Reflecting On The 5:2 Diet & Intermittent Fasting

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Mon Jul 27, 2015 5:51 pm

For those who like to skip breakfast...

Carbohydrate-rich breakfast attenuates glycaemic, insulinaemic and ghrelin response to ad libitum lunch relative to morning fasting in lean adults
British Journal of Nutrition (2015), 114, 98–107
doi:10.1017/S0007114515001506

Full text
http://journals.cambridge.org/download. ... 739ff44a29

Abstract

Breakfast omission is associated with obesity and CVD/diabetes, but the acute effects of extended morning fasting upon subsequent energy intake and metabolic/hormonal responses have received less attention. In a randomised cross-over design, thirty-five lean men (n 14) and women (n 21) extended their overnight fast or ingested a typical carbohydrate-rich breakfast in quantities relative to RMR (i.e. 1963 (SD 238)kJ), before an ad libitum lunch 3h later. Blood samples were obtained hourly throughout the day until 3h post-lunch, with subjective appetite measures assessed. Lunch intake was greater following extended fasting (640 (SD 1042)kJ, P,0·01) but incompletely compensated for the omitted breakfast, with total intake lower than the breakfast trial (3887 (SD 1326) v. 5213 (SD 1590)kJ, P,0·001). Systemic concentrations of peptide tyrosine–tyrosine and leptin were greater during the afternoon following breakfast (both P,0·05) but neither acylated/total ghrelin concentrations were suppressed by the ad libitum lunch in the breakfast trial, remaining greater than the morning fasting trial throughout the afternoon (all P,0·05). Insulin concentrations were greater during the afternoon in the morning fasting trial (all P,0·01). There were no differences between trials in subjective appetite during the afternoon. In conclusion, morning fasting caused incomplete energy compensation at an ad libitum lunch. Breakfast increased some anorectic hormones during the afternoon but paradoxically abolished ghrelin suppression by the second meal. Extending morning fasting until lunch altered subsequent metabolic and hormonal responses but without greater appetite during the afternoon. The present study clarifies the impact of acute breakfast omission and adds novel insights into second-meal metabolism.
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Fri Aug 14, 2015 7:30 pm

Health effects of intermittent fasting: hormesis or harm? A systematic review.
Horne BD, Muhlestein JB, Anderson JL.
Am J Clin Nutr. 2015 Aug;102(2):464-70. doi: 10.3945/ajcn.115.109553. Epub 2015 Jul 1.
PMID: 26135345

http://ajcn.nutrition.org/content/102/2/464.abstract

Abstract
Background: Intermittent fasting, alternate-day fasting, and other forms of periodic caloric desistance are gaining popularity in the lay press and among animal research scientists. Whether clinical evidence exists for or is strong enough to support the use of such dietary regimens as health interventions is unclear.

Objective:
This review sought to identify rigorous, clinically relevant research studies that provide high-quality evidence that therapeutic fasting regimens are clinically beneficial to humans.

Design:
A systematic review of the published literature through January 2015 was performed by using sensitive search strategies to identify randomized controlled clinical trials that evaluated the effects of fasting on either clinically relevant surrogate outcomes (e.g., weight, cholesterol) or actual clinical event endpoints [e.g., diabetes, coronary artery disease (CAD)] and any other studies that evaluated the effects of fasting on clinical event outcomes.

Results:
Three randomized controlled clinical trials of fasting in humans were identified, and the results were published in 5 articles, all of which evaluated the effects of fasting on surrogate outcomes. Improvements in weight and other risk-related outcomes were found in the 3 trials. Two observational clinical outcomes studies in humans were found in which fasting was associated with a lower prevalence of CAD or diabetes diagnosis. No randomized controlled trials of fasting for clinical outcomes were identified.

Conclusions:
Clinical research studies of fasting with robust designs and high levels of clinical evidence are sparse in the literature. Whereas the few randomized controlled trials and observational clinical outcomes studies support the existence of a health benefit from fasting, substantial further research in humans is needed before the use of fasting as a health intervention can be recommended.
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Tue Sep 01, 2015 8:29 am

INTERMITTENT FASTING AND HUMAN METABOLIC HEALTH
J Acad Nutr Diet. 2015 Aug; 115(8): 1203–1212.
Published online 2015 Apr 6.
doi: 10.1016/j.jand.2015.02.018

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516560/

CONCLUSIONS

It is well known that in humans, even a single fasting interval (e.g., overnight) can reduce basal concentrations of metabolic biomarkers associated with chronic disease such as insulin and glucose. For example, patients are required to fast for 8–12 hours before blood draws to achieve steady-state fasting levels for many metabolic substrates. Therefore the important clinical and scientific question is whether adoption of a regular intermittent fasting regimen is a feasible and sustainable population-based strategy for promoting metabolic health. In addition, research is needed to test whether these regimens can complement or replace energy restriction and if so, whether they support long-term weight management. Below, we briefly summarize the major conclusions that can be drawn based on the current evidence.

