Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial

Trepanowski, John F.; Kroeger, Cynthia M.; Barnosky, Adrienne; Klempel, Monica C.; Bhutani, Surabhi; Hoddy, Kristin K.; Gabel, Kelsey; Freels, Sally; Rigdon, Joseph; Rood, Jennifer; Ravussin, Eric; Varady, Krista A.

doi:10.1001/jamainternmed.2017.0936

Cited by 645Dietary Effects on HealthNutritional Studies and DietDiet and metabolism studies

Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial

Open access

Trepanowski, John F., Kroeger, Cynthia M., Barnosky, Adrienne, Klempel, Monica C., Bhutani, Surabhi, Hoddy, Kristin K., Gabel, Kelsey, Freels, Sally +4 more·2017·JAMA Internal Medicine

DOI 10.1001/jamainternmed.2017.0936PMC PMC5680777

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Abstract

Importance: Alternate-day fasting has become increasingly popular, yet, to date, no long-term randomized clinical trials have evaluated its efficacy. Objective: To compare the effects of alternate-day fasting vs daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease. Design, Setting, and Participants: A single-center randomized clinical trial of obese adults (18 to 64 years of age; mean body mass index, 34) was conducted between October 1, 2011, and January 15, 2015, at an academic institution in Chicago, Illinois. Interventions: Participants were randomized to 1 of 3 groups for 1 year: alternate-day fasting (25% of energy needs on fast days; 125% of energy needs on alternating "feast days"), calorie restriction (75% of energy needs every day), or a no-intervention control. The trial involved a 6-month weight-loss phase followed by a 6-month weight-maintenance phase. Main Outcomes and Measures: The primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease. Results: Among the 100 participants (86 women and 14 men; mean [SD] age, 44 [11] years), the dropout rate was highest in the alternate-day fasting group (13 of 34 [38%]), vs the daily calorie restriction group (10 of 35 [29%]) and control group (8 of 31 [26%]). Mean weight loss was similar for participants in the alternate-day fasting group and those in the daily calorie restriction group at month 6 (-6.8% [95% CI, -9.1% to -4.5%] vs -6.8% [95% CI, -9.1% to -4.6%]) and month 12 (-6.0% [95% CI, -8.5% to -3.6%] vs -5.3% [95% CI, -7.6% to -3.0%]) relative to those in the control group. Participants in the alternate-day fasting group ate more than prescribed on fast days, and less than prescribed on feast days, while those in the daily calorie restriction group generally met their prescribed energy goals. There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C-reactive protein, or homocysteine concentrations at month 6 or 12. Mean high-density lipoprotein cholesterol levels at month 6 significantly increased among the participants in the alternate-day fasting group (6.2 mg/dL [95% CI, 0.1-12.4 mg/dL]), but not at month 12 (1.0 mg/dL [95% CI, -5.9 to 7.8 mg/dL]), relative to those in the daily calorie restriction group. Mean low-density lipoprotein cholesterol levels were significantly elevated by month 12 among the participants in the alternate-day fasting group (11.5 mg/dL [95% CI, 1.9-21.1 mg/dL]) compared with those in the daily calorie restriction group. Conclusions and Relevance: Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction. Trial Registration: clinicaltrials.gov Identifier: NCT00960505.

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Findingown data
Lean mass did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“There were no statistically significant differences between the alternate-day fasting group and the daily calorie restriction group for fat mass, lean mass, or visceral fat mass at month 6 or month 12.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Heart rate did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“There were also no statistically significant differences in heart rate between the alternate-day fasting group and the daily calorie restriction group at month 6 or month 12 (Table 2).”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Blood pressure did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“Blood pressure was not significantly different between the intervention groups, or relative to controls, at month 6 or month 12 (Table 2).”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Total cholesterol did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“Total cholesterol levels were not significantly different between the intervention groups, or relative to controls, at month 6 or month 12.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Weight regain from months 6 to 12 did not differ significantly between the alternate-day fasting group and the control group.
“Moreover, weight regain from months 6 to 12 was not significantly different between the alternate-day fasting group and controls (0.8%; 95% CI, −1.8% to 3.3%)”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.

