Thus, ADF may produce a mean rate of weight loss of approximately 0. Fat free mass was also retained after 12 weeks of ADF in non-obese individuals. This finding is similar to what has been reported in previous short-term studies of ADF [ 2 — 4 ].

As such, the beneficial preservation of fat free mass observed in obese individuals [ 2 — 4 ] may be replicated in non-obese subjects participating in ADF protocols.

Our findings also indicate that normal weight and overweight subjects have no problem adhering to the fast day protocol for 12 weeks.

It should be noted, however, that one normal weight subject dropped out of the trial due to an inability to adhere to the diet. Complementary to previous reports [ 12 , 13 ], there was very little or no hyperphagic response on the feed day in response to the lack of food on the fast day.

This lack of hyperphagia allowed for overall energy restriction to remain high throughout the study, and undoubtedly contributed to the sizeable degree of weight loss observed here. As for eating behaviors, perceived hunger was moderate at baseline and did not change by week This is contrary to findings in obese participants, which consistently show declines in hunger after 8—12 weeks of ADF [ 11 , 12 ].

Dietary satisfaction and feelings of fullness, on the other hand, increased from baseline to post-treatment. These increases in satisfaction and fullness have also been noted in obese subjects [ 11 , 12 ], and may play a role in long-term adherence to the diet.

The cardio-protective effects of ADF were also examined. LDL particle size also increased post-treatment 4 Å from baseline. These changes in lipid risk factors are in line with what has been reported for obese ADF subjects [ 14 , 15 ].

Thus, ADF may improve plasma lipids to the same extent in non-obese subjects as it does in obese subjects. Additional vascular benefits, including decreases in circulating leptin and CRP concentrations, in conjunction with increases in adiponectin, were also noted in non-obese subjects undergoing ADF.

As for HDL cholesterol, homocysteine, and resistin concentrations, no effect was observed. It will be of interest in future studies to determine how alterations in macronutrient intake on the fast day may affect weight loss and cardiovascular outcomes.

For instance, it has been well established that Mediterranean [ 19 ] and certain low-carbohydrate diets [ 20 ] help to maintain a healthy body weight and reduce CHD risk.

Whether further reductions in body weight and CHD risk would occur if ADF were combined with Mediterranean or low-carbohydrate diets, undoubtedly warrants investigation. A couple of adverse events were reported during the study.

Two subjects experienced mild headaches during week 1 of the trial, which may or may not be related to dietary treatment. One other subject reported constipation during week 1 and 2 of the trial.

The subject was advised to consume more fruits and vegetables on feed days, and the constipation subsided by week 3 of the dietary intervention period. This study has several limitations. First and foremost, it must be acknowledged that this pilot study was originally designed to compare the effects of ADF in normal weight versus overweight individuals on body weight and CHD risk.

In view of this, we decided to combine the normal weight and overweight groups into one group to increase sample size. This post hoc change should be taken into consideration when interpreting the findings of this paper. Secondly, physical activity was not assessed throughout the trial, thus the degree of weight loss associated with increased energy expenditure from exercise is not known.

Thus, this study may not be adequately powered to detect changes in certain CHD risk parameters e. Thus, our findings for the hyperphagic response on the feed day may be inaccurate. In summary, these preliminary findings suggest that ADF is a viable weight loss strategy for normal weight and overweight individuals wishing to lose a moderate amount of weight 5—6 kg within a relatively short period of time 12 weeks.

This diet may also help lower CHD risk in non-obese individuals, though further investigation is warranted to confirm these effects.

It should also be noted that the purpose of this paper is to report pilot feasibility findings. It is our hope that this preliminary data will be utilized to design larger-scale longer-term trials with similar objectives, in normal weight and overweight participants undergoing ADF.

Varady KA, Hellerstein MK: Alternate-day fasting and chronic disease prevention: a review of human and animal trials. Am J Clin Nutr. CAS PubMed Google Scholar. Varady KA, Bhutani S, Church EC, Klempel MC: Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults.

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Chung M, Lichtenstein AH, Ip S, Lau J, Balk EM: Comparability of methods for LDL subfraction determination: a systematic review. Varady KA, Lamarche B: Lipoprint adequately estimates LDL size distribution, but not absolute size, versus polyacrylamide gradient gel electrophoresis. Klempel MC, Bhutani S, Fitzgibbon M, Freels S, Varady KA: Dietary and physical activity adaptations to alternate day modified fasting: implications for optimal weight loss.

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Diabetes Care. Jae SY, Fernhall B, Heffernan KS, et al: Effects of lifestyle modifications on C-reactive protein: contribution of weight loss and improved aerobic capacity. Kris-Etherton P, Eckel RH, Howard BV, St Jeor S, Bazzarre TL: Nutrition committee population science committee and clinical science committee of the American heart association.

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J Nutr. Download references. Department of Kinesiology and Nutrition, University of Illinois at Chicago, West Taylor Street, Room F, Chicago, IL, , USA. You can also search for this author in PubMed Google Scholar.

Icy fingers and toes: Poor circulation or Raynaud's phenomenon? The alternate-day fasting thing is very popular right now. This gist of it is, basically, feast and famine. You starve one day, then feast the next. Proponents claim that this approach will lead to weight loss, as well as a number of other benefits.

