Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults

• Published in: The American journal of clinical nutrition 2009-11, Vol.90 (5), p.1138-1143
• Main Authors: Varady, Krista A, Bhutani, Surabhi, Church, Emily C, Klempel, Monica C
• Format: Article
• Language: English
• Subjects: ad libitum feeding; Adult; Adults; Aged; Biological and medical sciences; cardiovascular diseases; Cholesterol - blood; Cholesterol, LDL - blood; Coronary Disease - prevention & control; Diet; diet therapy; disease incidence; disease prevalence; eating habits; Energy Intake; fasting; Fasting - physiology; Feeding. Feeding behavior; Female; Food; food intake; Fundamental and applied biological sciences. Psychology; Heart Rate; Humans; Hypertension - prevention & control; hypolipidemia; lifestyle; Male; mathematical models; Medical research; Middle Aged; Obesity; Obesity - rehabilitation; Overweight - rehabilitation; Patient Dropouts; risk factors; Systole; systolic blood pressure; Triglycerides - blood; vascular diseases; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight control; Weight Loss
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.2009.28380

BACKGROUND: The ability of modified alternate-day fasting (ADF; ie, consuming 25% of energy needs on the fast day and ad libitum food intake on the following day) to facilitate weight loss and lower vascular disease risk in obese individuals remains unknown. OBJECTIVE: This study examined the effects of ADF that is administered under controlled compared with self-implemented conditions on body weight and coronary artery disease (CAD) risk indicators in obese adults. DESIGN: Sixteen obese subjects (12 women, 4 men) completed a 10-wk trial, which consisted of 3 phases: 1) a 2-wk control phase, 2) a 4-wk weight loss/ADF controlled food intake phase, and 3) a 4-wk weight loss/ADF self-selected food intake phase. RESULTS: Dietary adherence remained high throughout the controlled food intake phase (days adherent: 86%) and the self-selected food intake phase (days adherent: 89%). The rate of weight loss remained constant during controlled food intake (0.67 ± 0.1 kg/wk) and self-selected food intake phases (0.68 ± 0.1 kg/wk). Body weight decreased (P < 0.001) by 5.6 ± 1.0 kg (5.8 ± 1.1%) after 8 wk of diet. Percentage body fat decreased (P < 0.01) from 45 ± 2% to 42 ± 2%. Total cholesterol, LDL cholesterol, and triacylglycerol concentrations decreased (P < 0.01) by 21 ± 4%, 25 ± 10%, and 32 ± 6%, respectively, after 8 wk of ADF, whereas HDL cholesterol remained unchanged. Systolic blood pressure decreased (P < 0.05) from 124 ± 5 to 116 ± 3 mm Hg. CONCLUSION: These findings suggest that ADF is a viable diet option to help obese individuals lose weight and decrease CAD risk. This trial was registered at clinicaltrials.gov as UIC-004-2009.