Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial.
Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial.
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DOI：
10.1001/jamainternmed.2017.0936
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发表时间：
2017-07-01
影响因子：
39
通讯作者：
Varady KA
中科院分区：
文献类型：
--
作者：
Trepanowski JF;Kroeger CM;Barnosky A;Klempel MC;Bhutani S;Hoddy KK;Gabel K;Freels S;Rigdon J;Rood J;Ravussin E;Varady KA
隔日禁食越来越受欢迎，但迄今为止，还没有长期随机临床试验评估其功效。比较隔日禁食与每日热量限制对减肥、体重维持和心血管疾病风险指标的影响。 2011年10月1日至2015年1月15日期间，在伊利诺伊州芝加哥的一家学术机构对肥胖成年人（18至64岁；平均体重指数为34）进行了一项单中心随机临床试验。参与者被随机分为三组中的一组，为期一年：隔日禁食（禁食日能量需求的 25%；交替“节日”能量需求的 125%）、热量限制（每天能量需求的 75%）或无干预对照组。该试验包括为期 6 个月的减肥阶段和随后的 6 个月的体重维持阶段。主要结果是体重变化。次要结果是遵守饮食干预和心血管疾病风险指标。在 100 名参与者中（86 名女性和 14 名男性；平均 [SD] 年龄为 44 岁），隔日禁食组的退出率最高（34 人中的 13 人 [38%]），而每日热量限制组（35 人中的 10 人 [29%]）和对照组（31 人中的 8 人 [26%]）。隔日禁食组和每日热量限制组的参与者在第 6 个月（−6.8% [95% CI，−9.1% 至 −4.5%] 与 −6.8% [95% CI，−9.1% 至 −4.6%]）和第 12 个月（−6.0% [95% CI，−8.5% 至 −3.6%] 与 −5.3% [95%] 时的平均体重减轻相似CI，-7.6％至-3.0％]）相对于对照组。隔日禁食组的参与者在禁食日的饮食量超过规定，而在节日的饮食量低于规定，而每日热量限制组的参与者通常达到了规定的能量目标。第 6 个月或第 12 个月时，干预组之间的血压、心率、甘油三酯、空腹血糖、空腹胰岛素、胰岛素抵抗、C 反应蛋白或同型半胱氨酸浓度没有显着差异。隔日禁食组参与者在第 6 个月的平均高密度脂蛋白胆固醇水平显着升高（6.2 mg/dL [95% CI，0.1–12.4 mg/dL]），但在第 12 个月时没有显着升高。 （1.0 mg/dL [95% CI，-5.9 至 7.8 mg/dL]），相对于每日热量限制组。与每日热量限制组相比，隔日禁食组参与者的平均低密度脂蛋白胆固醇水平在第 12 个月时显着升高（11.5 mg/dL [95% CI，1.9–21.1 mg/dL]）。与每日热量限制相比，隔日禁食并没有产生更好的依从性、减肥、体重维持或心脏保护作用。 ClinicalTrials.gov 标识符：NCT00960505
Alternate-day fasting has become increasingly popular, yet, to date, no long-term randomized clinical trials have evaluated its efficacy. To compare the effects of alternate-day fasting vs daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease. A single-center randomized clinical trial of obese adults (18 to 64 years of age; mean body mass index, 34) was conducted between October 1, 2011, and January 15, 2015, at an academic institution in Chicago, Illinois. Participants were randomized to 1 of 3 groups for 1 year: alternate-day fasting (25% of energy needs on fast days; 125% of energy needs on alternating “feast days”), calorie restriction (75% of energy needs every day), or a no-intervention control. The trial involved a 6-month weight-loss phase followed by a 6-month weight-maintenance phase. The primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease. Among the 100 participants (86 women and 14 men; mean [SD] age, 44 years), the dropout rate was highest in the alternate-day fasting group (13 of 34 [38%]), vs the daily calorie restriction group (10 of 35 [29%]) and control group (8 of 31 [26%]). Mean weight loss was similar for participants in the alternate-day fasting group and those in the daily calorie restriction group at month 6 (−6.8% [95% CI, −9.1% to −4.5%] vs −6.8% [95% CI, −9.1% to −4.6%]) and month 12 (−6.0% [95% CI, −8.5% to −3.6%] vs −5.3% [95% CI, −7.6% to −3.0%]) relative to those in the control group. Participants in the alternate-day fasting group ate more than prescribed on fast days, and less than prescribed on feast days, while those in the daily calorie restriction group generally met their prescribed energy goals. There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C-reactive protein, or homocysteine concentrations at month 6 or 12. Mean high-density lipoprotein cholesterol levels at month 6 significantly increased among the participants in the alternate-day fasting group (6.2 mg/dL [95% CI, 0.1–12.4 mg/dL]), but not at month 12 (1.0 mg/dL [95% CI, −5.9 to 7.8 mg/dL]), relative to those in the daily calorie restriction group. Mean low-density lipoprotein cholesterol levels were significantly elevated by month 12 among the participants in the alternate-day fasting group (11.5 mg/dL [95% CI, 1.9–21.1 mg/dL]) compared with those in the daily calorie restriction group. Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction. clinicaltrials.gov Identifier: NCT00960505
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影响因子：
37.8
作者：
Jensen MD;Ryan DH;Apovian CM;Ard JD;Comuzzie AG;Donato KA;Hu FB;Hubbard VS;Jakicic JM;Kushner RF;Loria CM;Millen BE;Nonas CA;Pi-Sunyer FX;Stevens J;Stevens VJ;Wadden TA;Wolfe BM;Yanovski SZ;Jordan HS;Kendall KA;Lux LJ;Mentor-Marcel R;Morgan LC;Trisolini MG;Wnek J;Anderson JL;Halperin JL;Albert NM;Bozkurt B;Brindis RG;Curtis LH;DeMets D;Hochman JS;Kovacs RJ;Ohman EM;Pressler SJ;Sellke FW;Shen WK;Smith SC Jr;Tomaselli GF;American College of Cardiology/American Heart Association Task Force on Practice Guidelines;Obesity Society
通讯作者：
Obesity Society
影响因子：
2.2
作者：
Alhamdan, B A;Garcia-Alvarez, A;Alzahrnai, A H;Karanxha, J;Stretchberry, D R;Contrera, K J;Utria, A F;Cheskin, L J
通讯作者：
Cheskin, L J
DOI：
10.1177/0884533611405992
发表时间：
2011-06
期刊：
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
影响因子：
--
作者：
Moreira EA;Most M;Howard J;Ravussin E
通讯作者：
Ravussin E
影响因子：
4.9
作者：
Demerath, E. W.;Ritter, K. J.;Towne, B.
通讯作者：
Towne, B.
影响因子：
120.7
作者：
Gardner, Christopher D.;Kiazand, Alexandre;King, Abby C.
通讯作者：
King, Abby C.