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Journal ArticleDOI

The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: a randomized trial in young overweight women

TL;DR: IER is as effective as CER with regard to weight loss, insulin sensitivity and other health biomarkers, and may be offered as an alternative equivalent to CER for weight loss and reducing disease risk.
Abstract: The problems of adherence to energy restriction in humans are well known. To compare the feasibility and effectiveness of intermittent continuous energy (IER) with continuous energy restriction (CER) for weight loss, insulin sensitivity and other metabolic disease risk markers. Randomized comparison of a 25% energy restriction as IER (∼2710 kJ/day for 2 days/week) or CER (∼6276 kJ/day for 7 days/week) in 107 overweight or obese (mean (±s.d.) body mass index 30.6 (±5.1) kg m−2) premenopausal women observed over a period of 6 months. Weight, anthropometry, biomarkers for breast cancer, diabetes, cardiovascular disease and dementia risk; insulin resistance (HOMA), oxidative stress markers, leptin, adiponectin, insulin-like growth factor (IGF)-1 and IGF binding proteins 1 and 2, androgens, prolactin, inflammatory markers (high sensitivity C-reactive protein and sialic acid), lipids, blood pressure and brain-derived neurotrophic factor were assessed at baseline and after 1, 3 and 6 months. Last observation carried forward analysis showed that IER and CER are equally effective for weight loss: mean (95% confidence interval ) weight change for IER was −6.4 (−7.9 to −4.8) kg vs −5.6 (−6.9 to −4.4) kg for CER (P-value for difference between groups=0.4). Both groups experienced comparable reductions in leptin, free androgen index, high-sensitivity C-reactive protein, total and LDL cholesterol, triglycerides, blood pressure and increases in sex hormone binding globulin, IGF binding proteins 1 and 2. Reductions in fasting insulin and insulin resistance were modest in both groups, but greater with IER than with CER; difference between groups for fasting insulin was −1.2 (−1.4 to −1.0) μU ml−1 and for insulin resistance was −1.2 (−1.5 to −1.0) μU mmol−1 l−1 (both P=0.04). IER is as effective as CER with regard to weight loss, insulin sensitivity and other health biomarkers, and may be offered as an alternative equivalent to CER for weight loss and reducing disease risk.
Citations
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Journal ArticleDOI
26 Mar 2015-Cell
TL;DR: Findings indicate that meal timing is crucial, with both intermittent fasting and adjusted diurnal rhythm of feeding improving health and function, in the absence of changes in overall intake.

928 citations


Cites background from "The effects of intermittent or cont..."

  • ...Several serum biomarkers of cancer risk also improved, but total and free IGF-1 did not change (Harvie et al., 2011)....

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  • ...Several serum biomarkers of cancer risk also improve, but total and free IGF-1 do not change (Harvie et al., 2011)....

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Journal ArticleDOI
TL;DR: In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease, and neurodegeneration, while in humans it helps reduce obesity, hypertension, asthma, and rheumatoid arthritis.

926 citations


Cites background from "The effects of intermittent or cont..."

  • ...Additional effects of fasting in human cells that can be considered as potentially ‘‘antiaging’’ are inhibition the mTOR pathway, stimulation of autophagy, and ketogenesis (Harvie et al., 2011; Sengupta et al., 2010)....

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  • ...Results of initial trials of IF (fasting 2 days per week or every other day) in human subjects suggest that there is a critical transition period of 3–6 weeks during which time the brain and body adapt to the new eating pattern and mood is enhanced (Harvie et al., 2011; Johnson et al., 2007)....

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  • ...Overweight subjects maintained for 6 months on a twice weekly IF diet in which they consumed only 500–600 calories on the fasting days, lost abdominal fat, displayed improved insulin sensitivity, and reduced blood pressure (Harvie et al., 2011)....

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  • ...Examples include the ‘‘5:2’’ IF diet (Harvie et al., 2011), the alternate day modified fasting diet (Johnson et al....

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  • ...Similarly, when on a 2 days/week fasting diet, overweight women at risk for breast cancer exhibited reduced oxidative stress and inflammation (Harvie et al., 2011), and elderly men exhibited reductions in body weight and body fat and improved mood (Teng et al....

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Journal ArticleDOI
TL;DR: It is demonstrated for the first time in humans that eTRF improves some aspects of cardiometabolic health and that IF's effects are not solely due to weight loss.

746 citations

Journal ArticleDOI
TL;DR: Effects of Intermittent Fasting on Health and Aging evidence is accumulating that eating in a 6-hour period and fasting for 18 hours can trigger a metabolic switch from glucose-based to ketone-base fasting.
Abstract: Effects of Intermittent Fasting on Health and Aging Evidence is accumulating that eating in a 6-hour period and fasting for 18 hours can trigger a metabolic switch from glucose-based to ketone-base...

730 citations


Cites background from "The effects of intermittent or cont..."

  • ...Likewise, members of the Calorie Restriction Society, who follow the CRON (Calorie Restriction with Optimal Nutrition) diet,(43-45) have low rates of diabetes mellitus, with low levels of insulin-like growth factor 1, growth hormone, and markers of inflammation and oxidative stress.(4,20,33,43) A multicenter study showed that daily caloric restriction improves many cardiometabolic risk factors in nonobese humans....

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  • ...However, these initial side effects usually disappear within 1 month, and patients should be advised of this fact.(17,20,27) Third, most physicians are not trained to prescribe specific intermittent-fasting interventions....

