Dietary recommendations for fasting days in an alternate-day intermittent fasting pattern: A randomized controlled trial

The aims of this study were to explore the safety and effectiveness of alternate-day fasting in Chinese people and to compare weight loss outcomes and safety when consuming a high-protein (HP) versus a normal protein (NP) diet versus a nutritional meal replacement (MR) on fasting days.This was a randomized, open, parallel-controlled, interventional, exploratory trial, that included a 3-d run-in period and a 28-d intervention period. Adult participants without restriction of body mass index (N = 60) were randomly assigned to three alternative-day fasting (ADF) intervention groups: group HP, group NP, and group MR. The primary outcome was weight change from baseline at 28 d.Overall participants lost an average of 2.53 kg. Mean triacylglycerols, total cholesterol, and low-density lipoprotein were significantly reduced by 0.10, 0.15, and 0.11 mmol/L, respectively. The mean hunger scale on day 1 of fasting was 18.73 at breakfast and 45.25 at dinner. The mean hunger scale on the last day of fasting decreased significantly, to 10.89 at breakfast and 18.93 at dinner. Weight loss of groups HP, NP, and MR were 2.16, 2.63, and 2.94 kg, respectively; groups did not differ significantly (P = 0.841). The most common adverse events were dizziness, heart palpitations, and fatigue.ADF is an effective, short-term weight loss strategy that was tolerated by most Chinese participants. We suggest that dietary patterns during fasting days is less important, and that calorie restriction during those days should be the focus.