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. 2010 Sep 3:9:35.
doi: 10.1186/1475-2891-9-35.

Dietary and physical activity adaptations to alternate day modified fasting: implications for optimal weight loss

Monica C Klempel  1 , Surabhi Bhutani, Marian Fitzgibbon, Sally Freels, Krista A Varady
Affiliations

Dietary and physical activity adaptations to alternate day modified fasting: implications for optimal weight loss

Monica C Klempel et al. Nutr J. .

Abstract

Background: Alternate day modified fasting (ADMF) is an effective strategy for weight loss in obese adults.

Objective: The objective of this study was to examine the dietary and physical activity adaptations that occur during short-term ADMF, and to determine how these modulations affect rate of weight loss.

Methods: Sixteen obese subjects (12 women/4 men) completed a 10-week trial consisting of 3 phases: 1) 2-week control phase, 2) 4-week ADMF controlled feeding phase, and 3) 4-week ADMF self-selected feeding phase.

Results: Body weight decreased (P < 0.001) by 5.6 ± 1.0 kg post-treatment. Energy intake on the fast day was 26 ± 3% of baseline needs (501 ± 28 kcal/d). No hyperphagic response occurred on the feed day (95 ± 6% of baseline needs consumed, 1801 ± 226 kcal/d). Daily energy restriction (37 ± 7%) was correlated to rate of weight loss (r = 0.42, P = 0.01). Dietary fat intake decreased (36% to 33% of kcal, P < 0.05) with dietary counseling, and was related to rate of weight loss (r = 0.38, P = 0.03). Hunger on the fast day decreased (P < 0.05) by week 2, and remained low. Habitual physical activity was maintained throughout the study (fast day: 6416 ± 851 steps/d; feed day: 6569 ± 910 steps/d).

Conclusion: These findings indicate that obese subjects quickly adapt to ADMF, and that changes in energy/macronutrient intake, hunger, and maintenance of physical activity play a role in influencing rate of weight loss by ADMF.

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Figures

Figure 1
Figure 1
Energy intake and energy restriction during each phase of the trial. Values reported as mean ± SEM. A. Mean energy intake during the control phase, and on feed and fast days during each week of the trial. Energy intake did not change from the beginning to the end of the control phase. *P < 0.001 fast day energy intake was lower than feed day energy intake at each week (One-factor ANOVA with Bonferroni analysis). B. Mean percent energy restriction during each week of the study. No difference for percent energy restriction between weeks (One-factor ANOVA with Bonferroni analysis).
Figure 2
Figure 2
Hyperphagic response on the feed day to lack of food on the fast day. Values reported as mean ± SEM. Calculated daily energy needs assessed for each subject using the Mifflin equation. No difference between feed day energy intake and calculated energy requirement at any week of the trial (One-factor ANOVA with Bonferroni analysis).
Figure 3
Figure 3
Hunger, satiety and fullness during each phase of the trial. Values reported as mean ± SEM. A. Hunger scores at each week of the study. B. Satisfaction with diet scores at each week of the study. C. Fullness scores at each week of the study. *P < 0.05, relative to week 3 (One-factor ANOVA with Bonferroni analysis).
Figure 4
Figure 4
Physical activity level of subjects at each week of the trial measured as steps per day. Values reported as mean ± SEM. Steps/d recorded by a pedometer worn daily. No changes in number of steps/d taken over the course of the 10-week trial, and no difference between feed and fast day values (One-factor ANOVA with Bonferroni correction).
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