Severely restricting energy intake for 24 h does not affect markers of bone metabolism at rest or in response to re-feeding

David J Clayton,Iain Templeman,Ian Varley,Craig Sale,James A Betts,Lewis J James

doi:10.1007/s00394-020-02186-4

David J Clayton, Iain Templeman + Show 4 more

Open Access

https://doi.org/10.1007/s00394-020-02186-4

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Abstract

PurposeIntermittent energy restriction commonly refers to ad libitum energy intake punctuated with 24 h periods of severe energy restriction. This can improve markers of metabolic health but the effects on bone metabolism are unknown. This study assessed how 24 h severe energy restriction and subsequent refeeding affected markers of bone turnover.MethodsIn a randomised order, 16 lean men and women completed 2, 48 h trials over 3 days. On day 1, participants consumed a 24 h diet providing 100% [EB: 9.27 (1.43) MJ] or 25% [ER: 2.33 (0.34) MJ] of estimated energy requirements. On day 2, participants consumed a standardised breakfast (08:00), followed by an ad libitum lunch (12:00) and dinner (19:30). Participants then fasted overnight, returning on day 3. Plasma concentrations of C-terminal telopeptide of type I collagen (CTX), procollagen type 1 N-terminal propeptide (P1NP) and parathyroid hormone (PTH) were assessed as indices of bone metabolism after an overnight fast on days 1–3, and for 4 h after breakfast on day 2.ResultsThere were no differences between trials in fasting concentrations of CTX, P1NP or PTH on days 1–3 (P > 0.512). During both trials, consuming breakfast reduced CTX between 1 and 4 h (P < 0.001) and PTH between 1 and 2 h (P < 0.05), but did not affect P1NP (P = 0.773) Postprandial responses for CTX (P = 0.157), P1NP (P = 0.148) and PTH (P = 0.575) were not different between trials. Ad libitum energy intake on day 2 was greater on ER [12.62 (2.46) MJ] than EB [11.91 (2.49) MJ].ConclusionsTwenty-four hour severe energy restriction does not affect markers of bone metabolism.

Highlights

Net energy balance over time will dictate changes in body mass, with a chronic positive energy balance increasing both tissue mass and the risk of several chronic diseases [1]
The present study shows that an acute episode of severe energy restriction has no effect on markers of bone metabolism in the fasted state, or for 4 h after consuming a highcarbohydrate breakfast
This study assessed the effect of an acute 24 h period of severe energy restriction on markers of bone formation and resorption in fasted and postprandial states, finding that a diet providing ~ 10 kcal kg Lean body mass (LBM)−1 had no immediate effects on markers of bone metabolism

Summary

Introduction

Net energy balance over time will dictate changes in body mass, with a chronic positive energy balance increasing both tissue mass and the risk of several chronic diseases [1]. Early to middle adulthood (18–49 years of age), with modest yearly weight increments eventually leading to a substantial excess of adipose tissue and increased risk of obesity-related chronic diseases [2]. This indicates strategies to help facilitate attaining and/or sustaining a healthy proportion of body fat are required. Imposing a daily limit on energy intake, such as reducing habitual energy intake by 20–50%, is a commonly used method of achieving a healthy weight [3]. Intermittent energy restriction can achieve similar weight loss and reduction in risk markers of obesity-related diseases compared to continuous energy restriction [7], suggesting

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