Studies in rodents and other nocturnal mammals support the hypothesis that intermittent fasting and restricting the availability of chow to the normal nighttime feeding cycle improves metabolic profiles and reduces the risk of obesity, obesity-related conditions such as non-alcoholic fatty liver disease, and chronic diseases such as diabetes and cancer.

In healthy, normal weight, overweight, or obese adults, there is little evidence that intermittent fasting regimens are harmful physically or mentally (i.e., in terms of mood).

It appears that almost any intermittent fasting regimen can result in some weight loss. Among the 13 intervention trials included in this review, 11 (84.6%) reported statistically significant weight loss ranging from 1.3% in a cross-over trial with a 2 week intervention23 to 8.0% in a 1-arm trial of 8 weeks duration.13

Based on only 3 studies, alternate day fasting appears to results in weight loss as well as reductions in glucose and insulin concentrations. However, this pattern may not be practical because of intense hunger on fasting days.

Modified alternate day fasting regimens result in reduced weight, ranging from 3.2% in comparison to a control group16 over a 12 week period to 8.0% in a one-arm trial over an 8 week period.13 There was limited and mixed evidence for reductions in insulin concentrations, improvements in lipids or reductions in inflammatory factors.

Research to date has not demonstrated that alternate day fasting regimens produce superior weight loss in comparison to standard, continuous calorie restriction weight loss plans.

There are limited data from human studies to support the robust rodent data regarding the positive impacts of time-restricted feeding (i.e., eating patterns aligned with normal circadian rhythms) on weight or metabolic health.

There are considerable observational data on various forms of religious fasting, most of which suggests that these regimes result in transitory weight loss with mixed impacts on other biomarkers.

Data are lacking regarding the impacts of intermittent fasting on other health behaviors such as diet, sleep, and physical activity.
There are little or no published data linking intermittent fasting regimens with clinical outcomes such as diabetes, cardiovascular disease, cancer, or other chronic diseases such as Alzheimer’s.


Compared to ad-libitum, but needed a sustained calorie restriction group

A 2-Year Randomized Controlled Trial of Human Caloric Restriction: Feasibility and Effects on Predictors of Health Span and Longevity, The Journals of Gerontology: Series A, Volume 70, Issue 9, 1 September 2015, Pages 1097–1104, https://doi.org/10.1093/gerona/glv057

http://biomedgerontology.oxfordjournals ... /1097.full

Abstract
Background
Caloric restriction (CR), energy intake reduced below ad libitum (AL) intake, increases life span in many species. The implications for humans can be clarified by randomized controlled trials of CR.

Methods
To determine CR's feasibility, safety, and effects on predictors of longevity, disease risk factors, and quality of life in nonobese humans aged 21–51 years, 218 persons were randomized to a 2-year intervention designed to achieve 25% CR or to AL diet. Outcomes were change from baseline resting metabolic rate adjusted for weight change (“RMR residual”) and core temperature (primary); plasma triiodothyronine (T3) and tumor necrosis factor-α (secondary); and exploratory physiological and psychological measures.

Results
Body mass index averaged 25.1 (range: 21.9–28.0kg/m2). Eighty-two percent of CR and 95% of AL participants completed the protocol. The CR group achieved 11.7±0.7 %CR (mean ± standard error) and maintained 10.4±0.4% weight loss. Weight change in AL was negligible. RMR residual decreased significantly more in CR than AL at 12 months (p = .04) but not 24 months (M24). Core temperature change differed little between groups. T3 decreased more in CR at M12 and M24 (p < .001), while tumor necrosis factor-α decreased significantly more only at M24 (p = .02). CR had larger decreases in cardiometabolic risk factors and in daily energy expenditure adjusted for weight change, without adverse effects on quality of life.

Conclusions
Sustained CR is feasible in nonobese humans. The effects of the achieved CR on correlates of human survival and disease risk factors suggest potential benefits for aging-related outcomes that could be elucidated by further human studies.

