13 votes

A randomized pilot study comparing zero-calorie alternate-day fasting to daily caloric restriction in adults with obesity

20 comments

  1. [12]
    tindall
    Link
    Intermittent fasting of some kind is very appealing as an option for reducing weight gain caused by some of my medication, as well as (supposedly) providing all kinds of other benefits....

    Intermittent fasting of some kind is very appealing as an option for reducing weight gain caused by some of my medication, as well as (supposedly) providing all kinds of other benefits. Unfortunately, there's a lot of nonsense and not a lot of science out there about it, so I'm posting one of the few controlled human trials I've see to get the discussion started.

    Tilderinos, do you fast? What fasting scheme do you use? Why do you fast, and has it worked? Are there issues with this study I'm not seeing?

    10 votes
    1. [2]
      NecrophiliaChocolate
      Link Parent
      My mom fasts for 'religious' reasons, I generally hate it when she does because she just ends up hungry and angry all day - and takes it out on the people around her. My friend is fasting for...

      My mom fasts for 'religious' reasons, I generally hate it when she does because she just ends up hungry and angry all day - and takes it out on the people around her. My friend is fasting for Ramadan, it is interesting because he is kinda using this as a New Year New Me kinda thing. He started going to the gym almost every day and waits table 4 or 5 days a week for 7+ hours. I hope he can maintain his current lifestyle in a healthy manner, I love seeing him succeed.

      6 votes
      1. Sahasrahla
        Link Parent
        Anecdotal experience but I find when you fast regularly for at least 16 hours a day your body adapts and you get used to it. Rather than feeling hungry and irritable while fasting you just feel...

        Anecdotal experience but I find when you fast regularly for at least 16 hours a day your body adapts and you get used to it. Rather than feeling hungry and irritable while fasting you just feel normal. If you're not used to fasting though and you go longer than normal without eating then you can feel pretty bad, even if it's been just half a day. Depending on what kind of religious fast one does you might get the feeling/benefits of IF or you might just be skipping meals sometimes and making yourself miserable. It also makes a big difference with religious fasting if you're not drinking water.

        As an aside, I'm happy for your friend and that you're supportive of him! It's so nice to see the people we care about making positive changes in their lives that make them happier.

        4 votes
    2. [4]
      aphoenix
      Link Parent
      I read about intermittent fasting a few times, and have somewhat adopted my routine to it, as it was close to what I was already doing. no eating before 11am no eating after 8pm I have paired this...

      I read about intermittent fasting a few times, and have somewhat adopted my routine to it, as it was close to what I was already doing.

      • no eating before 11am
      • no eating after 8pm

      I have paired this with:

      • non-alcoholic drinks shouldn't have calories
      • reduce the amount of alcoholic drinks

      I don't always stick to it on weekends; if there are circumstances that might lead me to break the routine, that's okay, such as a mother's day brunch or a late dinner for a party.

      It has been relatively effective for me, but I think that at least part of it is that I only really have time for two meals between 11 and 8; my caloric intake tends to hover right around 1800 - 2200, which is very good for me as I'm pretty active, and this puts me at a deficit of about 1/2 kg per week.

      4 votes
      1. [3]
        weystrom
        Link Parent
        So, water tea and coffee?

        non-alcoholic drinks shouldn't have calories

        So, water tea and coffee?

        1. Akir
          Link Parent
          There are other calorie-free drinks. Diet soda for instance. Unsweetened sodas have also been trending.

          There are other calorie-free drinks. Diet soda for instance. Unsweetened sodas have also been trending.

        2. aphoenix
          Link Parent
          Water, coffee, and coke Zero are the drinks I drink most.

          Water, coffee, and coke Zero are the drinks I drink most.

    3. JoylessAubergine
      Link Parent
      I've done both OMAD (One meal a day) and extended fasts (24 to 120 hour) in the past. Most of what i'm going to talk about is for <48 hours fasts and OMAD because things change for longer fasts. I...