As a physician researcher, this annoys and alarms me. I preach sensible intake of real foods as part of a lifelong approach to health.

I also depend on scientific evidence to guide my counseling. So, I welcomed this yearlong study comparing alternate-day fasting with more common calorie restriction. Researchers divided obese study volunteers mostly African-American women, without other major medical issues into three groups:. The two diet groups received counseling as well as all foods provided.

This "weight loss" period was followed by another six months of "weight maintenance" and observations. Both diet groups lost about 5. At the end of the 12 months, there was only one difference between the two diet groups: the alternate fasting day group had a significant elevation in low density lipoprotein LDL , an increase of LDL is known as a risk factor for heart attacks and strokes, so that's not good.

This was a very small study to begin with, and, more importantly, there was a fairly significant dropout rate. Twelve people quit the alternate-day fasting group, with almost half citing dissatisfaction with the diet.

By comparison, 10 people quit the daily calorie restriction group, and none cited dissatisfaction with diet, only personal reasons and scheduling conflicts eight quit the control group for the same reasons.

It's not surprising that people disliked alternate-day fasting. Previous studies have reported that people felt uncomfortably hungry and irritable on fasting days, and that they didn't get accustomed to these discomforts.

Interestingly, in this study, over time people in the fasting group ate more on fasting days and less on feasting days. So basically by the end of the study they were eating similarly to the calorie restriction group.

The authors note more limitations. The control group did not receive food, counseling, or the same attention from the study personnel, potential factors that could affect their results, besides how they ate. Bet that snack sack of crudités is sounding pretty mouthwatering now!

However, some studies report that fasters may be rewarded with improved satiety over time. This means that if you can stick it out, the hangries might not set in as often and may become less severe.

Set aside those weight- and body-comp-related results for a moment. According to research, ADF may serve up a buffet of health benefits. Type 2 diabetes and prediabetes are common in the United States.

Of the More than one-third of American adults have prediabetes , and the percentages go up with age. ADF might help strike back, in a few ways.

Losing weight with intermittent fasting is the biggest lever. This weight loss may help reduce or even reverse diabetes symptoms or risk factors. Research from suggests ADF could also help lower fasting insulin levels.

You might want to sit down for this one. Did you see that coming? Maintaining a healthy weight can positively impact the well-being of your chest ticker. ADF may also nudge other heart health biomarkers in the right direction. Autophagy is a natural body process. This function contributes to the prevention of diseases, chronic health conditions, and other illnesses.

Autophagy is also associated with the aging process. Data from a slew of animal studies suggests ADF may boost autophagy and correlate to:. The main bummer is that people who are at a moderate weight may still endure intense hunger levels on fasting days.

Since ADF could lead to some unneeded or unwanted weight loss, a slightly modified fasting practice say, eating one small meal on fast days could be a more manageable or sensible option. You might think that, with ADF, your chances of regaining lost weight or fat jump like they might with starvation or very low calorie diets.

A small study found that when participants followed a modified ADF plan in which they ate at least some food every day , depression and bingeing went down, while controlled eating practices and body image improved.

As with anything else related to health and wellness, approach ADF carefully. There are definitely scenarios in which fasting is not a good idea. ADF is a form of intermittent fasting in which you eat only every other day. Modified versions of ADF that permit some calories on fasting days are also extremely common.

ADF can have health benefits like improved biomarkers for metabolic well-being, heart health , and aging. It can also promote weight loss.

Some of these effects are more noticeable in people with higher body weights. Some benefits may get a boost when you pair ADF with exercise. The kinds of foods you eat on non-fasting days such as high fat or low carb foods may also change the effects of the plan.

Alternate-day fasting is safe for most people. If you have any health conditions or are taking medication, check with your doctor before trying ADF. Intermittent fasting is a method of alternating periods of eating and not eating.

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But if you want to eat while cleansing, you definitely can. Paleo and Whole30 are similar diets with very different purposes. Here are the main similarities and differences for paleo vs. Plus, how to…. Circadian rhythm fasting involves limiting your calorie consumption to daylight hours.

Here's how it works and how it might benefit your health. Fruits are a source of carbs, but remain an important source of nutrients for those on the keto. And watermelon is a powerhouse.

I went from hardly being able to jog for two minutes, to running for 20 to 28 minutes without stopping. Eventually, after a year of ADF, running every eat day, and losing 98 pounds, I also introduced weight lifting into my life with the help of my boyfriend.

I worked my way up to my current exercise routine. I run on every fasting day and try to walk two miles on my breaks at work. I lift on the days I am not fasting.

So, I run on Mondays, Wednesdays and Fridays, and weight lift on Tuesdays, Thursdays and Saturdays. I rest on Sundays. There have been times when I just wanted to give up and not care anymore. IF is not easy; it takes time and patience.

Going without eating can be difficult. But it has had so many more health benefits for me other than weight loss. I've also found that if I am busy on my fasting days, I am much more likely to stick with it.

