The body lufestyle fluctuations made a great influence on people's BMR and healthy weight loss indexes. Alternate-day fasting is safe for most people. EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease.

Alternate-day fasting and sustainable lifestyle -

Besides, all of the studies described the randomization process. All articles had an appropriate number of participants to analyze. The funnel plot displayed the conclusion of a qualitative estimation of publication bias Figure 3. Figure 3. Funnel plot of the studies included in our meta-analysis. MD, mean difference; SE, standard error.

Seven RCTs involving participants contained meaningful data on weight in the ADF group and in the control group.

It proved that compared with the control group Figure 4 , the ADF group showed statistically significant reductions in weight. Figure 4. Forest plots showing changes between two groups in A weight, B body mass index BMI , C total calorie intake; SD, standard deviation; IV, inverse variance; CI, confidence interval; df, degrees of freedom.

Four RCTs involving participants contained meaningful data on BMI 82 in the ADF group and 54 in the control group. The result proved that the ADF group showed statistical differences in BMI compared with the control group Figure 4. Four RCTs involving participants contained meaningful data on total calorie intake 72 in the ADF group and 66 in the control group.

It demonstrated that the ADF group showed statistically significant reductions in total calorie intake compared with the control group Figure 4. Five RCTs involving participants contained meaningful data on TC in the ADF group and 71 in the control group.

We found significant differences between the ADF group and the control group in the TC Figure 5. Figure 5. Forest plots showing changes between two groups in A total cholesterol TC , B triglycerides TG , C low-density lipoprotein LDL , D high-density lipoprotein HDL , E fasting blood sugar FBS , F homeostasis model assessment-insulin resistance HOMA-IR ; SD, standard deviation; IV, inverse variance; CI, confidence interval; df, degrees of freedom.

Five RCTs involving participants contained meaningful data on TG in the ADF group and 90 in the control group. The result proved that the ADF group showed significant differences in TG compared with the control group Figure 5.

Four RCTs involving participants contained meaningful data on LDL 90 in the ADF group and 61 in the control group. The result proved that the ADF group showed significant differences in LDL compared with the control group Figure 5.

Five RCTs involving participants contained meaningful data on HDL in the ADF group and 71 in the control group. The result showed that it was no statistical difference in terms of HDL between the two groups Figure 5.

Four RCTs involving participants contained meaningful data on FBS 88 in the ADF group and 56 in the control group. The model showed no marked differences between the ADF group and the control group in the change of FBS Figure 5.

Three RCTs involving participants contained meaningful data on HOMA-IR 55 in the ADF group and 46 in the control group. Compared with the control group, the ADF group showed no meaningful difference in HOMA-IR Figure 5. Six RCTs involving participants contained meaningful data on fat mass in the ADF group and in the control group.

In terms of lean mass, five RCTs had an appropriate sample size of patients 89 in the ADF group and 73 in the control group. Figure 6. Forest plots showing changes between two groups in A fat mass, B lean mass, C systolic blood pressure SBP , D diastolic blood pressure DBP ; total calorie intake; SD, standard deviation; IV, inverse variance; CI, confidence interval; df, degrees of freedom.

Four RCTs involving participants contained meaningful data on SBP and DBP 90 in the ADF group and 85 in the control group. A random-effects model was chosen to estimate changes between the two groups.

Recently, the most commonly used diet strategy for weight loss is calorie restriction. In many parts of the world, ADF is an age-old way that includes many forms. For example, Ramadan is a form of ADF and abided by Muslims all around the world If someone wants to lose weight, it is generally recommended to restrict diets and exercises in clinical practice guidelines 39 , The traditional methods of losing weight such as the daily calorie restriction , although the effect is affirmative, the control and compliance are poor Based on this foundation, intermittent fasting regimens, especially ADF protocols, are being proposed in many pieces of literature 9 , 19 , 33 — The important unsolved issue is whether the effects of ADF can play a role for people who want to lose weight.

This quantitative meta-analysis summarized the evidence from RCTs. We performed this meta-analysis from seven studies, including participants, to evaluate the effect of ADF on weight loss for at least 1 month.

In this case, we selected some meaningful indexes of many diverse indicators to illustrate this difference between the two groups.

