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Fasting as a weight-loss intervention in gestational diabetes – Australian trial

The 5:2, or intermittent fasting diet, is just as effective as a conventional energy-restricting diet, enabling women greater choice and flexibility when it comes to weight loss, found a University of South Australia study in The American Journal of Clinical Nutrition.

The 5:2 diet allows five days of normal eating each week while substantially restricting calories over two days a week, as opposed to a typical diet that requires moderate energy restrictions daily.

Globally, one in five pregnancies is affected by gestational diabetes, with these women having a 10-fold risk of developing type 2 diabetes later in life. Women who have had gestational diabetes and are also overweight are at an even higher risk.

Type 2 diabetes has lifelong consequences and can lead to other chronic diseases such as heart disease and cancer. Lead researcher, UniSA’s Dr Kristy Gray, says the finding will be greatly welcomed by women looking to lose weight.

“Gestational diabetes is the fastest growing type of diabetes in Australia, affecting 15 per cent of pregnancies,” says Gray. “Healthy eating and regular physical activity are recommended to manage gestational diabetes, with continuous energy restriction diets, or diets that cut calories by 25-30%, being the most common strategy for weight loss and diabetes prevention.

“The trouble is, however, that new mums often put themselves last: they’re struggling with fatigue and juggling family responsibilities, so when it comes to weight loss, many find it hard to stick to a low-calorie diet.”

The 5:2 diet may provide a less overwhelming option. As it only cuts
calories over two days, some women may find it easier to adopt and adhere to, as opposed to a consistently low-calorie diet requiring constant management.

“Our research shows that the 5:2 diet is just as effective at achieving weight loss as a continuous energy-restricted diet in women who have had gestational diabetes, which is great, because it provides women with greater choice and control.

“Of course, women should seek advice from a health professional before commencing this type of diet, to make sure that it is suitable for them.”

The research investigated the effects of both the 5:2 diet (five days of normal eating and two days of 500 calories) and a continuous energy-restricted diet (1,500 calories per day) on weight loss and diabetes risk markers in women with a previous diagnosis of gestational diabetes. Both diets restricted energy by approximately 25% each week.

Study details

The effect of intermittent energy restriction on weight loss and diabetes risk markers in women with a history of gestational diabetes: a 12-month randomized control trial

Kristy L Gray, Peter M Clifton, Jennifer B Keogh.

Published in The American Journal of Clinical Nutrition on 8 April 2021

The American Journal of Clinical Nutrition article – The effect of intermittent energy restriction on weight loss and diabetes risk markers in women with a history of gestational diabetes: a 12-month randomized control trial (Open access)

ABSTRACT

Background
Weight loss after gestational diabetes (GDM) can prevent or delay the onset of type 2 diabetes. Intermittent energy restriction (IER) may offer an alternative to continuous energy restriction (CER) for weight loss.

Objectives
We compared the effects of IER (2 days per week) to daily CER over 12 mo on weight loss and diabetes risk markers in overweight women with previous GDM.

Methods
Overweight females (n = 121) ≥18 y were randomized 1:1 to either IER [2-d 500 kcal (2100 kJ); n = 61] or CER [1500 kcal (6000 kJ); n = 60] in this 12-mo noninferiority trial.

Results
The trial was completed by 62 participants with a median age of 39.6 y [Quartile (Q) 1 to Quartile 3, 34.9 to 43.9 y] with a median BMI of 32.6 kg/m2 (Q1 to Q3, 28.5 to 37.9 kg/m2) at a median of 2.9 y after GDM (Q1 to Q3, 2.1 to 6.4 y; 49% attrition; IER n = 29; CER n = 30; P = 0.8). The mean ± SD weight loss was significant over time (P < 0.001) but not by diet group (IER −4.8 ± 5.0 kg; CER −3.2 ± 5.0; P = 0.2). The mean between-group difference was −1.6 kg (95% CI: −4.2 to 1.0 kg; P = 0.2). There were no significant between-group differences in change in HbA1c, fasting plasma glucose, fasting serum insulin, HOMA-IR or 2-h oral glucose tolerance at 12 mo (p>0.05). The trial was registered at https://www.anzctr.org.au/ (ACTRN12617001476325).

Conclusions
IER produces comparable weight loss to CER over 12 mo in overweight women with previous GDM. The high dropout rate in this study is a limitation in the interpretation of these results. Larger studies are needed to confirm noninferiority of IER compared to CER.

 

AJCN article – The effect of intermittent energy restriction on weight loss and diabetes risk markers in women with a history of gestational diabetes: a 12-month randomized control trial (Open access)

 

See more from MedicalBrief archives:

 

NHS scepticism over study claiming heart benefits of fasting diet

 

The pros and cons of intermittent fasting to lose weight

 

Intermittent fasting: From Pythagoras to Fung

 

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