But if you need to, you can eat up to calories without it disrupting anything. You have listen to the signs of your body. But if it nags at you, just eat. I wish I knew I had this type of willpower and strength in me all along because I have overcome so many obstacles since starting that I never thought I would achieve.

And I also wish I knew there would be people who still criticized me after losing weight. Now, the criticisms I get are not so much about my size, but about my method. Note: A fasting plan might not be right for everyone, and there are pros and cons to consider , so talk to your doctor or a dietitian first!

This is just what worked for me, and I like to be totally honest with people and my social media followers about my approach. When you find what works for you, as long as you're in a good place physically and mentally while you do it, that's great.

You just have to ignore them and trust the process. No one can control your life except you. Since starting ADF, I have lost pounds over one year and two months. I am gaining muscle and my body is still changing every day.

With Walk At Home And MIRROR'. This Mom Lost 95 Lbs. We hypothesized that the participants in the alternate-day fasting group would be more adherent to their diet, achieve greater weight loss, and experience more pronounced improvements in risk indicators for cardiovascular disease during the 6-month weight-loss phase compared with those in the daily calorie restriction group.

We also hypothesized that the alternate-day fasting group would better maintain their weight loss and sustain their improvements in risk indicators for cardiovascular disease during the 6-month weight-maintenance phase compared with the daily calorie restriction group.

We conducted the trial between October 1, , and January 15, , at the University of Illinois at Chicago. Participants were recruited from the Chicago area by means of flyers placed around the university and were screened via a questionnaire, an assessment of body mass index, and a pregnancy test.

Individuals included were men and women between 18 and 65 years of age, with a body mass index between The protocol was approved by the Office for the Protection of Research Subjects at the University of Illinois at Chicago, and written informed consent was obtained from all participants.

The full protocol is available in Supplement 1. Participants were randomized in a ratio to an alternate-day fasting group, daily calorie restriction group, or no-intervention control group. Randomization was performed by a stratified random sampling procedure by sex, age years and years , and body mass index Block size ranged from 1 to 11 participants.

The active trial duration was 1 year and consisted of a baseline phase 1 month , a weight-loss phase 6 months , and a weight-maintenance phase 6 months eFigure 1 in Supplement 2. We chose this design because weight loss typically peaks at 6 months during a lifestyle intervention.

Baseline total energy expenditure was measured using doubly labeled water. Participants in the alternate-day fasting group and those in the daily calorie restriction group were provided with all meals during the first 3 months of the trial and received dietary counseling thereafter eFigure 1 in Supplement 2.

From months 4 to 6, when food was no longer provided, intervention participants met individually with a dietician or nutritionist weekly to learn how to continue with their diets on their own. At the beginning of the 6-month weight-maintenance phase, total daily energy expenditure was reassessed using doubly labeled water.

Intervention participants met with the dietician individually each month to learn cognitive behavioral strategies to prevent weight regain 19 and received personalized energy targets for weight maintenance based on results from doubly labeled water.

Participants in the control group were instructed to maintain their weight throughout the trial and not to change their eating or physical activity habits. Controls received no food or dietary counseling but visited the research center at the same frequency as the intervention participants to provide outcome measurements.

Controls who completed the month trial received 3 months of free weight-loss counseling and a month gym membership at the end of the study. The primary outcome of the study was change in body weight, which was measured monthly via a digital scale while the participant was in a hospital gown.

Fat mass and lean mass were measured every 6 months in the fasted state by dual-energy x-ray absorptiometry QDR W; Hologic.

Visceral fat mass was measured every 6 months by magnetic resonance imaging performed with a 1. Mean percentage energy restriction during the weight-loss phase was retrospectively calculated by the intake balance method using doubly labeled water and changes in body composition.

Intervention participants were considered to be adherent when their actual energy intake, determined via food records, was within kcal of their prescribed daily energy goal. Blood samples were obtained following a hour fast every 6 months collected on the morning after a feast day for the alternate-day fasting group.

Secondary outcomes included blood pressure, heart rate, and total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, fasting glucose, fasting insulin, C-reactive protein, and homocysteine concentrations analytical methods are detailed in the full protocol in Supplement 1.

Thus, we initially aimed to recruit 90 participants 30 per group , assuming that 78 participants 26 per group would complete the trial. We later decided to recruit participants to increase our statistical power because our dropout rate was higher than expected.

Tests for normality were included in the model, and all data were found to be normally distributed. We conducted an intention-to-treat analysis, which included data from all participants who underwent randomization. Results are reported by intention-to-treat analysis unless indicated otherwise.

This model provides unbiased estimates of time and treatment effects under a missing-at-random assumption. Time was not assumed to be linear in the model. This strategy allowed for estimation of time and diet effects and their interaction without imposing a linear time trend.

The analyses were performed using SAS, version 9. Of the participants who were screened, More participants in the alternate-day fasting group than in the daily calorie restriction group withdrew owing to difficulties adhering with the diet. All baseline characteristics had comparable distributions between the alternate-day fasting group, the daily calorie restriction group, and the control group Table 1.

