Alternate Day Fasting Combined with A Low Carbohydrate Diet for Weight Loss and Weight Maintenance

This study investigated the effects of alternate day fasting (ADF) combined with a low carbohydrate diet on body weight and metabolic disease risk factors in adults with obesity. Changes in appetite were also evaluated. ADF regimens include a “feast day” where food is consumed ad-libitum over 24 h, alternated with a “fast day” where intake is limited to ~600 kcal over 24 h. Subjects with obesity (n = 31) participated in an ADF diet (600 kcal “fast day” alternated with an ad libitum “feast day”) with a low carbohydrate background diet (30% carbohydrates, 35% protein, 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period. Results from this study show that body weight decreased by 5.5% during the weight-loss period (month 0-3) and remained stable during the weight maintenance period (month 4-6). Net weight loss by month 6 was 6.3%. The ADF low carbohydrate diet produced significant reductions in fat mass, total cholesterol, LDL cholesterol, systolic blood pressure, and fasting insulin. However, lean mass, visceral fat mass, HDL cholesterol, triglycerides, diastolic blood pressure, heart rate, fasting glucose, insulin resistance (measured via HOMA-IR), and HbA1c remained unchanged. Moreover, subjective hunger and fullness did not change during the weight loss period, or the weight maintenance period. These findings suggest that ADF combined with a low carbohydrate diet is effective for weight loss, weight maintenance, and improving certain metabolic disease risk factors such as LDL cholesterol, blood pressure, and fasting insulin. This diet, however, has little impact on subjective appetite. While these preliminary findings are promising, they still require confirmation by a larger‐scale randomized control trial.