The effect of continuous or intermittent calorie-restricted diet on body composition and resting energy expenditure in patients with type 2 diabetes.

Both CCR and ICR diets resulted in significant weight loss after three months.

• CCR group weight decreased from 102.8 ± 17.1 kg to 97.7 ± 16.3 kg (p < 0.001)
• ICR group weight decreased from 107.3 ± 17.5 kg to 100.5 ± 15.2 kg (p < 0.001)
• CCR diet involved 750 kcal per day; ICR diet involved an eating window between 8AM and 6PM with 1300-1500 kcal per day
• 67 participants were included (mean age 60 years; 56% female; CCR: n = 41; ICR: n = 26)

Both CCR and ICR diets significantly reduced fat mass percentage after three months.

• CCR group fat mass decreased from 39.7 ± 7.7% to 36.2 ± 7.8% (p < 0.001)
• ICR group fat mass decreased from 38.5 ± 9.0% to 35.8 ± 8.6% (p < 0.001)
• No significant differences were observed between the two groups in fat mass change

Fat-free mass percentage increased significantly in both groups, indicating no excessive FFM loss.

• CCR group FFM increased from 59.6 ± 8.1% to 64.9 ± 9.9% (p = 0.001)
• ICR group FFM increased from 61.5 ± 9.1% to 64.1 ± 8.7% (p = 0.002)
• No significant differences in FFM change were observed between the two groups

Resting energy expenditure decreased significantly only in the CCR group, not in the ICR group.

• CCR group REE decreased from 2006 ± 377 kcal to 1820 ± 348 kcal (p < 0.001)
• A significant decrease in REE was not observed in the ICR group
• No significant between-group difference in REE change was reported

HbA1c decreased significantly only in the CCR group, while diabetes medication use decreased significantly in both groups.

• HbA1c in the CCR group decreased from 61.0 [52.0–74.0] mmol/mol to 54.0 [43.0–66.0] mmol/mol (p = 0.028)
• Medication Effect Score (MES) decreased significantly in the CCR group from 2.41 [1.11–3.25] to 1.62 [0.62–2.36] (p = 0.007)
• MES decreased significantly in the ICR group from 0.38 [0.0–1.35] to 0.25 [0.0–0.67] (p = 0.036)
• Reductions in MES indicate improved diabetes control in both groups

The dropout rate was significantly higher in the CCR group compared to the ICR group.

• Dropout rate was 19% for CCR and 0% for ICR (p = 0.016)
• This was the only parameter showing a significant difference between the two groups
• The lower dropout rate in ICR suggests greater feasibility of the intermittent calorie-restricted approach

This study was a post-hoc analysis of two ongoing trials (E-DIET and TIMED) in the Netherlands, which limits direct comparisons between the groups.

• The post-hoc design means the two groups were not originally randomized against each other
• The authors note that 'direct comparison is limited by the post-hoc design'
• Participants had type 2 diabetes and overweight or obesity; mean age was 60 years and 56% were female