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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Mon Sep 07, 2015 4:33 pm

CHALLENGING ONESELF INTERMITTENTLY TO IMPROVE HEALTH
Dose-Response, 12:600–618, 2014
Formerly Nonlinearity in Biology, Toxicology, and Medicine Copyright © 2014 University of Massachusetts
ISSN: 1559-3258
DOI: 10.2203/dose-response.14-028.Mattson

Mark P. Mattson h Laboratory of Neurosciences, National Institute on Aging
Intramural Research Program, Baltimore, MD. 21224.

Full Text
http://www.ncbi.nlm.nih.gov/pmc/article ... 12-600.pdf

h Humans and their predecessors evolved in environments where they were challenged intermittently with: 1) food scarcity; 2) the need for aerobic fitness to catch/kill prey and avoid or repel attackers; and 3) exposure to biological toxins present in foodstuffs. Accordingly, cells and organ systems acquired and retained molecular signaling and met- abolic pathways through which the environmental challenges enhanced the functionality and resilience of the cells and organisms. Within the past 60 years there has been a pre- cipitous diminution of such challenges in modern societies because of the development of technologies that provide a continuous supply of energy-dense processed foods and that largely eliminate the need for physical exertion. As a consequence of the modern ‘couch potato’ lifestyle, signaling pathways that mediate beneficial effects of environmental challenges on health and disease resistance are disengaged, thereby rendering people vul- nerable to obesity, diabetes, cardiovascular disease, cancers and neurodegenerative disor- ders. Reversal of the epidemic of diseases caused by unchallenging lifestyles will require a society-wide effort to re-introduce intermittent fasting, exercise and consumption of plants containing hormetic phytochemicals into daily and weekly routines.
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Sun Sep 20, 2015 12:51 pm

Effects of intermittent fasting on body composition and clinical health markers in humans.
Tinsley GM, La Bounty PM.
Nutr Rev. 2015 Sep 15. pii: nuv041.
PMID: 26374764

Abstract

Intermittent fasting is a broad term that encompasses a variety of programs that manipulate the timing of eating occasions by utilizing short-term fasts in order to improve body composition and overall health. This review examines studies conducted on intermittent fasting programs to determine if they are effective at improving body composition and clinical health markers associated with disease. Intermittent fasting protocols can be grouped into alternate-day fasting, whole-day fasting, and time-restricted feeding. Alternate-day fasting trials of 3 to 12 weeks in duration appear to be effective at reducing body weight (~3%-7%), body fat (~3-5.5 kg), total cholesterol (~10%-21%), and triglycerides (~14%-42%) in normal-weight, overweight, and obese humans. Whole-day fasting trials lasting 12 to 24 weeks also reduce body weight (~3%-9%) and body fat, and favorably improve blood lipids (~5%-20% reduction in total cholesterol and ~17%-50% reduction in triglycerides). Research on time-restricted feeding is limited, and clear conclusions cannot be made at present. Future studies should examine long-term effects of intermittent fasting and the potential synergistic effects of combining intermittent fasting with exercise.
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Fri Sep 25, 2015 7:06 pm

Do intermittent diets provide physiological benefits over continuous diets for weight loss? A systematic review of clinical trials.
Seimon RV, Roekenes JA, Zibellini J, Zhu B, Gibson AA, Hills AP, Wood RE, King NA, Byrne NM, Sainsbury A.
Mol Cell Endocrinol. 2015 Sep 15. pii: S0303-7207(15)30080-0. doi: 10.1016/j.mce.2015.09.014. [Epub ahead of print]
PMID: 26384657

http://www.sciencedirect.com/science/ar ... 0715300800

Abstract

Energy restriction induces physiological effects that hinder further weight loss. Thus, deliberate periods of energy balance during weight loss interventions may attenuate these adaptive responses to energy restriction and thereby increase the efficiency of weight loss (i.e. the amount of weight or fat lost per unit of energy deficit). To address this possibility, we systematically searched MEDLINE, PreMEDLINE, PubMed and Cinahl and reviewed adaptive responses to energy restriction in 40 publications involving humans of any age or body mass index that had undergone a diet involving intermittent energy restriction, 12 with direct comparison to continuous energy restriction. Included publications needed to measure one or more of body weight, body mass index, or body composition before and at the end of energy restriction. 31 of the 40 publications involved 'intermittent fasting' of 1-7-day periods of severe energy restriction. While intermittent fasting appears to produce similar effects to continuous energy restriction to reduce body weight, fat mass, fat-free mass and improve glucose homeostasis, and may reduce appetite, it does not appear to attenuate other adaptive responses to energy restriction or improve weight loss efficiency, albeit most of the reviewed publications were not powered to assess these outcomes. Intermittent fasting thus represents a valid - albeit apparently not superior - option to continuous energy restriction for weight loss.


