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Effect of the 5:2 diet on weight loss and cardiovascular disease risk factors in overweight and/or obesity: a systematic review and meta-analysis

Wu, Cui, Chen, Binqin, Yu, Jing, Zhang, Qi, Piao, Chunli·2025·International Journal of Endocrinology
DOI 10.1155/ije/6658512PMC PMC11876533
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Abstract

Introduction: We conducted a systematic review and meta‐analysis to evaluate the effects of the 5:2 diet on weight loss and cardiovascular disease (CVD) risk factors in overweight and obese individuals. Methods: Databases (PubMed, The Cochrane Library, Web of Science, Embase) were searched for randomized controlled trials of the intervention effects of the 5:2 diet in overweight and obese individuals. The search period was from database establishment to April 2024. RevMan 5.3 and Stata 14.0 were used for the meta‐analysis. Results: A total of 20 articles with 1393 participants were finally included. There were 689 participants in the treatment groups and 704 in the control groups. The meta‐analysis showed that the 5:2 diet significantly reduces body weight, body mass index, waist circumference, body fat percentage, hip circumference, fat mass, fat‐free mass, low‐density lipoprotein, systolic blood pressure, and homeostasis model assessment‐insulin resistance levels relative to the control group ( p < 0.05). However, there was no significant difference in levels of visceral fat, total cholesterol, triglycerides, high‐density lipoprotein, diastolic blood pressure, insulin, fasting blood glucose, glycated hemoglobin A1c, and heart rate. Although there were no serious adverse events in the 5:2 diet group, participants in this group experienced mild physical and psychological side effects during the fasting period, which resolved spontaneously after fasting. Conclusion: The 5:2 diet is effective for weight reduction and amelioration of CVD risk factors in overweight/obesity and is safe and feasible. However, the patient’s physical condition during the fasting period should be monitored and timely adjustments should be made accordingly.

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Crossref · 10.1155/ije/6658512

