Intermittent versus Continuous Energy Restriction for Weight Loss: A Systematic Review and Meta-Analysis of Human Trials
Received: 21-Jul-2022 / Manuscript No. jomb-22-69893 / Editor assigned: 23-Jul-2022 / PreQC No. jomb-22-69893 / Reviewed: 06-Aug-2022 / QC No. jomb-22-69893 / Revised: 11-Aug-2022 / Manuscript No. jomb-22-69893 / Published Date: 18-Aug-2022 DOI: 10.4172/jomb.1000121
Abstract
Background: This systematic review and meta-analysis summarized the most recent evidence on the efficacy of intermittent energy restriction (IER) versus continuous energy restriction on weight-loss, body composition, blood pressure and other cardiometabolic risk factors.
Methods: Randomized controlled trials were systematically searched from MEDLINE, Cochrane Library, TRIP databases, EMBASE and CINAHL until May 2018. Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI).
Results: Eleven trials were included (duration range 8-24 weeks). All selected intermittent regimens provided ≤ 25% of daily energy needs on “fast” days but differed for type of regimen (5:2 or other regimens) and/or dietary instructions given on the “feed” days (ad libitum energy versus balanced energy consumption). The intermittent approach determined a comparable weight-loss (WMD: - 0.61 kg; 95% CI - 1.70 to 0.47; p = 0.87) or percent weight loss (WMD: - 0.38%, - 1.16 to 0.40; p = 0.34) when compared to the continuous approach. A slight reduction in fasting insulin concentrations was evident with IER regimens (WMD = - 0.89 μU/mL; - 1.56 to - 0.22; p = 0.009), but the clinical relevance of this result is uncertain. No between-arms differences in the other variables were found.
Conclusions: Both intermittent and continuous energy restriction achieved a comparable effect in promoting weight-loss and metabolic improvements. Long-term trials are needed to draw definitive conclusions.
Keywords
Continuous energy restriction; Fasting glucose; Intermittent energy restriction; Triglycerides; Weight loss
Introduction
In 2015, the ordinary occurrence of weight problems (BMI ≥ 30 kg/m2) global was once 5.0% amongst teenagers and 12.0% amongst adults, as said by means of the Global Burden of Disease study. Weight attain is related with an multiplied threat of persistent diseases, such as diabetes mellitus, cardiovascular disease, persistent kidney disease, metabolic syndrome, cancer, and musculoskeletal disorders, which no longer solely have poor bodily consequences however additionally extend the economic burden on society. In 2014, it was once estimated that the influence of weight problems on the international economic system was once about $2 trillion (US dollars) [1], accounting for 2.8% of the world gross home product. Weight loss has been proven to enhance lipids, blood pressure, and glucose and to limit the danger of cardiovascular disorder and all-cause mortality. It has been counseled that sufferers with obese or weight problems need to gain and preserve >5% weight loss to enhance obesity-related conditions. Lifestyle interventions, consisting of diet, bodily activity [2], and behavioral therapy, are the basis for weight loss. Pharmacotherapy, clinical devices, or bariatric surgical procedure is appropriate for sufferers who do no longer reply to way of life intervention. Continuous power limits (CER) involving a day by day power deficit of five hundred to 750 kcal is endorsed as a common weight administration strategy.
Collection and Risk-of-Bias Assessment
Two authors one at a time searched and reviewed the abstracts in accordance to their inclusion and exclusion criteria. Any disagreements had been re-solved with the aid of consulting the senior investigator. The following records used to be extracted: (a) first writer identify and yealr of publication, (b) inclusion standards of participants, (c) RCT duration, (d) range of topics enrolled in every group, (e) kind of dietary intervention, (f) principal and secondary outcomes [3], (g) facet effects, and (h) attrition rate. Two authors independently assessed the chance of bias the usage of the cochrane collaboration tool. Six domains of conceivable chance of bias have been assessed; these protected decision bias (assessment of random sequence era and allocation concealment), overall performance bias (blinding of members and researchers), detection bias (blinding of effect assessment), attrition bias (reporting of incomplete outcomes), reporting bias (selective reporting of outcomes), and different dangers of bias, such as confounding factors. All RCTs have been assessed as having low, high, or doubtful danger of bias. Any disagreements had been resolved via consulting the senior investigator [4].
Cardiovascular risk markers
The stage of high-density lipoprotein ldl cholesterol expanded considerably in the ADF team after 6 months of intervention, and there used to be no statistical distinction between the two businesses after 12 months of intervention. He published that lipids in the ADF crew had been notably decrease than these in the CER team after eight weeks of intervention [5].
