Table 2.
Changes in biomarkers of metabolic disease risk in randomized controlled weight loss trials of intermittent energy restriction (IER) compared to continuous energy restriction (CER).
| Reference | Participants & Interventions | Measurement Conditions | Glycemic Outcomes | Lipid Outcomes | Other Biomarker Outcomes |
|---|---|---|---|---|---|
| Harvie et al., 2011 [40] | -Pre-menopausal women who were overweight or obese -2DW; CER |
-Overnight fast, at least 5 days after the last partial energy restriction day in the 2DW group -In a subset of the 2DW group (n = 15), fasting blood samples were collected after 5 days of normal intake on the morning after a partial energy restriction day and after 2 days of normal intake |
-Glucose (ND) -Greater decrease in insulin and increase in insulin sensitivity (HOMA-IR) in the 2DW group -Greater decreases in insulin sensitivity on the morning after a partial energy restriction day in a subset of the 2DW group |
-Cholesterol (ND) -LDL (ND) -HDL (ND) -TGs (ND) |
-CRP (ND) -Adiponectin (ND) -Leptin (ND) -Ketones (ND) |
| Varady et al., 2011 [47] | -Adults who were overweight or obese -ADMF; CER |
12 h fasting blood samples | Not assessed | -Cholesterol (ND) -LDL (ND) -HDL (ND) -Greater decrease in TGs in the ADMF group |
Not assessed |
| Harvie et al., 2013 [41] | -Pre-menopausal women -2DW + Carbohydrate Restriction; 2DW + Carbohydrate restriction and ad libitum protein and fat restriction; CER |
Overnight fast, at least 5 days after the weekly 2 day partial energy restriction day in the 2DW groups | -Greater decrease in insulin and increase in insulin sensitivity (HOMA-IR) in the 2DW groups -HbA1c (ND) -Glucose (ND) |
-Cholesterol (ND) -LDL (ND) -HDL (ND) -TGs (ND) |
-IGF-1 (ND) -IL-6 (ND) -TNF-α (ND) -Ketones (ND) -Leptin (ND) -Adiponectin (ND) |
| Carter et al., 2016 [42] | -Adults with T2DM who were overweight or obese -2DW; CER |
After an overnight fast (minimum of 8 h) | -HbA1c (ND) | Not assessed | Not assessed |
| Catenacci et al., 2016 [25] | -Adults who were overweight or obese -ADF; CER |
After an overnight fast (minimum of 8 h) | -Glucose (ND) -Insulin (ND) -Insulin sensitivity (HOMA-IR; ND) |
-Cholesterol (ND) -LDL (ND) -HDL (ND) -TGs (ND) |
-Metabolic rate (ND) -Leptin (ND) -Ghrelin (ND) -BDNF (ND) |
| Trepanowski et al., 2017 [48] | -Adults who were overweight or obese -ADMF; CER |
After a 12 h fast, the morning after a “feast” day for the ADMF group | -Glucose (ND) -Insulin (ND) -Insulin sensitivity (HOMA-IR; ND) |
-Cholesterol (ND) -Greater increase in LDL in ADMF -HDL (ND) -TGs (ND) |
-CRP (ND) -Homocysteine (ND) |
| Schübel et al., 2018 [44] | Adults who were overweight or obese -2DW; CER |
Metabolic measures sampled day after fed day and an overnight fast | -Fasting glucose decreased more in 2DW than CER -Insulin (ND) -Insulin sensitivity (HOMA-IR; ND) |
-Cholesterol (ND) -LDL (ND) -HDL (ND) -TGs (ND) |
Not assessed |
| Sundfør et al., 2018 [46] | -Adults who were overweight or obese -2DW; CER |
Blood samples were obtained following a minimum of a 10 h fast | Glucose (ND) HbA1c (ND) |
-Cholesterol (ND) -LDL (ND) -HDL (ND) -TGs (ND) -Apo B (ND) |
-CRP (ND) -Metabolic rate (ND) |
| Hutchison et al., 2019 [49] | -Female adults who were overweight or obese -ADMF 70; ADMF 100; CER |
Metabolic measures performed after a fed and fasted day | -Greater decreases in glucose and insulin in ADMF 70 when measured after a fast day -Insulin sensitivity (euglycemic-hyperinsulinemic clamp) increased in ADMF 70 when measured after a fed day, but changes not different than CER -Insulin sensitivity (clamp) decreased in ADMF 70 when measured after a fasted day |
-Greater decreases in fasting FFA, TC, LDL, and Tgs in ADMF 70 compared to CER, but ADMF 70 lost more weight -Differences in changes in cholesterol and LDL remained after adjusting for weight loss |
Not assessed |
Abbreviations: ADF = alternate day fasting; ADMF = alternate day modified fasting; 2DW = fasting 2 days per week; CER = continuous energy restriction; ND = no difference; HOMA-IR = Homeostatic Model Assessment of Insulin Resistance; LDL = low-density lipoprotein; HDL = high-density lipoprotein; TG = triglyceride; CRP = C-reactive protein; IGF-1 = insulin-like growth factor-1; IL-6 = interleukin-6; TNF-α = Tumor Necrosis Factor alpha; HbA1c = hemoglobin A1c; BDNF = brain-derived neurotrophic factor; Apo B = apolipoprotein B; FFA = free fatty acid.