在没有肥胖的成年人中，隔日禁食比限时饮食能引起更大的脂肪量变化——一项随机临床试验

IF 7.4 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-09-03 DOI:10.1016/j.clnu.2025.08.033

Nina Derron , Andreas T. Güntner , Ines C. Weber , Julia Braun , İlker Ö. Koska , Alaa Othman , Leonie Mönch , Arnold von Eckardstein , Milo A. Puhan , Felix Beuschlein , Michel Hochuli , Nicola Zamboni , Roman Guggenberger , Philipp A. Gerber

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引用次数: 0

摘要

背景和目的间歇性禁食（IF）是一种流行的营养策略，用于控制体重和改善代谢健康，但目前尚不清楚哪种类型的间歇性禁食最有效。这项随机试验直接比较了短期隔日禁食（ADF）和限时饮食（TRE）与超重或高正常体重成年人的对照。目的是比较ADF和TRE与对照组在全身脂肪量减少、体重控制和心脏代谢健康方面的效果。方法在这项为期4周的平行对照随机临床试验（2021年2月至2022年5月）中，年龄在18-40岁、体重指数在23 - 30 kg/m2之间的参与者被分配到ADF（交替禁食和随意进食日）、TRE（仅在12:00-20:00之间进食）或对照组（进食时间不变）。主要结果是总脂肪体积的变化（通过全身磁共振成像评估）。次要结局是皮下和内脏脂肪量、体重、静息代谢率、生化指标、能量摄入、活动能消耗和健康相关生活质量。结果76例受试者(平均[标准差（SD）]年龄29.6[5.6]岁；体质指数25.8 [2.2]kg/m2；34例（44%）女性)随机分为ADF组（n = 26）、TRE组（n = 26）和对照组（n = 24）。75名参与者完成了试验（ADF组25名，TRE组26名，对照组24名）。与对照组相比，ADF组总脂肪体积减少幅度更大（平均差值为- 1059.8 cm3, 95% CI: - 1380.0 cm3至- 739.6 cm3, p < 0.001），而TRE组（- 695.7 cm3, 95% CI: - 1013.9至- 377.6 cm3, p < 0.001）。与对照组相比，TRE还减少了总脂肪体积（- 364.0 cm3, 95% CI: - 621.3 cm3至- 106.7 cm3, p = 0.007）。ADF组能量摄入减少34% [18%]，TRE组减少15%[21%]，对照组减少3%[22%]。与对照组相比，ADF（而非TRE）降低了内脏脂肪量、静息代谢率、三碘甲状腺原氨酸和非高密度脂蛋白胆固醇。只有ADF增加了活动能量消耗和与健康相关的生活质量。未发生严重不良事件。结论在本随机临床试验中，ADF在减少能量摄入方面比TRE更有效，后者对脂肪质量和体重有后续影响。只有ADF改善了几个心脏代谢危险因素。唯一标识符：NCT04732130。

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Alternate-day fasting elicits larger changes in fat mass than time-restricted eating in adults without obesity – A randomized clinical trial

Background & aims

Intermittent fasting (IF) is a popular nutritional strategy for weight control and improved metabolic health, however it is unclear which type of intermittent fasting is most effective. This randomized trial directly compared short-term alternate-day fasting (ADF) and time-restricted eating (TRE) with controls in adults with overweight or a high normal weight. The aim was to compare the effects of ADF and TRE versus controls regarding whole-body fat mass loss, weight control and cardiometabolic health.

Methods

In this 4-week, parallel-arm, randomized clinical trial (February 2021–May 2022), participants aged 18–40 years with a body mass index between 23 and 30 kg/m² were assigned to ADF (alternating fasting and ad libitum eating days), to TRE (eating only between 12:00–20:00), or control (no change in eating times). The primary outcome was change in total fat volume (assessed by whole-body magnetic resonance imaging). Secondary outcomes were subcutaneous and visceral fat mass, body weight, resting metabolic rate, biochemical markers, energy intake, activity energy expenditure and health-related quality of life.

Results

Seventy-six participants (mean [standard deviation (SD)] age, 29.6 [5.6] years; body mass index, 25.8 [2.2] kg/m²; 34 [44 %] female) were randomized to ADF (n = 26), TRE (n = 26), or control (n = 24). Seventy-five participants completed the trial (25 in ADF, 26 in TRE, 24 in control). ADF led to a greater reduction in total fat volume than control (mean difference −1059.8 cm³, 95 % CI: −1380.0 cm³ to −739.6 cm³, p < 0.001) and TRE (−695.7 cm³, 95 % CI: −1013.9 to −377.6 cm³, p < 0.001). TRE also reduced total fat volume compared to control (−364.0 cm³, 95 % CI: −621.3 cm³ to −106.7 cm³, p = 0.007). Energy intake was reduced by 34 % [18 %] in ADF, 15 % [21 %] in TRE and 3 % [22 %] in control. ADF, but not TRE, reduced visceral fat mass, resting metabolic rate, triiodothyronine and non-HDL cholesterol compared to controls. Only ADF increased activity energy expenditure and health-related quality of life. No serious adverse events occurred.

Conclusions

In this randomized clinical trial, ADF was more effective in reducing energy intake than TRE which has subsequent effects on fat mass and body weight. Only ADF improved several cardiometabolic risk factors.

Registration

https://clinicaltrials.gov/study/NCT04732130; Unique identifier: NCT04732130.

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.