Findingown data
HOMA-IR did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“There were also no significant differences in fasting insulin or the homeostasis model assessment of insulin resistance between the intervention groups at month 6 or month 12.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
On fast days, the alternate-day fasting group exceeded its prescribed energy goal at months 3 and 6.
“On the fast day (Figure 2A), participants in the alternate-day fasting group exceeded their prescribed energy goal at months 3 and 6.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Weight regain from months 6 to 12 did not differ significantly between the daily calorie restriction group and the control group.
“or the daily calorie restriction group and controls (1.5%; 95% CI, −0.8% to 3.9%).”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Homocysteine did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“High-sensitivity C-reactive protein and homocysteine levels did not differ significantly between the intervention groups, or relative to controls, at month 6 or month 12.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
At month 12, LDL cholesterol was significantly higher in the alternate-day fasting group than in the daily calorie restriction group by 11.5 mg/dL.
“At month 12, low-density lipoprotein cholesterol levels significantly increased in the alternate-day fasting group (11.5 mg/dL [95% CI, 1.9–21.1 mg/ dL]) (to convert to millimoles per liter, multiply by 0.0259) relative to the daily calorie restriction group.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Triglycerides did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“Triglyceride levels did not differ significantly between the intervention groups at month 6 or month 12.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
At month 12, total weight loss did not differ significantly between the alternate-day fasting and daily calorie restriction groups.
“At the end of the study, total weight loss was −6.0% (95% CI, −8.5% to −3.6%) for the alternate-day fasting group and −5.3% (95% CI, −7.6% to −3.0%) for the daily calorie restriction group, relative to controls, with no significant difference between the intervention groups.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Fasting insulin did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“There were also no significant differences in fasting insulin or the homeostasis model assessment of insulin resistance between the intervention groups at month 6 or month 12.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Visceral fat mass did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“There were no statistically significant differences between the alternate-day fasting group and the daily calorie restriction group for fat mass, lean mass, or visceral fat mass at month 6 or month 12.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Weight regain from months 6 to 12 did not differ significantly between the alternate-day fasting and daily calorie restriction groups.
“Weight regain from months 6 to 12 (−0.8%; 95% CI, −3.2% to 1.7%) was not significantly different between the alternate-day fasting group and the daily calorie restriction group.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
At month 6, weight loss did not differ significantly between the alternate-day fasting and daily calorie restriction groups.
“Weight loss was not significantly different between the alternate-day fasting group and the daily calorie restriction group at month 6.”
- Also stated in: § RESULTS · plain
  “Mean weight loss was similar for participants in the alternate-day fasting group and those in the daily calorie restriction group at month 6 (−6.8% [95% CI, −9.1% to −4.5%] vs −6.8% [95% CI, −9.1% to −4.6%])”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
At month 6, HDL cholesterol was significantly higher in the alternate-day fasting group than in the daily calorie restriction group by 6.2 mg/dL.
“At month 6, high-density lipoprotein cholesterol levels were significantly elevated in the alternate-day fasting group by 6.2 mg/dL (95% CI, 0.1–12.4 mg/ dL) (to convert to millimoles per liter, multiply by 0.0259) vs the daily calorie restriction group, but this effect was no longer observed by month 12.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
At month 12, HDL cholesterol did not differ significantly between the alternate-day fasting and daily calorie restriction groups.
“At month 6, high-density lipoprotein cholesterol levels were significantly elevated in the alternate-day fasting group by 6.2 mg/dL (95% CI, 0.1–12.4 mg/ dL) (to convert to millimoles per liter, multiply by 0.0259) vs the daily calorie restriction group, but this effect was no longer observed by month 12.”
- Also stated in: § RESULTS · plain
  “Mean high-density lipoprotein cholesterol levels at month 6 significantly increased among the participants in the alternate-day fasting group (6.2 mg/dL [95% CI, 0.1–12.4 mg/dL]), but not at month 12 (1.0 mg/dL [95% CI, −5.9 to 7.8 mg/dL]), relative to those in the daily calorie restriction group.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Fat mass did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“There were no statistically significant differences between the alternate-day fasting group and the daily calorie restriction group for fat mass, lean mass, or visceral fat mass at month 6 or month 12.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
High-sensitivity C-reactive protein did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“High-sensitivity C-reactive protein and homocysteine levels did not differ significantly between the intervention groups, or relative to controls, at month 6 or month 12.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
A higher proportion of daily calorie restriction participants were adherent to their energy goals at months 3, 6, 9, and 12 compared with alternate-day fasting participants.
“A higher proportion of participants in the daily calorie restriction group were adherent to their energy goals at months 3, 6, 9, and 12 relative to those in the alternate-day fasting group.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
On feast days, the alternate-day fasting group ate less than its prescribed goal at months 3, 6, 9, and 12.
“On the feast day (Figure 2B), participants in the alternate-day fasting group ate less than their prescribed goal at months 3, 6, 9, and 12.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Fasting plasma glucose did not differ significantly between the alternate-day fasting and daily calorie restriction groups at month 6 or month 12.
“Fasting plasma glucose did not differ significantly between the intervention groups, or relative to controls, at month 6 or month 12.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
From baseline to month 6, percentage energy restriction did not differ significantly between the alternate-day fasting and daily calorie restriction groups.
“From baseline to month 6, the alternate-day fasting group achieved a mean (SD) percentage energy restriction of 21% (16%), and the daily calorie restriction group achieved a mean (SD) percentage energy restriction of 24% (16%), with no significant difference between the intervention groups or compared with the control group (eFigure 2 in Supplement 2).”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Physical activity, measured as steps per day, did not change during the trial in any group.
“Physical activity, measured as steps per day, did not change during the course of the trial in any group (eTable 2 in Supplement 2).”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Contrary to the original hypotheses, the alternate-day fasting group did not experience more pronounced improvements in cardiovascular risk indicators compared with the daily calorie restriction group.
“Contrary to our original hypotheses, the participants in the alternate-day fasting group did not experience more pronounced improvements in risk indicators for cardiovascular disease compared with the participants in the daily calorie restriction group.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
Percentage of energy intake from fat, carbohydrates, and protein did not differ significantly over time in any group.
“Percentage of energy intake from fat, carbohydrates, and protein did not differ significantly over time in any of the groups.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
The dropout rate was higher in the alternate-day fasting group (38%) than in the daily calorie restriction group (29%) and the control group (26%).
“The dropout rate was highest in the alternate-day fasting group (13 of 34 [38%]), relative to the daily calorie restriction group (10 of 35 [29%]) and control group (8 of 31 [26%]).”
- Also stated in: § RESULTS · plain
  “Among the 100 participants (86 women and 14 men; mean [SD] age, 44 [11] years), the dropout rate was highest in the alternate-day fasting group (13 of 34 [38%]), vs the daily calorie restriction group (10 of 35 [29%]) and control group (8 of 31 [26%]).”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Findingown data
More participants in the alternate-day fasting group than in the daily calorie restriction group withdrew because of difficulties adhering to the diet.
“More participants in the alternate-day fasting group than in the daily calorie restriction group with-drew owing to difficulties adhering with the diet.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Interpretationown data
Alternate-day fasting did not produce superior adherence compared with daily calorie restriction.
“Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction.”
- Also stated in: § Discussion · boosted
  “The results of this randomized clinical trial demonstrated that alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or improvement in risk indicators for cardiovascular disease compared with daily calorie restriction.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Interpretationown data
Alternate-day fasting did not produce superior weight maintenance compared with daily calorie restriction.
“Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction.”
- Also stated in: § Discussion · boosted
  “The results of this randomized clinical trial demonstrated that alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or improvement in risk indicators for cardiovascular disease compared with daily calorie restriction.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Interpretationown data
Alternate-day fasting did not produce superior weight loss compared with daily calorie restriction.
“Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction.”
- Also stated in: § Discussion · boosted
  “The results of this randomized clinical trial demonstrated that alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or improvement in risk indicators for cardiovascular disease compared with daily calorie restriction.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Study design and conductown data
All baseline characteristics had comparable distributions between the alternate-day fasting, daily calorie restriction, and control groups.
“All baseline characteristics had comparable distributions between the alternate-day fasting group, the daily calorie restriction group, and the control group (Table 1).”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Interpretationreasoning
The generalizability of the findings is limited by the enrollment of predominantly metabolically healthy obese individuals.
“Finally, we enrolled predominantly metabolically healthy obese individuals, which may have hindered the abilities of the interventions to produce greater improvements in our measured cardiovascular disease risk indicators.28,29 The generalizability of our findings is also limited by the enrollment.”
Quote in the paperSubstantial claim0 of 2 sources checked
- cites [28] Janiszewski PM Ross R Effects of weight loss among metabolically healthy obese men and women Diabetes Care 2010 33 9 1957 1959 20573755 PMC2928342
  Not checked in the free run.
- cites [29] Kantartzis K Machann J Schick F Effects of a lifestyle intervention in metabolically benign and malign obesity Diabetologia 2011 54 4 864 868 21174075
  Not checked in the free run.
Interpretationown data
Many participants in the alternate-day fasting group converted their diet into de facto calorie restriction as the trial progressed.
“Rather, it appears as though many participants in the alternate-day fasting group converted their diet into de facto calorie restriction as the trial progressed.”
Quote in the paperSubstantial claim
Study design and conductcitation
The higher dropout rate in the alternate-day fasting group may have introduced a possible selection bias between groups.
“The higher dropout rate in the alternate-day fasting group may have also introduced a possible selection bias between groups.27”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [27] Hernán MA Hernández-Díaz S Robins JM A structural approach to selection bias Epidemiology 2004 15 5 615 625 15308962
  Not checked in the free run.
Premisecitation
Weight loss typically peaks at 6 months during a lifestyle intervention.
“We chose this design because weight loss typically peaks at 6 months during a lifestyle intervention.16”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [16] Gardner CD Kiazand A Alhassan S Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial JAMA 2007 297 9 969 977 17341711
  Not checked in the free run.
Premisecitation
Many patients find it difficult to adhere to a conventional weight-loss diet because food intake must be limited every day.
“However, many patients find it difficult to adhere to a conventional weight-loss diet because food intake must be limited every day.2”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [2] Moreira EA Most M Howard J Ravussin E Dietary adherence to long-term controlled feeding in a calorie-restriction study in overweight men and women Nutr Clin Pract 2011 26 3 309 315 21586416 PMC4830337
  Not checked in the free run.
Premisecitation
Adherence to daily calorie restriction decreases after 1 month and continues to decline thereafter.
“As such, adherence to daily calorie restriction decreases after 1 month and continues to decline thereafter.3–5”
Quote in the paperSubstantial claim0 of 3 sources checked
- cites [3] Dansinger ML Gleason JA Griffith JL Selker HP Schaefer EJ Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial JAMA 2005 293 1 43 53 15632335
  Not checked in the free run.
- cites [4] Das SK Gilhooly CH Golden JK Long-term effects of 2 energy-restricted diets differing in glycemic load on dietary adherence, body composition, and metabolism in CALERIE: a 1-y randomized controlled trial Am J Clin Nutr 2007 85 4 1023 1030 17413101
  Not checked in the free run.
- cites [5] Sacks FM Bray GA Carey VJ Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates N Engl J Med 2009 360 9 859 873 19246357 PMC2763382
  Not checked in the free run.
Interpretationcitation
The provision of food is not a confounder when comparing past findings with present findings.
“Most of these past studies provided food on the fast day,7,8,10,11 so the provision of food is not a confounder when comparing past findings with present findings.”
Quote in the paperSubstantial claim0 of 4 sources checked
- cites [7] Bhutani S Klempel MC Kroeger CM Trepanowski JF Varady KA Alternate day fasting and endurance exercise combine to reduce body weight and favorably alter plasma lipids in obese humans Obesity (Silver Spring) 2013 21 7 1370 1379 23408502
  Not checked in the free run.
- cites [8] Hoddy KK Kroeger CM Trepanowski JF Barnosky A Bhutani S Varady KA Meal timing during alternate day fasting: impact on body weight and cardiovascular disease risk in obese adults Obesity (Silver Spring) 2014 22 12 2524 2531 25251676
  Not checked in the free run.
- cites [10] Klempel MC Kroeger CM Varady KA Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet Metabolism 2013 62 1 137 143 22889512
  Not checked in the free run.
- cites [11] Varady KA Bhutani S Church EC Klempel MC Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults Am J Clin Nutr 2009 90 5 1138 1143 19793855
  Not checked in the free run.
Study design and conductown data
Because the dropout rate was higher than anticipated, the power to detect the hypothesized 5% weight loss difference at month 6 decreased from 80% to 60%.
“Third, since the dropout rate was higher than anticipated, our power to detect the hypothesized difference of 5% weight loss between the intervention groups at month 6 decreased from 80% to 60%.”
Quote in the paperNot a substantial claim
Interpretationown data
Alternate-day fasting did not produce superior cardioprotection compared with daily calorie restriction.
“Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction.”
- Also stated in: § Discussion · boosted
  “The results of this randomized clinical trial demonstrated that alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or improvement in risk indicators for cardiovascular disease compared with daily calorie restriction.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Interpretationown data
Alternate-day fasting may be less sustainable in the long term than daily calorie restriction for most obese individuals.
“Taken together, these findings suggest that alternate-day fasting may be less sustainable in the long term, compared with daily calorie restriction, for most obese individuals.”
Quote in the paperSubstantial claim

