Abstract
The current obesity epidemic is staggering in terms of its magnitude and public health impact. Current guidelines recommend continuous energy restriction (CER) along with a comprehensive lifestyle intervention as the cornerstone of obesity treatment, yet this approach produces modest weight loss on average. Recently, there has been increased interest in identifying alternative dietary weight loss strategies that involve restricting energy intake to certain periods of the day or prolonging the fasting interval between meals (i.e., intermittent energy restriction, IER). These strategies include intermittent fasting (IMF; >60% energy restriction on 2–3 days per week, or on alternate days) and time-restricted feeding (TRF; limiting the daily period of food intake to 8–10 h or less on most days of the week). Here, we summarize the current evidence for IER regimens as treatments for overweight and obesity. Specifically, we review randomized trials of ≥8 weeks in duration performed in adults with overweight or obesity (BMI ≥ 25 kg/m2) in which an IER paradigm (IMF or TRF) was compared to CER, with the primary outcome being weight loss. Overall, the available evidence suggests that IER paradigms produce equivalent weight loss when compared to CER, with 9 out of 11 studies reviewed showing no differences between groups in weight or body fat loss.
Highlights
The current obesity epidemic in developed countries is staggering in terms of its magnitude and public health impact
We present a narrative review of randomized trials of ≥8 weeks in duration performed in adults with overweight or obesity (BMI ≥ 25 kg/m2 ) in which an Intermittent Energy Restriction (IER) paradigm (IMF or time-restricted feeding (TRF)) was compared to continuous energy restriction (CER) and the primary outcome was weight loss
Small reductions in total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, triglycerides, and fasting glucose and insulin with intermittent fasting (IMF) have been reported in several studies [25,40–42,44,47–50,62], but these changes are generally similar in magnitude to those observed with CER
Summary
The current obesity epidemic in developed countries is staggering in terms of its magnitude and public health impact. Despite different body weights and levels of intake, fasting glucose and insulin concentrations were improved to a similar extent in the ADF and CER groups, an effect that was not observed in the pair-fed or ad libitum-fed mice This is in contrast to a study conducted by Mager et al [33] that reported unchanged glucose concentrations in Sprague-Dawley rats following a period of ADF, and reduced glucose concentrations in a group of rats following a 40% CER regimen. Panda et al [20–22] have investigated a diet paradigm where rodents fed an HFD ad libitum are compared to rodents allowed to consume the same number of calories within a restricted time interval of 8–10 h aligned to the active period In these studies, TRF mice are protected from diet-induced obesity and have increased energy expenditure and fat oxidation. These data were interpreted to suggest that complex carbohydrates are less absorbed in TRF mice compared to high-fat fed mice
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