Alternate-day fasting and lean muscle mass -
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.
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Krista Varady, who has conducted most of the studies on ADF. The health and weight loss benefits seem to be the same regardless of whether the fasting-day calories are consumed at lunch or dinner, or as small meals throughout the day 4. Most of the studies on alternate-day fasting used the modified version, with calories on fasting days.
Alternate-day fasting cycles between days of fasting and normal eating. The most popular version allows for about calories on fasting days.
Although ADF may be helpful for promoting weight loss, studies have suggested that this type of calorie restriction is no more effective for weight loss than traditional daily calorie restriction.
Research suggests that this method is not superior to traditional daily calorie restriction for promoting weight loss 3 , 6 , 8 , 9 , Studies have shown that ADF and daily calorie restriction are equally effective at reducing harmful belly fat and inflammatory markers in those with obesity Although ADF may offer benefits for fat loss, recent research shows that ADF is no more effective than traditional calorie restriction for promoting weight loss or preserving muscle mass 6 , Furthermore, like other types of calorie restriction, weight loss during ADF may be accelerated when combined with increased physical activity.
For example, combining ADF with endurance exercise may cause twice as much weight loss than ADF alone and six times as much weight loss as endurance exercise alone Alternate-day fasting may help you lose weight. Some studies show that hunger ultimately goes down on fasting days, while others state that hunger remains unchanged 5 , 9 , However, research agrees that modified ADF with calories on fasting days is much more tolerable than full fasts on fasting days One study comparing ADF to calorie restriction showed that ADF increased levels of brain-derived neurotrophic factor BDNF after 24 weeks of follow- up.
Researchers concluded that ADF may induce long-term changes in BDNF and that this may promote improved weight loss maintenance. However, the researchers found that BDNF levels did not correlate with body weight changes in this particular study and suggested that these findings be interpreted with caution However, animal studies have shown that modified ADF resulted in decreased amounts of hunger hormones and increased amounts of satiety hormones compared to other diets 17 , 18 , Another factor to consider is compensatory hunger, which is a frequent downside of traditional, daily calorie restriction 20 , 21 , Compensatory hunger refers to increased levels of hunger in response to calorie restriction, which cause people to eat more than they need to when they finally allow themselves to eat.
In fact, many people who try modified ADF claim that their hunger diminishes after the first 2 weeks or so. After a while, some find that the fasting days are nearly effortless 5.
The effects of alternate-day fasting on hunger are inconsistent. Studies on modified alternate-day fasting show that hunger decreases as you adapt to the diet. Some studies have suggested that ADF may be more beneficial for preserving muscle mass than other types of calorie restriction,. However, results from a recent, high-quality study suggest that ADF is no more effective for preserving muscle mass than traditional calorie restriction 6 , 8 , 16 , 25 , Losing weight and restricting calories is usually an effective way to improve or reverse many symptoms of type 2 diabetes Similarly to continuous calorie restriction, ADF seems to cause mild reductions in risk factors for type 2 diabetes among people with overweight or obesity 30 , 31 , ADF may also help reduce fasting insulin levels, with some studies suggesting that it may be more effective than daily calorie restriction.
However, not all studies agree that ADF is superior to daily calorie restriction 6 , 33 , 34 , Having high insulin levels, or hyperinsulinemia, has been linked to obesity and chronic diseases, such as heart disease and cancer 36 , A reduction in insulin levels and insulin resistance should lead to a significantly reduced risk of type 2 diabetes, especially when combined with weight loss.
Alternate-day fasting may reduce risk factors for type 2 diabetes. It can reduce fasting insulin levels in people with prediabetes. Heart disease is the leading cause of death in the world and responsible for about one in four deaths 38 , 39 , However, there were clear sexual dimorphic differences in a number of these outcomes, and some disparities between groups when the measurement of whole-body changes were compared to localised muscle changes.
Future studies should investigate the longer-term impacts of fasting in comparison to continuous energy restriction, but importantly, explore the relationship between transient changes in energy balance and protein turnover, weight loss and muscle mass accrual.
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Download references. The authors would like to acknowledge Formulite for donating all supplement shakes and soups used in the study and Sonosite Australia for providing the ultrasound equipment.
This study received in-kind support from the Imaging and Image Analysis Centre at the Australian Institute for Musculoskeletal Science AIMSS. Open Access funding enabled and organized by CAUL and its Member Institutions. SK was supported by a student scholarship from Swinburne University. All protein shake and soup supplements were donated by Formulite.
Ultrasound equipment was provided by Sonosite Australia. Support for image analysis was received in-kind from the Imaging and Image Analysis Centre at the Australian Institute for Musculoskeletal Science AIMSS. Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University of Technology, John Street, Hawthorn, Melbourne, VIC, , Australia.
Stephen J. Keenan, Matthew B. Cooke, Won Sun Chen, Josef Sullivan, Sam X. Australian Institute for Musculoskeletal Science AIMSS , The University of Melbourne, Melbourne, VIC, Australia.
Matthew B. Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia. Department of Surgery, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.
You can also search for this author in PubMed Google Scholar. SK, RB, MC, SW, DE designed research. SK, RB, MC, EB, MI conducted the research. WSC, JS, SK performed the statistical analyses. SK, MC, RB wrote the paper; all authors contributed to the final manuscript. SK, MC, RB had primary responsibility for the final content.
Alternage-day a world full of quick Alternate-day fasting and lean muscle mass and weight-loss Nitric oxide and overall well-being, intermittent Atlernate-day is showing some Altdrnate-day power. Altwrnate-day Alternate-day fasting and lean muscle mass in the nuscle training world are getting a bit curious, so Altenrate-day want to know: does intermittent fasting help build muscle? Fastjng studies on intermittent fasting or Musscle have looked into its effect on weight loss, where it can be an effective tool for getting past a plateau. In the limited study into IF paired with regular resistance training, results suggest that while someone on IF may lose more weight than someone on a regular diet, their muscle gains and maintenance will be largely identical. According to Advanced Sports Dietician Lisa Middleton, committing to IF or any restrictive diet mostly comes down to whether it can work for you. Before trying it, here are four things you should know:. If your goal is to build muscle, sticking with IF can be tricky. Alternate-day fasting may help promote weight loss annd may help lower risk muslce related to heart disease and type 2 diabetes. Fxsting fasting ADF is an Alternate-day fasting and lean muscle mass fasting approach. Alterrnate-day include:. Krista Varady, who has conducted most of the studies on ADF. The health and weight loss benefits seem to be the same regardless of whether the fasting-day calories are consumed at lunch or dinner, or as small meals throughout the day 4. Most of the studies on alternate-day fasting used the modified version, with calories on fasting days.
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