Alternate day fasting for weight loss, weight maintenance, and cardio-protection

隔日禁食有助于减肥、维持体重和保护心脏

• 批准号: 8605464
• 负责人: Krista Amy Varady
• 金额: $ 35.95万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8605464
• 关键词: Address; Adherence; Adipocytes; Attitude; Behavioral; Blood Pressure; Body Weight; Body Weight decreased; Body fat; C-reactive protein; Caloric Restriction; Cell Size; Cell physiology; Cholesterol; Cognitive; Coronary heart disease; Data; Diet; Diet therapy; Eating; Eating Behavior; Energy Intake; Fasting; Food; Future; Hormones; Individual; Intervention; Link; Lipids; Low-Density Lipoproteins; Obesity; Overweight; Particle Size; Phase; Pilot Projects; Plasma; Protocols documentation; Randomized; Regimen; Relative (related person); Research; Risk; Risk Factors; Risk Reduction; Self Efficacy; Testing; Vascular Diseases; Weight; Weight Gain; arm; dietary restriction; disorder risk; experience; feeding; heart disease prevention; heart disease risk; improved; insight; nutrition; prevent; response; restraint; treatment duration; weight maintenance

DESCRIPTION (provided by applicant): Overweight and obese individuals are at increased risk for coronary heart disease (CHD). Losing weight by means of dietary restriction greatly reduces vascular disease risk. The most common dietary restriction protocol implemented is daily calorie restriction (CR). Another dietary restriction regimen employed, although far less commonly, is alternate day modified fasting (ADMF). ADMF involves a "feed day" where food is consumed ad-libitum, alternated with a "fast day", where food intake is partially reduced. Results from our 12- week pilot study show that adherence to ADMF exceeds that of CR after 8 weeks of treatment. This increased adherence to ADMF results in greater weight loss, which produces more pronounced improvements in CHD risk. What has yet to be determined is whether adherence to ADMF remains near maximal for longer treatment durations (24 weeks), and if this improved adherence results in greater reductions in body weight and CHD risk, versus CR. Once weight loss is achieved, weight maintenance is extremely important as CHD risk can increase if weight is regained. Whether ADMF is an effective strategy for weight maintenance remains unknown. Accordingly, the aims of this proposal are: Aim 1: To establish that adherence to ADMF is greater than that of CR during a 24-week intervention period and to determine if increased adherence to ADMF results in greater weight loss; Aim 2: To establish that greater reductions in body weight by ADMF over a 24-week period will result in greater improvements in traditional CHD risk parameters (blood pressure, plasma lipid levels, cholesterol synthesis rate, LDL particle size, and CRP) and emerging CHD risk parameters (fat cell- derived hormones, body fat distribution, and fat cell size) in comparison to CR; and Aim 3: To establish that ADMF is an effective diet therapy to maintain weight loss and sustain improvements in CHD risk indicators, and to compare changes in cognitive and behavioral components of eating between ADMF and CR subjects. A 52-week randomized, controlled, parallel-arm feeding trial will be implemented to test these objectives. The trial will be divided into 3 consecutive intervention periods: (1) 4-week baseline; (2) 24-week weight loss with food provided; and (3) 24-week weight maintenance with no food provided. Overweight and obese subjects (n = 90) will be randomized to 1 of 3 groups: (1) ADMF, 75% energy restriction on the "fast day" and ad libitum fed on the "feed day"; (2) CR, 25% restriction everyday; or 3) control, 100% energy intake every day. During the weight maintenance phase, ADMF subjects will consume 25% of their energy needs on the "fast day" and 175% of their needs on the "feed day", while CR and control subjects will consume 100% of their needs every day. Our findings will show that ADMF can be implemented as an alternative to CR to help overweight and obese individuals lose weight, maintain weight loss, and sustain reductions in CHD risk. This study will also generate insights into the specific behavioral changes that occur with ADMF that explain why ADMF is a successful diet strategy for weight maintenance.

描述（由申请人提供）：超重和肥胖个体患冠心病（CHD）的风险增加。通过饮食限制减轻体重大大降低了血管疾病的风险。实施的最常见的饮食限制方案是每日卡路里限制（CR）。虽然采用的另一种饮食限制方案（尽管不那么常见）是替代一天的禁食（ADMF）。 ADMF涉及一个“饲料日”，其中食物被食用，并与“快速的一天”交替，其中食物摄入量会部分降低。我们12周的试点研究的结果表明，在治疗8周后，对ADMF的依从性超过了CR。对ADMF的依从性增加导致体重减轻更大，这会导致CHD风险的更明显改善。尚未确定的是，在更长的治疗持续时间内（24周），对ADMF的依从性是否保持在最大程度上，并且如果这种改善的依从性会导致体重和冠心病风险的降低，而CR与CR相比。一旦实现了体重减轻，体重维持非常重要，因为如果恢复体重，冠心病风险可能会增加。 ADMF是否是维持体重的有效策略仍然未知。因此，该提案的目的是：目标1：确定在24周的干预期内对ADMF的遵守大于CR的依从性，并确定对ADMF的依从性是否增加会导致更大的体重减轻；目标2：确定在24周内ADMF的体重更大，将导致传统CHD风险参数（血压，血压，血浆脂质水平，胆固醇合成速率，LDL粒径和CRP）以及新兴的CHD风险参数（脂肪细胞衍生细胞，体内脂肪细胞，脂肪细胞的分布与脂肪分布）相比，相比目标3：确定ADMF是一种有效的饮食疗法，可维持体重减轻并维持CHD风险指标的改善，并比较ADMF和CR受试者之间饮食的认知和行为成分的变化。将实施一项为期52周的随机，受控的，并行臂喂养试验以测试这些目标。该试验将连续3个干预期分为：（1）4周基线； （2）提供的食物24周减肥； （3）不提供食物的24周体重维持。超重和肥胖的受试者（n = 90）将被随机分为3组中的1个：（1）ADMF，“快速日”的能量限制为75％，在“饲料日”中喂食的额外限制； （2）CR，每天25％的限制；或3）控制，每天100％能量摄入。在体重维持阶段，在“快速日”中，ADMF受试者将消耗25％的能量需求，而在“饲料日”中，他们的需求的175％，而CR和控制受试者每天将消耗100％的需求。我们的发现将表明，ADMF可以作为CR的替代方案来帮助超重，肥胖的个体减轻体重，保持体重减轻并维持CHD风险的减少。这项研究还将对ADMF发生的特定行为变化产生见解，这些行为变化解释了为什么ADMF是维持体重的成功饮食策略。

项目成果

Beverage intake during alternate-day fasting: Relationship to energy intake and body weight.

隔日禁食期间的饮料摄入量：与能量摄入和体重的关系。

• DOI: 10.1177/0260106019841452
• 发表时间: 2019
• 期刊: Nutrition and health
• 作者: Kalam,Faiza;Kroeger,CynthiaM;Trepanowski,JohnF;Gabel,Kelsey;Song,JeeHee;Cienfuegos,Sofia;Varady,KristaA
• 通讯作者: Varady,KristaA