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Figures

Figure 1 Systematic review flowchart.
Figure 1 Systematic review flowchart.CC BY · PubMed Central
Figure 2 Risk of bias assessment for included studies. (a) Risk of bias graph and (b) risk of bias summary.
Figure 2 Risk of bias assessment for included studies. (a) Risk of bias graph and (b) risk of bias summary.CC BY · PubMed Central
Figure 3 Forest plots of the primary indicators showed that the 5:2 diet could significantly decrease body weight, body mass index (BMI), waist circumference, and body fat percentage in overweight and obese individuals relative to the control group. The green squares denote individual study outcomes, and the black diamonds indicate the aggregated effect sizes. (a) Body weight; (b) BMI; (c) waist circumference; and (d) body fat percentage.
Figure 3 Forest plots of the primary indicators showed that the 5:2 diet could significantly decrease body weight, body mass index (BMI), waist circumference, and body fat percentage in overweight and obese individuals relative to the control group. The green squares denote individual study outcomes, and the black diamonds indicate the aggregated effect sizes. (a) Body weight; (b) BMI; (c) waist circumference; and (d) body fat percentage.CC BY · PubMed Central
Figure 4 Funnel plots of primary indicators. (a) Body weight; (b) body mass index (BMI); (c) waist circumference; and (d) body fat percentage. The blue dots represent each study included.
Figure 4 Funnel plots of primary indicators. (a) Body weight; (b) body mass index (BMI); (c) waist circumference; and (d) body fat percentage. The blue dots represent each study included.CC BY · PubMed Central
Figure 5 Sensitivity plots of primary indicators. (a) Body weight; (b) body mass index (BMI); (c) waist circumference; and (d) body fat percentage. The green dots represent each study included.
Figure 5 Sensitivity plots of primary indicators. (a) Body weight; (b) body mass index (BMI); (c) waist circumference; and (d) body fat percentage. The green dots represent each study included.CC BY · PubMed Central
Figure 6 Forest plots of blood lipids revealed that the 5:2 diet resulted in a statistically significant reduction in low-density lipoprotein (LDL) among overweight and obese individuals compared with the control group. However, no significant differences were observed in total cholesterol (TC), triglyceride (TG), or high-density lipoprotein (HDL) levels. The green squares denote individual study outcomes, and the black diamonds indicate the aggregated effect sizes. (a) Total cholesterol (TC); (b) triglyceride (TG); (c) low-density lipoprotein (LDL); and (d) high-density lipoprotein (HDL).
Figure 6 Forest plots of blood lipids revealed that the 5:2 diet resulted in a statistically significant reduction in low-density lipoprotein (LDL) among overweight and obese individuals compared with the control group. However, no significant differences were observed in total cholesterol (TC), triglyceride (TG), or high-density lipoprotein (HDL) levels. The green squares denote individual study outcomes, and the black diamonds indicate the aggregated effect sizes. (a) Total cholesterol (TC); (b) triglyceride (TG); (c) low-density lipoprotein (LDL); and (d) high-density lipoprotein (HDL).CC BY · PubMed Central
Figure 7 Forest plots of blood pressure and heart rate showed that the 5:2 diet resulted in a statistically significant reduction in systolic blood pressure (SBP) among overweight and obese individuals compared to the control group. However, no significant differences were observed in diastolic blood pressure (DBP) or heart rate. The green squares denote individual study outcomes, and the black diamonds indicate the aggregated effect sizes. (a) Systolic blood pressure (SBP); (b) diastolic blood pressure (DBP); and (c) heart rate.
Figure 7 Forest plots of blood pressure and heart rate showed that the 5:2 diet resulted in a statistically significant reduction in systolic blood pressure (SBP) among overweight and obese individuals compared to the control group. However, no significant differences were observed in diastolic blood pressure (DBP) or heart rate. The green squares denote individual study outcomes, and the black diamonds indicate the aggregated effect sizes. (a) Systolic blood pressure (SBP); (b) diastolic blood pressure (DBP); and (c) heart rate.CC BY · PubMed Central
Figure 8 Forest plots of glucose metabolism showed that the 5:2 diet resulted in a statistically significant reduction in HOMA-IR among overweight and obese individuals compared to the control group. However, no significant differences were observed in insulin, fasting blood glucose (FBG), or HbA1c. The green squares denote individual study outcomes, and the black diamonds indicate the aggregated effect sizes. (a) HOMA-IR; (b) insulin; (c) fasting blood glucose (FBG); and (d) HbA1c.
Figure 8 Forest plots of glucose metabolism showed that the 5:2 diet resulted in a statistically significant reduction in HOMA-IR among overweight and obese individuals compared to the control group. However, no significant differences were observed in insulin, fasting blood glucose (FBG), or HbA1c. The green squares denote individual study outcomes, and the black diamonds indicate the aggregated effect sizes. (a) HOMA-IR; (b) insulin; (c) fasting blood glucose (FBG); and (d) HbA1c.CC BY · PubMed Central
Figure 9 Forest plots of other secondary indicators showed that the 5:2 diet could significantly decrease hip circumference, fat mass, and fat-free mass in overweight and obese individuals relative to the control group. However, no significant differences were observed in visceral fat. The green squares denote individual study outcomes, and the black diamonds indicate the aggregated effect sizes. (a) Hip circumference; (b) visceral fat; (c) fat mass; (d) fat-free mass.
Figure 9 Forest plots of other secondary indicators showed that the 5:2 diet could significantly decrease hip circumference, fat mass, and fat-free mass in overweight and obese individuals relative to the control group. However, no significant differences were observed in visceral fat. The green squares denote individual study outcomes, and the black diamonds indicate the aggregated effect sizes. (a) Hip circumference; (b) visceral fat; (c) fat mass; (d) fat-free mass.CC BY · PubMed Central

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Citations

Cites

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Metadata

Authors
Wu, C., Chen, B., Yu, J., Zhang, Q., & Piao, C.
ORCID
Venue
International Journal of Endocrinology
Publisher
Wiley
Published
2025-01
Volume
2025
Issue
1
ISSN
  • 1687-8337
  • 1687-8345
DOI
10.1155/ije/6658512
PMC
PMC11876533
Cited by
6
References
7
Language
en
Licence
Funders
  • Sanming Project of Medicine in Shenzhen (SZZYSM202202010)
  • National Natural Science Foundation of China (82374380)
  • Shenzhen Science and Technology Innovation Program (JCYJ20220531091409022)

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