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No Obvious Bone Harm from "CR" and Modified Fasting in Obese

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Alternate-Day Fasting Poses No Threat to Bone Health

 

Fran Lowry

October 15, 2016

 

Alternate-day fasting, in which people restrict intake to 500 calories one day and eat whatever they want the next, results in successful weight loss with no adverse effects on bone health, according to new research [by] ... Krista Varady, PhD, from the University of Illinois at Chicago ...

 

Dr Varady randomly assigned 100 obese patients to alternate-day fasting, caloric restriction, or no dietary intervention (control group) for 6 months.

 

The reduction in body weight [and fat mass] was significantly better in the fasting and restriction groups than in the control group.

 

Table. Percent of Body Mass Lost Over 6 Months

Group Body Mass Lost, % P Value Alternate-day fasting 7.8 <.001 Caloric restriction 8.8 <.001 Control 1.0 ns

 

Levels of leptin decreased by 50% (P < .05) in the caloric-restriction group, compared with the control group, and levels of insulin-like growth factor-1 increased by 11% (P < .05). [?!] Both levels remained unchanged in the fasting group.

 

There were no changes in lean mass, circulating osteocalcin [marker of bone formation] circulating bone alkaline phosphatase [marker of aberrant bone formation], total bone mineral density, or C-terminal telopeptide type 1 collagen [marker of bone resorption] in the three groups.

 

"It doesn't seem that, as a result of these diets, your body starts breaking down bone. That's a null finding, but a really good null finding," Dr Varady reported.

 

The Diet for Postmenopausal Women?

 ... premenopausal women lost 7% to 8% of their body weight with alternate-day fasting, whereas postmenopausal women lost about 30%.

 

It is not clear why "postmenopausal women did so much better," Dr Varady acknowledged. It could be that "most postmenopausal women just know what kind of diet works for them at that age in their life, and that younger women are still experimenting with different diets."

 

"This trial adds to a growing body of evidence showing that alternate-day fasting is a safe and effective dietary intervention for weight loss ... showing compelling cardiovascular benefits... in obese individuals," said Pauline Maki, PhD, professor of psychiatry and psychology at the University of Illinois at Chicago, who was not involved in the study.

North American Menopause Society (NAMS) 2016 Annual Meeting. Presented October 8, 2016.

I'm skeptical of their main finding, since every study I've ever seen of the effects of weight loss from reduced energy intake has reported a loss of bone mineral density and evidence of bone resorption, with the differences by protocol being the magnitude of the effect. And intuitively, I'd expect fasting or very-low-calorie days to lead to more bone resorption in the context of net energy deficit than "continuous" energy restriction; here, instead, they report that neither did. And the increase in IGF-1 on "continuous" energy restriction is very surprising and contrary to other reports.

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Additional information are:

 

Alternate-Day Fasting Poses No Threat to Bone Health – Posted on October 15, 2016 in Health

http://archynewsy.com/alternate-day-fasting-poses-no-threat-to-bone-health-medscape/

It’s not obvious why “postmenopausal women accomplished it far better,” Dr Varady acknowledged. Maybe “most postmenopausal women just know what sort of diet works best for them at this age within their existence, which more youthful women continue to be tinkering with different diets.”

“Nice reductions in cardiovascular disease risk parameters, like Cholestrerol levels and triglycerides, and increases in High-density lipoprotein cholesterol” happen to be shown, she told Medical News. Additionally, “some diabetes protective effects” result, “where levels of insulin and insulin resistance go lower.”

There have been also significant reductions in fat mass within the fasting and restriction groups, in contrast to the control group.

Amounts of leptin decreased by 50% (P < .05) within the caloric-restriction group, in contrast to the control group, and amounts of insulin-like growth factor-1 elevated by 11% (P < .05). Both levels continued to be unchanged within the fasting group.

“It does not appear that, because of these diets, the body starts breaking lower bone. This is a null finding, but an excellent null finding,” Dr Varady reported.

“I’ve been running human trials in alternate-day fasting for around ten years,” stated investigator Krista Varady, PhD, in the College of Illinois at Chicago. “People can lose about one to three pounds per week, therefore it leads to good weight reduction.”