Based on our results, ADF was the positive influential method on the physiology, body composition, and parameters for obesity or a normal human. For the first time, this meta-analysis suggested that ADF is a potentially superior alternative to daily calorie restriction in normal-weight and overweight subjects.

Just the way we assumed, the ADF strategy was effectively reduced body-related biomarkers, such as weight, BMI, and so on. Compared with the complete calorie restriction method, ADF had a lower capacity for weight management.

In animal experiments, weight loss can redistribute fat in the ADF group without losing lean mass New research showed that exercise plus ADF would experience the largest reductions in cardiometabolic risk factors, with the least decrease in lean mass compared with ADF alone Also, it could be suggested as an alternative option for daily calorie restriction CR in treating nonalcoholic fatty liver disease On the one hand, the decrease of liver enzymes might be explained by an improvement in visceral fat or steatosis of the liver in animal and human experiments.

The phenomenon showed that ADF could promote hepatocyte restorative process when transient autophagy occurred to liver cells However, the exact molecular mechanisms that underlie fasting and liver autophagy need to be further studied and established The research suggested that ADF had effects on cardiovascular improvements.

As is known to all, alterations in cholesterol metabolism were known to be powerful predictors of developing cardiovascular events, even in the early stages of atherosclerosis For instance, abnormal cholesterol metabolism, including low intestinal cholesterol absorption and elevated cholesterol biosynthesis, played an important role in metabolic syndrome, obesity, and diabetes This diet strategy may also have cardioprotective effects in participants by reducing triacylglycerol and increasing LDL particle size and adiponectin concentration.

To our knowledge, the Mediterranean and certain low carbohydrate diets help maintain a healthy weight and reduce the risks of coronary heart disease.

If ADF were combined with a Mediterranean diet or a low-carbohydrate diet, it would be meaningful to observe how it affects weight loss and cardiovascular outcomes in future studies 48 , To improve lipid, the combination of diet and exercise is more effective than diet or exercise alone Previous research has already demonstrated that glucose and insulin have been associated with obesity.

Thus, it is important to manage and control glucose levels and insulin resistance At the same time, the significant decrease in fasting insulin may potentially be attributed in part to the decline in body weight and the reduction in total body fat We found a significant reduction in lean mass in the ADF group.

This serves as a caution for patient populations at risk for sarcopenia because ADF could exacerbate muscle loss. Some studies indicated that ADF is the most beneficial diet strategy for lowering fasting insulin, glucose, and HOMA-IR. However, there was no significant difference in insulin resistance between the two groups.

It suggested that ADF plus exercise might reduce insulin resistance, which needs to be further elucidated Meanwhile, ADF did not result in a decline in bone mineral density or white blood cell count.

It might even have a trend to increase bone mineral density values for a long period 54 — In a recent study we founded, ADF likely makes little differences compared with continuous energy restriction, but ADF probably slightly reduces body weight and fat mass. In additional analyses, no important differences were detected when comparing different types of ADF vs.

nonconsecutive days Randomized control trials suggested that ADF is effective for weight loss, weight maintenance, and improving certain metabolic disease risk factors such as LDL cholesterol, blood pressure, and fasting insulin after 6 months ADF had some physiological benefits with similar daily calorie restriction ADF might lead to fat redistribution from visceral to subcutaneous depots in female mice Evidence suggested that plasma adiponectin was inversely proportional to visceral fat accumulation 65 , Thus, the redistribution in body fat by ADF may be linked to increases in plasma adiponectin observed.

All in all, ADF may improve body fat distribution and circulating adiponectin; conversely, the diet strategy may take precautions against the development of obesity-related diseases whether these effects can be reproduced in clinical trials. Several adverse events were reported in the study.

Its incidences were significantly low and slight. A small number of participants experienced mild headaches or light-headedness in the early days of the trial. Others reported constipation during weeks 1 and 2 of the trial This phenomenon may or may not be linked with dietary therapy.

The participants were proposed to be consuming more fruits and vegetables on feed days. Those clinical manifestations would gradually disappear in the course of the experiment.

This meta-analysis included seven RCTs and concentrating on the efficacy of ADF in participants. Compared with previous studies, our study had some advantages; the data were derived from randomized, double-blind, controlled trials.

