Intermittent versus Continuous Calorie Restriction for Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Randomized Clinical Trial
Abstract
BACKGROUND
Calorie restriction has been demonstrated to be effective in treating metabolic dysfunction-associated steatotic liver disease (MASLD). However, it has been limited by poor long-term adherence.
OBJECTIVE
This study aimed to compare intermittent calorie restriction (ICR) with traditional continuous calorie restriction (CCR) for the treatment of MASLD.
METHODS
We conducted a 12-week, parallel-arm, randomized controlled trial that included 60 adults with MASLD and abnormal glucose metabolism. The participants were randomly assigned to either the ICR group (2 successive days of fasting [∼500 kcal/day] and 5 days of recovery per week) or the CCR group. The primary outcome was liver fat content (LFC) measured by 1H-Proton magnetic resonance spectroscopy. The secondary and exploratory outcomes included weight, body composition, glucose, insulin, lipids and liver stiffness.
RESULTS
The mean reduction in LFC was -20.5% (95% CI: -25.0, -15.9%) in the ICR group and -15.5% (95% CI: -20.3, -10.8%) in the CCR group. Changes in LFC were not significantly different between the two groups (P = 0.15), and were homogeneous among different liver segments. Analysis of exploratory endpoints provided clues that the ICR was associated with greater reductions in fat mass and glycosylated hemoglobin. There were no significant differences in changes of weight, lean mass, insulin resistance, triglyceride and liver stiffness between the two groups. Participants showed high adherence to both…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 60 participants or records.
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