Table 1.

Intermittent fasting combined with exercise and effect on body composition.

Author, Year	Participant Baseline Characteristics	Drop Outs (Final Number of Completers)	Duration of Study	Description of Fasting	Description of Exercise	Weight Change	Body Composition Changes	Method of Anthropometric Assessment	Quality Score (Downs and Black)	Fasted During Exercise?
Time Restricted Feeding Studies
Moro et al. (2016) [24]	n = 34 Male Resistance trained (at least 3–5 times/week for 5 years) Time restricted feeding group n = 17 29.9 ± 4.1 years old BMI 26.5 kg/m2 * BF% 13.0% * Control diet group n = 17 28.5 ± 3.5 years old BMI 27.2 kg/m2 * BF% 13.2% *	NR—assumed full completion	8 weeks	Time restricted feeding 100% of energy needs consumed over 3 meals in an 8 h window (1 p.m., 4 p.m. and 8 p.m.), 20 g of whey protein after training Control 100% of energy needs consumed over 3 meals across the day (8 a.m., 1 p.m. and 8 p.m.), 20 g of whey protein after training	Both groups 3 resistance sessions/week, split routine, 6–8 repetitions at 85–90% of 1 RM to failure, supervised sessions, conducted between 4–6 p.m.	Time restricted feeding ↓ 1.0 kg Control ↑ 0.2 kg	Time restricted feeding LBM ↑ 0.6 kg (NS) FM ↓ 1.6 kg Control LBM ↑ 0.5 kg (NS) FM ↓ 0.3 kg (NS)	DXA	18	No
Tinsley et al. (2017) [25]	n = 28 Male Both groups recreationally active; have not followed a consistent RT programme over previous 3 months Time restricted feeding group n = 14 22.9 ± 4.0 years old BMI 27.2 kg/m2 * BF% 21.3 ± 5.4% Normal diet group n = 14 22.0 ± 2.4 years old BMI 24.3 kg/m2 * BF% 18.7 ± 3.8%	Time restricted feeding group 1 (13 completers) Normal diet group 5 (9 completers)	8 weeks	Time restricted feeding 4 days/week (non-training days) all energy consumed in a 4 h window between 4 p.m. and midnight 3 days/week ad libitum Normal diet Usual dietary patterns	Both groups 3 resistance sessions/week on non-consecutive days, alternating upper and lower body, 8–12 reps to failure, 4 sets of each exercise	Time restricted feeding ↓ 1.0 kg (NS) Normal diet ↑ 3.0 kg (NS) Analysis based on n = 10 for time restricted feeders and n = 8 normal diet due to exclusion for low compliance	Time restricted feeding LBM ↓ 0.2 kg (NS) FM ↓ 0.6 kg (NS) Normal diet LBM ↑ 2.3 kg (NS) FM ↑ 0.8 kg (NS) Analysis based on n = 10 for time restricted feeders and n = 8 normal diet due to exclusion for low compliance	DXA	16	No
Tinsley et al. (2019) [26]	n = 40 Female Resistance trained (2 to 4 sessions per week for at least 1 year); BF% less than 33% Time restricted feeding group n = 13 23.3 ± 1.5 years old BMI 23.8 kg/m2 * BF% 28.4 ± 1.5% Time restricted feeding group plus HMB n = 13 22.3 ± 3.4 years old BMI 22.9 kg/m2 * BF% 28.7 ± 1.5% Control diet group n = 14 22.6 ± 2.7 years old BMI 22.5 kg/m2 * BF% 29.3 ± 1.5%	Time restricted feeding group 1 (12 completers) Time restricted feeding group plus HMB 3 (10 completers) Control diet group 5 (9 completers)	8 weeks	Time restricted feeding All energy consumed between 12 p.m. and 8 p.m. each day, prescribed energy deficit of 250 kcal and protein of ≥1.4 g/kg/d. Instructed to consume whey protein supplement each day to achieve protein target Time restricted feeding plus HMB Same as time restricted feeding group, plus 3 g/day HMB Control diet group Energy and protein targets as per the time restricted feeding group, however instructed to consume breakfast upon waking, and continue eating at self-selected intervals	All groups 3 resistance sessions/week on non-consecutive days, alternating 2 different upper and lower body sessions Conducted between 12 p.m. and 6 p.m.	