4. Summary and conclusions

Apart from a possible decrease in the drive to eat, likely associated with ketosis or other factors concomitant with severe energy restriction, this work found no evidence that IER, as applied in the clinical trials hereby reviewed, reduced adaptive responses to energy restriction relative to effects of CER. While very little research has been done in this domain, this finding is in keeping with the observation that a significant proportion of the IER interventions reviewed (most of which were intermittent fasting regimes) did not attain neutral or positive energy balance at any time during the intervention, and given that attenuation of adaptive responses to energy restriction is likely to be dependent upon relief from negative energy balance. Consistent with this is the finding that IER and CER produced apparently equivalent outcomes in terms of the amount of weight, waist or hip circumference, FM or FFM lost, the improvements in parameters related to glucose homeostasis, as well as the proportion of people dropping out of the intervention. Intermittent diets, notably the intermittent fasting diets that comprised the bulk of the trials hereby reviewed, thus represent an alternative and equivalent option to more conventional diets involving CER as a means of weight reduction.
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Mon Nov 16, 2015 11:59 am

Intermittent Fasting: Discussion with Valter Longo
12/26/2014

http://michelsonmedical.org/2014/12/26/ ... ter-longo/

Valter Longo is Professor of Gerontology and Professor of Biological Science at the University of Southern California. He also serves as director of the USC Longevity Institute.

- Dr Longo has established himself as an eminent and prolific researcher in the field of gerontology, recently being awarded the “Rising Star” Awardin Aging Research from the American Federation for Aging Research (AFAR) in recognition of his work.

- His research has so far revolved around the biology of aging, with a particular focus on the effects of fasting on the process of aging and the onset/progression of age-related disorders.

We were fortunate enough to have the opportunity to interview Dr Longo regarding his past research, upcoming publications and long-term plans.
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Thu Mar 10, 2016 1:51 pm

Not better, but comparable

"The results show that IER can result in weight loss in overweight and obese adults that is comparable to the traditional DER. In addition, body composition outcomes in the IER diet, including loss in fat mass and retention in lean body mass/fat-free mass, are comparable to those of the traditional DER for the majority of studies. One exception is for postmenopausal women who may lose more lean body mass when on the IER diet compared with the DER diet."

Intermittent energy restriction and weight loss: a systematic review.
Davis CS, Clarke RE, Coulter SN, Rounsefell KN, Walker RE, Rauch CE, Huggins CE, Ryan L.
Eur J Clin Nutr. 2015 Nov 25. doi: 10.1038/ejcn.2015.195. [Epub ahead of print]
PMID: 26603882
http://www.nature.com/ejcn/journal/v70/ ... 5195a.html
http://www.nature.com/ejcn/journal/v70/ ... 15195a.pdf

Abstract

BACKGROUND/OBJECTIVES:

Intermittent energy restriction (IER) is an eating pattern of regular daily periods of restricted energy intake followed by periods of unrestricted energy intake. This is gaining prominence as an alternative weight-loss strategy to daily energy restriction (DER). The aim of this systematic review was to determine the effectiveness of IER on weight loss in overweight and obese adults and compare this with DER.

SUBJECTS/METHODS:

A systematic literature search was conducted using the CINAHL, Embase, Medline, PsycINFO, Cochrane and Scopus databases. Eight studies that assigned overweight or obese adults to IER or to a DER 'control' were deemed eligible for inclusion.

RESULTS:

All studies reported significant weight loss for IER groups. Average weight loss was approximately 0.2-0.8 kg per week. IER resulted in comparable weight loss to DER when overall energy restriction remained similar between diets. The majority of studies that reported body composition outcomes have shown equal efficacy for fat mass, fat-free mass and waist circumference.

CONCLUSIONS:

Weight loss was achieved in overweight and obese adults following IER and this loss was comparable to a DER diet. IER may be an effective alternative strategy for health practitioners to promote weight loss for selected overweight and obese people.


From the full text....

