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The effect of intermittent energy restriction on weight loss and diabetes risk markers in women with a history of gestational diabetes: a 12-month randomized control trial.
Am J Clin Nutr. 2021 08 02; 114(2):794-803.AJ

Abstract

BACKGROUND

Weight loss after gestational diabetes (GDM) can prevent or delay the onset of type 2 diabetes. Intermittent energy restriction (IER) may offer an alternative to continuous energy restriction (CER) for weight loss.

OBJECTIVES

We compared the effects of IER (2 days per week) to daily CER over 12 mo on weight loss and diabetes risk markers in overweight women with previous GDM.

METHODS

Overweight females (n = 121) ≥18 y were randomized 1:1 to either IER [2-d 500 kcal (2100 kJ); n = 61] or CER [1500 kcal (6000 kJ); n = 60] in this 12-mo noninferiority trial.

RESULTS

The trial was completed by 62 participants with a median age of 39.6 y [Quartile (Q) 1 to Quartile 3, 34.9 to 43.9 y] with a median BMI of 32.6 kg/m2 (Q1 to Q3, 28.5 to 37.9 kg/m2) at a median of 2.9 y after GDM (Q1 to Q3, 2.1 to 6.4 y; 49% attrition; IER n = 29; CER n = 30; P = 0.8). The mean ± SD weight loss was significant over time (P < 0.001) but not by diet group (IER -4.8 ± 5.0 kg; CER -3.2 ± 5.0; P = 0.2). The mean between-group difference was -1.6 kg (95% CI: -4.2 to 1.0 kg; P = 0.2). There were no significant between-group differences in change in HbA1c, fasting plasma glucose, fasting serum insulin, HOMA-IR or 2-h oral glucose tolerance at 12 mo (p>0.05). The trial was registered at https://www.anzctr.org.au/ (ACTRN12617001476325).

CONCLUSIONS

IER produces comparable weight loss to CER over 12 mo in overweight women with previous GDM. The high dropout rate in this study is a limitation in the interpretation of these results. Larger studies are needed to confirm noninferiority of IER compared to CER.

Authors+Show Affiliations

University of South Australia, Clinical and Health Sciences, Adelaide, Australia. Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia.University of South Australia, Clinical and Health Sciences, Adelaide, Australia. Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia.University of South Australia, Clinical and Health Sciences, Adelaide, Australia. Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia.

Pub Type(s)

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

Language

eng

PubMed ID

33831950

Citation

Gray, Kristy L., et al. "The Effect of Intermittent Energy Restriction On Weight Loss and Diabetes Risk Markers in Women With a History of Gestational Diabetes: a 12-month Randomized Control Trial." The American Journal of Clinical Nutrition, vol. 114, no. 2, 2021, pp. 794-803.
Gray KL, Clifton PM, Keogh JB. The effect of intermittent energy restriction on weight loss and diabetes risk markers in women with a history of gestational diabetes: a 12-month randomized control trial. Am J Clin Nutr. 2021;114(2):794-803.
Gray, K. L., Clifton, P. M., & Keogh, J. B. (2021). The effect of intermittent energy restriction on weight loss and diabetes risk markers in women with a history of gestational diabetes: a 12-month randomized control trial. The American Journal of Clinical Nutrition, 114(2), 794-803. https://doi.org/10.1093/ajcn/nqab058
Gray KL, Clifton PM, Keogh JB. The Effect of Intermittent Energy Restriction On Weight Loss and Diabetes Risk Markers in Women With a History of Gestational Diabetes: a 12-month Randomized Control Trial. Am J Clin Nutr. 2021 08 2;114(2):794-803. PubMed PMID: 33831950.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of intermittent energy restriction on weight loss and diabetes risk markers in women with a history of gestational diabetes: a 12-month randomized control trial. AU - Gray,Kristy L, AU - Clifton,Peter M, AU - Keogh,Jennifer B, PY - 2020/07/03/received PY - 2021/02/16/accepted PY - 2021/4/9/pubmed PY - 2021/9/2/medline PY - 2021/4/8/entrez KW - diabetes prevention KW - gestational diabetes KW - intermittent energy restriction KW - intermittent fasting KW - overweight KW - weight loss KW - women SP - 794 EP - 803 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 114 IS - 2 N2 - BACKGROUND: Weight loss after gestational diabetes (GDM) can prevent or delay the onset of type 2 diabetes. Intermittent energy restriction (IER) may offer an alternative to continuous energy restriction (CER) for weight loss. OBJECTIVES: We compared the effects of IER (2 days per week) to daily CER over 12 mo on weight loss and diabetes risk markers in overweight women with previous GDM. METHODS: Overweight females (n = 121) ≥18 y were randomized 1:1 to either IER [2-d 500 kcal (2100 kJ); n = 61] or CER [1500 kcal (6000 kJ); n = 60] in this 12-mo noninferiority trial. RESULTS: The trial was completed by 62 participants with a median age of 39.6 y [Quartile (Q) 1 to Quartile 3, 34.9 to 43.9 y] with a median BMI of 32.6 kg/m2 (Q1 to Q3, 28.5 to 37.9 kg/m2) at a median of 2.9 y after GDM (Q1 to Q3, 2.1 to 6.4 y; 49% attrition; IER n = 29; CER n = 30; P = 0.8). The mean ± SD weight loss was significant over time (P < 0.001) but not by diet group (IER -4.8 ± 5.0 kg; CER -3.2 ± 5.0; P = 0.2). The mean between-group difference was -1.6 kg (95% CI: -4.2 to 1.0 kg; P = 0.2). There were no significant between-group differences in change in HbA1c, fasting plasma glucose, fasting serum insulin, HOMA-IR or 2-h oral glucose tolerance at 12 mo (p>0.05). The trial was registered at https://www.anzctr.org.au/ (ACTRN12617001476325). CONCLUSIONS: IER produces comparable weight loss to CER over 12 mo in overweight women with previous GDM. The high dropout rate in this study is a limitation in the interpretation of these results. Larger studies are needed to confirm noninferiority of IER compared to CER. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/33831950/The_effect_of_intermittent_energy_restriction_on_weight_loss_and_diabetes_risk_markers_in_women_with_a_history_of_gestational_diabetes:_a_12_month_randomized_control_trial_ DB - PRIME DP - Unbound Medicine ER -