Time restricted feeding group ↑ 0.6 kg Time restricted feeding group plus HMB ↑ 0.6 kg Control diet group ↑ 1.1 kg Data from ITT analysis. Results significant for all groups combined	Time restricted feeding group FM ↓ 0.4 kg LBM ↑ 0.9 kg BF% ↓ 0.8% Time restricted feeding group plus HMB FM ↓ 0.7 kg LBM ↑ 1.2 kg BF% ↓ 1.4% Control diet group FM ↑ 0.4 kg LBM ↑ 0.9 kg BF% ↑ 0.1% Data from ITT analysis. Results significant for all groups combined	4C	20	No
Stratton et al. (2020) [27]	n = 32 Male Recreationally trained (2–4 sessions per week for at least 6 months) Time restricted feeding group n = 13 22.9 ± 3.6 years old BMI 25.9 kg/m2 * BF% 19.9 ± 8.3% Control diet group n = 13 22.5 ± 2.2 years old BMI 26.4 kg/m2 * BF% 18.9 ± 7.4%	Time restricted feeding group 0 (16 completers Control diet group 2 (14 completers)	4 weeks	Time restricted feeding All energy consumed between 12 p.m. and 8 p.m., or 1 m and 9 p.m. each day, prescribed 25% energy deficit and protein intake of 1.8 g/kg/d. Provided 50 g whey protein supplement on training days. Control diet group Energy and protein targets as per the time restricted feeding group, but with no time restrictions on consumption. Additionally provided with 50 g whey protein supplement on training days	Both Groups 3 full body resistance sessions/week. Conducted between 3 p.m. and 8 p.m.	Time restricted feeding ↓ 1.2 kg Control diet group ↓ 1.4 kg	Time restricted feeding FM ↓ 1.5 kg LBM NS change (actual values NR) BF% ↓ 1.6% Control diet group FM ↓ 1.4 kg LBM NS change (actual values NR) BF% ↓ 1.5% Analysis based on n = 13 for time restricted feeders and n = 13 for control diet group due to exclusion for low compliance	4C	19	No
Modified Alternate Day Fasting Study
Oh et al. (2018) [28]	n = 45 Training history unclear, but described as ‘unfamiliar with resistance exercise’ Alternate day fasting + exercise group n = 12 male = 5, female = 7 37.3 ± 7.3 years old BMI 27.5 ± 2.6 kg/m2 BF% 34.2 ± 6.1% Alternate day fasting group n = 13 male = 3, female = 10 32.9 ± 7.3 years old BMI 27.6 ± 2.8 kg/m2 BF% 34.9 ± 4.6% Exercise only group n = 10 male = 7, female = 3 35.7 ± 7.9 years old BMI 28.3 ± 4.1 kg/m2 BF% 31.0 ± 5.0% Normal diet group n = 10 male = 4, female = 6 40.6 ± 10.0 years old BMI 26.3 ± 3.0 kg/m2 BF% 32.2 ± 4.4%	Alternate day fasting + exercise group 2 (10 completers) Alternate day fasting group 4 (9 completers) Exercise only group 2 (8 completers) Normal diet group 2 (8 completers) Sex of drop outs NR	8 weeks	Alternate day fasting groups 75% Calorie restriction alternating with ad libitum feeding Normal diet/exercise only groups No instruction given	Alternate day fasting + exercise and normal diet + exercise groups 3 training sessions per week consisting of 40 min of resistance training followed by 20 min of aerobic exercise on a treadmill. Resistance training was upper and lower body, 3 different sessions each week. Intensity ranged from 70% 10 RM (15 