The participants were primarily metabolically healthy obese women. On the fast day Figure 2 A , participants in the alternate-day fasting group exceeded their prescribed energy goal at months 3 and 6. On the feast day Figure 2 B , participants in the alternate-day fasting group ate less than their prescribed goal at months 3, 6, 9, and Participants in the daily calorie restriction group Figure 2 C met their prescribed energy goals at months 3, 6, and 12 but ate less than their prescribed goal at month 9.

A higher proportion of participants in the daily calorie restriction group were adherent to their energy goals at months 3, 6, 9, and 12 relative to those in the alternate-day fasting group. Data on dietary intake are displayed in eTable 1 in Supplement 2. Percentage of energy intake from fat, carbohydrates, and protein did not differ significantly over time in any of the groups.

Physical activity, measured as steps per day, did not change during the course of the trial in any group eTable 2 in Supplement 2. This level of activity is approximately to steps per day higher than that of the average overweight or obese adult. Changes in body weight are displayed in Figure 3 and Table 2.

Weight loss was not significantly different between the alternate-day fasting group and the daily calorie restriction group at month 6. At the end of the study, total weight loss was —6. Weight regain from months 6 to 12 —0. Moreover, weight regain from months 6 to 12 was not significantly different between the alternate-day fasting group and controls 0.

Changes in body composition are reported in Table 2. There were no statistically significant differences between the alternate-day fasting group and the daily calorie restriction group for fat mass, lean mass, or visceral fat mass at month 6 or month Blood pressure was not significantly different between the intervention groups, or relative to controls, at month 6 or month 12 Table 2.

There were also no statistically significant differences in heart rate between the alternate-day fasting group and the daily calorie restriction group at month 6 or month 12 Table 2.

Changes in plasma lipids during the course of the trial are shown in Table 2. Total cholesterol levels were not significantly different between the intervention groups, or relative to controls, at month 6 or month At month 6, high-density lipoprotein cholesterol levels were significantly elevated in the alternate-day fasting group by 6.

Low-density lipoprotein cholesterol concentrations did not differ significantly between the intervention groups at month 6. At month 12, low-density lipoprotein cholesterol levels significantly increased in the alternate-day fasting group Triglyceride levels did not differ significantly between the intervention groups at month 6 or month Changes in glucoregulatory and inflammatory factors are displayed in Table 2.

Fasting plasma glucose did not differ significantly between the intervention groups, or relative to controls, at month 6 or month There were also no significant differences in fasting insulin or the homeostasis model assessment of insulin resistance between the intervention groups at month 6 or month High-sensitivity C-reactive protein and homocysteine levels did not differ significantly between the intervention groups, or relative to controls, at month 6 or month The results of this randomized clinical trial demonstrated that alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or improvement in risk indicators for cardiovascular disease compared with daily calorie restriction.

Alternate-day fasting has been promoted as a potentially superior alternative to daily calorie restriction under the assumption that it is easier to restrict calories every other day. However, our data from food records, doubly labeled water, and regular weigh-ins indicate that this assumption is not the case.

Rather, it appears as though many participants in the alternate-day fasting group converted their diet into de facto calorie restriction as the trial progressed. It was also shown that more participants in the alternate-day fasting group withdrew owing to dissatisfaction with diet compared with those in the daily calorie restriction group Figure 1.

Taken together, these findings suggest that alternate-day fasting may be less sustainable in the long term, compared with daily calorie restriction, for most obese individuals.

Nevertheless, it is still possible that a certain smaller segment of obese individuals may prefer this pattern of energy restriction instead of daily restriction. It will be of interest to examine what behavioral traits eg, ability to go for long periods without eating make alternate-day fasting more tolerable for some individuals than others.

To our knowledge, the present study is the longest and largest trial of alternate-day fasting to date. Food was provided to the intervention participants during the first 3 months of the weight-loss phase to promote adherence 26 and show participants the types and quantities of foods that they should be eating.

This finding suggests that limiting caloric intake to approximately kcal every other day may have been difficult for many participants early in the intervention. For instance, measuring changes in subjective appetite hunger and fullness in conjunction with modulations in appetite hormones ghrelin, peptide YY, and glucagon-like peptide-1 could offer some insight into why daily calorie restriction may allow for easier adherence compared with alternate-day fasting.

Contrary to our original hypotheses, the participants in the alternate-day fasting group did not experience more pronounced improvements in risk indicators for cardiovascular disease compared with the participants in the daily calorie restriction group.

However, the trial included primarily metabolically healthy obese adults. Since many of the participants had normal cholesterol levels and normal blood pressure at baseline, it is not surprising that most risk indicators for cardiovascular disease did not change in response to diet.

Our study has several limitations. First, the duration of the maintenance phase was short 6 months. Second, the control group was imperfect, in that they received no food, no counseling, and less attention from study personnel, relative to the intervention groups, which may have confounded our findings.

We also failed to include the control group in our initial power calculation. The higher dropout rate in the alternate-day fasting group may have also introduced a possible selection bias between groups. The alternate-day fasting diet was not superior to the daily calorie restriction diet with regard to adherence, weight loss, weight maintenance, or improvement in risk indicators for cardiovascular disease.

