Potential Benefits and Harms of Intermittent Energy Restriction and Intermittent Fasting Amongst Obese, Overweight and Normal Weight Subjects-A Narrative Review of Human and Animal Evidence

Michelle Harvie, Anthony Howell, Michelle Harvie, Anthony Howell

Abstract

Intermittent energy restriction (IER) has become popular as a means of weight control amongst people who are overweight and obese, and is also undertaken by normal weight people hoping spells of marked energy restriction will optimise their health. This review summarises randomised comparisons of intermittent and isoenergetic continuous energy restriction for weight loss to manage overweight and obesity. It also summarises the potential beneficial or adverse effects of IER on body composition, adipose stores and metabolic effects from human studies, including studies amongst normal weight subjects and relevant animal experimentation. Six small short term (<6 month) studies amongst overweight or obese individuals indicate that intermittent energy restriction is equal to continuous restriction for weight loss, with one study reporting greater reductions in body fat, and two studies reporting greater reductions in HOMA insulin resistance in response to IER, with no obvious evidence of harm. Studies amongst normal weight subjects and different animal models highlight the potential beneficial and adverse effects of intermittent compared to continuous energy restriction on ectopic and visceral fat stores, adipocyte size, insulin resistance, and metabolic flexibility. The longer term benefits or harms of IER amongst people who are overweight or obese, and particularly amongst normal weight subjects, is not known and is a priority for further investigation.

Keywords: fasting; intermittent energy restriction; weight gain; weight loss.

Conflict of interest statement

The authors declare no conflict of interest. Michelle Harvie and Anthony Howell have written three self-help books for the public to follow intermittent diets. All author proceeds are paid directly to the charity Prevent Breast Cancer Limited (formally known as Genesis Breast Cancer Prevention Appeal Ltd., Registered Charity Number: 1109839) to fund breast cancer research.

Figures

Figure 1
Figure 1
Degree of dietary energy restriction with IER in Manchester studies. The IER cohort undertook a 70% energy restriction on two consecutive days per week and additionally undertook an unplanned carry-over energy restriction to an average of 20% below their baseline intake on the remaining five days of the week (solid line). The restricted days and the unplanned carry-over energy restriction resulted in an equivalent overall 35% energy restriction over the trial period (dashed line).

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