Classified as probably not a substantial claim. 17
May combine two claims. 8

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data
The daily calorie restriction group met its prescribed energy goals at months 3, 6, and 12 but ate less than prescribed at month 9.
“Participants in the daily calorie restriction group (Figure 2C) met their prescribed energy goals at months 3, 6, and 12 but ate less than their prescribed goal at month 9.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data
Participants had previously been sedentary.
“who had previously been sedentary (<60 minutes per week of light activity for the 3 months prior to the study)”
Quote in the paperNot a substantial claim
Classified as probably not a substantial claim.
Study design and conductreasoning
All participants were instructed not to change their physical activity habits during the trial to avoid potential confounding.
“All participants were instructed not to change their physical activity habits throughout the trial (eg, not to join a gym) to avoid potential confounding.”
Quote in the paperSubstantial claim
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown data
Tests for normality were included in the model, and all data were found to be normally distributed.
“Tests for normality were included in the model, and all data were found to be normally distributed.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Classified as probably not a substantial claim.
Study design and conductreasoning
The sample size calculation estimated that 26 participants per group would provide 80% power to detect a 5% difference in body weight at month 6.
“We calculated that 26 participants per group would provide 80% power to detect a significant difference of 5% in body weight between the alternate-day fasting group and the daily calorie restriction group at month 6, using a 2-tailed independent-samples t test with α = .05.”
Quote in the paperSubstantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given
The participants were primarily metabolically healthy obese women.
“The participants were primarily metabolically healthy obese women.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitation
Visceral fat images were analyzed using validated software.
“images were analyzed using validated software.20”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [20] Demerath EW Ritter KJ Couch WA Validity of a new automated software program for visceral adipose tissue estimation Int J Obes (Lond) 2007 31 2 285 291 16770332 PMC1783906
  Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data
A sensitivity analysis including sex and race/ethnicity as covariates did not affect the estimated treatment effects.
“We also performed a sensitivity analysis, in which sex and race/ethnicity were included as adjustment covariates in the intention-to-treat mixed model. The inclusion of sex and race/ethnicity did not affect any of the estimated treatment effects reported in Table 2.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data
The mean body mass index of participants was 34.
“mean body mass index, 34”
Quote in the paperNot a substantial claim
Classified as probably not a substantial claim.
Premisecitation
The first-line therapy prescribed to obese patients for weight loss is daily calorie restriction.
“The first-line therapy prescribed to obese patients for weight loss is daily calorie restriction.1”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [1] Jensen MD Ryan DH Apovian CM American College of Cardiology/American Heart Association, Task Force on Practice Guidelines; Obesity Society 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society Circulation 2014 129 25(suppl 2) S102 S138 24222017 PMC5819889
  Not checked in the free run.
May combine two claims.
Study design and conductreasoning
The control group was imperfect because it received no food, no counseling, and less attention from study personnel, which may have confounded the findings.
“Second, the control group was imperfect, in that they received no food, no counseling, and less attention from study personnel, relative to the intervention groups, which may have confounded our findings.”
Quote in the paperNot a substantial claim
May combine two claims.
Interpretationreasoning
Because many participants had normal cholesterol and blood pressure at baseline, it is not surprising that most cardiovascular risk indicators did not change with diet.
“Since many of the participants had normal cholesterol levels and normal blood pressure at baseline, it is not surprising that most risk indicators for cardiovascular disease did not change in response to diet.”
Quote in the paperSubstantial claim
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given
The protocol was approved by the Office for the Protection of Research Subjects, and written informed consent was obtained from all participants.
“The protocol was approved by the Office for the Protection of Research Subjects at the University of Illinois at Chicago, and written informed consent was obtained from all participants.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given
The control group was not included in the initial power calculation.
“We also failed to include the control group in our initial power calculation.”
Quote in the paperNot a substantial claim
May combine two claims.
Premisenone given
The present study is the longest and largest trial of alternate-day fasting to date.
“To our knowledge, the present study is the longest and largest trial of alternate-day fasting to date.”
Quote in the paperNot a substantial claim0 of 7 sources checked
- cites [7] Bhutani S Klempel MC Kroeger CM Trepanowski JF Varady KA Alternate day fasting and endurance exercise combine to reduce body weight and favorably alter plasma lipids in obese humans Obesity (Silver Spring) 2013 21 7 1370 1379 23408502
  Not checked in the free run.
- cites [8] Hoddy KK Kroeger CM Trepanowski JF Barnosky A Bhutani S Varady KA Meal timing during alternate day fasting: impact on body weight and cardiovascular disease risk in obese adults Obesity (Silver Spring) 2014 22 12 2524 2531 25251676
  Not checked in the free run.
- cites [9] Johnson JB Summer W Cutler RG Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma [published correction appears in Free Radic Biol Med. 2007;43(9):1348] Free Radic Biol Med 2007 42 5 665 674 17291990 PMC1859864
  Not checked in the free run.
- cites [10] Klempel MC Kroeger CM Varady KA Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet Metabolism 2013 62 1 137 143 22889512
  Not checked in the free run.
- cites [11] Varady KA Bhutani S Church EC Klempel MC Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults Am J Clin Nutr 2009 90 5 1138 1143 19793855
  Not checked in the free run.
- cites [12] Catenacci VA Pan Z Ostendorf D A randomized pilot study comparing zero-calorie alternate-day fasting to daily caloric restriction in adults with obesity Obesity (Silver Spring) 2016 24 9 1874 1883 27569118 PMC5042570
  Not checked in the free run.
- cites [13] Alhamdan BA Garcia-Alvarez A Alzahrnai AH Alternate-day versus daily energy restriction diets: which is more effective for weight loss? a systematic review and meta-analysis Obes Sci Pract 2016 2 3 293 302 27708846 PMC5043510
  Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data
The trial used an intention-to-treat analysis that included all 100 randomized participants.
“We conducted an intention-to-treat analysis, which included data from all 100 participants who underwent randomization.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: The missing data mechanism is missing at random.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data
The trial was registered at clinicaltrials.gov with identifier NCT00960505.
“clinicaltrials.gov Identifier: NCT00960505”
Quote in the paperNot a substantial claim
Classified as probably not a substantial claim. May combine two claims.
Study design and conductown data
Participants were randomized in a 1:1:1 ratio to alternate-day fasting, daily calorie restriction, or control, with stratification by sex, age, and body mass index.
“Participants were randomized in a 1:1:1 ratio to an alternate-day fasting group, daily calorie restriction group, or no-intervention control group. Randomization was performed by a stratified random sampling procedure by sex, age (18–42 years and 43–65 years), and body mass index (25.0–32.5 and 32.6–39.9).”
Quote in the paperSubstantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data
Participants were aged 18 to 64 years.
“obese adults (18 to 64 years of age; mean body mass index, 34)”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given
The maintenance phase duration was short (6 months).
“First, the duration of the maintenance phase was short (6 months).”
Quote in the paperNot a substantial claim
May combine two claims.
Premisecitation
Short-term studies indicate that participants lose 3% to 7% of body weight after 2 to 3 months of alternate-day fasting and experience improvements in lipid profiles, blood pressure, and insulin sensitivity.
“Findings from short-term studies indicate that participants lose 3% to 7% of body weight after 2 to 3 months of alternate-day fasting and experience improvements in lipid profiles, blood pressure, and insulin sensitivity.7–13”
Quote in the paperSubstantial claim0 of 7 sources checked
- cites [7] Bhutani S Klempel MC Kroeger CM Trepanowski JF Varady KA Alternate day fasting and endurance exercise combine to reduce body weight and favorably alter plasma lipids in obese humans Obesity (Silver Spring) 2013 21 7 1370 1379 23408502
  Not checked in the free run.
- cites [8] Hoddy KK Kroeger CM Trepanowski JF Barnosky A Bhutani S Varady KA Meal timing during alternate day fasting: impact on body weight and cardiovascular disease risk in obese adults Obesity (Silver Spring) 2014 22 12 2524 2531 25251676
  Not checked in the free run.
- cites [9] Johnson JB Summer W Cutler RG Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma [published correction appears in Free Radic Biol Med. 2007;43(9):1348] Free Radic Biol Med 2007 42 5 665 674 17291990 PMC1859864
  Not checked in the free run.
- cites [10] Klempel MC Kroeger CM Varady KA Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet Metabolism 2013 62 1 137 143 22889512
  Not checked in the free run.
- cites [11] Varady KA Bhutani S Church EC Klempel MC Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults Am J Clin Nutr 2009 90 5 1138 1143 19793855
  Not checked in the free run.
- cites [12] Catenacci VA Pan Z Ostendorf D A randomized pilot study comparing zero-calorie alternate-day fasting to daily caloric restriction in adults with obesity Obesity (Silver Spring) 2016 24 9 1874 1883 27569118 PMC5042570
  Not checked in the free run.
- cites [13] Alhamdan BA Garcia-Alvarez A Alzahrnai AH Alternate-day versus daily energy restriction diets: which is more effective for weight loss? a systematic review and meta-analysis Obes Sci Pract 2016 2 3 293 302 27708846 PMC5043510
  Not checked in the free run.

21 of 21

The authors state this as an assumption.
The missing data mechanism is missing at random.
“This model provides unbiased estimates of time and treatment effects under a missing-at-random assumption.”
The paper relies on this without support.
No long-term randomized clinical trials have evaluated the efficacy of alternate-day fasting or compared it with a conventional weight-loss diet.
“Despite the growing popularity of alternate-day fasting, to our knowledge, no long-term randomized clinical trials have evaluated its efficacy or compared this regimen with a conventional weight-loss diet.”