repetitions) to 100% 10 RM (10 repetitions) and altered each week. Aerobic exercise performed at 60–85% age predicted maximal heart rate	Alternate day fasting + exercise group ↓ 3.3 ± 2.4 kg Alternate day fasting group ↓ 2.4 ± 3.1 kg Exercise only group NS change Normal diet group NS change Data from ITT analysis	Alternate day fasting + exercise FM ↓ 2.7 ± 2.0 kg LBM ↓ 0.4 ± 0.5 kg BF% ↓ 2.5 ± 2.2% Alternate day fasting group FM ↓ 1.6 ± 2.3 kg (NS) LBM ↓ 0.5 ± 0.9 kg (NS) BF% ↓ 1.3 ± 2.4% Exercise only group FM ↓ 1.2 ± 1.9 kg LBM ↓ 0.1 ± 0.9 kg (NS) BF% ↓ 1.1 ± 1.8% (NS) Normal diet group FM ↓ 0.3 ± 1.3 kg (NS) LBM ↓ 0.2 ± 0.7 kg (NS) BF% ↓ 0.1 ± 1.5% (NS) Data from ITT analysis	BIA	18	No
Ramadan Fasting Studies
Trabelsi et al. (2013) [29]	n = 16 Male Resistance trained (3 times/week for 1.6 ± 0.6 and 1.5 ± 0.5 years) Fasted exercise n = 8 25.0 ± 3.0 years old BMI 25.8 ± 4.0 kg/m2 BF% 15.0 ± 2.0% Fed exercise n = 8 25.0 ± 2.0 years old BMI 26.0 ± 1.7 kg/m2 BF% 14.0 ± 1.0%	NR	4 weeks	Ramadan fasting Average fast 15 h	Both groups 4 resistance sessions/week, 4–6 exercises, 4 sets at 10 RM, split routine, supervised Fasted exercise group Exercise conducted between 4–6 p.m. before breaking fast Fed exercise group Exercise conducted between 9–10 p.m.	NS change in either group	Fasted exercise group LBM ↓ 0.2 kg (NS) BF% ↓ 0.7% (NS) Fed Exercise group LBM ↑ 0.3 kg (NS) BF% ↓ 0.4% (NS)	Skinfolds	17	Mixed—exercise conducted between 4–6 p.m. for fasted group, unclear when fast began
Trabelsi et al. (2012) [30]	n = 16 Male Recreational bodybuilders (at least 1 year experience) Fasters n = 9 (it is unclear whether this data is duplicated from Trabelsi et al. 2013) 24.0 ± 3.0 years old BMI 26.0 ± 0.7 kg/m2 BF% 14.5 ± 2.0% Non fasters n = 7 26.0 ± 3.0 years old BMI 26.0 ± 1.5 kg/m2 BF% 13.5 ± 1.4%	NR	4 weeks	Ramadan fasting Average fast 15 h Control group Normal diet	Both groups 4 resistance sessions/week, 4–6 exercises, 4 sets at 10 RM, split routine, supervised	Fasters NS change Non Fasters ↑ 1.9 kg	Fasters FM ↓ 0.6 kg (NS) LBM ↓ 0.1 kg (NS) BF% ↓ 0.7% (NS) Non Fasters FM ↑ 1.2 kg (NS) LBM ↑ 0.7 kg (NS) BF% ↑ 1.1% (NS)	Skinfolds	16	Yes—exercise conducted between 4–6 p.m., unclear when fast began
Stannard et al. (2008) [31]	n = 8 Male Recreationally active (2–5 sessions/week) 24.1 ± 0.8 years old BMI 24 kg/m2 * BF% 12.9 ± 3.5%	NR	4 weeks	Ramadan fasting Average fast 14.5 h	2–5 sessions/week in the ‘weight-training gymnasium’. Type and duration of exercise is unspecified	↓ 1.3 kg	FM ↓ 0.7 kg LBM ↑ 0.1 kg (NS) BF% ↓ 0.7% (NS)	Underwater weighing	16	Unclear

Notes: All results presented as mean ± SD. Where no SD has been reported in the original study, values are means. Baseline characteristics are representative of all participants before drop outs. * Data not reported, calculated by the authors from baseline height and weight (BMI), or from baseline weight and fat mass for BF%. 1 RM = 1 repetition maximum, 10 RM = 10 repetition maximum, 4C = 4 compartment model, BF% = body fat percentage, BMI = body mass index, DXA = dual X-ray absorptiometry, FM = fat mass, HMB = β-hydroxy β-methylbutyrate, ITT = intention to treat, LBM = lean body mass, NS = non-significant change, NR = not reported, PP = per protocol, RT = resistance training.