Breit Matthew J, Caldwell Ann E, Ostendorf Danielle M, Pan Zhaoxing, Creasy Seth A, Swanson Bryan, Clark Kevin, Hill Emily B, MacLean Paul S, Bessesen Daniel H, Melanson Edward L, Catenacci Victoria A
Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, 12348 E. Montview Boulevard, Aurora, CO 80045, USA.
Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, 12348 E. Montview Boulevard, Aurora, CO 80045, USA.
Nutrients. 2025 Jul 21;17(14):2385. doi: 10.3390/nu17142385.
BACKGROUND/OBJECTIVES: Daily caloric restriction (DCR) is a common dietary weight loss strategy, but leads to metabolic and behavioral adaptations, including maladaptive eating behaviors and dysregulated appetite. Intermittent fasting (IMF) may mitigate these effects by offering diet flexibility during energy restriction. This secondary analysis compared changes in eating behaviors and appetite-related hormones between 4:3 intermittent fasting (4:3 IMF) and DCR and examined their association with weight loss over 12 months.
Adults with overweight or obesity were randomized to 4:3 IMF or DCR for 12 months. Both randomized groups received a matched targeted weekly dietary energy deficit (34%), comprehensive group-based behavioral support, and a prescription to increase moderate-intensity aerobic activity to 300 min/week. Eating behaviors were assessed using validated questionnaires at baseline and months 3, 6, and 12. Fasting levels of leptin, ghrelin, peptide YY, brain-derived neurotrophic factor, and adiponectin were measured at baseline and months 6 and 12. Linear mixed models and Pearson correlations were used to evaluate outcomes.
Included in this analysis were 165 adults (mean ± SD; age 42 ± 9 years, BMI 34.2 ± 4.3 kg/m, 74% female) randomized to 4:3 IMF (n = 84) or DCR (n = 81). At 12 months, binge eating and uncontrolled eating scores decreased in 4:3 IMF but increased in DCR ( < 0.01 for between-group differences). Among 4:3 IMF, greater weight loss was associated with decreased uncontrolled eating (r = -0.27, = 0.03), emotional eating (r = -0.37, < 0.01), and increased cognitive restraint (r = 0.35, < 0.01) at 12 months. There were no between-group differences in changes in fasting appetite-related hormones at any time point.
Compared to DCR, 4:3 IMF exhibited improved binge eating and uncontrolled eating behaviors at 12 months. This may, in part, explain the greater weight loss achieved by 4:3 IMF versus DCR. Future studies should examine mechanisms underlying eating behavior changes with 4:3 IMF and their long-term sustainability.
背景/目的：每日热量限制（DCR）是一种常见的饮食减肥策略，但会导致代谢和行为适应，包括适应不良的饮食行为和食欲调节失调。间歇性禁食（IMF）可以通过在能量限制期间提供饮食灵活性来减轻这些影响。这项二次分析比较了4:3间歇性禁食（4:3 IMF）和DCR之间饮食行为和食欲相关激素的变化，并研究了它们与12个月内体重减轻的关联。
超重或肥胖的成年人被随机分配到4:3 IMF或DCR组，为期12个月。两个随机分组均接受匹配的每周目标饮食能量赤字（34%）、基于小组的全面行为支持，以及将中等强度有氧运动增加到每周300分钟的处方。在基线以及第3、6和12个月时，使用经过验证的问卷评估饮食行为。在基线以及第6和12个月时，测量瘦素、胃饥饿素、肽YY、脑源性神经营养因子和脂联素的空腹水平。使用线性混合模型和Pearson相关性来评估结果。
本分析纳入了165名成年人（均值±标准差；年龄42±9岁，BMI 34.2±4.3 kg/m²，74%为女性），他们被随机分配到4:3 IMF组（n = 84）或DCR组（n = 81）。在12个月时，4:3 IMF组的暴饮暴食和无节制饮食得分下降，而DCR组则上升（组间差异P < 0.01）。在4:3 IMF组中，更大程度的体重减轻与12个月时无节制饮食的减少（r = -0.27，P = 0.03）、情绪化饮食的减少（r = -0.37，P < 0.01）以及认知抑制的增加（r = 0.35，P < 0.01）相关。在任何时间点，两组之间空腹食欲相关激素的变化均无差异。
与DCR相比，4:3 IMF在12个月时表现出更好的暴饮暴食和无节制饮食行为。这可能部分解释了4:3 IMF比DCR实现更大程度体重减轻的原因。未来的研究应探讨4:3 IMF饮食行为变化的潜在机制及其长期可持续性。