      I've done both OMAD (One meal a day) and extended fasts (24 to 120 hour) in the past. Most of what i'm going to talk about is for <48 hours fasts and OMAD because things change for longer fasts.

      I enjoy it for the most part. I feel lighter, less agitated, less itchy (have eczema) and for OMAD and shorter fasts i sleep better and wake up feeling better instead of like death. Sleep gets funky past 48 hours fasts for me which i could probably solve with electrolytes and stuff like that but those fasts were few and far between. I don't really feel any negatives on short fasts, the hunger is there and worst about 2 hours before eating time but nothing debilitating. I get headaches for the first day or two of the diet, but they go away after i eat, just my body wondering where all the carbs have gone. Socially i tended to eat my one meal when i was with family or friends, i never went over the top eating but if i couldn't get out of making people uncomfortable with my fast at a family event i'd just eat and catch up the next day by skipping my one meal and eating earlier the day after (so turning it into a ~36 hour fast).

      It definitely works for weightloss but you have to be very careful when you eat because i found it's really easy to fail by degrees, eating slightly more in your eating period every day until you are negating any calorific benefit of the fast which destroys motivation. The other benefits are there but like nofap it's going to differ depending on what your issues with food are and it's not going to make you super human or anything like that.

      One last thing i'd say is find something to do that fills your time. The amount of time we spend thinking about food, going to food, cooking food, eating food, washing up after food is mindboggling and it's only when you fast and you suddenly have a bunch of time on your hands that you realise it.

      4 votes
    4. [4]
      xstresedg
      Link Parent
      I don't do it as often anymore, which is just me falling off the horse. However, I employ 16:8 intermittent fasting. Usually stop eating at 8 PM and don't have anything but a single cup of Stevia...

      I don't do it as often anymore, which is just me falling off the horse. However, I employ 16:8 intermittent fasting. Usually stop eating at 8 PM and don't have anything but a single cup of Stevia sweetened coffee in the morning (~5 kcal) with no effect on my blood sugar/insulin release due to Stevia having no Glycemic Index rating, and what it's cut with, Erythritol, also having a 1 GI rating, meaning it affects my blood sugar levels at 1% that of glucose.

      When I was fasting and successfully losing weight (combination of walking every day, eating less, and fasting), I was using Stevia cut with maltodextrin (110 GI) and still was losing weight. I believe the GI levels only matter when doing keto, rather than when fasting, but I could be wrong.

      Let me know if I have something wrong in my understanding of the sciences.

      3 votes
      1. [3]
        tindall
        Link Parent
        This is a great suggestion, thank you! From my further reading, I think you're right about the GI not mattering so much. The point is to keep your body in the post-absorbative and fasting states...

        This is a great suggestion, thank you! From my further reading, I think you're right about the GI not mattering so much. The point is to keep your body in the post-absorbative and fasting states as often as possible.

        2 votes
        1. [2]
          xstresedg
          Link Parent
          Correct. You want your body self-cannablising (see: autophagy) as much as you can without putting yourself in harm.

          Correct. You want your body self-cannablising (see: autophagy) as much as you can without putting yourself in harm.

          1 vote
          1. ThatFanficGuy
            Link Parent
            Listen, just don't go about talking about self-cannibalism when fasts come up. I'm all up for fasting, but it just don't sound right to me. EDIT: I'm mostly joking.

            Listen, just don't go about talking about self-cannibalism when fasts come up. I'm all up for fasting, but it just don't sound right to me.

            EDIT: I'm mostly joking.

            2 votes
  2. [3]
    joelthelion
    Link
    Too bad they only followed 26 people for 8 weeks. Interesting study nevertheless! I feel like it would be far easier to fast almost completely on alternate days than to reduce calorie intake every...

