcome was change in body weight (in kilograms) at 12 months.
Results: Of the 165 (4:3 IMF, = 84; DCR, = 81) randomly assigned participants (mean age, 42 years [SD, 9]; mean BMI, 34.1 kg/m [SD, 4.4]; 73.9% female), 125 completed the trial. In an intention-to-treat analysis, 4:3 IMF showed greater reductions in weight than DCR at 12 months (mean difference, 2.89 kg [95% CI, 5.65 to 0.14 kg]; = 0.040).
Limitation: Limited generalizability.
Conclusion: Compared with DCR, 4:3 IMF resulted in modestly greater weight loss among adults with overweight or obesity enrolled in a 12-month, high-intensity, comprehensive behavioral weight loss program.
Primary Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases.
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| http://dx.doi.org/10.7326/ANNALS-24-01631 | DOI Listing |