A randomised controlled trial of short-term Intermittent Energy Restriction IER
versus Continuous Energy Restriction CER on body fat stores and measures of
insulin resistance in women with obesity at increased risk of breast cancer
#MMPMID41146360
Harvie M
; Coe P
; Higham C
; Peach N
; Howell A
; Evans DG
; Williams S
; Sellers K
; Malcomson L
; Pegington M
; Renehan AG
BMC Nutr
2025[Oct]; 11
(1
): 199
PMID41146360
show ga
BACKGROUND: Weight loss and energy restriction are potential strategies for
reducing cancer risk, particularly if they reduce ectopic body fat and improve
insulin resistance. This randomised study compared the effects of intermittent
energy restriction [IER] to continuous energy restriction [CER] on hepatic,
pancreatic and intramuscular fat, and insulin resistance. METHOD: Premenopausal
women with obesity [n?=?28] were randomised to 8 weeks of 25% energy restriction:
IER [2 days/week 600 kcal/2511kj and 5 days/week Mediterranean diet] versus CER
[7 days/week Mediterranean diet]. Changes in body weight, hepatic, pancreatic and
calf intramuscular fat fractions [magnetic resonance spectroscopy] and insulin
resistance [HOMA and oral glucose tolerance test], body fat and fat free mass
[bioelectrical impedance], resting metabolic rate [RMR, indirect calorimetry] and
lipids (total, LDL, HDL cholesterol and tryglycerides) were assessed during the
energy restricted and normal eating days of IER compared to CER. RESULTS: 9 IER
and 11 CER participants completed the trial. IER and CER had comparable
reductions in body weight mean [SD]: IER ??6.7[1.4] kg CER ??6.2[2.9] kg, and
reductions in hepatic fat fraction mean [SD]: IER ??74.1[22.0]% CER
??51.4[34.8]%, pancreatic fat fraction mean [SD]: IER ??41.1[35.4]% CER
??30.8[25.4]% and calf intramuscular fat fraction mean [SD]: IER ??8.9[27.4]% CER
??2.3[24.1]%. Fasting measures of insulin resistance [HOMA IR, HOMA-? and fasting
insulin] reduced in the CER group and with IER when assessed immediately after
the two low energy days but were not maintained during normal eating days. There
were no changes in 2-hour glucose in either group. The IER and CER groups had
comparable reductions in FFM IER ??1.2[1.4] kg CER ??1.2[1.0] kg and RMR IER
??380[594] kj CER ??594[670] kj. Both groups had reductions in total and HDL
cholesterol and triglyceride and maintained LDL. CONCLUSIONS: IER and CER have
comparable reductions in weight and ectopic fat stores, fat free mass and RMR and
lipids. The clinical significance of the failure to maintain beneficial insulin
sensitivity across the week with IER is not known and requires further study.
TRIAL REGISTRATION: ISRCTN 10,803,394 Registration date 12/01/2015. SUPPLEMENTARY
INFORMATION: The online version contains supplementary material available at
10.1186/s40795-025-01181-4.
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