Corresponding Author: Krista A. Varady, PhD, Department of Kinesiology and Nutrition, University of Illinois at Chicago, W Taylor St, Room , Chicago, IL varady uic. Published Online: May 1, There are no strict guidelines regarding what to eat and drink on fasting days. Some think that ADF increases your risk of binge eating , but studies have found that it may help reduce binge eating behavior and decrease depressive symptoms.

It may also improve restrictive eating and body image perception among people with obesity. However, more research on the effectiveness and safety of ADF in people with disordered eating tendencies is needed These include children, pregnant and lactating women, people who are underweight, and those with certain medical conditions that may be exacerbated by fasting like Gilbert Syndrome Although some research suggests that ADF may be helpful for reducing symptoms of binge eating, this dietary pattern is likely not appropriate for people with eating disorders, including anorexia nervosa or bulimia.

Be sure to consult a healthcare provider before trying this eating pattern if you have a medical condition or are currently taking any medications. Alternate-day fasting is safe for most people.

Consult a healthcare provider to learn if alternate-day fasting is right for you. Alternate-day fasting is a very effective way to lose weight for most people. It is not recommended for children, people with eating disorders, or those who are pregnant, lactating, or living with rare disorders like Gilbert Syndrome.

It may have benefits over traditional calorie-restricted diets in some cases. Intermittent fasting is one of the most popular diets these days.

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A Quiz for Teens Are You a Workaholic? How Well Do You Sleep? Health Conditions Discover Plan Connect. Nutrition Evidence Based Alternate-Day Fasting: A Comprehensive Beginner's Guide. Medically reviewed by Grant Tinsley, Ph. Basics Weight loss Hunger Body composition Health benefits Starvation mode For people with average weight Fasting diet options Is ADF safe?

Bottom line Alternate-day fasting is one way to do intermittent fasting. How to do alternate-day fasting. Alternate-day fasting and weight loss. Alternate-day fasting and hunger. Alternate-day fasting and body composition. Health benefits of alternate-day fasting.

Does alternate-day fasting induce starvation mode? Is it also good for people who are within a normal weight range? What to eat and drink on fasting days. Is alternate-day fasting safe? The bottom line.

Before I knew it, I was at my heaviest: pounds. It was only two miles long, but I could barely keep up even a mile in. My feet hurt, my knees ached, and I was struggling to breathe. It was embarrassing, and I was so ashamed of myself.

Something had to change. My boyfriend was doing the method for his own health reasons, and we had briefly talked about it. I was skeptical at first. But after finding an inspiring first-person article by someone who had success using intermittent fasting, I figured maybe it might work for me.

The woman whose article interested me followed the method of alternate-day fasting, where she fasts for three days and eats for four, along with counting calories. It was then on September 5th, that I decided while munching on a snack of mixed nuts that I would commit to IF.

I decided to start my own method of complete intermittent, alternate-day fasting ADF , where I would go every other day or 36 to 40 hours without eating, also counting my calories as I went.

When I first started ADF I calculated what my calorie needs would be for my body using a total daily energy expenditure calculator.

During my first week of fasting, I allowed myself up to calories on my fasting day to wean myself into going 40 hours without food. The second week of fasting, I was able to go the whole fasting day without intaking any calories. For example, I changed little things, like my 2 percent milk to almond milk, or started measuring out my pasta per serving instead of just using the whole box.

The small changes can really add up to a whole lot of success. Within my first month of ADF I lost 16 pounds. I was elated that I had finally found something that worked for me. Breakfast: Overnight oats or banana oatmeal.

Lunch: Cauliflower rice with lemon pepper shrimp or braised beef, or spinach with a sweet potato, hard boiled egg and salsa. Snacks: Mixed nuts, or a protein bar, or I also make my own tortilla chips with high-fiber, low-carb Xtreme Wellness tortillas. Dinner: Two-ingredient dough pizzas or baked chicken with veggies.

Dessert: Breyers Low-Carb Vanilla Ice Cream with cookie butter mixed in, or frozen fruit blended in a food processor healthy sorbet! Before intermittent fasting, I never worked out.

I started using a couch-to-5k running app and took my time, not exactly following the program, but it helped tremendously. I went from hardly being able to jog for two minutes, to running for 20 to 28 minutes without stopping.

Eventually, after a year of ADF, running every eat day, and losing 98 pounds, I also introduced weight lifting into my life with the help of my boyfriend. I worked my way up to my current exercise routine.

I run on every fasting day and try to walk two miles on my breaks at work. I lift on the days I am not fasting. So, I run on Mondays, Wednesdays and Fridays, and weight lift on Tuesdays, Thursdays and Saturdays. I rest on Sundays. There have been times when I just wanted to give up and not care anymore.

IF is not easy; it takes time and patience. Going without eating can be difficult. But it has had so many more health benefits for me other than weight loss. I've also found that if I am busy on my fasting days, I am much more likely to stick with it.

But if you need to, you can eat up to calories without it disrupting anything. You have listen to the signs of your body. But if it nags at you, just eat.

I wanted to feel confident when I was in a room full of strangers instead of looking at the ground thinking they were all judging me on my weight. I was motivated to finally make the change I had always attempted, but never pushed myself hard enough to succeed at.

