There’s now been a number of well-controlled studies comparing IF to a more traditional approach to weight loss. To date, they don’t find IF superior to more traditional approaches. A well controlled iso-caloric feeding study just published in 2024 “Effect of Isocaloric, Time-Restricted Eating on Body Weight in Adults With Obesity: A Randomized Controlled Trial” came to similar findings as the prior studies below, if matched for calories and macros, no statistically significant differences are found between groups for weight at 12 weeks. Secondary outcomes of this study examined were “fasting glucose, homeostatic model assessment for insulin resistance (HOMA-IR), glucose area under the curve by oral glucose tolerance test, and glycated albumin.” People can read the study linked for the details if interested, but their summary was:
“In the setting of isocaloric eating, Time-restricted eating (TRE) did not decrease weight or improve glucose homeostasis relative to a usual eating pattern, suggesting that any effects of TRE on weight in prior studies may be due to reductions in caloric intake.”
Another published in 2022 the J. Of Clinical Nutrition comparing an iso-caloric Mediterranean Diet, found no differences in body weight, BMI, arm circumferences and waist circumferences between groups. What all of the studies have in common is they fail to find major differences between standard approaches to weight loss vs IF. Another recent study in published in JAMA, and below is the essential details, along with earlier studies, came to the same conclusions…
My Advice:
I’m not against IF per se, but those making claims there’s a metabolically unique effect from IF vs traditional approaches when calories are matched, ignore the the actual data. What IF does for some is simply leads them to consume less calories, and that’s it. No metabolic magic is taking place. But, some find following an IF schedule helps them achieve their goals of weight loss, and that’s what matters all things being equal. It should also be noted the studies ran for different lengths of time, used different IF schedules, and different groups of people, different energy intakes, all fail to find benefits of isocaloric and better yet, matched for macros between IF and other approaches.
If you find IF works for you and helps get the fat off, then no harm done and carry on, just don’t buy into the clearly debunked claims it’s anything but good old calorie reduction packed differently and my advice/conclusions below this latest study remain unchanged:
Calorie Restriction with or without Time-Restricted Eating in Weight Loss
N Engl J Med 2022; 386:1495-1504
Abstract
Background
The long-term efficacy and safety of time-restricted eating for weight loss are not clear.
Methods
We randomly assigned 139 patients with obesity to time-restricted eating (eating only between 8:00 a.m. and 4:00 p.m.) with calorie restriction or daily calorie restriction alone. For 12 months, all the participants were instructed to follow a calorie-restricted diet that consisted of 1500 to 1800 kcal per day for men and 1200 to 1500 kcal per day for women. The primary outcome was the difference between the two groups in the change from baseline in body weight; secondary outcomes included changes in waist circumference, body-mass index (BMI), amount of body fat, and measures of metabolic risk factors.
Results
Of the total 139 participants who underwent randomization, 118 (84.9%) completed the 12-month follow-up visit. The mean weight loss from baseline at 12 months was −8.0 kg (95% confidence interval [CI], −9.6 to −6.4) in the time-restriction group and −6.3 kg (95% CI, −7.8 to −4.7) in the daily-calorie-restriction group. Changes in weight were not significantly different in the two groups at the 12-month assessment (net difference, −1.8 kg; 95% CI, −4.0 to 0.4; P=0.11). Results of analyses of waist circumferences, BMI, body fat, body lean mass, blood pressure, and metabolic risk factors were consistent with the results of the primary outcome. In addition, there were no substantial differences between the groups in the numbers of adverse events.
Conclusions
Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily calorie restriction
Previous studies and Comments:
A study the prestigious JAMA did not find benefits of IF compared to the more traditional approach. (1)
Another recent study (2) following the popular 5:2 IF schedule vs a calorie matched restricted calorie diet, yet again, found no statistically significant differences in endpoints studied, which was weight weight cardiometabolic factors:
“Intermittent energy restriction was as successful in achieving modest weight loss over a 24-month period as continuous energy restriction.”
The study ran a full year and followed over 100 people. The Abstract is posted blow.
