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. 2018 Aug;35(8):1265-1283.
doi: 10.1007/s12325-018-0746-5. Epub 2018 Jul 25.

Intermittent Fasting (Alternate Day Fasting) in Healthy, Non-obese Adults: Protocol for a Cohort Trial with an Embedded Randomized Controlled Pilot Trial

Affiliations

Intermittent Fasting (Alternate Day Fasting) in Healthy, Non-obese Adults: Protocol for a Cohort Trial with an Embedded Randomized Controlled Pilot Trial

Norbert J Tripolt et al. Adv Ther. 2018 Aug.

Abstract

Background/objectives: Alternate day fasting (ADF) is a subtype of intermittent fasting and is defined as a continuous sequence of a fast day (100% energy restriction, zero calories) and a feed day (ad libitum food consumption), resulting in roughly 36-h fasting periods. Previous studies demonstrated weight reductions and improvements of cardiovascular risk factors with ADF in obese subjects. However, rigorous data on potential endocrine, metabolic and cardiovascular effects, besides weight loss, are lacking. Therefore we aim to investigate the short- and mid- to long-term clinical and molecular effects of ADF in healthy non-obese subjects.

Methods: We will perform a prospective cohort study with an embedded randomized controlled trial (RCT) including 90 healthy subjects. Thirty of them will have performed ADF for at least 6 months (mid-term group). Sixty healthy subjects without a particular diet before enrolment will serve as the control group. These subjects will be 1:1 randomized to either continuing their current diet or performing ADF for 4 weeks. All subjects will undergo study procedures that will be repeated in RCT participants after 4 weeks. These procedures will include assessment of outcome parameters, dual-energy X-ray absorptiometry, measurement of endothelial function, an oral glucose tolerance test, 24-h blood pressure measurement, retinal vessel analysis, echocardiography and physical activity measurement by an accelerometer. Blood, sputum, buccal mucosa and faeces will be collected for laboratory analyses. Participants in the RCT will wear a continuous glucose monitor to verify adherence to the study intervention.

Planned outcomes: The aim of this project is to investigate the effects of ADF on human physiology and molecular cellular processes. This investigation should gain in-depth mechanistic insights into the concept of ADF and form the basis for larger subsequent cohort recruitment and consecutive intervention studies.

Trial registration: NCT02673515; registered 24 November 2015. Current protocol date/version: 7 February 2017/version 1.8.

Keywords: Alternate day fasting; Blood pressure; Cell death; Cell signalling; Cohort study; Endothelial function; Glucose metabolism; Healthy subjects; Insulin sensitivity; Intermittent fasting.

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Conflict of interest statement

Norbert J. Tripolt, Slaven Stekovic, Felix Aberer, Jasmin Url, Peter N. Pferschy, Sabrina Schröder, Nicolas Verheyen, Albrecht Schmidt, Ewald Kolesnik, Sophie H. Narath, Regina Riedl, Barbara Obermayer-Pietsch, Thomas R. Pieber, Frank Madeo and Harald Sourij have nothing to disclose.

Figures

Fig. 1
Fig. 1
Study design
Fig. 2
Fig. 2
Flow chart enrolment

References

    1. Faris MA, Kacimi S, Al-Kurd RA, Fararjeh MA, Bustanji YK, Mohammad MK, et al. Intermittent fasting during Ramadan attenuates proinflammatory cytokines and immune cells in healthy subjects. Nutr Res. 2012;32(12):947–55. 10.1016/j.nutres.2012.06.021 - DOI - PubMed
    1. Joslin PM, Bell RK, Swoap SJ. Obese mice on a high-fat alternate-day fasting regimen lose weight and improve glucose tolerance. J Anim Physiol Anim Nutr (Berl). 2017;101(5):1036–1045. 10.1111/jpn.12546 - DOI - PubMed
    1. Catenacci VA, Pan Z, Ostendorf D, Brannon S, Gozansky WS, Mattson MP, et al. A randomized pilot study comparing zero-calorie alternate-day fasting to daily caloric restriction in adults with obesity. Obesity (Silver Spring). 2016;24(9):1874–83. 10.1002/oby.21581 - DOI - PMC - PubMed
    1. Varady KA, Bhutani S, Klempel MC, Kroeger CM, Trepanowski JF, Haus JM, et al. Alternate day fasting for weight loss in normal weight and overweight subjects: a randomized controlled trial. Nutr J. 2013;12(1):146. 10.1186/1475-2891-12-146 - DOI - PMC - PubMed
    1. Varady KA, Hoddy KK, Kroeger CM, Trepanowski JF, Klempel MC, Barnosky A, et al. Determinants of weight loss success with alternate day fasting. Obes Res Clin Pract. 2016;10(4):476–80. 10.1016/j.orcp.2015.08.020 - DOI - PubMed

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