Enough was enough, and I was ready to do whatever it took to get healthy and actually stick to it this time. I don't think there was a plan or diet I hadn't tried over the years, from calorie-counting and hitting the gym every day, to Jillian Michaels workout DVDs to Insanity.

I'd even attempted the Hamburger Diet, where you just eat plain hamburgers for three days running. Prescription weight-loss pills hadn't worked for me either.

It wasn't that I was thinking " Why can't I lose weight? My boyfriend was doing intermittent fasting IF , and I'll admit I was skeptical of it.

It wasn't hugely popular at the time, and there were a lot of naysayers insisting it wasn't healthy to fast. But after reading an article by entrepreneur Sumaya Kazi, where she talked about losing 50 pounds through IF, I decided to go for it.

Within five months I was down 50 pounds, and within a year I had lost 98 pounds, and I just kept going. There were a number of different methods of intermittent fasting, but I threw caution to the wind and opted for alternate-day fasting ADF , which means I would only eat every other day, which I know can sound scary.

To begin with, I allowed myself up to calories on my fasting days to help me ease into it. After the first week, I was able to go every other day, or 38 to 40 hours, without eating.

I made sure I learned how to calculate calories and would eat between my basal metabolic rate — how many calories my body needs at rest — and my total daily energy expenditure, or how many calories I actually burned in a given day.

I began my ADF journey on September 5, , and one month later I was down 16 pounds. Now I normally fluctuate between and pounds. Keep in mind that alternate-day fasting and intermittent fasting is not for everyone. It may not be a sustainable diet plan for people with underlying health conditions, like type 1 diabetes, or if you're pregnant.

It can also trigger disordered eating tendencies in those with a history of eating disorders. Talk to your doctor before trying a diet plan like alternate-day fasting, to see if it's suitable for you and your health needs. People always ask me what I eat on my "eat days," as perhaps they think I gorge.

But I'm actually much more mindful about what I put in my body now. I like the salad because it adds lots of nutrients and fiber to keep me full. It's full of protein and probiotics and gives me the energy I need before I workout for the day. I never seem to make the same thing twice.

But I do like making a lot of healthy chicken recipes , which I'll come up with myself or search for inspiration on Pinterest. If I feel I need to modify anything to make it healthier, then I do so.

The best thing with fasting is that as long as it fits within your calorie range, you can have it! I never count macros or limit myself. I think I assumed that the most difficult thing would be getting through the days when I didn't eat anything.

I went from eating around 2, calories a day to fewer than 2, every other day, so it was a huge change. But because I was so determined to change, somehow that wasn't the hardest part. I started adding physical activity about six months into my weight-loss journey.

I would run on the days I wasn't fasting. When I had dropped 85 pounds, I began lifting weights, too. When I began, it was something I just could not enjoy. I found it hard to lift and felt like I wasn't making progress. I couldn't see the calories I was burning, unlike when I was on a treadmill.

As I pushed myself to continue and get more into it, though, the physical difference was apparent and I was hooked!

Now that I have gotten down to a healthy weight, I work out six days a week , lifting weights on my fasting days and running on my eat days.

I would have to say my results are what helped me to keep going. Every month I was losing weight and getting stronger and feeling healthier. I loved that feeling of seeing actual results for once when I struggled with it for so long before.

It's what continued to push me forward and lead me to where I am today. It takes time and patience. I took regular photos of myself, too, so I could have a record of before and after.

When you see yourself in the mirror every day, it's difficult to see those changes. Even though everyone was telling me how well I was doing and how great I looked, it was hard to believe.

This can then have the opposite effects of the intended health benefits. New to intermittent fasting? Check out our guide to intermittent fasting for beginners for a more detailed guide. If you have a chronic health condition or mental health condition, you will also want to take extra caution when undertaking big dietary changes, such as alternate day fasting.

This is because eating minimal or no calories may work against these medications. This article is for informational purposes only and is not meant to offer medical advice. Lou Mudge is a health writer based in Bath, United Kingdom for Future PLC.

She regularly writes about health and fitness-related topics such as air quality, gut health, diet and nutrition and the impacts these things have on our lives. She has worked for the University of Bath on a chemistry research project and produced a short book in collaboration with the department of education at Bath Spa University.

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Jump to: What is alternate day fasting? What are the benefits of alternate day fasting? How to do alternate day fasting Is alternate day fasting safe? Contact me with news and offers from other Future brands Receive email from us on behalf of our trusted partners or sponsors.

Lou Mudge. Social Links Navigation. Hunger, irritability, constipation, bad breath, occasional sleep problems, dizziness, and weakness are the most common side effects. Reported symptoms are mild and often go away a couple of weeks after beginning alternate-day fasting. Furthermore, there was no evidence that thyroid function had been negatively affected in people doing long-term alternate-day fasting, even though some anecdotal reports suggest this may be an issue with frequent, extended fasting, especially for women.

Try these practical tips to help you successfully implement alternate-day fasting into your health routine. As the saying goes, failing to plan is planning to fail.

You lose even more electrolytes if you are physically active or eat a diet low in carbohydrates and processed foods. While the act of fasting itself improves fat adaptation, following a low-carbohydrate, ketogenic-style diet is a great way to prepare your body for fasting.