2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

The superior weight loss in the INT group in the present study is in contrast with the majority of studies that have reported no advantage of intermittent over continuous ER.
“The superior weight loss in the INT group in the present study is in contrast with the majority of studies that have reported no advantage of intermittent over continuous ER.”
From Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study (2018) · cites this paper as [42]
The Results (Weight Loss and Weight Maintenance; page not available) report no significant weight-loss difference between alternate-day fasting and daily calorie restriction, so this study supports the cited comparison. As a single trial, it does not establish the claim that a majority of studies found no advantage. The citing authors’ finding of superior weight loss in their own INT group is not attributed to this source. (LLM, conf=0.82)
Experimental — accuracy not yet measured
This trend is consistent with Trepanowski et al.'s findings, which observed improvements in plasma lipids with ADF at 6 months.
“This trend is consistent with Trepanowski et al.'s findings [74], which also observed improvements in plasma lipids with ADF at 6 months.”
From Comparing caloric restriction regimens for effective weight management in adults: a systematic review and network meta-analysis (2024) · cites this paper as [74]
The Results (Plasma Lipids) report a significant increase in HDL cholesterol with alternate-day fasting versus daily calorie restriction at month 6. They report no significant differences in total cholesterol, LDL cholesterol, or triglycerides at that time, so the broader claim of improvements in plasma lipids overstates the finding. (LLM, conf=0.88)
Experimental — accuracy not yet measured
A recent 12-month clinical trial and several recent reviews have concluded that existing models of intermittent ER (largely versions of intermittent fasting) could be considered equivalent, but not superior, alternatives for weight loss.
“A recent 12-month clinical trial42 and several recent reviews9,43, 44 have concluded that existing models of intermittent ER (largely versions of intermittent fasting), could be considered equivalent, but not superior, alternatives for weight loss.”
From Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study (2018) · cites this paper as [42]
In a 12-month study, ADF (25% of daily energy needs on fasting days: one day on, one day off) compared with a calorie-restricted (75% of energy needs every day) and a control diet resulted in weight loss in the two intervention groups, but insulin sensitivity, blood lipid levels and blood glucose were not improved.
“It was demonstrated that although the two intervention groups lost weight, insulin sensitivity, blood lipid levels and blood glucose were not improved.”
From Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance (2022) · cites this paper as [350]
A few studies have extended up to 52 weeks and show similar findings on intermittent fasting and weight loss.
“A few studies have extended up to 52 weeks and show similar findings (152-155).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [153]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Trial phases total 13 months, not one year
Minor
The stated baseline, weight-loss, and maintenance phases add up to 13 months, although the active trial duration is described as one year (12 months).
Reported 12 · recomputed 13

1 of 1

Homeostasis model assessment: insulin resistance and ?-cell function from fasting plasma glucose and insulin concentrations in man
Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F., & Turner, R. C. (1985) · Diabetologia · doi:10.1007/bf00280883 · Cited by 31,502 · see citing works
Magnesium Replacement Improves the Metabolic Profile in Obese and Pre-Diabetic Patients with Mild-to-Moderate Chronic Kidney Disease: A 3-Month, Randomised, Double-Blind, Placebo-Controlled Study
Toprak, Ö., Kurt, H., Sarı, Y., Şarkış, C., Us, H., & Kırık, A. (2017) · Kidney & Blood Pressure Research · doi:10.1159/000468530 · Cited by 29,769 · see citing works
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.11.004 · Cited by 4,058 · see citing works
A structural approach to selection bias
Hernán, M. A., Hernández-Díaz, S., & Robins, J. M. (2004) · Epidemiology · doi:10.1097/01.ede.0000135174.63482.43 · Cited by 2,844 · see citing works
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437739.71477.ee · Cited by 2,735 · see citing works
2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
Eckel, R. H., Jakicic, J. M., Ard, J. D., de Jesus, J. M., Miller, N. H., Hubbard, V. S., Lee, I.-M., Lichtenstein, A. H., Loria, C. M., Millen, B. E., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437740.48606.d1 · Cited by 2,261 · see citing works
Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates
Sacks, F. M., Bray, G. A., Carey, V. J., Smith, S. R., Ryan, D. H., Anton, S. D., McManus, K., Champagne, C. M., Bishop, L. M., Laranjo, N., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0804748 · Cited by 1,966 · see citing works
Self-citation
Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction: A Randomized Trial
Dansinger, M. L., Gleason, J. A., Griffith, J. L., Selker, H. P., & Schaefer, E. J. (2005) · JAMA · doi:10.1001/jama.293.1.43 · Cited by 1,726 · see citing works
Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women: The A TO Z Weight Loss Study: A Randomized Trial
Gardner, C. D., Kiazand, A., Alhassan, S., Kim, S., Stafford, R. S., Balise, R. R., Kraemer, H. C., & King, A. C. (2007) · JAMA · doi:10.1001/jama.297.9.969 · Cited by 1,051 · see citing works
Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma
Johnson, J. B., Summer, W., Cutler, R. G., Martin, B., Hyun, D.-H., Dixit, V. D., Pearson, M., Nassar, M., Tellejohan, R., Maudsley, S., et al. (2007) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2006.12.005 · Cited by 604 · see citing works
A 2-year randomized controlled trial of human caloric restriction: Feasibility and effects on predictors of health span and longevity
Ravussin, E., Redman, L. M., Rochon, J., Das, S. K., Fontana, L., Kraus, W. E., Romashkan, S., Williamson, D. A., Meydani, S. N., Villareal, D. T., et al. (2015) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glv057 · Cited by 489 · see citing works
Self-citation
Accuracy of Armband Monitors for Measuring Daily Energy Expenditure in Healthy Adults
Johannsen, D. L., Calabro, M. A., Stewart, J. W., Franke, W. D., Rood, J. C., & Welk, G. J. (2010) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181e0b3ff · Cited by 424 · see citing works
Self-citation
Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese U.S. men and women
Tudor‐Locke, C., Brashear, M. M., Johnson, W. D., & Katzmarzyk, P. T. (2010) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-7-60 · Cited by 377 · see citing works
Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults
Varady, K. A., Bhutani, S., Church, E. C., & Klempel, M. C. (2009) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.28380 · Cited by 365 · see citing works
Self-citation
Alternate-day fasting and chronic disease prevention: a review of human and animal trials
Varady, K. A., & Hellerstein, M. K. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/86.1.7 · Cited by 358 · see citing works
Self-citation
Alternate day fasting and endurance exercise combine to reduce body weight and favorably alter plasma lipids in obese humans
Bhutani, S., Klempel, M. C., Kroeger, C. M., Trepanowski, J. F., & Varady, K. A. (2013) · Obesity · doi:10.1002/oby.20353 · Cited by 349 · see citing works
Self-citation
A randomized pilot study comparing zero‐calorie alternate‐day fasting to daily caloric restriction in adults with obesity
Catenacci, V. A., Pan, Z., Ostendorf, D., Brannon, S., Gozansky, W. S., Mattson, M. P., Martin, B., MacLean, P. S., Melanson, E. L., & Troy Donahoo, W. (2016) · Obesity · doi:10.1002/oby.21581 · Cited by 332 · see citing works
Long-term effects of 2 energy-restricted diets differing in glycemic load on dietary adherence, body composition, and metabolism in CALERIE: a 1-y randomized controlled trial
Das, S. K., Gilhooly, C. H., Golden, J. K., Pittas, A. G., Fuss, P. J., Cheatham, R. A., Tyler, S., Tsay, M., McCrory, M. A., Lichtenstein, A. H., et al. (2007) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.4.1023 · Cited by 314 · see citing works
Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet
Klempel, M. C., Kroeger, C. M., & Varady, K. A. (2012) · Metabolism · doi:10.1016/j.metabol.2012.07.002 · Cited by 165 · see citing works
Self-citation
Effects of a lifestyle intervention in metabolically benign and malign obesity
Kantartzis, K., Machann, J., Schick, F., Rittig, K., Machicao, F. E., Fritsche, A., Häring, H., & Stefan, N. (2010) · Diabetologia · doi:10.1007/s00125-010-2006-3 · Cited by 141 · see citing works
Comparison of Weight-Loss Diets With Different Compositions of Fat, Protein, and Carbohydrates
Sacks, F. M., Bray, G. A., Carey, V. J., Smith, S. R., Ryan, D. H., Anton, S. D., McManus, K. D., Champagne, C. M., Bishop, L. M., Laranjo, N., et al. (2009) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000351673.32059.13 · Cited by 140 · see citing works
Self-citation
Meal timing during alternate day fasting: Impact on body weight and cardiovascular disease risk in obese adults
Hoddy, K. K., Kroeger, C. M., Trepanowski, J. F., Barnosky, A., Bhutani, S., & Varady, K. A. (2014) · Obesity · doi:10.1002/oby.20909 · Cited by 138 · see citing works
Self-citation
Effects of Weight Loss Among Metabolically Healthy Obese Men and Women
Janiszewski, P. M., & Ross, R. (2010) · Diabetes Care · doi:10.2337/dc10-0547 · Cited by 115 · see citing works
Validation study of energy expenditure and intake during calorie restriction using doubly labeled water and changes in body composition
de Jonge, L., DeLany, J. P., Nguyen, T., Howard, J., Hadley, E. C., Redman, L. M., & Ravussin, É. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.1.73 · Cited by 110 · see citing works
Self-citation
Calorie Restriction and Bone Health in Young, Overweight Individuals
Redman, L. M. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.17.1859 · Cited by 98 · see citing works
Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: A randomized trial
Dansinger, M. L., Gleason, J. A., Griffith, J. L., Selker, H. P., & Schaefer, E. J. (2005) · ACC Current Journal Review · doi:10.1016/j.accreview.2005.02.079 · Cited by 95 · see citing works
Alternate‐day versus daily energy restriction diets: which is more effective for weight loss? A systematic review and meta‐analysis
Alhamdan, B. A., García-Álvarez, A., Alzahrnai, A. H., Karanxha, J., Stretchberry, D. R., Contrera, K. J., Utria, A. F., & Cheskin, L. J. (2016) · Obesity Science & Practice · doi:10.1002/osp4.52 · Cited by 95 · see citing works
Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women. The A to Z Weight Loss Study: A Randomized Trial
Gardner, C. D., Kiazand, A., Alhassan, S., Kim, S., Stafford, R. S., Balise, R. R., KRAEMER, H. C., & King, A. C. (2007) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000269084.43998.38 · Cited by 73 · see citing works
Validity of a new automated software program for visceral adipose tissue estimation
Demerath, E. W., Ritter, K. J., Couch, W. P., Rogers, N. L., Moreno, G. J., Choh, A. C., Lee, M., Remsberg, K. E., Czerwiński, S., Chumlea, W. C., et al. (2006) · International Journal of Obesity · doi:10.1038/sj.ijo.0803409 · Cited by 63 · see citing works
Dietary Adherence to Long‐Term Controlled Feeding in a Calorie‐Restriction Study in Overweight Men and Women
Moreira, E. A. M., Most, M. M., Howard, J., & Ravussin, É. (2011) · Nutrition in Clinical Practice · doi:10.1177/0884533611405992 · Cited by 60 · see citing works
Self-citation
Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction: A Randomized Trial
Gersh, B. J. (2006) · Yearbook of Cardiology · doi:10.1016/s0145-4145(07)70170-3 · Cited by 58 · see citing works
Dietary adherence in well-controlled feeding studies.
Hall, D. M., & Most, M. (2005) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2005.05.009 · Cited by 32 · see citing works