However, this study also has some limitations, which reflect the common limitations of other systematic reviews and meta-analyses.

First of all, this article did not include numerous RCTs such as unpublished studies, which limit evidence to affect study quality. Second, RCTs had low methodological rigor and short intervention; more appropriate high-quality trials are needed to improve the accuracy of results.

In summary, this meta-analysis suggests that ADF is a viable diet strategy for weight loss, and it has a substantial improvement in risk indicators for diseases in obese or normal people. Therefore, adults, whether healthy or not, should perform ADF with recommendations of clinical physicians to prevent adverse effects.

YL: literature search. ZG: study design and data collection. TC: data interpretation. JW and YZ: writing. All authors contributed to the article and approved the submitted version. This work was supported by the National Nature Science Foundation of China nos.

tsqn , Beijing Municipal Administration of Hospitals' Ascent Plan, code: DFL, and Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support, code: ZYLX The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

ADF, alternate day fasting; RCTs, randomized controlled trials; TC, total cholesterol; BMI, body mass index; LDL, low-density lipoprotein; LDL, low-density lipoprotein; TG, triglycerides; SBP, systolic blood pressure; DBP, diastolic blood pressure; HDL, high-density lipoprotein; HOMA-IR, homeostasis model assessment-insulin resistance; FBS, fasting blood sugar; MD, mean difference; OR, odds ratio; CI, confidence intervals; CR, calorie restriction.

Wilson PW, D'Agostino RB, Sullivan L, Parise H, Kannel WB. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience.

Arch Intern Med. doi: PubMed Abstract CrossRef Full Text Google Scholar. Popkin BM, Gordon-Larsen P. The nutrition transition: worldwide obesity dynamics and their determinants.

Int J Obes Relat Metab Dis. Kroemer G, López-Otín C, Madeo F, De Cabo R. Carbotoxicity—noxious effects of carbohydrates.

Curioni CC, LourenO PM. Long-term weight loss after diet and exercise: a systematic review. Int J Obes. Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, et al.

Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. CrossRef Full Text Google Scholar. Miller WC, Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord.

Wu T, Gao X, Chen M, Dam RMV. Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis.

Obes Rev. Wood PD, Stefanick ML, Williams PT, Haskell WL. The effects on plasma lipoproteins of a prudent weight-reducing diet, with or without exercise, in overweight men and women. J Cardiopulm Rehabil. Trepanowski JF, Kroeger CM, Barnosky A, Klempel MC, Bhutani S, Hoddy KK, et al.

Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults. JAMA Intern Med. Hansen D, Dendale P, Berger J, van Loon LJC. The effects of exercise training on fat-mass loss in obese patients during energy intake restriction.

Sports Med. Ross R, Rissanen J, Pedwell H, Clifford J, Shragge P. Influence of diet and exercise on skeletal muscle, and visceral adipose tissue in men.

J Appl Physiol. Fock KM, Khoo J. Diet and exercise in management of obesity and overweight. J Gastroenterol Hepatol. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al.

J Am Coll Cardiol. Moreira EAM, Most M, Howard J, Ravussin E. Dietary adherence to long-term controlled feeding in a calorie-restriction study in overweight men and women. Nutr Clin Pract. Moroshko I, Brennan L, O"Brien P.

Predictors of dropout in weight loss interventions: a systematic review of the literature. Antoni R, Johnston KL, Collins AL, Robertson MD. Intermittent v. Br J Nutr. Mattison JA, Colman RJ, Beasley TM, Allison DB, Kemnitz JW, Roth GS, et al.

Caloric restriction improves health and survival of rhesus monkeys. Nat Commun. Redman LM, Heilbronn LK, Martin CK, de Jonge L, Williamson DA, Delany JP, et al. Metabolic and behavioral compensations in response to caloric restriction: implicationsfor the maintenance of weight loss.

PLoS ONE. Varady KA, Klempel MC, Kroeger CM, Trepanowski JF, et al. Alternate day fasting for weight loss in normal weight and overweight subjects: a randomized controlled trial. Nutr J.

Varady KA, Church EC, Klempel MC. Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults. Am J Clin Nutr. Klempel MC, Kroeger CM, Trepanowski JF, Varady KA.

