Improvement in coronary heart disease risk factors during an intermittent fasting/calorie restriction regimen: Relationship to adipokine modulations

Background: The ability of an intermittent fasting (IF)-calorie restriction (CR) regimen (with or without liquid meals) to modulate adipokines in a way that is protective against coronary heart disease (CHD) has yet to be tested. Objective: Accordingly, we examined the effects of an IFCR diet on adipokine profile, body composition, and markers of CHD risk in obese women. Methods: Subjects (n = 54) were randomized to either the IFCR-liquid (IFCR-L) or IFCR-food based (IFCR-F) diet for 10 weeks. Results: Greater decreases in body weight and waist circumference were noted in the IFCR-L group (4 +/- 1 kg; 6 +/- 1 cm) versus the IFCR-F group (3 +/- 1 kg; 4 +/- 1 cm). Similar reductions (P < 0.0001) in fat mass were demonstrated in the IFCR-L (3 +/- 1 kg) and IFCR-F group (2 +/- 1 kg). Reductions in total and LDL cholesterol levels were greater (P = 0.04) in the IFCR-L (19 +/- 10%; 20 +/- 9%, respectively) versus the IFCR-F group (8 +/- 3%; 7 +/- 4%, respectively). LDL peak particle size increased (P < 0.01) in the IFCR-L group only. The proportion of small LDL particles decreased (P < 0.01) in both groups. Adipokines, such as leptin, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and insulin-like growth factor-1 (IGF-1) decreased (P < 0.05), in the IFCR-L group only. Conclusion: These findings suggest that IFCR with a liquid diet favorably modulates visceral fat and adipokines in a way that may confer protection against CHD.