Effects of IER on weight loss
Our covered research tried to in shape for calorie limit with IER and CER, no longer such as time-restricted feeding. The long-term results on weight loss with IER versus CER have been constant with findings of preceding reviews. The temporary consequences of IER had been best to these of CER. A median of fifty nine days was once required Figure three Meta-analysis of the impact of intermittent electricity restrict (IER) versus non-stop strength restrict (CER) on weight loss. In IER, in contrast with seventy three days in CER, to gain 5% weight loss in the trial. However, the mechanistic purpose for this stays unclear. A larger adherence and spontaneous strength limit on feeding days with IER at some point of the brief time period might also play a role. Patients with obese or weight problems lose extra than 5% of weight, which can drastically minimize blood lipids, blood sugar, and blood pressure [6].
Dietary intervention
Participants acquired dietary training earlier than the scan used to be con-ducted and furnished their digital scales to make sure the accuracy of power intake. The IER companies confined strength consumption via four hundred to 600 kcal or by using 25% to 30% on fasting days and have been allowed advert libitum consumption or power in accordance to desires on feeding days [7]. Participants in the intermittent strength and carbohydrate limit crew had been requested no longer solely to avoid strength consumption however additionally hinder their consumption of carbohydrates to forty g on fasting days. The ADF crew required 125% of strength wants on feeding days. All research cautioned following wholesome consuming practices on feeding days. The CER organizations have been prescribed to observe a 400- to 600-kcal day by day discount or a 20% to 33% strength restriction. The precept of strength composition was once in accordance with the Mediterranean-type diet [8].
Discussion
Literature search and learn about characteristics. The complete posted literature search recognized 3,754 records, and a complete of eleven RCTs (24-34) have been covered (n = 850) for the systematic assessment and meta-analysis. Eight RCTs (24-31) in contrast the 5:2 weight loss plan with CER (n = 707), and three RCTs in contrast ADF with CER (n = 143). Three RCTs covered men and women with obesity, and others covered persons with obese or obesity. Two RCTs blanketed sufferers with kind two diabetes mellitus (T2DM), and one RCT (30) covered individuals with extra than one extra metabolic syndrome issue without waist circumference (WC) ≥ 90/80 cm (male/ female) [9]. A massive range of protected members had been women, with three of the trials having members who have been all girls and one trial having individuals who had been all men. Interventions ranged from two months to 12 months in period throughout studies, amongst which there have been 5 RCTs with temporary interventions and six RCTs with long-term interventions [10]. There had been 5 RCTs that solely con-ducted an intervention phase. The timing of the weight protection or follow-up segment ranged from 1 month to 12 months after the intervention phase. The ebook date ranged from 2011 to 2019. The RCTs had been carried out in the United Kingdom, Germany, Australia, the United States, and Norway, respectively. Dietary intervention Participants acquired dietary schooling earlier than the test used to be con-ducted and supplied their digital scales to make certain the accuracy of power intake. The IER businesses restrained electricity consumption by way of four hundred to 600 kcal or with the aid of 25% to 30% on fasting days and had been allowed advert libitum consumption or electricity in accordance to desires on feeding days. Participants in the intermittent electricity and carbohydrate limit crew have been requested now not solely to preclude power consumption however additionally avert their consumption of carbohydrates to forty g on fasting days [11]. The ADF crew required 125% of power wants on feeding days. All research counseled following wholesome consuming practices on feeding days. The CER companies had been prescribed to observe a 400- to 600-kcal every day discount or a 20% to 33% power restriction. The precept of power composition was once in accordance with the Mediterranean-type diet.
Conclusion
This systematic review shows that IER is a viable alternative to CER for many patients. Further RCTs with longer follow-up are required to draw solid conclusions. This find out about is special in that it centered on 5:2 and ADF diets, and now not on time-restricted feeding, and in contrast these with matched CER. In addition, the variety of sensitivity analyses we have carried out protected quick and long-term studies. Moreover, we assessed the discount of weight, FM, and FFM no longer solely in phrases of absolute values however additionally in phrases of relative values. The restrained follow-up, small pattern sizes, excessive dropout rates, excessive chance of overall performance bias, enrolment of metabolically healthful people or well-controlled sufferers with T2DM and obese or obesity, extraordinary strategies of measuring FM and FFM, and different methodological issues restrict the generalizability of these results. Furthermore, that many of the serum markers had been measured at once after limited days may also be linked to the attainable acute effects.
Acknowledgement
I would like to acknowledge Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Quebec, Canada for providing an opportunity to do research.
Conflict of Interest
No potential conflicts of interest relevant to this article were reported.
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Citation: Choi J (2022) Intermittent Versus Continuous Energy Restriction for Weight Loss: A Systematic Review and Meta-Analysis of Human Trials. J Obes Metab 5: 121. DOI: 10.4172/jomb.1000121
Copyright: © 2022 Choi J. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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