Abstract
Alternate day fasting (ADF) is effective for weight loss and cardio‐protection, but its effect on type 2 diabetes (T2D) risk remains unclear. Moreover, whether ADF produces greater reductions in T2D risk versus daily calorie restriction (CR) is also unknown. Accordingly, this study compared the effect ADF versus CR on T2D risk indicators. Obese subjects (n = 48) were randomized to: 1) ADF (75% restriction fast day alternated with ad libitum feed day), or 2) CR (25% restriction everyday), for a 6‐month weight loss period followed by a 6‐month weight maintenance period. Body weight, fat mass, and visceral fat mass decreased similarly (P < 0.01) in the ADF (7 ± 1 kg; 5 ± 1 kg; 0.4 ± 0.1 kg) and CR group (7 ± 1 kg; 5 ± 1 kg; 0.4 ± 0.1 kg) during the weight loss period, and remained stable during the weight maintenance period. Fat free mass did not change throughout the study. Glucose remained unchanged. Insulin decreased (P < 0.05) by ADF only (7 ± 4 uIU/ml) with weight loss, and was sustained with weight maintenance. HOMA‐IR remained unchanged in both groups. Resistin, an adipokine involved in insulin resistance, decreased (P < 0.05) by ADF (2 ± 2 ng/ml) and CR (4 ± 1 ng/ml) with weight loss, and was sustained with weight maintenance. Thus, ADF and CR produce mild but comparable reductions in T2D risk, which are sustained with weight maintenance.
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