Table 1.
Randomized clinical weight loss studies with ≥8 week duration in individuals with overweight/obesity comparing an IMF paradigm to a calorie-restricted control group.
| Reference | N | Age b (Years) | BMI (kg/m2) | Intervention Duration | Analysis | Interventions | Weight Loss a | Attrition a |
|---|---|---|---|---|---|---|---|---|
| Harvie et al., 2011 [40] | 107 100% Female |
30–45 | 24–40 | 26 weeks | Intent-to-Treat | 2DW 25% overall energy restriction delivered as VLCD (25% estimated EI) on 2 consecutive days/week; no restriction on the other 5 days |
2DW = −6.4 ± 11.2 kg e | 2DW = 20.8% |
| CER 25% restriction below estimated requirements 7 days/week |
CER = −5.6 ± 9.2 kg e | CER = 13% | ||||||
| Varady et al., 2011 [47] | 49 81.2% Female |
35–65 | 25–39.9 | 12 weeks | Completer | AMDF 25% of baseline EI on fast days (meals provided), ad libitum at home on fed days |
ADMF = −5.2 ± 4.0% e | ADMF = 13.3% |
| CER 75% of baseline EI daily (meals provided) |
CER = −5.0 ± 4.9% e | CER = 20% | ||||||
| Exercise Ad libitum during the entire study; engaged in moderate intensity exercise program 3 times/week |
Exercise = −5.1 ± 3.1% e | Exercise = 20% | ||||||
| Control Ad libitum during the entire study |
Control = −0.2 ± 1.4% e | Control = 20% | ||||||
| Harvie et al., 2013 [41] | 115 100% Female |
20–69b | 24–45 | 12 weeks | Intent-to-Treat | 2DW—Carbohydrate Restriction (CR) 30% EI of baseline energy requirements (high protein, moderate fat) with 40 g carbohydrate restriction on two consecutive days; eucaloric diet the other 5 days |
2DW CR = 79.4 (95%CI 74.6–84.1) kg to 74.4 (95%CI 70.0–78.9) kg | 2DW CR = 10.8% |
| 2DW—Carbohydrate Restriction + ad libitum Protein and Fat (CR+PF) 30% EI of baseline energy requirements and 40 g carbohydrate restriction with ad libitum protein and fat on two consecutive days; eucaloric diet the other 5 days |
2DW CR + PF = 82.4 (95%CI 77.2–87.6) kg to 77.6 (95%CI 72.9–82.4) kg | 2DW CR+PF = 18.4% | ||||||
| CER 75% EI of baseline energy requirements daily |
DER = 86 (95%CI 80.6–91.3) kg to 82.3 (95%CI 77.1–87.5) kg | DER = 17.5% | ||||||
| Carter et al., 2016 [42] | 63 52.4% Female |
≥18 | ≥27 | 12 weeks | Completer | 2DW 1670–2500 kJ/day for 2 non-consecutive days each week, and 5 days of ad libitum intake |
2DW = −6.2 ± 3.6% | 2DW = 16.1% |
| CER Continuous energy restriction diet of 5000–6500 kJ/day |
CER = −5.6 ± 4.4% | CER = 21.8% | ||||||
| Catenacci et al., 2016 [25] | 26 80% Female |
18–55 | ≥30 | 8 weeks | Completer | ADF 100% energy restriction on fasting day, ad libitum on fed days. Meals provided |
ADF = −8.8 ± 3.7% e | ADF = 6.7% |
| CER ~1675 kJ deficit per day. Meals provided |
CER = −6.2 ± 3.1% e | CER = 14.3% | ||||||
| Trepanowski et al., 2017 [48] | 100 84% Female |
18–64 | 25–40 | 26 weeks | Intent-to-Treat | ADMF 25% of baseline EI as lunch on fast days, 125% of baseline EI split between meals on fed days. Meals provided in first 3 months |
ADMF = −6.8% (95%CI −9.1% to −4.5%) | ADF = 26.5% |
| CER 75% of baseline EI split between three meals daily. Meals provided in first 3 months |
CER = −6.8% (95% CI −9.1% to −4.6%) | CER = 17.1% | ||||||
| Control No intervention; maintain baseline weight |
As compared to control | Control = 19.4% | ||||||