"This systematic review finds that IER may be an effective dietary alternative for promoting weight loss in overweight/obese adults in the short term (that is, over a 12-month period) for the treatment of overweight and obesity. Because of the small number of studies meeting the inclusion criteria and the heterogeneity of study designs it was not possible to undertake a meta-analysis of study results for weight loss and other body composition outcomes or to compare the IER protocols on these measures. The results show that IER can result in weight loss in overweight and obese adults that is comparable to the traditional DER. In addition, body composition outcomes in the IER diet, including loss in fat mass and retention in lean body mass/fat-free mass, are comparable to those of the traditional DER for the majority of studies. One exception is for postmenopausal women who may lose more lean body mass when on the IER diet compared with the DER diet. Further research is required to confirm the findings for this population group and to investigate the significance and mechanisms involved behind this difference. Future IER research must also focus on compliance and long-term outcomes and investigate whether compliance to IER is more suited to certain population groups."
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Sat May 21, 2016 1:02 pm

5:2 diet no better than cutting calories
Australian Associated Press
Thursday 19 May 2016 20.39 EDT

http://www.theguardian.com/lifeandstyle ... tudy-finds

- Weight loss after six months similar for those on a standard calorie-reduced diet as for those on the more restrictive 5:2 diet

- People on the 5:2 diet are restricted to eating just 600 calories on two non-consecutive days of the week and eating normally the other five days.

The popular 5:2 diet, when you eat normally for five days and heavily restrict your intake for two, does work in the short-term, a study has found.

But you can lose about the same amount of weight while on a standard diet of reducing your daily calorie intake in a much less restricted way.

The mean weight loss after six months for those on the standard calorie-reduced diet was 5.5kg (12lbs), while those on the 5:2 diet lost 5.3kg (11.7lbs), according to researchers from Austin Health and the University of Melbourne.

The randomised study involved 24 obese male war veterans aged 55-75 years, who had five counselling sessions with a dietitian over the six-month study, one of the researchers, Margie Conley, told the Dietitians Association of Australia’s national conference in Melbourne.

One group went on the 5:2 diet – which originated in the UK – restricting them to 2,500kJs, or 600 calories, on two non-consecutive days a week while they ate normally on the other five days.

The others, who on average had been consuming around 10,080kJs (2,400 calories) a day, went on a diet cutting their daily intake by 2,500kJs (600 calories).

Men in both groups lost body fat and girth, with the standard calorie-reduced diet group reducing their percentage body fat by an average 2.3% and their waistline by 6.4cm.

The figures for those on the 5:2 group were 1.3% and 8cm.

Eating just 2,500kJ (600 calories) over a day might mean having two poached eggs and some spinach for breakfast, 60g to 80g grilled chicken with a side salad of cucumber and tomato for lunch, and a small piece of fish with vegetables for dinner.

“Compliance rates were similar for the two groups, but the 5:2 diet group reported being hungrier, especially early on in the study,” Conley said.

“Interestingly, weight loss slowed at the three-month mark for both groups, which was when the dietitian follow-up tapered out, showing support may be the key element in continuing success.”
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Sat Jul 02, 2016 12:34 pm

Once again, no better.

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Weight-Loss Outcomes: A Systematic Review and Meta-Analysis of Intermittent Energy Restriction Trials Lasting a Minimum of 6 Months. Nutrients. 2016 Jun 8;8(6). pii: E354. doi: 10.3390/nu8060354. Review.
PMID: 27338458
http://www.mdpi.com/2072-6643/8/6/354/htm

Abstract
The aim of this systematic review and meta-analysis is to summarise the effects of intermittent energy restriction on weight and biological markers in long term intervention studies of >6 months duration. An electronic search was performed using the MEDLINE, EMBASE and the Cochrane Library databases for intervention trials lasting 6 months or longer investigating the effects of intermittent energy restriction. A total of nine studies were identified as meeting the pre-specified criteria. All studies included an intermittent energy restriction arm, with six being directly compared to continuous energy restriction. A total of 981 subjects were enrolled and randomised, with weight loss observed in all intermittent energy restriction arms regardless of study duration or follow up length. Eight interventions in six trials were used for the meta-analyses, with results indicating neither intermittent or continuous energy restriction being superior with respect to weight loss, 0.084 ± 0.114 (overall mean difference between groups ± standard error; p = 0.458). The effects of intermittent energy restriction in the long term remain unclear. The number of long term studies conducted is very limited, and participant numbers typically small (less than 50 completers), indicating the need for larger, long term trials of 12 months or more, to be conducted in order to understand the impact of intermittent energy restriction on weight loss and long term weight management. Blood lipid concentrations, glucose, and insulin were not altered by intermittent energy expenditure in values greater than those seen with continuous energy restriction.


