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Abstract

The ability of modified alternate-day fasting (ADF; ie, consuming 25% of energy needs on the fast day and ad libitum food intake on the following day) to facilitate weight loss and lower vascular disease risk in obese individuals remains unknown. This study examined the effects of ADF that is administered under controlled compared with self-implemented conditions on body weight and coronary artery disease (CAD) risk indicators in obese adults. Sixteen obese subjects (12 women, 4 men) completed a 10-wk trial, which consisted of 3 phases: 1) a 2-wk control phase, 2) a 4-wk weight loss/ADF controlled food intake phase, and 3) a 4-wk weight loss/ADF self-selected food intake phase. Dietary adherence remained high throughout the controlled food intake phase (days adherent: 86%) and the self-selected food intake phase (days adherent: 89%). The rate of weight loss remained constant during controlled food intake (0.67 +/- 0.1 kg/wk) and self-selected food intake phases (0.68 +/- 0.1 kg/wk). Body weight decreased (P < 0.001) by 5.6 +/- 1.0 kg (5.8 +/- 1.1%) after 8 wk of diet. Percentage body fat decreased (P < 0.01) from 45 +/- 2% to 42 +/- 2%. Total cholesterol, LDL cholesterol, and triacylglycerol concentrations decreased (P < 0.01) by 21 +/- 4%, 25 +/- 10%, and 32 +/- 6%, respectively, after 8 wk of ADF, whereas HDL cholesterol remained unchanged. Systolic blood pressure decreased (P < 0.05) from 124 +/- 5 to 116 +/- 3 mm Hg. These findings suggest that ADF is a viable diet option to help obese individuals lose weight and decrease CAD risk. This trial was registered at clinicaltrials.gov as UIC-004-2009.

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Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: findings from a systematic review.

T Chaston, J Michael Dixon (2008)

Visceral adipose tissue (VAT) is associated with greater obesity-related metabolic disturbance. Many studies have reported preferential loss of VAT with weight loss. This systematic review looks for factors associated with preferential loss of VAT relative to subcutaneous abdominal fat (SAT) during weight loss. Medline and Embase were searched for imaging-based measurements of VAT and subcutaneous abdominal adipose tissue (SAT) before and after weight loss interventions. We examine for factors that influences the percentage change in VAT versus SAT (%deltaV/%deltaS) with weight loss. Linear regression analyses were performed on the complete data set and on subgroups of studies. Factors examined included percentage weight loss, degree of caloric restriction, exercise, initial body mass index (BMI), gender, time of follow-up and baseline VAT/SAT. There were 61 studies with a total of 98 cohort time points extracted. Percentage weight loss was the only variable that influenced %deltaV/%deltaS (r=-0.29, P=0.005). Modest weight loss generated preferential loss of VAT, but with greater weight loss this effect was attenuated. The method of weight loss was not an influence with one exception. Very-low-calorie diets (VLCDs) provided exceptional short-term (<4 weeks) preferential VAT loss. But this effect was lost by 12-14 weeks. Visceral adipose tissue is lost preferentially with modest weight loss, but the effect is attenuated with greater weight loss. Acute caloric restriction, using VLCD, produces early preferential loss of VAT. These observations may help to explain the metabolic benefits of modest weight loss.

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Randomized clinical trials of weight loss maintenance: a review.

Melanie Turk, Kyeongra Yang, Marilyn Hravnak … (2015)

The problem of overweight and obesity has reached epidemic proportions in the United States and globally, and the high prevalence is due in part to the recidivism associated with weight loss treatment. Approximately one-third of lost weight is often regained in the first year after treatment and, at times, continues. Because a plethora of comorbid diseases are associated with obesity, in particular, cardiovascular disease, hypertension, and hyperlipidemia, clinicians and researchers have attempted to find useful strategies for maintaining weight loss. This review presents the findings from 42 randomized clinical trials of weight loss maintenance from 1984 through 2007 using interventions that include (1) the Internet, (2) strategies after a very low calorie diet, (3) pharmacotherapy, (4) behavioral strategies, (5) physical activity, and (6) alternative strategies. The results of the reviewed trials revealed that treatment with orlistat or sibutramine combined with dietary modification, caffeine or protein supplementation, consuming a diet lower in fat, adherence to physical activity routines, prolonged contact with participants, problem-solving therapy, and the alternative treatment of acupressure were efficacious in reducing weight regain after weight loss treatment. The limitations of some studies may reduce the robustness of their findings, and future studies are necessary to replicate and support these results so that individuals are able to maintain weight loss and retain the health benefits associated with a lower weight.

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Changes in self-efficacy and dietary adherence: the impact on weight loss in the PREFER study.

Mindi Styn, Melanie Warziski, Sandra Burke … (2008)

Findings from studies examining self-efficacy and its relationship to weight loss have been inconsistent. We examined self-efficacy specific to changing eating behaviors in the PREFER trial, an 18-month behavioral weight-loss study, to determine if self-efficacy and dietary adherence were associated with weight change, and what impact self-efficacy had on weight change after controlling for adherence. Measurements included the weight efficacy lifestyle (WEL) questionnaire, body weight, self-reported fat gram intake, kilocalorie intake, and adherence to kilocalorie and fat gram goals at baseline, 6, 12, and 18 months. The sample (N = 170) was 88.2% female and 70.0% Caucasian; the mean age was 44.1 years (SD = 8.8). Mean weight loss at 18 months was 4.64% (SD = 6.24) of baseline body weight and the mean increase in self-efficacy was 11.70% (SD = 38.61). Self-efficacy improved significantly over time (p = 0.04) and was associated with weight loss (p = 0.02). Adherence to the fat gram goal was associated with weight loss (p = 0.0003), and self-efficacy remained associated with weight loss after controlling for fat gram adherence (p = 0.0001). Consistent with self-efficacy theory, improvement in self-efficacy over time supported greater weight loss. Adherence to the fat gram goal also influenced weight loss.

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PubMed ID:: 19793855

DOI:: 10.3945/ajcn.2009.28380

ScienceOpen disciplines: Chemistry

Keywords: Adult,Aged,Cholesterol,blood,Cholesterol, LDL,Coronary Disease,prevention & control,Energy Intake,Fasting,physiology,Female,Heart Rate,Humans,Hypertension,Male,Middle Aged,Obesity,rehabilitation,Overweight,Patient Dropouts,Systole,Triglycerides,Weight Loss

Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults.

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Most cited references 8

Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: findings from a systematic review.

Randomized clinical trials of weight loss maintenance: a review.

Changes in self-efficacy and dietary adherence: the impact on weight loss in the PREFER study.

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