Intermittent Fasting (IF) continues to be a popular approach to weight loss. It’s not a new approach, and most of my comments HERE still hold up. Since that vid, a number of studies in humans have been done (latest updates 2024), and the effects have not been impressive. The study below, the largest to date, that ran 50 weeks, did not find major differences in weight loss, and other endpoints looked at.
I’m not ready to dismiss IF per se, as there’s still more questions then answers but controlled studies continue to fail to demonstrate benefits. In the second study, in obese non-exercising people, a 5;2 IF protocol was not superior to calorie matched diet for weight loss. The next step would be comparing different IF protocols. For example, perhaps the 5:2 approach may not potentiate endocrine adaptation as well as other approaches, or maybe different protocols will be more effective for different populations. Fact is, we don’t have the answers at this time, and what exists for human studies small and or short term.
Also, what impact does IF have on performance or strength? Does a strength or physique athlete respond differently to IF than say an endurance athlete? What about lean vs people with higher bodyfat levels? There’s still plenty of Qs to be answered regarding IF…
Bottom line at this time: find the approach you find most beneficial to your goals, but don’t fall for IF being a magical approach to fat loss, cuz it’s not. It’s still about the calories. Some recent thoughts on calories vs exercise worth a read HERE also as well as understanding the 3,500 calorie myth HERE.
Key Points
Question
What is the effect of time-restricted eating on weight loss and metabolic health in patients with overweight and obesity?
Findings In this prospective randomized clinical trial that included 116 adults with overweight or obesity, time-restricted eating was associated with a modest decrease (1.17%) in weight that was not significantly different from the decrease in the control group (0.75%).
Importance The efficacy and safety of time-restricted eating have not been explored in large randomized clinical trials.
Objective To determine the effect of 16:8-hour time-restricted eating on weight loss and metabolic risk markers.
Interventions Participants were randomized such that the consistent meal timing (CMT) group was instructed to eat 3 structured meals per day, and the time-restricted eating (TRE) group was instructed to eat ad libitum from 12:00 pm until 8:00 pm and completely abstain from caloric intake from 8:00 pm until 12:00 pm the following day.
Design, Setting, and Participants This 12-week randomized clinical trial including men and women aged 18 to 64 years with a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 27 to 43 was conducted on a custom mobile study application. Participants received a Bluetooth scale. Participants lived anywhere in the United States, with a subset of 50 participants living near San Francisco, California, who underwent in-person testing.
Main Outcomes and Measures The primary outcome was weight loss. Secondary outcomes from the in-person cohort included changes in weight, fat mass, lean mass, fasting insulin, fasting glucose, hemoglobin A1c levels, estimated energy intake, total energy expenditure, and resting energy expenditure.
Results Overall, 116 participants (mean [SD] age, 46.5 [10.5] years; 70 [60.3%] men) were included in the study. There was a significant decrease in weight in the TRE (−0.94 kg; 95% CI, −1.68 to −0.20; P = .01), but no significant change in the CMT group (−0.68 kg; 95% CI, -1.41 to 0.05, P = .07) or between groups (−0.26 kg; 95% CI, −1.30 to 0.78; P = .63). In the in-person cohort (n = 25 TRE, n = 25 CMT), there was a significant within-group decrease in weight in the TRE group (−1.70 kg; 95% CI, −2.56 to −0.83; P < .001). There was also a significant difference in appendicular lean mass index between groups (−0.16 kg/m2; 95% CI, −0.27 to −0.05; P = .005). There were no significant changes in any of the other secondary outcomes within or between groups. There were no differences in estimated energy intake between groups.
Conclusions and Relevance Time-restricted eating, in the absence of other interventions, is not more effective in weight loss than eating throughout the day.
(2) Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial
The American Journal of Clinical Nutrition, Volume 108, Issue 5, 1 November 2018, Pages 933–945,
ABSTRACT
Background
Although preliminary evidence suggests that intermittent calorie restriction (ICR) exerts stronger effects on metabolic parameters, which may link obesity and major chronic diseases, compared with continuous calorie restriction (CCR), there is a lack of well-powered intervention studies.
