The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women

Intermittent energy restriction may result in greater improvements in insulin sensitivity and weight control than daily energy restriction (DER). We tested two intermittent energy and carbohydrate restriction (IECR) regimens, including one which allowed ad libitum protein and fat (IECR + PF). Overweight women (n 115) aged 20 and 69 years with a family history of breast cancer were randomised to an overall 25% energy restriction, either as an IECR (2500-2717 kJ/d, <40 g carbohydrate/d for 2 d/week) or a 25% DER (approximately 6000 kJ/d for 7 d/week) or an IECR + PF for a 3-month weight-loss period and 1 month of weight maintenance (IECR or IECR + PF for 1 d/week). Insulin resistance reduced with the IECR diets (mean -0.34 (95% CI -0.66, -0.02) units) and the IECR + PF diet (mean -0.38 (95% CI -0.75, -0.01) units). Reductions with the IECR diets were significantly greater compared with the DER diet (mean 0.2 (95% CI -0.19, 0.66) mu U/unit, P=0.02). Both IECR groups had greater reductions in body fat compared with the DER group (IECR: mean -3.7 (95% CI -2.5, -4.9) kg, P=0.007; IECR + PF: mean -3.7 (95% CI -2.8, -4.7) kg, P=0.019; DER: mean -2.0 (95% CI -1.0, 3.0)kg). During the weight maintenance phase, 1 d of IECR or IECR + PF per week maintained the reductions in insulin resistance and weight. In the short term, IECR is superior to DER with respect to improved insulin sensitivity and body fat reduction. Longer-term studies into the safety and effectiveness of IECR diets are warranted.