Intermittent fasting combined with calorie restriction is effective for weight loss and cardio-protection in obese women. Varady KA, Hellerstein MK.

Alternate-day fasting and chronic disease prevention: a review of human and animal trials. Luigi F. Aging, adiposity, and calorie restriction. Tinsley GM, La BPM. Effects of intermittent fasting on body composition and clinical health markers in humans.

Nutr Rev. PubMed Abstract Google Scholar. Hoddy KK, Kroeger CM, Trepanowski JF, Barnosky A, Bhutani S, Varady KA. Meal timing during alternate day fasting: impact on body weight and cardiovascular disease risk in obese adults. Ganesan K, Habboush Y, Sultan S. Intermittent fasting: the choice for a healthier lifestyle.

Mosley M, Spencer M. The Fastdiet: Lose Weight, Stay Healthy, and Live Longer With the Simple Secret of Intermittent Fasting. Atria Books. Britain Google Scholar.

The Fast Diet For Beginners. Berkeley, CA: Rockridge Press Moher D. Corrigendum to: preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. This "weight loss" period was followed by another six months of "weight maintenance" and observations.

Both diet groups lost about 5. At the end of the 12 months, there was only one difference between the two diet groups: the alternate fasting day group had a significant elevation in low density lipoprotein LDL , an increase of LDL is known as a risk factor for heart attacks and strokes, so that's not good.

This was a very small study to begin with, and, more importantly, there was a fairly significant dropout rate.

Twelve people quit the alternate-day fasting group, with almost half citing dissatisfaction with the diet. By comparison, 10 people quit the daily calorie restriction group, and none cited dissatisfaction with diet, only personal reasons and scheduling conflicts eight quit the control group for the same reasons.

It's not surprising that people disliked alternate-day fasting. Previous studies have reported that people felt uncomfortably hungry and irritable on fasting days, and that they didn't get accustomed to these discomforts. Interestingly, in this study, over time people in the fasting group ate more on fasting days and less on feasting days.

So basically by the end of the study they were eating similarly to the calorie restriction group. The authors note more limitations. The control group did not receive food, counseling, or the same attention from the study personnel, potential factors that could affect their results, besides how they ate.

And this study can't tell us about the potential benefits for people who have high blood pressure, high cholesterol, or diabetes because the study didn't include individuals with those conditions. Usually at this point we say something like "more studies of this approach are needed," but I won't.

There's already plenty of evidence supporting a common-sense lifestyle approach to weight loss: ample intake of fruits and veggies, healthy fats, lean proteins, and plenty of exercise. From apples to zucchini, there are over a hundred "real" foods you can eat endlessly, enjoy, and yes, still lose weight.

I would advise against spending any more money on fad diet books. Or processed carbs, for that matter. Rather, hit the fresh or frozen produce aisle, or farmer's market, and go crazy. Then go exercise. Do that, say, for the rest of your life, and you will be fine.

No one got fat eating broccoli, folks. That said, if you tend to binge or stress-eat sugary or starchy foods, and you feel like you can't control your habit, talk to your doctor, because that is a separate issue to be addressed. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial.

JAMA Internal Medicine, Published online May 1, Alternate-day fasting in nonobese subjects: effects on body weight, body composition, and energy metabolism. American Journal of Clinical Nutrition, January As a service to our readers, Harvard Health Publishing provides access to our library of archived content.

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Alternate-Day Fasting — on your marks, get set, go! Aiding smooth bowel movements fasting ADF lifestyel a type of intermittent fasting. People following this food regimen eat every other day, but this varies depending on the exact regimen. Why do people look to ADF? Want more than just this little introductory nibble? Intermittent fasting sustaiable a popular Alternate-day fasting and sustainable lifestyle these days, kifestyle when talking about suxtainable weight and getting Seasonal Fruit Tarts. This fastkng approach, involving cycles of fasting and eating, is often praised for BMR and healthy weight loss benefits lifestylr blood sugar regulation and potential weight loss. The core idea revolves around alternating periods of eating and fasting, creating a rhythm that can impact various aspects of health. This method is often chosen for its flexibility and less restrictive nature. Alternate Day Fasting: A less popular method is called alternate day fasting. This approach involves alternating between days of normal eating and days where food intake is heavily reduced or eliminated.