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The effect of intermittent v. chronic energy restriction on weight loss and markers of chronic disease risk in premenopausal women: a randomised pilot trial

Published online by Cambridge University Press:  27 October 2009

M. Harvie ,
M. Pegington ,
J. Frystyk ,
M. Mattson ,
S. Jebb ,
J. Cuzick  and
A. Howell
M. Harvie
Affiliation:
Genesis Prevention Centre, University Hospital of South Manchester, Manchester M23 9LT, UK
M. Pegington
Affiliation:
Genesis Prevention Centre, University Hospital of South Manchester, Manchester M23 9LT, UK
J. Frystyk
Affiliation:
Medical Research Laboratories, Aarhus University, Denmark
M. Mattson
Affiliation:
Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, MD, USA
S. Jebb
Affiliation:
MRC Human Nutrition Research Group, Cambridge CB1 9NL, UK
J. Cuzick
Affiliation:
CRUK Department of Epidemiology and Statistics, Wolfson Institute, London EC1M 6B, UK
A. Howell
Affiliation:
Genesis Prevention Centre, University Hospital of South Manchester, Manchester M23 9LT, UK
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Abstract

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Proceedings of the Nutrition Society , Volume 68 , Issue OCE2: Scottish Section of The Nutrition Society, 7–8 April 2009 , 2009 , E80
Copyright
Copyright © The Authors 2009

Excess adiposity increases risk of diseases such as diabetes, CVD, dementia and certain forms of cancer including breast cancer. Weight loss is likely to reduce risk of these diseases but is difficult to achieve and maintain. Animal studies indicate that intermittent energy restriction (IER) may be superior to continuous energy restriction (CER) for improving insulin sensitivity(Reference Anson, Guo and de Cabo1) and reducing cancer risk(Reference Cleary, Jacobson and Phillips2). It is hypothesised that IER may be superior to CER for reducing weight and improving insulin sensitivity, and may have beneficial effects on other biomarkers of disease risk, e.g. lipids, adipokines and inflammatory and oxidative stress markers and may also be more acceptable to women.

The effectiveness and acceptability of IER (n 53) v. CER (n 54) were tested in overweight or obese premenopausal women (mean age 40.1 (sd 3.9) years, mean adult weight gain 20.7 (sd 11.2) kg). Both diets provided 75% estimated energy requirements; CER subjects had approximately (approx) 6270 kJ (1500 kcal)/d for 7 d/week, IER subjects had approx 2665 kJ (550 kcal)/d for 2 d/week and approx 7524 kJ (1800 kcal) for 5 d/week.

Eighteen women (17%) withdrew from the study before 6 months (IER 11, CER 7; main reasons: stress 4, pregnancy 3, change in employment 3, couldn't stick to diet 3). Change in weight, body composition, anthropometry and biomarkers at 6 months for last observation carried forward are reported.

CRP, C-reactive protein; HOMA, homeostasis model assessment of insulin resistance; IGF-I insulin-like growth factor; BDNF, brain-derived neurotrophic factor; AOPP, advanced oxidation protein products. **P<0.05. †Median and 95% CI.

IER gives similar results to CER in relation to weight loss and many of the risk variables measured and may be an alternative approach to CER. The superior reductions in insulin resistance with IER may be related to periods of very low energy intake (approx 70% restriction). Future studies will investigate the mechanism of IER and its optimal duration.

References

1.Anson, RM, Guo, Z, de Cabo, R et al. (2003) Proc Natl Acad Sci U S A 100, 6216–6220.CrossRefGoogle Scholar
2.Cleary, MP, Jacobson, MK, Phillips, FC et al. (2002) Cancer Epidemiol Biomarkers Prev 11, 836–843.Google Scholar