Stay busy Fasting is easier when you have something productive to do to occupy your mind and body. This would be a great time to take a long walk, tackle a challenging puzzle, or do whatever hobby keeps you mentally and physically occupied.

Summary Alternate-day fasting is an alternative to traditional caloric restriction that shows promise to help you lose weight, improve your metabolic health, and positively affect your cardiovascular blood markers.

It can be easier to do than the usual recommendation of eating less all the time because you only need to reduce your energy intake every other day. Other than a few minor side effects, alternate-day fasting is safe for most people.

Guide Want to try intermittent fasting for weight loss or health? In this top guide, leading expert on fasting, Dr. Jason Fung, explains what you need to get started in a safe and effective way.

Guide Intermittent fasting can help with health and weight loss. Here are our top tips to make sure you lose weight in a healthy way. Guide Can some foods boost your metabolism and help burn fat? In our guide, we explore the truth about fat-burning foods. This guide is written by Jada Rankin, RD and was last updated on October 17, It was medically reviewed by Dr.

Bret Scher, MD on January 20, The guide contains scientific references. You can find these in the notes throughout the text, and click the links to read the peer-reviewed scientific papers.

When appropriate we include a grading of the strength of the evidence, with a link to our policy on this. Our evidence-based guides are updated at least once per year to reflect and reference the latest science on the topic.

All our evidence-based health guides are written or reviewed by medical doctors who are experts on the topic. To stay unbiased we show no ads, sell no physical products, and take no money from the industry.

We're fully funded by the people, via an optional membership. Most information at Diet Doctor is free forever. Actual energy intake assessed via a 7-day food record at baseline and months 3, 6, 9, and C, Participants in the daily calorie restriction group met their prescribed energy goal at months 3, 6, and Data are expressed as mean SD values; only observed values were included.

The weight-loss period was from baseline to month 6; the weight-maintenance period was from month 6 to month a Significant difference between prescribed energy intake and actual energy intake at a particular month in the study. Data were included for participants; mean SD values were estimated using an intention-to-treat analysis with a linear mixed model.

ADF indicates alternate-day fasting; DCR, daily calorie restriction. eFigure 2. Mean Energy Restriction by Diet Group at Month 6 Measured by Doubly Labeled Water.

Trepanowski JF , Kroeger CM , Barnosky A, et al. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults : A Randomized Clinical Trial.

JAMA Intern Med. Question Is alternate-day fasting more effective for weight loss and weight maintenance compared with daily calorie restriction? Findings This randomized clinical trial included metabolically healthy obese adults.

Weight loss after 1 year in the alternate-day fasting group 6. Meaning Alternate-day fasting does not produce superior weight loss or weight maintenance compared with daily calorie restriction.

Importance Alternate-day fasting has become increasingly popular, yet, to date, no long-term randomized clinical trials have evaluated its efficacy. Objective To compare the effects of alternate-day fasting vs daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease.

Design, Setting, and Participants A single-center randomized clinical trial of obese adults 18 to 64 years of age; mean body mass index, 34 was conducted between October 1, , and January 15, , at an academic institution in Chicago, Illinois.

The trial involved a 6-month weight-loss phase followed by a 6-month weight-maintenance phase. Main Outcomes and Measures The primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease.

Mean weight loss was similar for participants in the alternate-day fasting group and those in the daily calorie restriction group at month 6 —6. Participants in the alternate-day fasting group ate more than prescribed on fast days, and less than prescribed on feast days, while those in the daily calorie restriction group generally met their prescribed energy goals.

There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C-reactive protein, or homocysteine concentrations at month 6 or Mean high-density lipoprotein cholesterol levels at month 6 significantly increased among the participants in the alternate-day fasting group 6.

Mean low-density lipoprotein cholesterol levels were significantly elevated by month 12 among the participants in the alternate-day fasting group Conclusions and Relevance Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction.

Trial Registration clinicaltrials. gov Identifier: NCT The first-line therapy prescribed to obese patients for weight loss is daily calorie restriction.

Alternate-day fasting regimens have increased in popularity during the past decade, and several best-selling diet books 14 , 15 have promoted this approach.

More than 1 million copies of these books have been sold in the United States and United Kingdom to date. Despite the growing popularity of alternate-day fasting, to our knowledge, no long-term randomized clinical trials have evaluated its efficacy or compared this regimen with a conventional weight-loss diet.

We conducted a 1-year, randomized clinical trial to compare the effects of alternate-day fasting vs daily calorie restriction on body weight and risk indicators for cardiovascular disease. We hypothesized that the participants in the alternate-day fasting group would be more adherent to their diet, achieve greater weight loss, and experience more pronounced improvements in risk indicators for cardiovascular disease during the 6-month weight-loss phase compared with those in the daily calorie restriction group.

We also hypothesized that the alternate-day fasting group would better maintain their weight loss and sustain their improvements in risk indicators for cardiovascular disease during the 6-month weight-maintenance phase compared with the daily calorie restriction group.

We conducted the trial between October 1, , and January 15, , at the University of Illinois at Chicago. Participants were recruited from the Chicago area by means of flyers placed around the university and were screened via a questionnaire, an assessment of body mass index, and a pregnancy test.