4. Discussion
The results of this systematic review of the available literature provides evidence that whilst IER is not superior to CER, it is as effective for weight loss. The effect of the IER regimens on weight included in this reviews are varied, most likely due to the diverse range of dietary methods used. Currently there is insufficient data to support the notion that IER (in any form) can affect CVD risk markers (i.e., blood pressure and blood lipid levels) or insulin and glucose to a greater extent than that seen with CER. Moreover, changes in HbA1c or insulin sensitivity levels beyond weight loss have not been established. Further investigations into this are needed.

5. Conclusions
This review confirms that in the little long term evidence available, IER achieves weight loss but there was no evidence that it provided superior management in comparison to CER. Furthermore dropout rates were similar in the IER and CER arms of the included studies, suggesting that long term adherence to IER may be similar to CER and therefore present a successful alternative for individuals who find CER too restrictive in dietary choices during weight reduction. Larger, longer-term trials of 12 months or more are needed to fully investigate the effects of IER on weight loss, weight management, and diet sustainability. Studies of intermittent VLED use have shown positive results but further longer-term trials are required to fully appreciate any lasting benefits they may produce.
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Tue Aug 30, 2016 8:05 pm

One again...

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

Obesity (Silver Spring). 2016 Sep;24(9):1874-83. doi: 10.1002/oby.21581.

https://www.ncbi.nlm.nih.gov/pubmed/27569118

Abstract
OBJECTIVE:
To evaluate the safety and tolerability of alternate-day fasting (ADF) and to compare changes in weight, body composition, lipids, and insulin sensitivity index (Si) with those produced by a standard weight loss diet, moderate daily caloric restriction (CR).

METHODS:
Adults with obesity (BMI ≥30 kg/m(2) , age 18-55) were randomized to either zero-calorie ADF (n = 14) or CR (-400 kcal/day, n = 12) for 8 weeks. Outcomes were measured at the end of the 8-week intervention and after 24 weeks of unsupervised follow-up.

RESULTS:
No adverse effects were attributed to ADF, and 93% completed the 8-week ADF protocol. At 8 weeks, ADF achieved a 376 kcal/day greater energy deficit; however, there were no significant between-group differences in change in weight (mean ± SE; ADF -8.2 ± 0.9 kg, CR -7.1 ± 1.0 kg), body composition, lipids, or Si. After 24 weeks of unsupervised follow-up, there were no significant differences in weight regain; however, changes from baseline in % fat mass and lean mass were more favorable in ADF.

CONCLUSIONS:
ADF is a safe and tolerable approach to weight loss. ADF produced similar changes in weight, body composition, lipids, and Si at 8 weeks and did not appear to increase risk for weight regain 24 weeks after completing the intervention.
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Sat Oct 01, 2016 4:22 pm

Valter Longo, Ph.D. on Fasting-Mimicking Diet & Fasting for Longevity, Cancer & Multiple Sclerosis
(~80 Minute Video)

https://www.youtube.com/watch?v=d6PyyatqJSE

Published on Oct 1, 2016

Dr. Rhonda Patrick speaks with Dr. Valter Longo, a professor of gerontology and biological sciences and director of the longevity institute at the University of Southern California. Dr. Longo has made huge contributions to the field of aging, including the role of fasting and diet in longevity and healthspan in humans as well as metabolic fasting therapies for the treatment of human diseases.

In this conversation, Rhonda and Valter discuss...
• The effects of prolonged fasting, which refers to 2-3 day fasting intervals in mice and 4-5 days in humans.
• Dr. Longo’s work on the fasting-mimicking diet, which is 5 day restricted diet that is meant to simulate some of the biological effects of prolonged fasting while still allowing some food.
• How clinical trials have demonstrated efficacy for this diet for type 2 diabetes, multiple sclerosis, and cancer patients.
• Fasting as an inducer of differential stress resistance, where it can simultaneously make cancer cells more sensitive to death while also making healthy cells more resistant to these same death stimuli (such as chemotherapy) which might otherwise induce cell death amongst healthy cells as collateral damage.
• Fasting as a biological state which humans historically experienced with extreme regularity and we may ultimately need in order to mitigate various disease states.
• The effects of prolonged fasting on the immune system, namely, how it clears away damaged white blood cells via autophagy and how this causes hematopoietic stem cells to self renew and make more stem cells and also produce new blood cells to fully replenish the white blood cell population.
• How prolonged fasting causes a shift in the immune cell population towards one that is more representative of youth by normalizing the ratio of myeloid cells to lymphoid cells.
• The positive effects of prolonged fasting and the fasting-mimicking diet on markers of systemic inflammation, blood glucose levels and other aging biomarkers.
• The conclusions of Dr. Longo & Dr. Marcus Bock’s research comparing 1 week of the fasting-mimicking diet followed by 6 months of mediterranean diet to six months of a ketogenic diet in people with multiple sclerosis.
• The strange, somewhat paradoxical role of autophagy genes in cancer progression and some of the open questions surrounding the exact role that these genes are playing.
• Dr. Longo’s high level thoughts on metformin as an anti-aging drug.
• How the growth hormone/IGF-1 axis is one of the most important genetic pathways in aging from yeast to worms to mice to humans.
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Sun Nov 13, 2016 8:20 am

