| Background and purpose: Obesity is a chronic disease caused by abnormal or excessive accumulation of body fat that can harm human health,and the prevalence of obesity is still steadily increasing in the world.Weight loss has become a growing concern by people all over the world and dietary intervention has been a common strategy for weight loss and weight management.In the past,continuous energy restrictions(CER)have been recommended by guidelines as a cornerstone of weight-loss therapy,but in the last decade or so,Intermittent Energy restrictions(IER)are getting a lot of attention and interest because they are easier to stick to than CER.The 5:2 diet is a classic form of IER,the main method is to limit energy intake through two consecutive or non-consecutive fasting days per week(maximum energy intake is500 kcal for women and 600 kcal for men),and many studies have compared the weight loss effects of IER and CER.However,no meta-analysis has independently examined the weight loss effects of 5:2diet and compared it with other dietary interventions.Many studies have reported the effect of 5:2 fasting as an intervention group on weight loss and metabolism improvement in obese and overweight patients.Therefore,this study aims to retrieve relevant literature and conduct a meta-analysis to further evaluate the effect of 5:2 fasting on weight loss and metabolism improvement in obese and overweight adults.Methods:We searched five databases(Pub Med,EMBASE,Cochrane Library,China National Knowledge Infrastructure and Wangfang Datebase)to find literature on weight loss and metabolism improvement in obese and overweight patients with 5:2 fasting.The scope of the search was all Randomized controlled trials(RCTs)literature in three databases up to December 1,2021.After obtaining relevant literature and data extraction,Rev Man 5.4 software was used for bias risk assessment,Stata16.0 software was used for Meta analysis of data,random effect model was used in Meta analysis.The effect values were selected as Standard mean differences(SMD),Weight mean differences(WMD)and 95%Confidence intervals(CI).Main outcome measures were body weight,body mass index,fat body mass and lean body mass;Secondary outcome measures were waist circumference,hip circumference,high-density lipoprotein,low-density lipoprotein,total cholesterol,and triglyceride.Results:1176 RCTS that might meet the requirements were obtained by searching the database,and 10 RCTS that met the requirements were finally obtained after screening.These 10 studies included 800 obese and overweight participants,all older than 18 years of age.Three of the studies were female and one of the studies was male.Eight of the studies included CER as a control group,one with a blank control group and another with DASH(Diets Aim to Stop Hypertension),an intervention that ranged from 52 days to 12 months.The final results suggest that compared with the control group,fasting at 5:2 was associated with significantly lower body weight(WMD=-0.80kg;95%CI=[-1.51;-0.09]kg),hip circumference(WMD=-1.12cm;95%CI=[-2.16;-0.07]cm),waist circumference(WMD=-1.47cm;95%CI=[-2.63;-0.31]cm),total cholesterol(SMD=-0.50;95%CI=[-0.82;-0.18]),and lean body weight(WMD=-0.62kg;95%CI=[-0.73;-0.51]kg).In subgroup analyses,5:2 fasting was associated with significant reductions in body weight,fat weight,lean body mass,waist circumference,total cholesterol,and total triglycerides when the intervention lasted less than 6 months,compared with controls.When the control group was restricted to CER,we found that 5∶2 fasting was superior to CER in weight loss and total cholesterol.Conclusion: Short-term 5:2 fasting could significantly reduce body weight,fat weight,lean body weight,waist circumference,total cholesterol,and total triglycerides in overweight and obese adults.In addition,5∶2 fasting was associated with more effective weight loss and total cholesterol reduction than CER. |
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