Objective
We conducted a randomized controlled trial to test whether ICR, operationalized as the “5:2 diet,” has stronger effects on adipose tissue gene expression, anthropometric and body composition measures, and circulating metabolic biomarkers than CCR and a control regimen.
Design
One hundred and fifty overweight and obese nonsmokers [body mass index (kg/m2) ≥25 to <40, 50% women], aged 35–65 y, were randomly assigned to an ICR group (5 d without energy restriction and 2 d with 75% energy deficit, net weekly energy deficit ∼20%), a CCR group (daily energy deficit ∼20%), or a control group (no advice to restrict energy) and participated in a 12-wk intervention phase, a 12-wk maintenance phase, and a 26-wk follow-up phase.
Results
Loge relative weight change over the intervention phase was −7.1% ± 0.7% (mean ± SEM) with ICR, −5.2% ± 0.6% with CCR, and −3.3% ± 0.6% with the control regimen (Poverall < 0.001, PICR vs. CCR = 0.053). Despite slightly greater weight loss with ICR than with CCR, there were no significant differences between the groups in the expression of 82 preselected genes in adipose tissue implicated in pathways linking obesity to chronic diseases. At the final follow-up assessment (week 50), weight loss was −5.2% ± 1.2% with ICR, −4.9% ± 1.1% with CCR, and −1.7% ± 0.8% with the control regimen (Poverall = 0.01, PICR vs. CCR = 0.89). These effects were paralleled by proportional changes in visceral and subcutaneous adipose tissue volumes. There were no significant differences between ICR and CCR regarding various circulating metabolic biomarkers.
Conclusion
Our results on the effects of the “5:2 diet” indicate that ICR may be equivalent but not superior to CCR for weight reduction and prevention of metabolic diseases.
Background and objectiveIntermittent energy restriction continues to gain popularity as a weight loss strategy; however, data assessing it’s long-term viability is limited. The objective of this study was to follow up with participants 12 months after they had completed a 12-month dietary intervention trial involving continuous energy restriction and two forms of intermittent energy restriction; a week-on-week-off energy restriction and a 5:2 programme, assessing long-term changes on weight, body composition, blood lipids and glucose.
Subjects and methods 109 overweight and obese adults, aged 18–72 years, attended a 12-month follow-up after completing a 12-month dietary intervention involving three groups: continuous energy restriction (1000 kcal/day for women and 1200 kcal/day for men), week-on-week-off energy restriction (alternating between the same energy restriction as the continuous group for one week and one week of habitual diet), or 5:2 (500 kcal/day on modified fast days each week for women and 600 kcal/day for men). The primary outcome was weight change at 24 months from baseline, with secondary outcomes of change in body composition, blood lipids and glucose.
Results For the 109 individuals who completed the 12-month follow-up (82 female, 15 male, mean BMI 33 kg/m2), weight decreased over time with no differences between week-on and week-off and continuous energy restriction or 5:2 and continuous energy restriction with −4.5 ± 4.9 kg for continuous energy restriction, −2.8 ± 6.5 kg for week-on, week-off and −3.5 ± 5.1 kg for 5:2. Total cholesterol reduced over time and glucose, HDL, LDL and triglycerides were unchanged.
Discussion and conclusion Intermittent energy restriction was as successful in achieving modest weight loss over a 24-month period as continuous energy restriction.
Will Brink is the owner of the Brinkzone Blog. Will has over 30 years experience as a respected author, columnist and consultant, to the supplement, fitness, bodybuilding, and weight loss industry and has been extensively published. Will graduated from Harvard University with a concentration in the natural sciences, and is a consultant to major supplement, dairy, and pharmaceutical companies.
His often ground breaking articles can be found in publications such as Lets Live, Muscle Media 2000, MuscleMag International, The Life Extension Magazine, Muscle n Fitness, Inside Karate, Exercise For Men Only, Body International, Power, Oxygen, Penthouse, Women’s World and The Townsend Letter For Doctors.
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