Impact of Intermittent Fasting on Health and Disease Processes.
Mattson MP, Longo VD, Harvie M.
Ageing Res Rev. 2016 Oct 31. pii: S1568-1637(16)30251-3. doi: 10.1016/j.arr.2016.10.005. [Epub ahead of print] Review.
PMID: 27810402

Abstract

Humans in modern societies typically consume food at least three times daily, while laboratory animals are fed ad libitum. Overconsumption of food with such eating patterns often leads to metabolic morbidities (insulin resistance, excessive accumulation of visceral fat, etc.), particularly when associated with a sedentary lifestyle. Because animals, including humans, evolved in environments where food was relatively scarce, they developed numerous adaptations that enabled them to function at a high level, both physically and cognitively, when in a food-deprived/fasted state. Intermittent fasting (IF) encompasses eating patterns in which individuals go extended time periods (e.g., 16-48hours) with little or no energy intake, with intervening periods of normal food intake, on a recurring basis. We use the term periodic fasting (PF) to refer to IF with periods of fasting or fasting mimicking diets lasting from 2 to as many as 21 or more days. In laboratory rats and mice IF and PF have profound beneficial effects on many different indices of health and, importantly, can counteract disease processes and improve functional outcome in experimental models of a wide range of age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer's disease Parkinson's disease and stroke. Studies of IF (e.g., 60% energy restriction on 2days per week or every other day), PF (e.g., a 5day diet providing 750-1100kcal) and time-restricted feeding (TRF; limiting the daily period of food intake to 8hours or less) in normal and overweight human subjects have demonstrated efficacy for weight loss and improvements in multiple health indicators including insulin resistance and reductions in risk factors for cardiovascular disease. The cellular and molecular mechanisms by which IF improves health and counteracts disease processes involve activation of adaptive cellular stress response signaling pathways that enhance mitochondrial health, DNA repair and autophagy. PF also promotes stem cell-based regeneration as well as long-lasting metabolic effects. Randomized controlled clinical trials of IF versus PF and isoenergetic continuous energy restriction in human subjects will be required to establish the efficacy of IF in improving general health, and preventing and managing major diseases of aging.
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Wed Feb 22, 2017 5:27 pm

"Randomized controlled clinical trials of IF versus PF and isoenergetic continuous energy restriction in human subjects will be required to establish the efficacy of IF in improving general health, and preventing and managing major diseases of aging "

Impact of Intermittent Fasting on Health and Disease Processes.
Mattson MP, Longo VD, Harvie M.
Ageing Res Rev. 2016 Oct 31. pii: S1568-1637(16)30251-3. doi: 10.1016/j.arr.2016.10.005. [Epub ahead of print] Review.
PMID: 27810402