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  • ...The women in the two groups lost the same amount of weight during the 6-month period, but those in the group assigned to 5:2 intermittent fasting had a greater increase in insulin sensitivity and a larger reduction in waist circumference.(20,27) Figure 3....

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Journal ArticleDOI
TL;DR: The term periodic fasting (PF) is used to describe eating patterns in which individuals go extended time periods (e.g., 16-48h) with little or no energy intake, with intervening periods of normal food intake, on a recurring basis as mentioned in this paper.

655 citations


Cites background or methods or result from "The effects of intermittent or cont..."

  • ...Thus on these days the energy restriction was similar to the planned 25% restriction in women taking CER (Harvie et al., 2011, 2013a)....

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  • ...(Harvie et al., 2011, 2013a), and increased LDL particle size (Varady et al., 2011)....

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  • ...Reductions of inflammatory markers with F are comparable to CER for a given weight loss (Harvie et al., 2011). hus, although limited, the available biomarker data suggest that IF eads to comparable changes in most cancer risk biomarkers to CER, ith the possible exceptions of insulin resistance and…...

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  • ...Based on Harvie et al., 2011. ies have been relatively small and all reported equivalent weight loss between IF and CER....

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  • ...We reported no change in total circulating IGF-1 alongside weight loss with IF or CER in either of our studies (Harvie et al., 2011, 2013a)....

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References
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TL;DR: A method for estimating the cholesterol content of the serum low-density lipoprotein fraction (Sf0-20) is presented and comparison of this suggested procedure with the more direct procedure, in which the ultracentrifuge is used, yielded correlation coefficients of .94 to .99.
Abstract: A method for estimating the cholesterol content of the serum low-density lipoprotein fraction (Sf0-20) is presented. The method involves measurements of fasting plasma total cholesterol, triglyceride, and high-density lipoprotein cholesterol concentrations, none of which requires the use of the preparative ultracentrifuge. Comparison of this suggested procedure with the more direct procedure, in which the ultracentrifuge is used, yielded correlation coefficients of .94 to .99, depending on the patient population compared.

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Journal ArticleDOI
TL;DR: The correlation of the model's estimates with patient data accords with the hypothesis that basal glucose and insulin interactions are largely determined by a simple feed back loop.
Abstract: The steady-state basal plasma glucose and insulin concentrations are determined by their interaction in a feedback loop. A computer-solved model has been used to predict the homeostatic concentrations which arise from varying degrees beta-cell deficiency and insulin resistance. Comparison of a patient's fasting values with the model's predictions allows a quantitative assessment of the contributions of insulin resistance and deficient beta-cell function to the fasting hyperglycaemia (homeostasis model assessment, HOMA). The accuracy and precision of the estimate have been determined by comparison with independent measures of insulin resistance and beta-cell function using hyperglycaemic and euglycaemic clamps and an intravenous glucose tolerance test. The estimate of insulin resistance obtained by homeostasis model assessment correlated with estimates obtained by use of the euglycaemic clamp (Rs = 0.88, p less than 0.0001), the fasting insulin concentration (Rs = 0.81, p less than 0.0001), and the hyperglycaemic clamp, (Rs = 0.69, p less than 0.01). There was no correlation with any aspect of insulin-receptor binding. The estimate of deficient beta-cell function obtained by homeostasis model assessment correlated with that derived using the hyperglycaemic clamp (Rs = 0.61, p less than 0.01) and with the estimate from the intravenous glucose tolerance test (Rs = 0.64, p less than 0.05). The low precision of the estimates from the model (coefficients of variation: 31% for insulin resistance and 32% for beta-cell deficit) limits its use, but the correlation of the model's estimates with patient data accords with the hypothesis that basal glucose and insulin interactions are largely determined by a simple feed back loop.

29,217 citations

Journal ArticleDOI
TL;DR: A unified working diagnostic tool for the metabolic syndrome that is convenient to use in clinical practice and that can be used world-wide so that data from different countries can be compared.
Abstract: 469 Abstract Aims To establish a unified working diagnostic tool for the metabolic syndrome (MetS) that is convenient to use in clinical practice and that can be used world- wide so that data from different countries can be compared. An additional aim was to highlight areas where more research into the MetS is needed. Participants The International Diabetes Federation (IDF) convened a workshop held 12-14 May 2004 in London, UK. The 21 participants included experts in the fields of diabetes, public health, epidemiology, lipidology, genetics, metabolism, nutrition and cardiology. There were participants from each of the five con- tinents as well as from the World Health Organization (WHO) and the National Cholesterol Education Program—Third Adult Treatment Panel (ATP III). The workshop was sponsored by an educational grant from AstraZeneca Pharmaceuticals. Consensus process The consensus statement emerged following detailed discussions at the IDF workshop. After the workshop, a writing group produced a consensus statement which was reviewed and approved by all participants. Conclusions The IDF has produced a new set of criteria for use both epidemio- logically and in clinical practice world-wide with the aim of identifying people with the MetS to clarify the nature of the syndrome and to focus therapeutic strategies to reduce the long-term risk of cardiovascular disease. Guidance is included on how to compensate for differences in waist circumference and in regional adipose tissue distribution between different populations. The IDF has also produced recommendations for additional criteria that should be included when studying the MetS for research purposes. Finally, the IDF has identified areas where more studies are currently needed; these include research into the aetiology of the syndrome. Diabet. Med. 23, 469-480 (2006)

5,612 citations

Journal ArticleDOI
TL;DR: Assessment of the strength of associations between BMI and different sites of cancer and differences in these associations between sex and ethnic groups should inform the exploration of biological mechanisms that link obesity with cancer.

4,504 citations

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