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Intermittent Energy Restriction, Weight Loss and Cardiometabolic Risk: A Critical Appraisal of Evidence in Humans

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Third Surgical Clinic, Hygeia Hospital, 15123 Athens, Greece
2
Research Laboratory Christeas Hall, Medical Faculty, National Kapodistrian University of Athens, 11527 Athens, Greece
3
First Propaedeutic Department of Internal Medicine and Diabetes Center, Laiko University Hospital, National Kapodistrian University of Athens, 11527 Athens, Greece
*
Author to whom correspondence should be addressed.
Academic Editor: Edyta Mądry
Healthcare 2021, 9(5), 495; https://doi.org/10.3390/healthcare9050495
Received: 26 March 2021 / Revised: 16 April 2021 / Accepted: 20 April 2021 / Published: 22 April 2021
Dietary patterns with intermittent energy restriction (IER) have been proposed as an attractive alternative to continuous energy restriction (CER) for the management of obesity and its associated comorbidities. The most widely studied regimens of IER comprise energy restriction on two days per week (5:2), alternate-day energy restriction by 60–70% (ADF), and timely restriction of energy intake during a specific time window within the day (TRF; time-restricted feeding). Although there is some evidence to suggest that IER can exert beneficial effects on human cardiometabolic health, yet is apparently not superior compared to CER, there are still some critical issues/questions that warrant further investigation: (i) high-quality robust scientific evidence regarding the long-term effects of IER (safety, efficacy, compliance) is limited since the vast majority of intervention studies had a duration of less than 6 months; (ii) whether the positive effects of IER are independent of or actually mediated by weight loss remains elusive; (iii) it remains unknown whether IER protocols are a safe recommendation for the general population; (iv) data concerning the impact of IER on ectopic fat stores, fat-free mass, insulin resistance and metabolic flexibility are inconclusive; (v) the cost-effectiveness of IER dietary regimens has not been adequately addressed; (vi) direct head-to-head studies comparing different IER patterns with variable macronutrient composition in terms of safety and efficacy are scarce; and (vii) evidence is limited with regard to the efficacy of IER in specific populations, including males, the elderly and patients with morbid obesity and diabetes mellitus. Until more solid evidence is available, individualization and critical perspective are definitely warranted to determine which patients might benefit the most from an IER intervention, depending on their personality traits and most importantly comorbid health conditions. View Full-Text
Keywords: intermittent energy restriction; periodic fasting; alternate day-fasting; time-restricted feeding; obesity; diabetes; cardiometabolic risk intermittent energy restriction; periodic fasting; alternate day-fasting; time-restricted feeding; obesity; diabetes; cardiometabolic risk
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MDPI and ACS Style

Katsarou, A.L.; Katsilambros, N.L.; Koliaki, C.C. Intermittent Energy Restriction, Weight Loss and Cardiometabolic Risk: A Critical Appraisal of Evidence in Humans. Healthcare 2021, 9, 495. https://doi.org/10.3390/healthcare9050495

AMA Style

Katsarou AL, Katsilambros NL, Koliaki CC. Intermittent Energy Restriction, Weight Loss and Cardiometabolic Risk: A Critical Appraisal of Evidence in Humans. Healthcare. 2021; 9(5):495. https://doi.org/10.3390/healthcare9050495

Chicago/Turabian Style

Katsarou, Alexia L., Nicholas L. Katsilambros, and Chrysi C. Koliaki 2021. "Intermittent Energy Restriction, Weight Loss and Cardiometabolic Risk: A Critical Appraisal of Evidence in Humans" Healthcare 9, no. 5: 495. https://doi.org/10.3390/healthcare9050495

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