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Matched Weight Loss Through Intermittent or Continuous Energy Restriction Does Not Lead To Compensatory Increases in Appetite and Eating Behavior in a Randomized Controlled Trial in Women with Overweight and Obesity.
J Nutr. 2020 03 01; 150(3):623-633.JN

Abstract

BACKGROUND

Continuous energy restriction (CER) is purported to be problematic because of reductions in fat-free mass (FFM), compensatory motivation to overeat, and weakened satiety. Intermittent energy restriction (IER) is an alternative behavioral weight loss (WL) strategy that may mitigate some of these limitations.

OBJECTIVE

The objective of the DIVA study was to compare the effects of CER and IER on appetite when the degree of WL (≥5%) is matched.

METHODS

Women with overweight/obesity (BMI 25.0-34.9 kg/m2; age 18-55 y) were recruited for this controlled-feeding RCT via CER (25% daily energy restriction) or IER (alternating ad libitum and 75% energy restriction days). Probe days were conducted at baseline and post-intervention to assess body composition, ad libitum energy intake and subjective appetite in response to a fixed-energy breakfast, and eating behavior traits. After baseline measurements, participants were allocated to CER (n = 22) or IER (n = 24). Per protocol analyses (≥5% WL within 12 wk) were conducted with use of repeated measures ANOVA.

RESULTS

Thirty of 37 completers reached ≥5% WL [CER (n = 18): 6.3 ± 0.8% in 57 ± 16 d, IER (n = 12): 6.6 ± 1.1% in 67 ± 13 d; % WL P = 0.43 and days P = 0.10]. Fat mass [-3.9 (95% CI: -4.3, -3.4) kg] and FFM [-1.3 (95% CI: -1.6, -1.0) kg] were reduced post-WL (P < 0.001), with no group differences. Self-selected meal size decreased post-WL in CER (P = 0.03) but not in IER (P = 0.19). Hunger AUC decreased post-WL (P < 0.05), with no group differences. Satiety quotient remained unchanged and was similar in both groups. Both interventions improved dietary restraint, craving control, susceptibility to hunger, and binge eating (P < 0.001).

CONCLUSIONS

Controlled ≥5% WL via CER or IER did not differentially affect changes in body composition, reductions in hunger, and improvements in eating behavior traits. This suggests that neither CER nor IER lead to compensatory adaptations in appetite in women with overweight/obesity. This trial was registered at clinicaltrials.gov as NCT03447600.

Authors+Show Affiliations

School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK.School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK.Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA.School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.

Pub Type(s)

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

Language

eng

PubMed ID

31825067

Citation

Beaulieu, Kristine, et al. "Matched Weight Loss Through Intermittent or Continuous Energy Restriction Does Not Lead to Compensatory Increases in Appetite and Eating Behavior in a Randomized Controlled Trial in Women With Overweight and Obesity." The Journal of Nutrition, vol. 150, no. 3, 2020, pp. 623-633.
Beaulieu K, Casanova N, Oustric P, et al. Matched Weight Loss Through Intermittent or Continuous Energy Restriction Does Not Lead To Compensatory Increases in Appetite and Eating Behavior in a Randomized Controlled Trial in Women with Overweight and Obesity. J Nutr. 2020;150(3):623-633.
Beaulieu, K., Casanova, N., Oustric, P., Turicchi, J., Gibbons, C., Hopkins, M., Varady, K., Blundell, J., & Finlayson, G. (2020). Matched Weight Loss Through Intermittent or Continuous Energy Restriction Does Not Lead To Compensatory Increases in Appetite and Eating Behavior in a Randomized Controlled Trial in Women with Overweight and Obesity. The Journal of Nutrition, 150(3), 623-633. https://doi.org/10.1093/jn/nxz296
Beaulieu K, et al. Matched Weight Loss Through Intermittent or Continuous Energy Restriction Does Not Lead to Compensatory Increases in Appetite and Eating Behavior in a Randomized Controlled Trial in Women With Overweight and Obesity. J Nutr. 2020 03 1;150(3):623-633. PubMed PMID: 31825067.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Matched Weight Loss Through Intermittent or Continuous Energy Restriction Does Not Lead To Compensatory Increases in Appetite and Eating Behavior in a Randomized Controlled Trial in Women with Overweight and Obesity. AU - Beaulieu,Kristine, AU - Casanova,Nuno, AU - Oustric,Pauline, AU - Turicchi,Jake, AU - Gibbons,Catherine, AU - Hopkins,Mark, AU - Varady,Krista, AU - Blundell,John, AU - Finlayson,Graham, PY - 2019/07/29/received PY - 2019/09/23/revised PY - 2019/11/13/accepted PY - 2019/12/12/pubmed PY - 2020/9/10/medline PY - 2019/12/12/entrez KW - alternate day fasting KW - appetite KW - body composition KW - eating behavior KW - intermittent energy restriction KW - weight loss KW - women with overweight/obesity SP - 623 EP - 633 JF - The Journal of nutrition JO - J Nutr VL - 150 IS - 3 N2 - BACKGROUND: Continuous energy restriction (CER) is purported to be problematic because of reductions in fat-free mass (FFM), compensatory motivation to overeat, and weakened satiety. Intermittent energy restriction (IER) is an alternative behavioral weight loss (WL) strategy that may mitigate some of these limitations. OBJECTIVE: The objective of the DIVA study was to compare the effects of CER and IER on appetite when the degree of WL (≥5%) is matched. METHODS: Women with overweight/obesity (BMI 25.0-34.9 kg/m2; age 18-55 y) were recruited for this controlled-feeding RCT via CER (25% daily energy restriction) or IER (alternating ad libitum and 75% energy restriction days). Probe days were conducted at baseline and post-intervention to assess body composition, ad libitum energy intake and subjective appetite in response to a fixed-energy breakfast, and eating behavior traits. After baseline measurements, participants were allocated to CER (n = 22) or IER (n = 24). Per protocol analyses (≥5% WL within 12 wk) were conducted with use of repeated measures ANOVA. RESULTS: Thirty of 37 completers reached ≥5% WL [CER (n = 18): 6.3 ± 0.8% in 57 ± 16 d, IER (n = 12): 6.6 ± 1.1% in 67 ± 13 d; % WL P = 0.43 and days P = 0.10]. Fat mass [-3.9 (95% CI: -4.3, -3.4) kg] and FFM [-1.3 (95% CI: -1.6, -1.0) kg] were reduced post-WL (P < 0.001), with no group differences. Self-selected meal size decreased post-WL in CER (P = 0.03) but not in IER (P = 0.19). Hunger AUC decreased post-WL (P < 0.05), with no group differences. Satiety quotient remained unchanged and was similar in both groups. Both interventions improved dietary restraint, craving control, susceptibility to hunger, and binge eating (P < 0.001). CONCLUSIONS: Controlled ≥5% WL via CER or IER did not differentially affect changes in body composition, reductions in hunger, and improvements in eating behavior traits. This suggests that neither CER nor IER lead to compensatory adaptations in appetite in women with overweight/obesity. This trial was registered at clinicaltrials.gov as NCT03447600. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/31825067/Matched_Weight_Loss_Through_Intermittent_or_Continuous_Energy_Restriction_Does_Not_Lead_To_Compensatory_Increases_in_Appetite_and_Eating_Behavior_in_a_Randomized_Controlled_Trial_in_Women_with_Overweight_and_Obesity_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.1093/jn/nxz296 DB - PRIME DP - Unbound Medicine ER -