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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2023; 06(03): 118-125
DOI: 10.1055/s-0043-1771447
Review Article

Effect of Intermittent Fasting versus Continuous Caloric Restriction on Body Weight and Metabolic Parameters in Adults with Overweight or Obesity: A Narrative Review

Jessica Abou Chaaya   *
1   Division of Endocrinology, Department of Internal Medicine, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon
,
Jana Dib El Jalbout   *
2   Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
,
Mona P. Nasrallah
1   Division of Endocrinology, Department of Internal Medicine, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon
› Author Affiliations Funding and Sponsorship None.
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Abstract

Obesity and type 2 diabetes have reached epidemic proportions worldwide, including the Middle East and North Africa region. Intermittent fasting (IF) has been increasingly used to manage overweight/obesity and its metabolic complications. Physiologically, IF shifts the body's metabolism into ketosis (the metabolic switch) and induces cellular changes, which have a theoretical benefit over and above continuous caloric restriction (CCR). In this narrative overview of IF, the focus is on summarizing studies that compare IF to CCR in adults with overweight or obesity. The most commonly practiced types of IF (5:2, the alternate day fast, and the time-restricted eating) were included. Nine studies of 1-year duration or longer, with weight loss as the primary outcome, were summarized. The effect on body weight and improved metabolic parameters such as blood pressure, glycemic indicators, and lipid profile are described. Overall, IF was well tolerated and effective for weight loss in a manner comparable to CCR. The benefits were similar among adults with type 2 diabetes. There were no additional metabolic effects or benefits over and above CCR. However, more studies are needed to address specific details of IF, such as the type and timing of fasting and its application to different populations. In conclusion, IF is safe and beneficial for weight loss in adults with overweight/obesity with or without diabetes. It can be used as an alternative to CCR.

Keywords

intermittent fasting - time-restricted eating - caloric restriction - obesity - weight loss

Compliance with Ethical Principles

No ethical approval is required for review article types of studies.


Authors' Contribution

J.A. and J.J. each wrote significant components of the manuscript. J.J. reviewed the literature and extracted the data into tables and figures. M.N. was responsible for the manuscript's concept, reviewing, and editing.


