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Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial.
Am J Clin Nutr. 2018 11 01; 108(5):933-945.AJ

Abstract

Background

Although preliminary evidence suggests that intermittent calorie restriction (ICR) exerts stronger effects on metabolic parameters, which may link obesity and major chronic diseases, compared with continuous calorie restriction (CCR), there is a lack of well-powered intervention studies.

Objective

We conducted a randomized controlled trial to test whether ICR, operationalized as the "5:2 diet," has stronger effects on adipose tissue gene expression, anthropometric and body composition measures, and circulating metabolic biomarkers than CCR and a control regimen.

Design

One hundred and fifty overweight and obese nonsmokers [body mass index (kg/m2) ≥25 to <40, 50% women], aged 35-65 y, were randomly assigned to an ICR group (5 d without energy restriction and 2 d with 75% energy deficit, net weekly energy deficit ∼20%), a CCR group (daily energy deficit ∼20%), or a control group (no advice to restrict energy) and participated in a 12-wk intervention phase, a 12-wk maintenance phase, and a 26-wk follow-up phase.

Results

Loge relative weight change over the intervention phase was -7.1% ± 0.7% (mean ± SEM) with ICR, -5.2% ± 0.6% with CCR, and -3.3% ± 0.6% with the control regimen (Poverall < 0.001, PICR vs. CCR = 0.053). Despite slightly greater weight loss with ICR than with CCR, there were no significant differences between the groups in the expression of 82 preselected genes in adipose tissue implicated in pathways linking obesity to chronic diseases. At the final follow-up assessment (week 50), weight loss was -5.2% ± 1.2% with ICR, -4.9% ± 1.1% with CCR, and -1.7% ± 0.8% with the control regimen (Poverall = 0.01, PICR vs. CCR = 0.89). These effects were paralleled by proportional changes in visceral and subcutaneous adipose tissue volumes. There were no significant differences between ICR and CCR regarding various circulating metabolic biomarkers.

Conclusion

Our results on the effects of the "5:2 diet" indicate that ICR may be equivalent but not superior to CCR for weight reduction and prevention of metabolic diseases. This trial was registered at clinicaltrials.gov as NCT02449148.

Authors+Show Affiliations

Divisions of Cancer Epidemiology.Divisions of Cancer Epidemiology. Diagnostic and Interventional Radiology.Divisions of Cancer Epidemiology.Divisions of Cancer Epidemiology. Diagnostic and Interventional Radiology.Divisions of Cancer Epidemiology.Divisions of Cancer Epidemiology.Divisions of Cancer Epidemiology. Diagnostic and Interventional Radiology.Divisions of Cancer Epidemiology. Diagnostic and Interventional Radiology.Divisions of Cancer Epidemiology.Divisions of Cancer Epidemiology. Medical and Biological Informatics, German Cancer Research Center (DKFZ), Heidelberg, Germany.Divisions of Cancer Epidemiology. Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany. Biobank of the National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.Divisions of Cancer Epidemiology. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.Divisions of Cancer Epidemiology. Diagnostic and Interventional Radiology.Divisions of Cancer Epidemiology. Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT.Divisions of Cancer Epidemiology.Divisions of Cancer Epidemiology.

Pub Type(s)

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

Language

eng

PubMed ID

30475957

Citation

Schübel, Ruth, et al. "Effects of Intermittent and Continuous Calorie Restriction On Body Weight and Metabolism Over 50 Wk: a Randomized Controlled Trial." The American Journal of Clinical Nutrition, vol. 108, no. 5, 2018, pp. 933-945.
Schübel R, Nattenmüller J, Sookthai D, et al. Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial. Am J Clin Nutr. 2018;108(5):933-945.
Schübel, R., Nattenmüller, J., Sookthai, D., Nonnenmacher, T., Graf, M. E., Riedl, L., Schlett, C. L., von Stackelberg, O., Johnson, T., Nabers, D., Kirsten, R., Kratz, M., Kauczor, H. U., Ulrich, C. M., Kaaks, R., & Kühn, T. (2018). Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial. The American Journal of Clinical Nutrition, 108(5), 933-945. https://doi.org/10.1093/ajcn/nqy196
Schübel R, et al. Effects of Intermittent and Continuous Calorie Restriction On Body Weight and Metabolism Over 50 Wk: a Randomized Controlled Trial. Am J Clin Nutr. 2018 11 1;108(5):933-945. PubMed PMID: 30475957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial. AU - Schübel,Ruth, AU - Nattenmüller,Johanna, AU - Sookthai,Disorn, AU - Nonnenmacher,Tobias, AU - Graf,Mirja E, AU - Riedl,Lena, AU - Schlett,Christopher L, AU - von Stackelberg,Oyunbileg, AU - Johnson,Theron, AU - Nabers,Diana, AU - Kirsten,Romy, AU - Kratz,Mario, AU - Kauczor,Hans-Ulrich, AU - Ulrich,Cornelia M, AU - Kaaks,Rudolf, AU - Kühn,Tilman, PY - 2017/12/20/received PY - 2018/07/30/accepted PY - 2018/11/27/entrez PY - 2018/11/27/pubmed PY - 2019/9/10/medline SP - 933 EP - 945 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 108 IS - 5 N2 - Background: Although preliminary evidence suggests that intermittent calorie restriction (ICR) exerts stronger effects on metabolic parameters, which may link obesity and major chronic diseases, compared with continuous calorie restriction (CCR), there is a lack of well-powered intervention studies. Objective: We conducted a randomized controlled trial to test whether ICR, operationalized as the "5:2 diet," has stronger effects on adipose tissue gene expression, anthropometric and body composition measures, and circulating metabolic biomarkers than CCR and a control regimen. Design: One hundred and fifty overweight and obese nonsmokers [body mass index (kg/m2) ≥25 to <40, 50% women], aged 35-65 y, were randomly assigned to an ICR group (5 d without energy restriction and 2 d with 75% energy deficit, net weekly energy deficit ∼20%), a CCR group (daily energy deficit ∼20%), or a control group (no advice to restrict energy) and participated in a 12-wk intervention phase, a 12-wk maintenance phase, and a 26-wk follow-up phase. Results: Loge relative weight change over the intervention phase was -7.1% ± 0.7% (mean ± SEM) with ICR, -5.2% ± 0.6% with CCR, and -3.3% ± 0.6% with the control regimen (Poverall < 0.001, PICR vs. CCR = 0.053). Despite slightly greater weight loss with ICR than with CCR, there were no significant differences between the groups in the expression of 82 preselected genes in adipose tissue implicated in pathways linking obesity to chronic diseases. At the final follow-up assessment (week 50), weight loss was -5.2% ± 1.2% with ICR, -4.9% ± 1.1% with CCR, and -1.7% ± 0.8% with the control regimen (Poverall = 0.01, PICR vs. CCR = 0.89). These effects were paralleled by proportional changes in visceral and subcutaneous adipose tissue volumes. There were no significant differences between ICR and CCR regarding various circulating metabolic biomarkers. Conclusion: Our results on the effects of the "5:2 diet" indicate that ICR may be equivalent but not superior to CCR for weight reduction and prevention of metabolic diseases. This trial was registered at clinicaltrials.gov as NCT02449148. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/30475957/Effects_of_intermittent_and_continuous_calorie_restriction_on_body_weight_and_metabolism_over_50_wk:_a_randomized_controlled_trial_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqy196 DB - PRIME DP - Unbound Medicine ER -