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Research works printed but not linked: 1

[15]The 5:2 Fast Diet For Beginners Berkeley, CA Rockridge Press 2013

Sorted by citations

Effects of intermittent fasting on health, aging, and disease
de Cabo, R., & Mattson, M. P. (2019) · New England Journal of Medicine · doi:10.1056/nejmra1905136 · Cited by 1,605 · see citing works
Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes
Sutton, E. F., Beyl, R., Early, K. S., Cefalu, W. T., Ravussin, E., & Peterson, C. M. (2018) · Cell Metabolism · doi:10.1016/j.cmet.2018.04.010 · Cited by 1,531 · see citing works
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“Table 3 presents findings from clinical trials that examined ADMF and ADF regimens (12,54,119,131-135).”
Background
Molecular mechanisms of dietary restriction promoting health and longevity
Green, C. L., Lamming, D. W., & Fontana, L. (2022) · Nature Reviews Molecular Cell Biology · doi:10.1038/s41580-021-00411-4 · Cited by 714 · see citing works
Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: A pilot study
Gabel, K., Hoddy, K. K., Haggerty, N., Song, J., Kroeger, C. M., Trepanowski, J. F., Panda, S., & Varady, K. A. (2018) · Nutrition and Healthy Aging · doi:10.3233/nha-170036 · Cited by 631 · see citing works
“Previous work indicates that intermittent fasting regimens [4, 8, 10] and other lifestyle regimens [21, 22] have little effect on cardiometabolic disease risk factors in healthy obese subjects.”
BackgroundMethodResultInfluentialSelf-citation
Effects of 4- and 6-h Time-Restricted Feeding on Weight and Cardiometabolic Health: A Randomized Controlled Trial in Adults with Obesity
Cienfuegos, S., Gabel, K., Kalam, F., Ezpeleta, M., Wiseman, E., Pavlou, V., Lin, S., Oliveira, M. L., & Varady, K. A. (2020) · Cell Metabolism · doi:10.1016/j.cmet.2020.06.018 · Cited by 597 · see citing works
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Gut microbiota mediates intermittent-fasting alleviation of diabetes-induced cognitive impairment
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A time to fast
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Alternate day fasting improves physiological and molecular markers of aging in healthy, non-obese humans
Stekovic, S., Hofer, S. J., Tripolt, N., Aon, M. A., Royer, P., Pein, L., Stadler, J. T., Pendl, T., Prietl, B., Url, J., et al. (2019) · Cell Metabolism · doi:10.1016/j.cmet.2019.07.016 · Cited by 412 · see citing works
“…will be an interesting course of upcoming research, although a recent study suggests that the effects onweight loss and cardiovascular improvements are very similar between a mild form of ADF (25% calories on fast days, 125% on feast days) and 25% continuous CR (Trepanowski et al., 2017).”
Background
5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i>
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s005 · Cited by 362 · see citing works
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“Most of the IMF studies used seven-day diet records [40,41,44,46,48,49] or diet checklists [43] to assess adherence, with the exception of Catenacci et al.”
BackgroundMethodInfluential
Intermittent Fasting in Cardiovascular Disorders—An Overview
Malinowski, B., Zalewska, K., Węsierska, A., Sokołowska, M. M., Socha, M., Liczner, G., Pawlak-Osińska, K., & Wiciński, M. (2019) · Nutrients · doi:10.3390/nu11030673 · Cited by 290 · see citing works
“Moreover, there were no significant differences between the ADF and CR groups in terms of heart rate, blood pressure, fasting glucose, fasting insulin, triglycerides, and CRP at both time-point assessments [66].”
BackgroundMethodInfluential
Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial
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Carter, S., Clifton, P. M., & Keogh, J. B. (2018) · JAMA Network Open · doi:10.1001/jamanetworkopen.2018.0756 · Cited by 299 · see citing works
Intermittent and periodic fasting, longevity and disease
Longo, V. D., Tano, M. D., Mattson, M. P., & Guidi, N. (2021) · Nature Aging · doi:10.1038/s43587-020-00013-3 · Cited by 288 · see citing works
Intermittent Fasting and Metabolic Health
Vasim, I., Majeed, C. N., & DeBoer, M. D. (2022) · Nutrients · doi:10.3390/nu14030631 · Cited by 309 · see citing works
“Overall, the authors concluded that alternate-day fasting did not improve health beyond calorie restriction [33].”
BackgroundInfluential
Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial
Schübel, R., Nattenmüller, J., Sookthai, D., Nonnenmacher, T., Graf, M. E., Riedl, L., Schlett, C. L., von Stackelberg, O., Johnson, T., Nabers, D., et al. (2018) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqy196 · Cited by 274 · see citing works
“Of note, results of a 1-y RCT on another popular form of ICR, alternate day fasting (ADF), have recently been published (25).”
BackgroundInfluential
5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Beverly, E. A., Bruemmer, D., Collins, B. S., Darville, A. K., Ekhlaspour, L., Hassanein, M. M., Hilliard, M. E., et al. (2023) · Diabetes Care · doi:10.2337/dc24-s005 · Cited by 325 · see citing works
Oxidative damage in neurodegeneration: roles in the pathogenesis and progression of Alzheimer disease
Marzia Perluigi, A., Domenico, F. D., & Butterfield, D. A. (2023) · Physiological Reviews · doi:10.1152/physrev.00030.2022 · Cited by 306 · see citing works
Intermittent Fasting: Is the Wait Worth the Weight?
Stockman, M.-C., Thomas, D. D., Burke, J., & Apovian, C. M. (2018) · Current Obesity Reports · doi:10.1007/s13679-018-0308-9 · Cited by 235 · see citing works
Dietary interventions for obesity: clinical and mechanistic findings.
Chao, A. M., Quigley, K. M., & Wadden, T. A. (2021) · Journal of Clinical Investigation · doi:10.1172/jci140065 · Cited by 257 · see citing works
“3% observed in the daily (isocaloric) restriction group (46).”
Background
Calorie Restriction and Aging in Humans
Flanagan, E. W., Most, J., Mey, J. T., & Redman, L. M. (2020) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-122319-034601 · Cited by 239 · see citing works
Intermittent Fasting: A Heart Healthy Dietary Pattern?
Dong, T. A., Sandesara, P. B., Dhindsa, D. S., Mehta, A., Arneson, L. C., Dollar, A. L., Taub, P. R., & Sperling, L. S. (2020) · The American Journal of Medicine · doi:10.1016/j.amjmed.2020.03.030 · Cited by 240 · see citing works
Nutrition, Obesity, and Cachexia in Patients With Heart Failure: A Consensus Statement from the Heart Failure Society of America Scientific Statements Committee
Vest, A. R., Chan, M. C. Y., Deswal, A. M., Givertz, M. M., Lekavich, C. L., Lennie, T. A., Litwin, S. E., Parsly, L., Rodgers, J. E., Rich, M. W., et al. (2019) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2019.03.007 · Cited by 233 · see citing works
Food Timing, Circadian Rhythm and Chrononutrition: A Systematic Review of Time-Restricted Eating's Effects on Human Health.
Réda, A., Wassil, M., Meriem, M., Alexia, P., Abdelmalik, H., Sabine, B., & Nassir, M. (2020) · Nutrients · doi:10.3390/nu12123770 · Cited by 189 · see citing works
“, 100% energy restriction) followed by and a feed day (ad libitum food consumption), resulting in 36-h fasting [12,13].”
Background
Treatment of NAFLD with intermittent calorie restriction or low-carb high-fat diet—a randomised controlled trial
Holmer, M., Lindqvist, C., Petersson, S., Moshtaghi-Svensson, J., Tillander, V., Brismar, T. B., Hagström, H., & Stål, P. (2021) · JHEP Reports · doi:10.1016/j.jhepr.2021.100256 · Cited by 224 · see citing works
The ups and downs of caloric restriction and fasting: from molecular effects to clinical application
Hofer, S. J., Carmona‐Gutiérrez, D., Mueller, M. I., & Madeo, F. (2021) · EMBO Molecular Medicine · doi:10.15252/emmm.202114418 · Cited by 207 · see citing works
Time-restricted feeding improves blood glucose and insulin sensitivity in overweight patients with type 2 diabetes: a randomised controlled trial
Che, T., Cheng, Y. Z., Tian, D., Zhang, X., Liu, X., & Wu, Z. (2021) · Nutrition & Metabolism · doi:10.1186/s12986-021-00613-9 · Cited by 213 · see citing works
“HDL cholesterol is also not affected by these diets, although one study observed a slight increase [40].”
Intermittent fasting and weight loss: Systematic review.
(2020) · Europe PMC (PubMed Central) · Cited by 206 · see citing works
Effects of alternate-day fasting on body weight and dyslipidaemia in patients with non-alcoholic fatty liver disease: a randomised controlled trial
Cai, H., Qin, Y.-L., Shi, Z.-Y., Chen, J.-H., Zeng, M.-J., Zhou, W., Chen, R.-Q., & Chen, Z.-Y. (2019) · BMC Gastroenterology · doi:10.1186/s12876-019-1132-8 · Cited by 205 · see citing works
Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials
Cioffi, I., Evangelista, A., Ponzo, V., Ciccone, G., Soldati, L., Santarpia, L., Contaldo, F., Pasanisi, F., Ghigo, E., & Bo, S. (2018) · Journal of Translational Medicine · doi:10.1186/s12967-018-1748-4 · Cited by 190 · see citing works
Intermittent Fasting Improves Cardiometabolic Risk Factors and Alters Gut Microbiota in Metabolic Syndrome Patients
Guo, Y., Luo, S., Ye, Y., Yin, S., Fan, J., & Xia, M. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa644 · Cited by 198 · see citing works
Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance
Papakonstantinou, E., Oikonomou, C., Nychas, G., & Dimitriadis, G. D. (2022) · Nutrients · doi:10.3390/nu14040823 · Cited by 199 · see citing works
Regulators of health and lifespan extension in genetically diverse mice on dietary restriction
Di Francesco, A., Deighan, A. G., Litichevskiy, L., Chen, Z., Luciano, A., Robinson, L., Garland, G., Donato, H., Schott, W., Wright, K. M., et al. (2023) · doi:10.1101/2023.11.28.568901 · Cited by 194 · see citing works
Cardiometabolic Benefits of Intermittent Fasting
Varady, K. A., Cienfuegos, S., Ezpeleta, M., & Gabel, K. (2021) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-052020-041327 · Cited by 186 · see citing works
Self-citation
Diet and exercise in NAFLD/NASH: Beyond the obvious
Semmler, G., Datz, C., Reiberger, T., & Trauner, M. A. (2021) · Liver International · doi:10.1111/liv.15024 · Cited by 183 · see citing works
Feasibility of time-restricted eating and impacts on cardiometabolic health in 24-h shift workers: The Healthy Heroes randomized control trial
Manoogian, E. N. C., Zadourian, A., Lo, H. C., Gutierrez, N. R., Shoghi, A., Rosander, A. M., Pazargadi, A., Ormiston, C. K., Wang, X., Sui, J., et al. (2022) · Cell Metabolism · doi:10.1016/j.cmet.2022.08.018 · Cited by 184 · see citing works
Short-term time-restricted feeding is safe and feasible in non-obese healthy midlife and older adults
Martens, C. R., Rossman, M. J., Mazzo, M. R., Jankowski, L. R., Nagy, E. E., Denman, B. A., Richey, J. J., Johnson, S. A., Ziemba, B. P., Wang, Y., et al. (2020) · GeroScience · doi:10.1007/s11357-020-00156-6 · Cited by 182 · see citing works
A Heart-Healthy Diet for Cardiovascular Disease Prevention: Where Are We Now?
Diab, A., Dastmalchi, L. N., Gulati, M., & Michos, E. D. (2023) · Vascular Health and Risk Management · doi:10.2147/vhrm.s379874 · Cited by 202 · see citing works
Spermidine is essential for fasting-mediated autophagy and longevity
Hofer, S. J., Daskalaki, I., Bergmann, M., Friščić, J., Zimmermann, A., Mueller, M. I., Abdellatif, M., Nicastro, R., Masser, S., Durand, S., et al. (2024) · Nature Cell Biology · doi:10.1038/s41556-024-01468-x · Cited by 183 · see citing works
Effect of alternate day fasting combined with aerobic exercise on non-alcoholic fatty liver disease: A randomized controlled trial
Ezpeleta, M., Gabel, K., Cienfuegos, S., Kalam, F., Lin, S., Pavlou, V., Song, Z., Haus, J. M., Koppe, S., Alexandria, S. J., et al. (2023) · Cell Metabolism · doi:10.1016/j.cmet.2022.12.001 · Cited by 181 · see citing works
Self-citation
Intermittent fasting in the prevention and treatment of cancer
Clifton, K., Ma, C. X., Fontana, L., & Peterson, L. L. (2021) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21694 · Cited by 160 · see citing works
Developing dietary interventions as therapy for cancer
Taylor, S. R., Falcone, J. N., Cantley, L. C., & Goncalves, M. D. (2022) · Nature reviews. Cancer · doi:10.1038/s41568-022-00485-y · Cited by 160 · see citing works
Chrono-nutrition for the prevention and treatment of obesity and type 2 diabetes: from mice to men
Hawley, J. A., Sassone‐Corsi, P., & Zierath, J. R. (2020) · Diabetologia · doi:10.1007/s00125-020-05238-w · Cited by 155 · see citing works
“Several short-term studies report that IF is as effective for weight loss as standard weight-loss diets (see [29]), whereas a 12 month study that compared IF (one day on, one day off), CER and a control diet found that, although the two intervention groups lost weight, insulin sensitivity, blood lipid levels and blood…”
Background
Effect of intermittent vs. daily calorie restriction on changes in weight and patient-reported outcomes in people with multiple sclerosis
Fitzgerald, K. C., Vizthum, D., Henry-Barron, B. J., Schweitzer, A., Cassard, S. D., Kossoff, E. H., Hartman, A. L., Kapogiannis, D., Sullivan, P. S., Baer, D. J., et al. (2018) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2018.05.002 · Cited by 150 · see citing works
Dietary Restrictions and Nutrition in the Prevention and Treatment of Cardiovascular Disease
Brandhorst, S., & Longo, V. D. (2019) · Circulation Research · doi:10.1161/circresaha.118.313352 · Cited by 146 · see citing works
Differential Effects of Alternate-Day Fasting Versus Daily Calorie Restriction on Insulin Resistance
Gabel, K., Kroeger, C. M., Trepanowski, J. F., Hoddy, K. K., Cienfuegos, S., Kalam, F., & Varady, K. A. (2019) · Obesity · doi:10.1002/oby.22564 · Cited by 144 · see citing works
“Very few studies have examined the impact of intermittent fasting versus daily CR on inflammatory mediators (5,7,8).”
BackgroundMethodInfluentialSelf-citation
Clinical Management of Intermittent Fasting in Patients with Diabetes Mellitus
Grajower, M. M., & Horne, B. D. (2019) · Nutrients · doi:10.3390/nu11040873 · Cited by 160 · see citing works
“Early in the study of fasting’s health effects it was hypothesized that fasting could ameliorate some of the major undesirable effects of weight loss diets [10].”
Background
Effects of time-restricted feeding in weight loss, metabolic syndrome and cardiovascular risk in obese women
Schröder, J. D., Falqueto, H., Mânica, A., Zanini, D., de Oliveira, T., Sá, C. A. D., Cardoso, A. M., & Manfredi, L. H. (2021) · Journal of Translational Medicine · doi:10.1186/s12967-020-02687-0 · Cited by 152 · see citing works
Effects of alternate-day fasting or daily calorie restriction on body composition, fat distribution, and circulating adipokines: Secondary analysis of a randomized controlled trial
Trepanowski, J. F., Kroeger, C. M., Barnosky, A., Klempel, M. C., Bhutani, S., Hoddy, K. K., Rood, J. C., Ravussin, É., & Varady, K. A. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2017.11.018 · Cited by 149 · see citing works
“First, these findings are from a secondary analysis; and in the primary analysis, which included all participants (including non-completers), insulin and HOMA-IR both changed similarly between the ADF and CR groups (2).”
BackgroundMethodResultInfluentialSelf-citation
Effects of Intermittent Versus Continuous Energy Intakes on Insulin Sensitivity and Metabolic Risk in Women with Overweight
Hutchison, A. T., Liu, B., Wood, R. E., Vincent, A. D., Thompson, C. H., O’Callaghan, N. J., Wittert, G., & Heilbronn, L. K. (2018) · Obesity · doi:10.1002/oby.22345 · Cited by 148 · see citing works
Time-Restricted Eating Without Calorie Counting for Weight Loss in a Racially Diverse Population