“It develops work showing compelling cardiovascular benefits,” Dr Maki told Medical News.

There have been no alterations in lean mass, circulating osteocalcin, circulating bone alkaline phosphatase, total bone mineral density, or C-terminal telopeptide type 1 bovine collagen within the three groups.

 

Table. Percent of Weight Lost Over 6 Several weeks

--------------------------------

Group Weight Lost, % P Value

--------------------------------

Alternate-day fasting 7.8 <.001

Caloric restriction 8.8 <.001

Control 1. ns

 

You will find “some interesting variations between premenopausal ladies and postmenopausal women using the alternate-day fasting diet,” she stated.

The Diet Plan for Postmenopausal Women?

Alternate-day fasting, by which people restrict intake to 500 calories eventually and eat anything they want the following, leads to effective weight reduction without any negative effects on bone health, based on new information.

Dr Krista Varady

United States Menopause Society (NAMS) 2016 Annual Meeting. Presented October 8, 2016.

“What we should would never know was if the diet might have negative effects on bone health,” Dr Varady stated in the United States Menopause Society 2016 Annual Meeting in Orlando.

This research was supported, partly, by grant funding from Pharmavite LLC. Dr Varady has written a magazine for everyone known as The Every Second Day Diet. Dr Maki has disclosed no relevant financial relationships.

To look at that issue, Dr Varady at random assigned 100 obese patients to alternate-day fasting, caloric restriction, or no nutritional intervention (control group) for six several weeks.

“This trial contributes to an increasing body of evidence showing that alternate-day fasting is really a effective and safe nutritional intervention to lose weight in obese individuals,” stated Pauline Maki, PhD, professor of psychiatry and psychology in the College of Illinois at Chicago, who had been not active in the study.

“Postmenopausal women do much better onto it. They lost two times the quantity of weight because the premenopausal women,” she reported. Actually, premenopausal women lost 7% to eightPercent of the bodyweight with alternate-day fasting, whereas postmenopausal women lost about 30%.

The decrease in bodyweight was considerably better within the fasting and restriction groups compared to the control group.

 

Menopause Issue: Volume 23(12), December 2016, p 1363–1407

Copyright: © 2016 by The North American Menopause Society.

Publication Type: [Abstracts]

DOI: 10.1097/GME.0000000000000783

ISSN: 1072-3714

Accession: 00042192-201612000-00016

[Abstracts] 27th Annual Meeting of The North American Menopause Society October 5–8, 2016, Orlando, FL

---------------------

PLENARY SYMPOSIUM #9

Alternate-Day Fasting

Krista Varady

Background: Alternate day fasting (ADF) is a novel diet therapy that reduces body weight, but its effect on bone metabolism remains unknown.

Objective: This study examined the impact of ADF on markers of bone turnover in a 6-month randomized controlled trial. The effect of ADF versus a conventional diet therapy, daily calorie restriction (CR), was also examined.

Methods: Obese subjects (n = 100) were randomized to 1 of 3 groups for 6 months: 1) ADF (25% energy intake fast day, alternated with 125% intake feast day; 2) CR (75% intake every day); 3) control (ad libitum intake every day).

Results: Body weight decreased (P < 0.001) by ADF (-7.8 ± 1.2%) and CR (-8.8 ± 1.5%), relative to controls (-1.0 ± 0.7%). Fat mass was reduced (P < 0.01) by ADF and CR, versus controls. Lean mass remained unchanged in all groups. Circulating osteocalcin and bone alkaline phosphatase did not change in any group. Leptin decreased (P < 0.05) by 50 ± 20% and insulin like growth factor-1 (IGF-1) increased (P < 0.05) by 11 ± 8% in the CR group versus controls. Leptin and IGF-1 remained unchanged in the ADF group, relative to controls. C-terminal telopeptide type I collagen (CTX) did not change in any group. Total bone mineral density remained unchanged in all groups.

Conclusion: These preliminary findings suggest that 6 months of ADF does not have any deleterious impact markers of bone turnover or total bone mineral density in obese adults with moderate weight loss.

Edited by AlPater

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