Intermittent fasting as potential non-pharmacological therapeutic tool in overweight and obesity management among Malay adults

Abstract

Obesity and its associated metabolic consequences such as hypertension, type 2 diabetes mellitus and cardiovascular disease are global epidemic. Conventional treatment of obesity is daily calorie restriction but patients have adherence issue with it. Intermittent fasting specifically time-restricted feeding (TRF) is an emerging alternative but limited scientific evidence on TRF is available. Furthermore, there has been a great deal of confusion about the role of physical activity and exercise in overweight and obesity management. Therefore, the aims of this study were to investigate and compare the effects of brisk walking combined with time-restricted feeding of 16-hour fasting period daily for 5 days a week for 16 weeks, time-restricted feeding alone of 16-hour fasting period daily for 5 days a week for 16 weeks and control group (who maintain their lifestyle feeding ad libitum) for 16 weeks on body weight and metabolic health parameters in young overweight and obese adult subjects. Thirty-six (n=36) overweight and obese participants were enrolled equally into three different groups according to their preferences in this 16-week prospective experimental study; Group A (BW combined with TRF), Group B (TRF alone) and Group C (control group maintaining their lifestyle feeding ad libitum). The subjects were matched according to race, gender, age and body mass index (BMI). Physiological parameters such as body weight, BMI, body compositions (measured using OMRON Body Fat Analyser), blood pressures, waist and hip circumferences were measured in the beginning of the study and at the end of 16 weeks. The data were analysed using statistical methods paired t-test to compare means of dependent samples (non-parametric alternative Wilcoxon Signed Rank test), analysis of variance (One-way ANOVA) to compare the means of three independent groups (non-parametric alternative Kruskal-Wallis test) and Independent Sample t-test to compare the means of two independent groups (non-parametric alternative Mann-Whitney test). After 16 weeks of study, TRF alone (Group B) and BW combined with TRF (Group A) significantly reduced body weight (male= -2.1 ± 1.1kg/m2 vs. -2.2 ± 1.3 kg/m2 vs. 0.7 ± 0.4kg/m2, female= -2.3 ± 1.0kg/m2 vs. -2.4 ± 1.3kg/m2 vs. 0.5 ± 0.5kg/m2), body fat percentage (male= -1.5 ± 1.5% vs. -2.6 ± 2.2% vs. 1.0 ± 0.4%, female= -1.9 ± 1.7% vs. -2.2 ± 1.4% vs. 1.0 ± 0.9%), systolic blood pressure (male= -8 ± 6mmHg vs. -3 ± 3mmHg vs. 9 ± 5mmHg, female= -4 ± 10mmHg vs. -2 ± 9mmHg vs. 9 ± 5mmHg), diastolic blood pressure [male= -10 (10)mmHg vs. -9 (10)mmHg vs. 4 (7)mmHg, female= -3 ± 9mmHg vs. -3 ± 3mmHg vs. 7 ± 5mmHg] and serum TNF-α concentration [male= -70.7 (109.9)pg/ml vs. -142.8 (204.4)pg/ml vs. 3.15 (17.3pg/ml)] (all p<0.05) compared to control group respectively in young overweight and obese adults. In conclusion, TRF alone or BW combined with TRF has the potential to be utilized as therapeutic tool in overweight and obesity management in young overweight and obese adults. TRF alone is equally effective to BW combined with TRF in reducing body weight and body fat compositions in young overweight and obese adults.