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. 2019 Sep 13;5(6):531-539.
doi: 10.1002/osp4.367. eCollection 2019 Dec.

Alternate day fasting combined with a low-carbohydrate diet for weight loss, weight maintenance, and metabolic disease risk reduction

Faiza Kalam  1 , Kelsey Gabel  1 , Sofia Cienfuegos  1 , Eric Wiseman  1 , Mark Ezpeleta  1 , Malik Steward  1 , Vasiliki Pavlou  1 , Krista A Varady  1
Affiliations

Alternate day fasting combined with a low-carbohydrate diet for weight loss, weight maintenance, and metabolic disease risk reduction

Faiza Kalam et al. Obes Sci Pract. .

Abstract

Objective: Alternate day fasting (ADF) is a popular weight loss regimen. Whether carbohydrate restriction can enhance the weight loss achieved with ADF remains unclear. Accordingly, this study examined the effect of ADF combined with a low-carbohydrate diet on body weight and metabolic disease risk factors.

Methods: Adults with obesity (n = 31) participated in ADF (600 kcal "fast day" alternated with an ad libitum "feast day") with a low-carbohydrate background diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period.

Results: Body weight decreased (-5.5 ± 0.5%; P < .001) during the weight loss period (month 0-3) but remained stable (P = .57) during the weight maintenance period (month 4-6). Net weight loss by month 6 was -6.3 ± 1.0%. Fat mass was reduced (P < .01) by month 6, while lean mass and visceral fat mass remained unchanged. Total cholesterol and low-density lipoprotein (LDL) cholesterol levels decreased (P < .05) by -6 ± 2% and - 8 ± 3%, respectively, by month 6. Systolic blood pressure was also reduced (P = .03) by -7 ± 3 mm Hg. Fasting insulin decreased (P = .03) by -24 ± 8% by month 6 relative to baseline. High-density lipoprotein (HDL) cholesterol, triglycerides, diastolic blood pressure, heart rate, fasting glucose, homeostatic model assessment of insulin resistance (HOMA-IR), and haemoglobin A1C (HbA1c) remained unchanged.

Conclusions: These findings suggest that ADF combined with a low-carbohydrate diet is effective for weight loss, weight maintenance, and improving certain metabolic disease risk factors such as LDL cholesterol, blood pressure, and fasting insulin. While these preliminary findings are promising, they still require confirmation by a randomized control trial.

Keywords: alternate day fasting; body weight; low‐carbohydrate diet; obesity.

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Conflict of interest statement

K.A.V. has a consulting relationship with the sponsor of the research, Nestle Health Sciences.

Figures

Figure 1
Figure 1
Study flow chart
Figure 2
Figure 2
Weight loss after 6 months of alternate day fasting with a low‐carbohydrate diet. Values reported as mean ± SEM. Body weight decreased (P < .001) during the weight loss period (baseline to month 3) but remained stable (P = .57) during the weight maintenance period (months 3 to 6): Repeated‐measures ANOVA
See this image and copyright information in PMC

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