* Equal contributions




Publication History

Article published online:
29 September 2023

© 2023. Gulf Association of Endocrinology and Diabetes (GAED). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Petersen MC, Gallop MR, Flores Ramos S. et al. Complex physiology and clinical implications of time-restricted eating. Physiol Rev 2022; 102 (04) 1991-2034
    CrossrefPubMedGoogle Scholar
  • 2 Flandrin JL, Montanari M. eds. Food : a culinary history from Antiquity to the present. New York, NY: Columbia University Press; 1999
    Google Scholar
  • 3 Gill S, Panda S. A smartphone app reveals erratic diurnal eating patterns in humans that can be modulated for health benefits. Cell Metab 2015; 22 (05) 789-798
    CrossrefPubMedGoogle Scholar
  • 4 Popp CJ, Curran M, Wang C. et al. Temporal eating patterns and eating windows among adults with overweight or obesity. Nutrients 2021; 13 (12) 4485
    CrossrefPubMedGoogle Scholar
  • 5 Hays J. Arab and Middle Eastern Food | Facts and Details. Accessed July 03, 2023 at: https://factsanddetails.com/world/cat55/sub359/entry-5913.html
    Google Scholar
  • 6 Zhu S, Surampudi P, Rosharavan B, Chondronikola M. Intermittent fasting as a nutrition approach against obesity and metabolic disease. Curr Opin Clin Nutr Metab Care 2020; 23 (06) 387-394
    CrossrefPubMedGoogle Scholar
  • 7 Okati-Aliabad H, Ansari-Moghaddam A, Kargar S, Jabbari N. Prevalence of obesity and overweight among adults in the Middle East countries from 2000 to 2020: a systematic review and meta-analysis. J Obes 2022; 2022: 8074837
    CrossrefPubMedGoogle Scholar
  • 8 NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. [published correction appears in Lancet. 2016 May 14;387(10032):1998] Lancet 2016; 387 (10026): 1377-1396
    CrossrefPubMedGoogle Scholar
  • 9 Al-Lawati JA, Jousilahti PJ. Prevalence and 10-year secular trend of obesity in Oman. Saudi Med J 2004; 25 (03) 346-351
    PubMedGoogle Scholar
  • 10 Abarca-Gómez L, Abdeen ZA, Hamid ZA. et al; NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017; 390 (10113): 2627-2642
    CrossrefPubMedGoogle Scholar
  • 11 Al-Daghri NM, Al-Attas OS, Alokail MS. et al. Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (Riyadh cohort 2): a decade of an epidemic. BMC Med 2011; 9: 76
    CrossrefPubMedGoogle Scholar
  • 12 Diabetes. World Health Organization. Accessed July 03, 2023 at: https://www.who.int/news-room/fact-sheets/detail/diabetes
  • 13 Diabetes in MENA. International Diabetes Federation – Home. Accessed July 03, 2023 at: https://www.idf.org/our-network/regions-members/middle-east-and-north-africa/diabetes-in-mena.html
    Google Scholar
  • 14 Hoddy KK, Marlatt KL, Çetinkaya H, Ravussin E. Intermittent fasting and metabolic health: from religious fast to time-restricted feeding. Obesity (Silver Spring) 2020; 28 (Suppl 1, Suppl 1): S29-S37
    CrossrefPubMedGoogle Scholar
  • 15 Gabel K, Cienfuegos S, Kalam F, Ezpeleta M, Varady KA. Time-restricted eating to improve cardiovascular health. Curr Atheroscler Rep 2021; 23 (05) 22
    CrossrefPubMedGoogle Scholar
  • 16 Chaix A, Zarrinpar A, Miu P, Panda S. Time-restricted feeding is a preventative and therapeutic intervention against diverse nutritional challenges. Cell Metab 2014; 20 (06) 991-1005
    CrossrefPubMedGoogle Scholar
  • 17 Cienfuegos S, Gabel K, Kalam F. et al. Effects of 4- and 6-h time-restricted feeding on weight and cardiometabolic health: a randomized controlled trial in adults with obesity. Cell Metab 2020; 32 (03) 366-378.e3
    CrossrefPubMedGoogle Scholar
  • 18 Tinsley GM, Forsse JS, Butler NK. et al. Time-restricted feeding in young men performing resistance training: a randomized controlled trial. Eur J Sport Sci 2017; 17 (02) 200-207
    CrossrefPubMedGoogle Scholar
  • 19 Pureza IROM, Melo ISV, Macena ML. et al. Acute effects of time-restricted feeding in low-income women with obesity placed on hypoenergetic diets: Randomized trial. Nutrition 2020; 77: 110796
    CrossrefPubMedGoogle Scholar
  • 20 de Oliveira Maranhão Pureza IR, da Silva Junior AE, Silva Praxedes DR. et al. Effects of time-restricted feeding on body weight, body composition and vital signs in low-income women with obesity: a 12-month randomized clinical trial. Clin Nutr 2021; 40 (03) 759-766
    CrossrefPubMedGoogle Scholar
  • 21 Gabel K, Hoddy KK, Haggerty N. et al. Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: a pilot study. Nutr Healthy Aging 2018; 4 (04) 345-353
    CrossrefPubMedGoogle Scholar
  • 22 Moro T, Tinsley G, Bianco A. et al. Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. J Transl Med 2016; 14 (01) 290
    CrossrefPubMedGoogle Scholar
  • 23 Newman JC, Verdin E. β-hydroxybutyrate: a signaling metabolite. Annu Rev Nutr 2017; 37: 51-76
    CrossrefPubMedGoogle Scholar
  • 24 Cahill Jr GF. Fuel metabolism in starvation. Annu Rev Nutr 2006; 26: 1-22
    CrossrefPubMedGoogle Scholar
  • 25 Anton SD, Moehl K, Donahoo WT. et al. Flipping the metabolic switch: understanding and applying the health benefits of fasting. Obesity (Silver Spring) 2018; 26 (02) 254-268
    CrossrefPubMedGoogle Scholar
  • 26 de Cabo R, Mattson MP. Effects of intermittent fasting on health, aging, and disease. N Engl J Med 2019; 381 (26) 2541-2551
    CrossrefPubMedGoogle Scholar
  • 27 Grabowska W, Sikora E, Bielak-Zmijewska A. Sirtuins, a promising target in slowing down the ageing process. Biogerontology 2017; 18 (04) 447-476
    CrossrefPubMedGoogle Scholar
  • 28 Patterson RE, Laughlin GA, LaCroix AZ. et al. Intermittent fasting and human metabolic health. J Acad Nutr Diet 2015; 115 (08) 1203-1212
    CrossrefPubMedGoogle Scholar
  • 29 Kraus WE, Bhapkar M, Huffman KM. et al; CALERIE Investigators. 2 years of calorie restriction and cardiometabolic risk (CALERIE): exploratory outcomes of a multicentre, phase 2, randomised controlled trial. Lancet Diabetes Endocrinol 2019; 7 (09) 673-683
    CrossrefPubMedGoogle Scholar
  • 30 Carter S, Clifton PM, Keogh JB. Effect of intermittent compared with continuous energy restricted diet on glycemic control in patients with type 2 diabetes: a randomized noninferiority trial. JAMA Netw Open 2018; 1 (03) e180756
    CrossrefPubMedGoogle Scholar
  • 31 Carter S, Clifton PM, Keogh JB. The effect of intermittent compared with continuous energy restriction on glycaemic control in patients with type 2 diabetes: 24-month follow-up of a randomised noninferiority trial. Diabetes Res Clin Pract 2019; 151: 11-19
    CrossrefPubMedGoogle Scholar
  • 32 Sundfør TM, Svendsen M, Tonstad S. Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: a randomized 1-year trial. Nutr Metab Cardiovasc Dis 2018; 28 (07) 698-706
    CrossrefPubMedGoogle Scholar
  • 33 Headland ML, Clifton PM, Keogh JB. Effect of intermittent compared to continuous energy restriction on weight loss and weight maintenance after 12 months in healthy overweight or obese adults. Int J Obes 2019; 43 (10) 2028-2036
    CrossrefPubMedGoogle Scholar
  • 34 Headland ML, Clifton PM, Keogh JB. Impact of intermittent vs. continuous energy restriction on weight and cardiometabolic factors: a 12-month follow-up. Int J Obes 2020; 44 (06) 1236-1242
    CrossrefPubMedGoogle Scholar
  • 35 Schübel R, Nattenmüller J, Sookthai D. et al. Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial. Am J Clin Nutr 2018; 108 (05) 933-945
    CrossrefPubMedGoogle Scholar
  • 36 Trepanowski JF, Kroeger CM, Barnosky A. et al. Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults: a randomized clinical trial. JAMA Intern Med 2017; 177 (07) 930-938
    CrossrefPubMedGoogle Scholar
  • 37 Liu D, Huang Y, Huang C. et al. Calorie restriction with or without time-restricted eating in weight loss. N Engl J Med 2022; 386 (16) 1495-1504
    CrossrefPubMedGoogle Scholar
  • 38 El-Kebbi IM, Bidikian NH, Hneiny L, Nasrallah MP. Epidemiology of type 2 diabetes in the Middle East and North Africa: challenges and call for action. World J Diabetes 2021; 12 (09) 1401-1425
    CrossrefPubMedGoogle Scholar