Abstract
Background Calorie restriction (CR) with variable macronutrient distributions has yielded inconsistent effects on brachial artery flow mediated dilation (FMD) related to weight loss and adipocyte physiology. Alternate day fasting (ADF) is a modified form of CR that has already elicited favorable changes in body weight and adipokine levels in both high fat (ADF-HF) and low fat (ADF-LF) background diets. However, the degree to which adipokines mediate vascular biology mechanisms on an ADF regimen is still unclear. This study examined if beneficial changes in body weight and adipokines influences endothelial function in ADF-HF and ADF-LF diets. Methods Thirty-two obese subjects were randomized to an ADF-HF (45% fat) or ADF-LF diet (25% fat), which consisted of two phases: 1) a 2-week baseline weight maintenance period, and 2) an 8-week ADF weight loss period. All food was provided to subjects. Results Body weight was reduced (P < 0.0001) by ADF-HF (5 ± 1%) and by ADF-LF (4 ± 1%). Fat mass decreased (P < 0.0001) by ADF-HF (5 ± 1 kg) and ADF-LF (4 ± 1 kg). Fat free mass remained unchanged. Waist circumference decreased (P < 0.001) by ADF-HF (7 ± 1 cm) and ADF-LF (7 ± 1 cm). FMD decreased (P < 0.05) in ADF-HF (2 ± 2%) and increased (P < 0.05) in ADF-LF (2 ± 2%). Adiponectin increased (P < 0.05) in ADF-HF (43 ± 7%) and in ADF-LF (51 ± 7%). Leptin decreased (P < 0.05) in ADF-HF (32 ± 5%) and in ADF-LF (30 ± 3%). Resistin decreased (P < 0.05) in ADF-HF (23 ± 5%) and ADF-LF (27 ± 4%). Increases in adiponectin were associated with augmented FMD post-treatment in the ADF-LF group only (r = 0.34, P = 0.03). Leptin and resistin were not correlated with changes in FMD. Conclusion Thus, an ADF-LF diet produces more favorable increases in FMD which are correlated with increased adiponectin as compared to the ADF-HF diet. These findings are important in terms of developing future behavioral modifications in energy restriction and macronutrient distribution that will improve vascular health.
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