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Adherence and Dietary Composition during Intermittent vs. Continuous Calorie Restriction: Follow-Up Data from a Randomized Controlled Trial in Adults with Overweight or Obesity

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Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
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Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, 69120 Heidelberg, Germany
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Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany
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Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84112, USA
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Institute for Global Food Security, Queen’s University Belfast, Belfast BT9 5DL, UK
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Heidelberg Institute of Global Health, Heidelberg University, 69120 Heidelberg, Germany
*
Authors to whom correspondence should be addressed.
Academic Editor: Donald K. Ingram
Nutrients 2021, 13(4), 1195; https://doi.org/10.3390/nu13041195
Received: 26 February 2021 / Revised: 25 March 2021 / Accepted: 2 April 2021 / Published: 5 April 2021
(This article belongs to the Section Clinical Nutrition)
Although intermittent calorie restriction (ICR) has become popular as an alternative weight loss strategy to continuous calorie restriction (CCR), there is insufficient evidence on diet quality during ICR and on its feasibility over longer time periods. Thus, we compared dietary composition and adherence between ICR and CCR in a follow-up analysis of a randomized trial. A total of 98 participants with overweight or obesity [BMI (kg/m2) 25–39.9, 35–65 years, 49% females] were randomly assigned to ICR, operationalized as a “5:2 diet” (energy intake: ~100% on five non-restricted (NR) days, ~25% on two restricted (R) days), or CCR (daily energy intake: ~80%). The trial included a 12-week (wk) intervention phase, and follow-up assessments at wk24, wk50 and wk102. Apart from a higher proportion of energy intake from protein with ICR vs. CCR during the intervention (wk2: p < 0.001; wk12: p = 0.002), there were no significant differences with respect to changes in dietary composition over time between the groups, while overall adherence to the interventions appeared to be good. No significant difference between ICR and CCR regarding weight change at wk102 was observed (p = 0.63). However, self-reported adherence was worse for ICR than CCR, with 71.1% vs. 32.5% of the participants reporting not to or only rarely have followed the regimen to which they were assigned between wk50 and wk102. These results indicate that within a weight management setting, ICR and CCR were equivalent in achieving modest weight loss over two years while affecting dietary composition in a comparable manner. View Full-Text
Keywords: obesity; weight loss; fasting; intermittent energy restriction; compliance; energy intake; diet quality; food records obesity; weight loss; fasting; intermittent energy restriction; compliance; energy intake; diet quality; food records
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MDPI and ACS Style

Pannen, S.T.; Maldonado, S.G.; Nonnenmacher, T.; Sowah, S.A.; Gruner, L.F.; Watzinger, C.; Nischwitz, K.; Ulrich, C.M.; Kaaks, R.; Schübel, R.; Grafetstätter, M.; Kühn, T. Adherence and Dietary Composition during Intermittent vs. Continuous Calorie Restriction: Follow-Up Data from a Randomized Controlled Trial in Adults with Overweight or Obesity. Nutrients 2021, 13, 1195. https://doi.org/10.3390/nu13041195

AMA Style

Pannen ST, Maldonado SG, Nonnenmacher T, Sowah SA, Gruner LF, Watzinger C, Nischwitz K, Ulrich CM, Kaaks R, Schübel R, Grafetstätter M, Kühn T. Adherence and Dietary Composition during Intermittent vs. Continuous Calorie Restriction: Follow-Up Data from a Randomized Controlled Trial in Adults with Overweight or Obesity. Nutrients. 2021; 13(4):1195. https://doi.org/10.3390/nu13041195

Chicago/Turabian Style

Pannen, Sarah T., Sandra G. Maldonado, Tobias Nonnenmacher, Solomon A. Sowah, Laura F. Gruner, Cora Watzinger, Karin Nischwitz, Cornelia M. Ulrich, Rudolf Kaaks, Ruth Schübel, Mirja Grafetstätter, and Tilman Kühn. 2021. "Adherence and Dietary Composition during Intermittent vs. Continuous Calorie Restriction: Follow-Up Data from a Randomized Controlled Trial in Adults with Overweight or Obesity" Nutrients 13, no. 4: 1195. https://doi.org/10.3390/nu13041195

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