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Is Fasting Superior to Continuous Caloric Restriction for Weight Loss and Metabolic Outcomes in Obese Adults? A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Siles-Guerrero, Víctor, Romero-Márquez, Jose M., García-Pérez, Rosa Natalia, Novo-Rodríguez, Cristina, Guardia-Baena, Juan Manuel, Hayón-Ponce, María, Tenorio-Jiménez, Carmen, López-de-la-Torre-Casares, Martín, Muñoz-Garach, Araceli·2024·Nutrients
DOI 10.3390/nu16203533PMC PMC11510157
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Abstract

Background: fasting-based strategies (FBS) and continuous caloric restriction (CCR) are popular methods for weight loss and improving metabolic health. FBS alternates between eating and fasting periods, while CCR reduces daily calorie intake consistently. Both aim to create a calorie deficit, but it is still uncertain as to which is more effective for short- and long-term weight and metabolic outcomes. Objectives: this systematic review and meta-analysis aimed to compare the effectiveness of FBS and CCR on these parameters in obese adults. Methods: after screening 342 articles, 10 randomized controlled trials (RCTs) with 623 participants were included. Results: both interventions led to weight loss, with a reduction of 5.5 to 6.5 kg observed at the six-month mark. However, the results showed that FBS led to slightly greater short-term reductions in body weight (−0.94 kg, p = 0.004) and fat mass (−1.08 kg, p = 0.0001) compared to CCR, although these differences are not clinically significant. Both interventions had similar effects on lean mass, waist and hip circumference, blood pressure, lipid profiles, and glucose metabolism. However, FBS improved insulin sensitivity, with significant reductions in fasting insulin (−7.46 pmol/L, p = 0.02) and HOMA-IR (−0.14, p = 0.02). Conclusions: despite these short-term benefits, FBS did not show superior long-term outcomes compared to CCR. Both strategies are effective for weight management, but more research is needed to explore the long-term clinical relevance of FBS in obese populations.

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Crossref · 10.3390/nu16203533

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Figure 1 PRISMA flow diagram of study selection process.
Figure 1 PRISMA flow diagram of study selection process.CC BY · PubMed Central
Figure 2 (A) Risk of bias summary: risk of bias item for each included RCT according to Cochrane Risk-of-Bias tool. (B) Risk of bias graph: each risk of bias item is presented as percentages across all included RCTs. (C) Funnel plot of publication bias for the primary outcomes of short- and long-term effects of this meta-analysis [21,22,23,24,25,26,27,28,29,30].
Figure 2 (A) Risk of bias summary: risk of bias item for each included RCT according to Cochrane Risk-of-Bias tool. (B) Risk of bias graph: each risk of bias item is presented as percentages across all included RCTs. (C) Funnel plot of publication bias for the primary outcomes of short- and long-term effects of this meta-analysis [21,22,23,24,25,26,27,28,29,30].CC BY · PubMed Central
Figure 3 (A) Forest plot of the short-term effects (<6 months) of fasting based interventions versus continuous caloric restriction on body weight. (B) Forest plot of the long-term effects (>6 months) of fasting based interventions versus continuous caloric restriction on body weight [21,22,23,24,25,26,27,28,29,30].
Figure 3 (A) Forest plot of the short-term effects (<6 months) of fasting based interventions versus continuous caloric restriction on body weight. (B) Forest plot of the long-term effects (>6 months) of fasting based interventions versus continuous caloric restriction on body weight [21,22,23,24,25,26,27,28,29,30].CC BY · PubMed Central
Figure 4 Representative illustration of the results obtained in the present meta-analysis on short- and long-term interventions based on fasting compared to continuous caloric restriction.
Figure 4 Representative illustration of the results obtained in the present meta-analysis on short- and long-term interventions based on fasting compared to continuous caloric restriction.CC BY · PubMed Central

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Citations

Cites

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Metadata

Authors
Siles-Guerrero, V., Romero-Márquez, J. M., García-Pérez, R. N., Novo-Rodríguez, C., Guardia-Baena, J. M., Hayón-Ponce, M., Tenorio-Jiménez, C., López-de-la-Torre-Casares, M., & Muñoz-Garach, A.
Affiliations
Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital, 18014 Granada, Spain
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2024-10-18
Volume
16
Issue
20
Pages
3533
ISSN
2072-6643
DOI
10.3390/nu16203533
PMC
PMC11510157
Cited by
25
References
4
Language
en
Licence
creativecommons.org/licenses/by/4.0/ (vor)

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