Effects of alternate-day fasting or daily calorie restriction on body composition, fat distribution, and circulating adipokines: Secondary analysis of a randomized controlled trial

Clin Nutr. 2018 Dec;37(6 Pt A):1871-1878. doi: 10.1016/j.clnu.2017.11.018. Epub 2017 Dec 5.


Background & aims: Indirect comparisons suggest that alternate-day fasting (ADF) may produce greater improvements in body composition, fat distribution, and/or the adipokine profile compared to daily calorie restriction (CR), but this has not been tested directly. In a pre-planned secondary analysis of a randomized controlled trial, we compared changes in the VAT:SAT ratio, FFM:total mass ratio, and the adipokine profile between ADF and CR.

Methods: Overweight and obese participants (n = 100) were randomized to 1) ADF (alternating every 24-h between consuming 25% or 125% of energy needs); 2) CR (consuming 75% of needs every day); or 3) control (consuming 100% of needs every day) for 24 wk.

Results: The VAT:SAT ratio did not change in any group. The FFM:total mass ratio increased in both ADF (0.03 ± 0.00) and CR (0.03 ± 0.01) compared to the control group (P < 0.01), with no differences between the intervention groups. Circulating leptin decreased in both the ADF group (-18 ± 6%) and CR group (-31 ± 10%) relative to the control group (P < 0.05), with no differences between the intervention groups. Circulating levels of adiponectin, resistin, IL-6, and TNF-α did not change in either intervention group relative to the control group.

Conclusion: ADF and CR similarly improve the FFM:total mass ratio and reduce leptin after a 24-wk intervention.

Trial registration: Clinicaltrials.gov, number NCT00960505.

Keywords: Adipokine; Alternate day fasting; Body composition; Calorie restriction; Obese adult; Visceral adipose tissue.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adipokines / blood*
  • Adult
  • Body Composition / physiology*
  • Body Weight
  • Caloric Restriction*
  • Diet, Reducing / methods*
  • Exercise
  • Fasting*
  • Female
  • Humans
  • Leptin / blood
  • Male
  • Middle Aged
  • Obesity / diet therapy
  • Overweight / diet therapy
  • Treatment Outcome
  • Weight Loss


  • Adipokines
  • Leptin

Associated data

  • ClinicalTrials.gov/NCT00960505