Lin, S., Cienfuegos, S., Ezpeleta, M., Gabel, K., Pavlou, V., Mulas, A., Chakos, K., McStay, M., Wu, J. Q., Tussing-Humphreys, L. M., et al. (2023) · Annals of Internal Medicine · doi:10.7326/m23-0052 · Cited by 142 · see citing works
“Statistical Analysis For the sample size calculation, we estimated that the TRE and CR groups would reduce body weight by 8 kg (extrapolated from our pilot data) and 5 kg (16), respectively, by month 12 versus the control group (no change in body weight).”
BackgroundMethodSelf-citation
Time-restricted eating effects on performance, immune function, and body composition in elite cyclists: a randomized controlled trial
Moro, T., Tinsley, G. M., Longo, G., Grigoletto, D., Bianco, A., Ferraris, C., Guglielmetti, M., Veneto, A., Tagliabue, A., Marcolin, G., et al. (2020) · Journal of the International Society of Sports Nutrition · doi:10.1186/s12970-020-00396-z · Cited by 153 · see citing works
Effects of intermittent fasting and energy-restricted diets on lipid profile: A systematic review and meta-analysis
Meng, H., Zhu, L., Kord-Varkaneh, H., O Santos, H., Tinsley, G. M., & Fu, P. (2020) · Nutrition · doi:10.1016/j.nut.2020.110801 · Cited by 146 · see citing works
Intermittent fasting plus early time-restricted eating versus calorie restriction and standard care in adults at risk of type 2 diabetes: a randomized controlled trial
Teong, X. T., Liu, K., Vincent, A. D., Bensalem, J., Liu, B., Hattersley, K. J., Zhao, L., Feinle‐Bisset, C., Sargeant, T. J., Wittert, G., et al. (2023) · Nature Medicine · doi:10.1038/s41591-023-02287-7 · Cited by 141 · see citing works
Impact of intermittent fasting on the lipid profile: Assessment associated with diet and weight loss
Santos, H. O., & Macedo, R. C. O. (2018) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2018.01.002 · Cited by 139 · see citing works
A meta‐analysis comparing the effectiveness of alternate day fasting, the 5:2 diet, and time‐restricted eating for weight loss
Elortegui Pascual, P., Rolands, M. R., Eldridge, A. L., Kassis, A., Mainardi, F., Lê, K., Karagounis, L. G., Gut, P., & Varady, K. A. (2023) · Obesity · doi:10.1002/oby.23568 · Cited by 133 · see citing works
“In Varady et al. [15] and Trepanowski et al. [16], data on mean body weight loss were obtained by directly contacting the authors.”
BackgroundMethodResultInfluentialSelf-citation
Twelve Months of Time-restricted Eating and Resistance Training Improves Inflammatory Markers and Cardiometabolic Risk Factors
MORO, T., TINSLEY, G., PACELLI, F. Q., MARCOLIN, G., BIANCO, A., & PAOLI, A. (2021) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002738 · Cited by 134 · see citing works
“In a 12-month long-term study, Trepanowski and colleagues (49) compared the effect of an alternate day fasting protocol with daily CR diet on cardiometabolic risk factors in obese adults.”
Background
Intermittent Fasting and Metabolic Health: From Religious Fast to Time‐Restricted Feeding
Hoddy, K. K., Marlatt, K. L., Çetinkaya, H., & Ravussin, É. (2020) · Obesity · doi:10.1002/oby.22829 · Cited by 137 · see citing works
“Small studies (<20 participants per group) appear to report similar dropout rates (70,77,79), whereas, larger studies (>40 participants) are equivocal (81,83).”
BackgroundResultInfluentialSelf-citation
Intermittent fasting: from calories to time restriction
Duregon, E., Pomatto, L. C. D., Bernier, M., Price, N. L., & de Cabo, R. (2021) · GeroScience · doi:10.1007/s11357-021-00335-z · Cited by 128 · see citing works
Intermittentv. continuous energy restriction: differential effects on postprandial glucose and lipid metabolism following matched weight loss in overweight/obese participants
Antoni, R., Johnston, K. L., Collins, A. L., & Robertson, M. D. (2018) · British Journal Of Nutrition · doi:10.1017/s0007114517003890 · Cited by 124 · see citing works
“More recently, a study by Trepanowski et al.(7) of alternate day ER also reported a higher attrition rate among IER participants of 38 v. 29% among CER 100 200 300 –1.0 –0.5 0.0 0.5 1.0 1.5 IER P= 0.943* Time (min) G lu co se ( m m ol /l) C ha ng e fr om b as el in e 100 200 300 –1.0 –0.5 0.0 0.5 1.0 1.5 2.0 CER P= 0.…”
BackgroundInfluential
Beneficial Effects of Early Time-Restricted Feeding on Metabolic Diseases: Importance of Aligning Food Habits with the Circadian Clock
Charlot, A., Hutt, F., Sabatier, E., & Zoll, J. (2021) · Nutrients · doi:10.3390/nu13051405 · Cited by 119 · see citing works
“The evaluation of fasting efficacy during a year on obese adults also did not show improvement in risk indicators for cardiovascular disease [28].”
Background
Unravelling the health effects of fasting: a long road from obesity treatment to healthy life span increase and improved cognition
de Toledo, F. W., Grundler, F., Sirtori, C. R., & Ruscica, M. (2020) · Annals of Medicine · doi:10.1080/07853890.2020.1770849 · Cited by 119 · see citing works
“These were randomised to adhere for 1 year (6-month intervention followed by 6-month weight maintenance) to one of the following regimens: (i) ADF (25% of energy needs on fasting days and 125% on alternating feast days), and (ii) 75% CR. Compared to the control group, no differences between interventions were found ei…”
BackgroundResultInfluential
Intermittent fasting: is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians
Albosta, M. S., & Bakke, J. (2021) · Clinical Diabetes and Endocrinology · doi:10.1186/s40842-020-00116-1 · Cited by 123 · see citing works
“Alternate Day Fasting One day of fasting/One day of ad libitum feeding Trepanowski et al [11].”
Background
Nutrients in the Prevention of Alzheimer’s Disease
Cremonini, A. L., Caffa, I., Cea, M., Nencioni, A., Odetti, P. R., & Monacelli, F. (2019) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2019/9874159 · Cited by 114 · see citing works
A systematic review, meta-analysis, and meta-regression of the impact of diurnal intermittent fasting during Ramadan on body weight in healthy subjects aged 16 years and above
Jahrami, H., Alsibai, J., Clark, C. C. T., & Faris, M. E. (2020) · European Journal of Nutrition · doi:10.1007/s00394-020-02216-1 · Cited by 116 · see citing works
Calorie restriction for enhanced longevity: The role of novel dietary strategies in the present obesogenic environment
Dorling, J. L., Martin, C. K., & Redman, L. M. (2020) · Ageing Research Reviews · doi:10.1016/j.arr.2020.101038 · Cited by 118 · see citing works
“Following the second six months of the study, where participants were instructed to maintain their dietary patterns but meet their energy needs in lieu of creating an energy deficit, similar between-group responses were seen with outcome measures (Trepanowski et al., 2017).”
BackgroundResultInfluential
A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults
Templeman, I., Smith, H. A., Chowdhury, E., Chen, Y.-C., Carroll, H., Johnson-Bonson, D., Hengist, A., Smith, R., Creighton, J., Clayton, D., et al. (2021) · Science Translational Medicine · doi:10.1126/scitranslmed.abd8034 · Cited by 113 · see citing works
Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study
Byrne, N. M., Sainsbury, A., King, N. A., Hills, A. P., & Wood, R. E. (2018) · International Journal of Obesity · doi:10.1038/ijo.2017.206 · Cited by 113 · see citing works
Understanding weight regain after a nutritional weight loss intervention: systematic review and meta-analysis
Machado, A. M., Guimarães, N. S., Bocardi, V. B., da Silva, T. P. R., Carmo, A. S. D., Menezes, M. C. D., & Duarte, C. K. (2022) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2022.03.020 · Cited by 109 · see citing works
Time-restricted eating with or without low-carbohydrate diet reduces visceral fat and improves metabolic syndrome: A randomized trial
He, M., Wang, J., Liang, Q., Li, M., Guo, H., Wang, Y., Deji, C., Sui, J., Wang, Y.-W., Liu, Y., et al. (2022) · Cell Reports Medicine · doi:10.1016/j.xcrm.2022.100777 · Cited by 111 · see citing works
The obesity-breast cancer link: a multidisciplinary perspective
Devericks, E. N., Carson, M. S., McCullough, L. E., Coleman, M. F., & Hursting, S. D. (2022) · Cancer and Metastasis Reviews · doi:10.1007/s10555-022-10043-5 · Cited by 109 · see citing works
Intermittent administration of a fasting-mimicking diet intervenes in diabetes progression, restores β cells and reconstructs gut microbiota in mice
Wei, S., Han, R., Zhao, J., Wang, S., Huang, M., Wang, Y., & Chen, Y. (2018) · Nutrition & Metabolism · doi:10.1186/s12986-018-0318-3 · Cited by 106 · see citing works
Time-Restricted Eating, Intermittent Fasting, and Fasting-Mimicking Diets in Weight Loss
Fanti, M., Mishra, A. K., Longo, V. D., & Brandhorst, S. (2021) · Current Obesity Reports · doi:10.1007/s13679-021-00424-2 · Cited by 109 · see citing works
Modified alternate-day fasting vs. calorie restriction in the treatment of patients with metabolic syndrome: A randomized clinical trial
Parvaresh, A., Razavi, R., Abbasi, B., Yaghoobloo, K., Hassanzadeh, A., Mohammadifard, N., Safavi, S. M., Hadi, A., & Clark, C. C. T. (2019) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2019.08.021 · Cited by 109 · see citing works
Effects of Calorie Restriction on Health Span and Insulin Resistance: Classic Calorie Restriction Diet vs. Ketosis-Inducing Diet
Napoleão, A., Fernandes, L., Miranda, C., & Marum, A. P. (2021) · Nutrients · doi:10.3390/nu13041302 · Cited by 103 · see citing works
“Yet, another study showed that insulin decreased equally in CCR and ADMF, but 776 the C-peptide reduction was more pronounced after ADMF, suggesting a reduction in 777 postprandial insulin production [130,131].”
BackgroundResultInfluential
Effect of intermittent compared to continuous energy restriction on weight loss and weight maintenance after 12 months in healthy overweight or obese adults
Headland, M. L., Clifton, P. M., & Keogh, J. B. (2018) · International Journal of Obesity · doi:10.1038/s41366-018-0247-2 · Cited by 101 · see citing works
Time-restricted eating and circadian rhythms: the biological clock is ticking
Queiroz, J., Macedo, R. C., Tinsley, G., & Reischak-Oliveira, A. (2020) · Critical reviews in food science and nutrition · doi:10.1080/10408398.2020.1789550 · Cited by 75 · see citing works
“In the last decade, intermittent fasting (IF) has emerged as an increasingly common alternative to traditional dietary strategies in both healthy and at-risk populations (Anton et al. 2018; Patterson and Sears 2017; Trepanowski et al. 2017).”
Background
Intermittent fasting for the prevention of cardiovascular disease
Allaf, M., Elghazaly, H., Mohamed, O. G., Fareen, M. F. K., Zaman, S., Salmasi, A.-M., Tsilidis, K., & Dehghan, A. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013496.pub2 · Cited by 98 · see citing works
Caloric Restriction and Its Effect on Blood Pressure, Heart Rate Variability and Arterial Stiffness and Dilatation: A Review of the Evidence
Nicoll, R., & Henein, M. Y. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19030751 · Cited by 94 · see citing works
“A couple of studies of six months’ duration have used the American Heart Association (AHA) guidelines for the subjects’ diet (30% of energy as fat, 55% as carbohydrate and 15% as protein) but neither showed any improvement or difference between the intervention and control groups [37,52].”
Background
Effect of time restricted feeding on the gut microbiome in adults with obesity: A pilot study
Gabel, K., Hampton‐Marcell, J., Cares, K., Kalam, F., Cienfuegos, S., Ezpeleta, M., & Varady, K. A. (2020) · Nutrition and Health · doi:10.1177/0260106020910907 · Cited by 97 · see citing works
“Intermittent fasting has been shown to be an effective alternative to daily calorie restriction for weight loss and metabolic disease reduction in adults with obesity (Trepanowski et al., 2017).”
BackgroundMethodSelf-citation
Randomized controlled trial for time-restricted eating in overweight and obese young adults
Zhang, L.-M., Liu, Z., Wang, J., Li, R.-Q., Ren, J.-Y., Gao, X., Lv, S.-S., Liang, L.-Y., Zhang, F., Yin, B.-W., et al. (2022) · iScience · doi:10.1016/j.isci.2022.104870 · Cited by 78 · see citing works
Best Practices in the Management of Overweight and Obesity
Tchang, B. G., Saunders, K. H., & Igel, L. I. (2020) · Medical Clinics of North America · doi:10.1016/j.mcna.2020.08.018 · Cited by 92 · see citing works
Time-restricted feeding normalizes hyperinsulinemia to inhibit breast cancer in obese postmenopausal mouse models
Das, M., Ellies, L. G., Kumar, D., Sauceda, C., Oberg, A., Gross, E. T. E., Mandt, T., Newton, I. G., Kaur, M., Sears, D. D., et al. (2021) · Nature Communications · doi:10.1038/s41467-020-20743-7 · Cited by 87 · see citing works
The Effect of Fasting on Human Metabolism and Psychological Health
Wang, Y., & Wu, R. (2022) · Disease Markers · doi:10.1155/2022/5653739 · Cited by 103 · see citing works
“The caloric intake on the fasting day is 25% of the daily caloric intake (approximately 2090 kJ), and the subjects can eat freely on the feeding day [3].”
Background
Exercise Training and Fasting: Current Insights
Zouhal, H., Saeidi, A., Salhi, A., Li, H., Essop, M. F., Laher, I., Rhibi, F., Amani-Shalamzari, S., & Abderrahman, A. B. (2020) · Open Access Journal of Sports Medicine · doi:10.2147/oajsm.s224919 · Cited by 97 · see citing works
The Role of Exercise, Diet, and Cytokines in Preventing Obesity and Improving Adipose Tissue
ATAKAN, M. M., Koşar, Ş. N., Güzel, Y., Tin, H. T., & Yan, X. (2021) · Nutrients · doi:10.3390/nu13051459 · Cited by 94 · see citing works
“The authors [214] concluded that alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardio-protection vs.”
BackgroundInfluential
Effect of early time-restricted feeding on the metabolic profile of adults with excess weight: A systematic review with meta-analysis
Pureza, I. R. D. O. M., Macena, M. D. L., da Silva Junior, A. E., Praxedes, D. R. S., Vasconcelos, L. G. L., & Bueno, N. B. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2020.10.031 · Cited by 89 · see citing works
Nutrition Concepts for the Treatment of Obesity in Adults
Wiechert, M., & Holzapfel, C. (2021) · Nutrients · doi:10.3390/nu14010169 · Cited by 95 · see citing works
Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guideline
Morgan-Bathke, M., Raynor, H. A., Baxter, S. D., Halliday, T. M., Lynch, A., Malik, N., Garay, J. L., & Rozga, M. (2023) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2022.11.014 · Cited by 85 · see citing works
The role of intermittent fasting and meal timing in weight management and metabolic health
Templeman, I., Gonzalez, J. T., Thompson, D., & Betts, J. A. (2019) · Proceedings of The Nutrition Society · doi:10.1017/s0029665119000636 · Cited by 86 · see citing works
The neuroprotective effects of intermittent fasting on brain aging and neurodegenerative diseases via regulating mitochondrial function
Zhao, Y., Jia, M., Chen, W., & Liu, Z. (2022) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2022.02.021 · Cited by 86 · see citing works
Effects of Intermittent Fasting on Brain Metabolism
Brocchi, A., Rebelos, E., Dardano, A., Mantuano, M., & Daniele, G. (2022) · Nutrients · doi:10.3390/nu14061275 · Cited by 91 · see citing works
Effect of Intermittent Fasting on Reproductive Hormone Levels in Females and Males: A Review of Human Trials
Cienfuegos, S., Corapi, S., Gabel, K., Ezpeleta, M., Kalam, F., Lin, S., Pavlou, V., & Varady, K. A. (2022) · Nutrients · doi:10.3390/nu14112343 · Cited by 91 · see citing works
Self-citation
Molecular Decolonization: An Indigenous Microcosm Perspective of Planetary Health
Redvers, N., Bird, M. Y., Quinn, D., Yunkaporta, T., & Arabena, K. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17124586 · Cited by 88 · see citing works

Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: a review of human findings
Barnosky, A., Hoddy, K. K., Unterman, T. G., & Varady, K. A. (2014) · Translational research · doi:10.1016/j.trsl.2014.05.013 · Cited by 294 · see citing works
Self-citation
Intermittent Fasting and Metabolic Health: From Religious Fast to Time‐Restricted Feeding
Hoddy, K. K., Marlatt, K. L., Çetinkaya, H., & Ravussin, É. (2020) · Obesity · doi:10.1002/oby.22829 · Cited by 137 · see citing works
Self-citation
Calories or protein? The effect of dietary restriction on lifespan in rodents is explained by calories alone
Speakman, J. R., Mitchell, S. E., & Mazidi, M. (2016) · Experimental Gerontology · doi:10.1016/j.exger.2016.03.011 · Cited by 131 · see citing works
Calorie restriction is more effective for obesity treatment than dietary fat restriction
Harvey‐Berino, J. (1999) · Annals of Behavioral Medicine · doi:10.1007/bf02895031 · Cited by 43 · see citing works
Effects of an Intermittent Fasting 5:2 Plus Program on Body Weight in Chinese Adults with Overweight or Obesity: A Pilot Study
Kang, J., Shi, X., Fu, J., Li, H., Ma, E., & Chen, W. (2022) · Nutrients · doi:10.3390/nu14224734 · Cited by 35 · see citing works

