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

The DOI matches its Crossref record; 31 of the 32 references it cites were found in a registry or an index, and 1 are not checked yet; none of the 28 sources its claims cite is checked for support yet.

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

Open access

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.

Checked 2026-10-05 · 1 reference not checked yet

Overview

Integrity signals

Registry

Crossref · 10.1001/jamainternmed.2017.0936

Cites

31 of 32 references verified0 citation errors · 0 not checkable

Statistics

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Verification

Claims the paper makes

0 of 28 cited sources checked · 0 supported · 0 flagged

  • Probably not a substantial claim. 17
  • It may state two separate claims as one. 8
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

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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

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  1. [15]The 5:2 Fast Diet For Beginners Berkeley, CA Rockridge Press 2013

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Metadata

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.
Venue
JAMA Internal Medicine
Published
2017-07-01
Volume
177
Issue
7
Pages
930
ISSN
2168-6106 (ISSN-L)
OpenAlex
W2611504779
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
FWCI
33.20
Type
journal article
Language
en
Open access
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 (medical) › Dietary Effects on Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Physiology (medical) › 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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