    Too bad they only followed 26 people for 8 weeks. Interesting study nevertheless! I feel like it would be far easier to fast almost completely on alternate days than to reduce calorie intake every day. I hope there's a larger followup study.

    3 votes
    1. vakieh
      Link Parent
      That is why it's called a pilot study after all.

      That is why it's called a pilot study after all.

      2 votes
    2. tindall
      Link Parent
      Indeed! I'm hoping that larger studies are conducted soon, as it's a potentially very promising method of promoting weight loss without a huge effort on the part of people involved. I'm currently...

      Indeed! I'm hoping that larger studies are conducted soon, as it's a potentially very promising method of promoting weight loss without a huge effort on the part of people involved. I'm currently reading "Intermittent Fasting: Is the Wait Worth the Weight?" by Stockman, Thomas, Burke, and Apovian, which is a literature review on the subject, and it really looks like we're at the point where a large study is needed. Animal models are pretty promising and pilot studies like this one have been done plenty.

      2 votes
  3. [4]
    vakieh
    Link
    That's your problem right there, and IMO completely invalidates this research almost to the point of complete uselessness. TDEE + up to 1400kcal is NOT what obese people eat on a regular day, let...

    which was supplemented with ad libitum access to 5-7 optional food modules (200 kcal each)

    That's your problem right there, and IMO completely invalidates this research almost to the point of complete uselessness. TDEE + up to 1400kcal is NOT what obese people eat on a regular day, let alone a day that they feel they have 'won' something the day before and need to 'prepare' for a win the next day. This is not comparing calorie restriction to alternate day fasting, this is comparing calorie restriction with alternate day fasting plus lesser calorie restriction.

    3 votes
    1. [3]
      tindall
      Link Parent
      Really? I'm medically categorized as obese and I definitely don't eat more than 3247 (!) calories per day, which would be my sedentary TDEE plus 5 of those optional modules. I think a lot of...

      Really? I'm medically categorized as obese and I definitely don't eat more than 3247 (!) calories per day, which would be my sedentary TDEE plus 5 of those optional modules. I think a lot of people are in a similar boat as me; low BMR to start with plus medications (hormones, in my case) that make the body freak out and retain lots of fat.

      2 votes
      1. [2]
        vakieh
        Link Parent
        If you did not eat anything on a particular day, you would increase your intake the next day. And it is famously well known that unless you are actively measuring your caloric intake people are...

        If you did not eat anything on a particular day, you would increase your intake the next day. And it is famously well known that unless you are actively measuring your caloric intake people are utterly incapable of estimating their own intake - from top athletes all the way down. And if you personally are actively measuring your caloric intake then there is an implicit reduction likely to be taking place that puts you in a completely different category to most overweight people.

        4 votes
        1. tindall
          Link Parent
          Just coming back to this after a few months of doing IF on and off. I did the full quadrant sweep (IF and calorie tracking, IF and no calorie tracking, no IF and calorie tracking, neither IF nor...

          And if you personally are actively measuring your caloric intake then there is an implicit reduction likely to be taking place that puts you in a completely different category to most overweight people.

          Just coming back to this after a few months of doing IF on and off. I did the full quadrant sweep (IF and calorie tracking, IF and no calorie tracking, no IF and calorie tracking, neither IF nor calorie tracking) and found that, for me personally at least, IF was more effective in improving sleep and losing weight than was calorie tracking.

          5 votes
  4. ProofTechnique
    Link
    I do 16:8 IF and keto, and the results have been pretty great for me. Dropped 10 kilos in the first month or two, hit a plateau for a while. Trying to adjust my calorie budget to keep my progress...

    I do 16:8 IF and keto, and the results have been pretty great for me. Dropped 10 kilos in the first month or two, hit a plateau for a while. Trying to adjust my calorie budget to keep my progress steady. My sleep has been better, my skin is much clearer, and I feel less shitty in general. I expect most of that is just from eating less garbage, but IF definitely makes it easier.

    3 votes