Intermittent fasting combined with calorie restriction is effective for weight loss and cardio-protection in obese women

Monica C Klempel, Cynthia M Kroeger, Surabhi Bhutani, John F Trepanowski, Krista A Varady, Monica C Klempel, Cynthia M Kroeger, Surabhi Bhutani, John F Trepanowski, Krista A Varady

Abstract

Background: Intermittent fasting (IF; severe restriction 1 d/week) facilitates weight loss and improves coronary heart disease (CHD) risk indicators. The degree to which weight loss can be enhanced if IF is combined with calorie restriction (CR) and liquid meals, remains unknown.

Objective: This study examined the effects of IF plus CR (with or without a liquid diet) on body weight, body composition, and CHD risk.

Methods: Obese women (n = 54) were randomized to either the IFCR-liquid (IFCR-L) or IFCR-food based (IFCR-F) diet. The trial had two phases: 1) 2-week weight maintenance period, and 2) 8-week weight loss period.

Results: Body weight decreased more (P = 0.04) in the IFCR-L group (3.9 ± 1.4 kg) versus the IFCR-F group (2.5 ± 0.6 kg). Fat mass decreased similarly (P < 0.0001) in the IFCR-L and IFCR-F groups (2.8 ± 1.2 kg and 1.9 ± 0.7 kg, respectively). Visceral fat was reduced (P < 0.001) by IFCR-L (0.7 ± 0.5 kg) and IFCR-F (0.3 ± 0.5 kg) diets. Reductions in total and LDL cholesterol levels were greater (P = 0.04) in the IFCR-L (19 ± 10%; 20 ± 9%, respectively) versus the IFCR-F group (8 ± 3%; 7 ± 4%, respectively). LDL peak particle size increased (P < 0.01), while heart rate, glucose, insulin, and homocysteine decreased (P < 0.05), in the IFCR-L group only.

Conclusion: These findings suggest that IF combined with CR and liquid meals is an effective strategy to help obese women lose weight and lower CHD risk.

Figures

Figure 1
Figure 1
Study flow chart. IFCR-L: Intermittent fasting calorie restriction-liquid diet; IFCR-F: Intermittent fasting calorie restriction-food based diet.
Figure 2
Figure 2
Body weight and body composition changes during the weight loss period. IFCR-L: Intermittent fasting calorie restriction-liquid diet (n = 28); IFCR-F: Intermittent fasting calorie restriction-food based diet (n = 26); BW: Body weight; FM: Fat mass; FFM: Fat free mass, VAT: Visceral adipose tissue; SAT: Abdominal subcutaneous adipose tissue. A. Changes in body weight, fat mass, and fat free mass in the IFCR-L and IFCR-F groups. IFCR-L group lost more body weight (P = 0.04) compared to the IFCR-F group (Repeated-measures ANOVA). *Week 10 absolute values significantly different from baseline (week 3) absolute values, P < 0.0001 (Repeated-measures ANOVA). B. Changes in visceral adipose tissue and abdominal subcutaneous adipose tissue in the IFCR-L and IFCR-F groups. *Week 10 absolute values significantly different from baseline (week 3) absolute values, P < 0.001 (Repeated-measures ANOVA).
Figure 3
Figure 3
Change in visceral and subcutaneous adipose tissue area after the IFCR-L intervention. A. Abdominal visceral fat (58 cm2) and subcutaneous fat (245 cm2) before the intermittent fasting calorie restriction-liquid diet (IFCR-L) at the L3-L4 vertebrae (week 3). B. Abdominal visceral fat (17 cm2) and subcutaneous fat (173 cm2) after the IFCR-L regimen at the L3-L4 vertebrae (week 10).
Figure 4
Figure 4
Plasma lipid changes during the weight loss period. IFCR-L: Intermittent fasting calorie restriction-liquid diet (n = 28); IFCR-F: Intermittent fasting calorie restriction-food based diet (n = 26); TC: Total cholesterol; LDL: Low density lipoprotein cholesterol; HDL: High density lipoprotein cholesterol; TG: Triglycerides. *Week 10 values significantly different from baseline (week 3) values, P < 0.01 (Repeated-measures ANOVA). IFCR-L group experienced significantly greater reductions in total cholesterol and LDL cholesterol concentrations when compared to the IFCR-F group (P < 0.05) (Repeated-measures ANOVA).

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