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Compensatory mechanisms activated with intermittent energy restriction: A randomized control trial.
Clin Nutr. 2018 06; 37(3):815-823.CN

Abstract

BACKGROUND & AIMS

Strong compensatory responses, with reduced resting metabolic rate (RMR), increased exercise efficiency (ExEff) and appetite, are activated when weight loss (WL) is achieved with continuous energy restriction (CER), which try to restore energy balance. Intermittent energy restriction (IER), where short spells of energy restriction are interspaced by periods of habitual energy intake, may offer some protection in minimizing those responses. We aimed to compare the effect of IER versus CER on body composition and the compensatory responses induced by WL.

METHODS

35 adults (age: 39 ± 9 y) with obesity (BMI: 36 ± 4 kg/m2) were randomized to lose a similar weight with an IER (N = 18) or a CER (N = 17) diet over a 12 week period. Macronutrient composition and overall energy restriction (33% reduction) were similar between groups. Body weight/composition, RMR, fasting respiratory quotient (RQ), ExEff (10, 25, and 50 W), subjective appetite ratings (hunger, fullness, desire to eat, and prospective food consumption (PFC)), and appetite-regulating hormones (active ghrelin (AG), cholecystokinin (CCK), total peptide YY (PYY), active glucagon-like peptide-1 (GLP-1), and insulin) were measured before and after WL.

RESULTS

Changes in body weight (≈12.5% WL) and composition were similar in both groups. Fasting RQ and ExEff at 10 W increased in both groups. Losing weight, either by IER or CER dieting, did not induce significant changes in subjective appetite ratings. RMR decreased and ExEff at 25 and 50 W increased (P < 0.001 for all) in IER group only. Basal and postprandial AG increased (P < 0.05) in IER group, whereas basal active GLP-1 decreased (P = 0.033) in CER group only. Postprandial CCK decreased in both groups (P = 0.0012 and P = 0.009 for IER and CER groups, respectively). No between group differences were apparent for any of the outcomes.

CONCLUSIONS

The technique used to achieve energy restriction, whether it is continuous or intermittent, does not appear to modulate the compensatory mechanisms activated by weight loss.

CLINICAL TRIAL REGISTRATION NUMBER

NCT02169778 (the study was registered in clinicaltrial.gov).

Authors+Show Affiliations

Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: silvia.coutinho@ntnu.no.Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Centre for Obesity, Department of Surgery, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway.Department of Food, Nutrition and Dietetics, Monash University, Melbourne, Australia.Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Centre for Obesity, Department of Surgery, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28446382

Citation

Coutinho, Sílvia Ribeiro, et al. "Compensatory Mechanisms Activated With Intermittent Energy Restriction: a Randomized Control Trial." Clinical Nutrition (Edinburgh, Scotland), vol. 37, no. 3, 2018, pp. 815-823.
Coutinho SR, Halset EH, Gåsbakk S, et al. Compensatory mechanisms activated with intermittent energy restriction: A randomized control trial. Clin Nutr. 2018;37(3):815-823.
Coutinho, S. R., Halset, E. H., Gåsbakk, S., Rehfeld, J. F., Kulseng, B., Truby, H., & Martins, C. (2018). Compensatory mechanisms activated with intermittent energy restriction: A randomized control trial. Clinical Nutrition (Edinburgh, Scotland), 37(3), 815-823. https://doi.org/10.1016/j.clnu.2017.04.002
Coutinho SR, et al. Compensatory Mechanisms Activated With Intermittent Energy Restriction: a Randomized Control Trial. Clin Nutr. 2018;37(3):815-823. PubMed PMID: 28446382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Compensatory mechanisms activated with intermittent energy restriction: A randomized control trial. AU - Coutinho,Sílvia Ribeiro, AU - Halset,Eline Holli, AU - Gåsbakk,Sigrid, AU - Rehfeld,Jens F, AU - Kulseng,Bård, AU - Truby,Helen, AU - Martins,Cátia, Y1 - 2017/04/07/ PY - 2016/12/25/received PY - 2017/03/22/revised PY - 2017/04/03/accepted PY - 2017/4/28/pubmed PY - 2019/9/13/medline PY - 2017/4/28/entrez KW - Appetite KW - Body composition KW - Continuous energy restriction KW - Energy expenditure KW - Intermittent energy restriction KW - Weight loss SP - 815 EP - 823 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 37 IS - 3 N2 - BACKGROUND & AIMS: Strong compensatory responses, with reduced resting metabolic rate (RMR), increased exercise efficiency (ExEff) and appetite, are activated when weight loss (WL) is achieved with continuous energy restriction (CER), which try to restore energy balance. Intermittent energy restriction (IER), where short spells of energy restriction are interspaced by periods of habitual energy intake, may offer some protection in minimizing those responses. We aimed to compare the effect of IER versus CER on body composition and the compensatory responses induced by WL. METHODS: 35 adults (age: 39 ± 9 y) with obesity (BMI: 36 ± 4 kg/m2) were randomized to lose a similar weight with an IER (N = 18) or a CER (N = 17) diet over a 12 week period. Macronutrient composition and overall energy restriction (33% reduction) were similar between groups. Body weight/composition, RMR, fasting respiratory quotient (RQ), ExEff (10, 25, and 50 W), subjective appetite ratings (hunger, fullness, desire to eat, and prospective food consumption (PFC)), and appetite-regulating hormones (active ghrelin (AG), cholecystokinin (CCK), total peptide YY (PYY), active glucagon-like peptide-1 (GLP-1), and insulin) were measured before and after WL. RESULTS: Changes in body weight (≈12.5% WL) and composition were similar in both groups. Fasting RQ and ExEff at 10 W increased in both groups. Losing weight, either by IER or CER dieting, did not induce significant changes in subjective appetite ratings. RMR decreased and ExEff at 25 and 50 W increased (P < 0.001 for all) in IER group only. Basal and postprandial AG increased (P < 0.05) in IER group, whereas basal active GLP-1 decreased (P = 0.033) in CER group only. Postprandial CCK decreased in both groups (P = 0.0012 and P = 0.009 for IER and CER groups, respectively). No between group differences were apparent for any of the outcomes. CONCLUSIONS: The technique used to achieve energy restriction, whether it is continuous or intermittent, does not appear to modulate the compensatory mechanisms activated by weight loss. CLINICAL TRIAL REGISTRATION NUMBER: NCT02169778 (the study was registered in clinicaltrial.gov). SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/28446382/Compensatory_mechanisms_activated_with_intermittent_energy_restriction:_A_randomized_control_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(17)30125-5 DB - PRIME DP - Unbound Medicine ER -