Intermittent v. continuous energy restriction: differential effects on postprandial glucose and lipid metabolism following matched weight loss in overweight/obese participants.
Antoni R, Johnston KL, Collins AL, Robertson MD.
Br J Nutr. 2018 Mar;119(5):507-516. doi: 10.1017/S0007114517003890.
PMID: 29508693
Abstract
The intermittent energy restriction (IER) approach to weight loss involves short periods of substantial (>70 %) energy restriction (ER) interspersed with normal eating. Studies to date comparing IER to continuous energy restriction (CER) have predominantly measured fasting indices of cardiometabolic risk. This study aimed to compare the effects of IER and CER on postprandial glucose and lipid metabolism following matched weight loss. In all, twenty-seven (thirteen male) overweight/obese participants (46 (sem 3) years, 30·1 (sem 1·0) kg/m2) who were randomised to either an IER intervention (2638 kJ for 2 d/week with an overall ER of 22 (sem 0·3) %, n 15) or a CER intervention (2510 kJ below requirements with overall ER of 23 (sem 0·8) %) completed the study. Postprandial responses to a test meal (over 360 min) and changes in anthropometry (fat mass, fat-free mass, circumferences) were assessed at baseline and upon attainment of 5 % weight loss, following a 7-d period of weight stabilisation. The study found no statistically significant difference in the time to attain a 5 % weight loss between groups (median 59 d (interquartile range (IQR) 41-80) and 73 d (IQR 48-128), respectively, P=0·246), or in body composition (P≥0·437). For postprandial measures, neither diet significantly altered glycaemia (P=0·266), whereas insulinaemia was reduced comparatively (P=0·903). The reduction in C-peptide tended (P=0·057) to be greater following IER (309 128 (sem23 268) to 247781 (sem20 709) pmol×360 min/l) v. CER (297 204 (sem25 112) to 301 655 (sem32 714) pmol×360 min/l). The relative reduction in TAG responses was greater (P=0·045) following IER (106 (sem30) to 68 (sem 15) mmol×360 min/l) compared with CER (117 (sem 43) to 130 (sem 31) mmol×360 min/l). In conclusion, these preliminary findings highlight underlying differences between IER and CER, including a superiority of IER in reducing postprandial lipaemia, which now warrant targeted mechanistic evaluation within larger study cohorts.
KEYWORDS:
3-OHB 3-hydroxybutyrate; CER continuous energy restriction; ER energy restriction; IER intermittent energy restriction; REE resting energy expenditure; Glucose; Humans; Intermittent fasting; Lipids; TAG
Intermittent v. continuous energy restriction: differential effects on postprandial glucose and lipid metabolism following matched weight loss in overweight/obese participants
I don’t understand all of it, but it’s interesting that extended fasting doesn’t seem to have an advantage over intermittent fasting in the measures that they tested.
The comparison was “intermittent energy restriction” to “continuous energy restriction” and found benefits to the intermittent approach. The IER wasn’t actual intermittent fasting but just greater variation between restricted and unrestricted periods.
The way I read this was calorie restriction such as a long term diet focused on CICO. The IER was 70% reduction of calories intermittent as opposed to the steady calorie reduction. As I read it it seems the main difference was in triglyceride accumulation in the blood. @brownfat would this be a correct interpretation?