Abstract

Humans in modern societies typically consume food at least three times daily, while laboratory animals are fed ad libitum. Overconsumption of food with such eating patterns often leads to metabolic morbidities (insulin resistance, excessive accumulation of visceral fat, etc.), particularly when associated with a sedentary lifestyle. Because animals, including humans, evolved in environments where food was relatively scarce, they developed numerous adaptations that enabled them to function at a high level, both physically and cognitively, when in a food-deprived/fasted state. Intermittent fasting (IF) encompasses eating patterns in which individuals go extended time periods (e.g., 16-48hours) with little or no energy intake, with intervening periods of normal food intake, on a recurring basis. We use the term periodic fasting (PF) to refer to IF with periods of fasting or fasting mimicking diets lasting from 2 to as many as 21 or more days. In laboratory rats and mice IF and PF have profound beneficial effects on many different indices of health and, importantly, can counteract disease processes and improve functional outcome in experimental models of a wide range of age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer's disease Parkinson's disease and stroke. Studies of IF (e.g., 60% energy restriction on 2days per week or every other day), PF (e.g., a 5day diet providing 750-1100kcal) and time-restricted feeding (TRF; limiting the daily period of food intake to 8hours or less) in normal and overweight human subjects have demonstrated efficacy for weight loss and improvements in multiple health indicators including insulin resistance and reductions in risk factors for cardiovascular disease. The cellular and molecular mechanisms by which IF improves health and counteracts disease processes involve activation of adaptive cellular stress response signaling pathways that enhance mitochondrial health, DNA repair and autophagy. PF also promotes stem cell-based regeneration as well as long-lasting metabolic effects. Randomized controlled clinical trials of IF versus PF and isoenergetic continuous energy restriction in human subjects will be required to establish the efficacy of IF in improving general health, and preventing and managing major diseases of aging.
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JeffN
 
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Re: Reflecting On The 5:2 Diet & Intermittent Fasting

Postby JeffN » Mon May 01, 2017 10:52 am

JeffN wrote:"Randomized controlled clinical trials of IF versus PF and isoenergetic continuous energy restriction in human subjects will be required to establish the efficacy of IF in improving general health, and preventing and managing major diseases of aging "


Now we have them.

And again, no better and maybe worse. Higher drop out rate and LDL was elevated at 12 months.

Original Investigation
May 1, 2017

Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults
A Randomized Clinical Trial
JAMA Intern Med. Published online May 1, 2017. doi:10.1001/jamainternmed.2017.0936
http://jamanetwork.com/journals/jamaint ... le/2623528

Key Points
Question Is alternate-day fasting more effective for weight loss and weight maintenance compared with daily calorie restriction?

Findings This randomized clinical trial included 100 metabolically healthy obese adults. Weight loss after 1 year in the alternate-day fasting group (6.0%) was not significantly different from that of the daily calorie restriction group (5.3%), relative to the no-intervention control group.

Meaning Alternate-day fasting does not produce superior weight loss or weight maintenance compared with daily calorie restriction.

Abstract
Importance Alternate-day fasting has become increasingly popular, yet, to date, no long-term randomized clinical trials have evaluated its efficacy.

Objective To compare the effects of alternate-day fasting vs daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease.

Design, Setting, and Participants A single-center randomized clinical trial of obese adults (18 to 64 years of age; mean body mass index, 34) was conducted between October 1, 2011, and January 15, 2015, at an academic institution in Chicago, Illinois.

Interventions Participants were randomized to 1 of 3 groups for 1 year: alternate-day fasting (25% of energy needs on fast days; 125% of energy needs on alternating “feast days”), calorie restriction (75% of energy needs every day), or a no-intervention control. The trial involved a 6-month weight-loss phase followed by a 6-month weight-maintenance phase.

Main Outcomes and Measures The primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease.

Results Among the 100 participants (86 women and 14 men; mean [SD] age, 44 [11] years), the dropout rate was highest in the alternate-day fasting group (13 of 34 [38%]), vs the daily calorie restriction group (10 of 35 [29%]) and control group (8 of 31 [26%]). Mean weight loss was similar for participants in the alternate-day fasting group and those in the daily calorie restriction group at month 6 (–6.8% [95% CI, –9.1% to –4.5%] vs –6.8% [95% CI, –9.1% to –4.6%]) and month 12 (–6.0% [95% CI, –8.5% to –3.6%] vs –5.3% [95% CI, –7.6% to –3.0%]) relative to those in the control group. Participants in the alternate-day fasting group ate more than prescribed on fast days, and less than prescribed on feast days, while those in the daily calorie restriction group generally met their prescribed energy goals. There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C-reactive protein, or homocysteine concentrations at month 6 or 12. Mean high-density lipoprotein cholesterol levels at month 6 significantly increased among the participants in the alternate-day fasting group (6.2 mg/dL [95% CI, 0.1-12.4 mg/dL]), but not at month 12 (1.0 mg/dL [95% CI, –5.9 to 7.8 mg/dL]), relative to those in the daily calorie restriction group. Mean low-density lipoprotein cholesterol levels were significantly elevated by month 12 among the participants in the alternate-day fasting group (11.5 mg/dL [95% CI, 1.9-21.1 mg/dL]) compared with those in the daily calorie restriction group.

Conclusions and Relevance Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction.
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