Authors: Trepanowski, J. F., Kroeger, C. M., Barnosky, A., Klempel, M. C., Bhutani, S., Hoddy, K. K., Gabel, K., Freels, S., Rigdon, J., Rood, J., Ravussin, E., & Varady, K. A.
Affiliations: University of Illinois Chicago (US)
University of Alabama at Birmingham (US)
Stanford University (US)
Pennington Biomedical Research Center (US)
Nutrition Obesity Research Center, Pennington Biomedical Research Center, Baton Rouge, Louisiana
Corresponding author: Varady, Krista A.
ORCID: Kroeger, Cynthia M.
Bhutani, Surabhi
Hoddy, Kristin K.
Gabel, Kelsey
Freels, Sally
Rigdon, Joseph
Rood, Jennifer
Varady, Krista A.
Venue: JAMA Internal Medicine
Publisher: American Medical Association (AMA)
Published: 2017-07-01
Volume: 177
Issue: 7
Pages: 930
ISSN: 2168-6106 (ISSN-L)
DOI: 10.1001/jamainternmed.2017.0936
PMC: PMC5680777
OpenAlex: W2611504779
Semantic Scholar: 90534c8b9843eb662b022d9e79d5b5143434d1c6
Cited by: 645
References: 32
Citations by year: 2026: 45 · 2025: 71 · 2024: 76 · 2023: 95 · 2022: 103 · 2021: 90 · 2020: 81 · 2019: 35 · 2018: 38 · 2017: 10 · 2016: 1
FWCI: 33.20
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: JAMA Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Heart, Lung, and Blood Institute (R01HL106228)
National Institute of Diabetes and Digestive and Kidney Diseases (F32DK107157, P30DK072476)
Topics: Health Sciences › Medicine › Physiology › Dietary Effects on Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Health Sciences › Medicine › Physiology › Diet and metabolism studies
Keywords: alternate-day fasting, caloric restriction, weight loss, weight maintenance, metabolically healthy obesity, cardiovascular risk factors, cardioprotection, dietary adherence, blood pressure, insulin resistance, fasting blood glucose, triglycerides, long-term weight management, heart rate, blood pressure variability, heart rate variability
MeSH terms: Adult, Blood Glucose, Cardiovascular Diseases, Diet Therapy, Fasting, Feeding Behavior, Female, Humans, Insulin, Male, Middle Aged, Obesity, Outcome and Process Assessment, Health Care, Patient Compliance, Risk Factors, Weight Loss, Caloric Restriction

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Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial

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