Individuals included were men and women between 18 and 65 years of age, with a body mass index between The protocol was approved by the Office for the Protection of Research Subjects at the University of Illinois at Chicago, and written informed consent was obtained from all participants.

The full protocol is available in Supplement 1. Participants were randomized in a ratio to an alternate-day fasting group, daily calorie restriction group, or no-intervention control group.

Randomization was performed by a stratified random sampling procedure by sex, age years and years , and body mass index Block size ranged from 1 to 11 participants. The active trial duration was 1 year and consisted of a baseline phase 1 month , a weight-loss phase 6 months , and a weight-maintenance phase 6 months eFigure 1 in Supplement 2.

We chose this design because weight loss typically peaks at 6 months during a lifestyle intervention. Baseline total energy expenditure was measured using doubly labeled water.

Participants in the alternate-day fasting group and those in the daily calorie restriction group were provided with all meals during the first 3 months of the trial and received dietary counseling thereafter eFigure 1 in Supplement 2.

From months 4 to 6, when food was no longer provided, intervention participants met individually with a dietician or nutritionist weekly to learn how to continue with their diets on their own. At the beginning of the 6-month weight-maintenance phase, total daily energy expenditure was reassessed using doubly labeled water.

Intervention participants met with the dietician individually each month to learn cognitive behavioral strategies to prevent weight regain 19 and received personalized energy targets for weight maintenance based on results from doubly labeled water.

Participants in the control group were instructed to maintain their weight throughout the trial and not to change their eating or physical activity habits. Controls received no food or dietary counseling but visited the research center at the same frequency as the intervention participants to provide outcome measurements.

Controls who completed the month trial received 3 months of free weight-loss counseling and a month gym membership at the end of the study. The primary outcome of the study was change in body weight, which was measured monthly via a digital scale while the participant was in a hospital gown.

Fat mass and lean mass were measured every 6 months in the fasted state by dual-energy x-ray absorptiometry QDR W; Hologic. Visceral fat mass was measured every 6 months by magnetic resonance imaging performed with a 1.

Mean percentage energy restriction during the weight-loss phase was retrospectively calculated by the intake balance method using doubly labeled water and changes in body composition. Intervention participants were considered to be adherent when their actual energy intake, determined via food records, was within kcal of their prescribed daily energy goal.

Blood samples were obtained following a hour fast every 6 months collected on the morning after a feast day for the alternate-day fasting group. Secondary outcomes included blood pressure, heart rate, and total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, fasting glucose, fasting insulin, C-reactive protein, and homocysteine concentrations analytical methods are detailed in the full protocol in Supplement 1.

Thus, we initially aimed to recruit 90 participants 30 per group , assuming that 78 participants 26 per group would complete the trial. We later decided to recruit participants to increase our statistical power because our dropout rate was higher than expected.

Tests for normality were included in the model, and all data were found to be normally distributed. We conducted an intention-to-treat analysis, which included data from all participants who underwent randomization.

Results are reported by intention-to-treat analysis unless indicated otherwise. This model provides unbiased estimates of time and treatment effects under a missing-at-random assumption. Time was not assumed to be linear in the model. This strategy allowed for estimation of time and diet effects and their interaction without imposing a linear time trend.

The analyses were performed using SAS, version 9. Of the participants who were screened, More participants in the alternate-day fasting group than in the daily calorie restriction group withdrew owing to difficulties adhering with the diet.

All baseline characteristics had comparable distributions between the alternate-day fasting group, the daily calorie restriction group, and the control group Table 1. The participants were primarily metabolically healthy obese women.

On the fast day Figure 2 A , participants in the alternate-day fasting group exceeded their prescribed energy goal at months 3 and 6. On the feast day Figure 2 B , participants in the alternate-day fasting group ate less than their prescribed goal at months 3, 6, 9, and Participants in the daily calorie restriction group Figure 2 C met their prescribed energy goals at months 3, 6, and 12 but ate less than their prescribed goal at month 9.

A higher proportion of participants in the daily calorie restriction group were adherent to their energy goals at months 3, 6, 9, and 12 relative to those in the alternate-day fasting group.

Data on dietary intake are displayed in eTable 1 in Supplement 2. Percentage of energy intake from fat, carbohydrates, and protein did not differ significantly over time in any of the groups. Physical activity, measured as steps per day, did not change during the course of the trial in any group eTable 2 in Supplement 2.

This level of activity is approximately to steps per day higher than that of the average overweight or obese adult. Changes in body weight are displayed in Figure 3 and Table 2. Weight loss was not significantly different between the alternate-day fasting group and the daily calorie restriction group at month 6.

At the end of the study, total weight loss was —6. Weight regain from months 6 to 12 —0. Moreover, weight regain from months 6 to 12 was not significantly different between the alternate-day fasting group and controls 0.

Changes in body composition are reported in Table 2. There were no statistically significant differences between the alternate-day fasting group and the daily calorie restriction group for fat mass, lean mass, or visceral fat mass at month 6 or month Blood pressure was not significantly different between the intervention groups, or relative to controls, at month 6 or month 12 Table 2.