| Carter et al., 2018 [43] | 137 56.2% Female |
≥18 | ≥27 | 52 weeks | Intent-to-Treat | 2DW 2100–2500 kJ/day for 2 non-consecutive days each week, and 5 days of habitual eating |
2DW = −6.8 ± 6.4 kg e (about −6.8%) c | 2DW = 28.6% |
| CER Continuous energy restriction diet of 5000–6300 kJ/day |
CER = −5.0 ± 7.1 kg e (about −4.9%) c | CER = 31.3% | ||||||
| Conley et al., 2018 [45] | 24 0% Female |
55–75 | ≥30 | 26 weeks | Completer | 2DW Restrict calorie intake to ~2500 kJ on two non-consecutive days per week; ad libitum intake on remaining five days |
2DW = 5.3 ± 3.0 kg (5.5 ± 3.2%) | 2DW = 8.3% |
| CER Daily ~2100 kJ energy-restricted diet from average requirement |
CER = 5.5 ± 4.3 kg (5.4 ± 4.2%) | CER = 0% | ||||||
| Schübel et al., 2018 [44] | 150 50% Female |
35–65 | 25–40 | 12 weeks | Intent-to-Treat | 2DW Restriction at 80% weekly as 2 non-consecutive days with 75% energy restriction 5 days with no restriction |
2DW = −7.1 ± 0.7% d | 2DW = 4.1% |
| CER Continuous energy restriction at 80% |
CER = −5.2 ± 0.6% d | CER = 6.1% | ||||||
| Control No energy restriction |
Control = −3.3 ± 0.6% d | Control = 1.9% | ||||||
| Sundfør et al., 2018 [46] | 112 50% female |
21–70 | 30–45 | 26 weeks | Intent-to-Treat | 2DW ~1700/2500 kJ (female/male) energy restriction on two non-consecutive fasting days; ad libitum energy intake on remaining 5 days |
2DW = −9.1 ± 5.0 kg (about −8.4%) c | 2DW = 1.9% |
| CER Daily restriction of energy to match IER groups |
CER = −9.4 ± 5.3 kg (about −8.7%) c | CER = 3.4% | ||||||
| Hutchison et al., 2019 [49] | 88 100% Female |
35–70 | 25–42 | 10 weeks | Completer | ADMF 70 IF diet (32% EI on fast days and 100% EI on fed days) to equal 70% of calculated baseline energy requirements on three non-consecutive days per week |
ADMF 70 = −5.4 ± 2.5 kg e (about −6.0%) c | ADMF 70 = 12% |
| ADMF 100 IF diet (37% of EI on fast days and 145% EI on fed days) to equal 100% of calculated baseline energy requirements on three non-consecutive days per week |
ADMF 100 = −2.7 ± 2.5 kg e (about −3.2%) c | ADMF 100 = 12% | ||||||
| CER Continuous restriction at 70% of calculated baseline energy requirements daily |
CER = −3.9 ± 2.0 kg e (about −4.4%) c | CER = 7.7% | ||||||
| Control 100% of calculated baseline requirements daily |
Control = 0.4 ± 1.4 kg e (about 0.5%) c | Control = 8.3% |
Abbreviations: EI = energy intake; TDEE = total daily energy expenditure; ADF = alternate day fasting; ADMF = alternate day modified fasting; 2DW = fasting 2 days per week; CER = continuous energy restriction. a Reported attrition at end of intervention period, not at end of study periods, including follow-up observation or maintenance periods. b Age range of participants reflects baseline age of randomized participants. There was no age limit for recruitment in this study, but participants had to have gained ≥7 kg since the age of 20. c Estimated percent change in weight reported as absolute weight at end of the intervention compared to absolute weight at baseline. d Reported as individual log relative changes ± geometric SEM, with baseline values as the reference. e Reported as mean ±SD, converted from data in the manuscript by the authors for the purposes of this table.