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Open AccessArticle

Effects of Intermittent Energy Restriction Combined with a Mediterranean Diet on Reducing Visceral Adiposity: A Randomized Active Comparator Pilot Study

1
University of Hawaii Cancer Center, Honolulu, HI 96813, USA
2
Prevent Breast Cancer Research Unit, Manchester University Hospital Foundation, National Health Service Trust, Wythenshawe, Manchester M23 9LT, UK
3
School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907-2025, USA
4
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
*
Authors to whom correspondence should be addressed.
Nutrients 2019, 11(6), 1386; https://doi.org/10.3390/nu11061386
Received: 16 May 2019 / Revised: 18 June 2019 / Accepted: 18 June 2019 / Published: 20 June 2019
Intermittent energy restriction combined with a Mediterranean diet (IER+MED) has shown promise to reduce body fat and insulin resistance. In the Multiethnic Cohort Adiposity Phenotype Study, Japanese Americans had the highest visceral adipose tissue (VAT) when adjusting for total adiposity. We conducted this pilot study to demonstrate feasibility and explore efficacy of following IER+MED for 12 weeks to reduce VAT among East Asians in Hawaii. Sixty volunteers (aged 35–55, BMI 25–40 kg/m2, VAT ≥ 90 cm2 for men and ≥ 80 cm2 for women) were randomized to IER+MED (two consecutive days with 70% energy restriction and 5 days euenergetic MED) or an active comparator (euenergetic Dietary Approaches to Stop Hypertension (DASH) diet). Participants and clinic staff (except dietitians) were blinded to group assignments. IER+MED had significantly larger reductions in DXA-measured VAT and total fat mass (−22.6 ± 3.6 cm2 and −3.3 ± 0.4 kg, respectively) vs. DASH (−10.7 ± 3.5 cm2 and −1.6 ± 0.4 kg) (p = 0.02 and p = 0.005). However, after adjusting for total fat mass, change in VAT was not statistically different between groups; whereas, improvement in alanine transaminase remained significantly greater for IER+MED vs. DASH (−16.2 ± 3.8 U/L vs. −4.0 ± 3.6 U/L, respectively, p = 0.02). Attrition rate was 10%, and participants adhered well to study prescriptions with no reported major adverse effect. Results demonstrate IER+MED is acceptable, lowers visceral and total adiposity among East Asian Americans, and may improve liver function more effectively than a healthful diet pattern. ClinicalTrials.gov Identifier: NCT03639350. View Full-Text
Keywords: DASH; East Asian American; intermittent energy restriction; Mediterranean diet; randomized trial; total adiposity; visceral adipose tissue DASH; East Asian American; intermittent energy restriction; Mediterranean diet; randomized trial; total adiposity; visceral adipose tissue
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Panizza, C.E.; Lim, U.; Yonemori, K.M.; Cassel, K.D.; Wilkens, L.R.; Harvie, M.N.; Maskarinec, G.; Delp, E.J.; Lampe, J.W.; Shepherd, J.A.; Le Marchand, L.; Boushey, C.J. Effects of Intermittent Energy Restriction Combined with a Mediterranean Diet on Reducing Visceral Adiposity: A Randomized Active Comparator Pilot Study. Nutrients 2019, 11, 1386.

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