Is fasting better than dieting to lose weight? Study indicates that no

Intermittent fasting has gained popularity as a weight loss strategy, especially for its possible metabolic benefits. But there is evidence that stopping eating for certain periods is no more effective than traditional diets for weight loss.

This was the conclusion of an analysis of 22 clinical trials, with almost 2 thousand overweight or obese adults, published in February in the Cochrane Library.

Intermittent fasting is a strategy that alternates periods of eating with longer intervals of little or no caloric intake.

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In the study, models were evaluated with a restricted time window throughout the day, fasting on specific days of the week, fasting on alternate days, in addition to the 5:2 diet, in which the usual diet is maintained for five days and caloric restriction on two non-consecutive days.

"The logic of the method is relatively simple: prolong periods without calorie intake to reduce total energy intake. Physiologically, this can increase fat mobilization and generate some metabolic adaptations", explains endocrinologist Rafael Scarin, from Einstein Hospital Israelita in Goiânia.

Despite these mechanisms, the results indicate that, in practice, the impact on body weight is similar to that of conventional diets, which restrict calories without cutting out meals completely. The average difference found was small and statistically non-significant: those who followed a fasting method lost around 300 grams compared to the control groups.

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"In practice, intermittent fasting does not seem to be better than a well-conducted conventional diet, but it can be a valid alternative for some patients, as long as it is sustainable and compatible with their routine", analyzes Scarin.

Part of the popularity of intermittent fasting is associated with the idea that it could generate additional metabolic benefits. According to the endocrinologist, there is evidence of physiological changes in this regard.

"Intermittent fasting is usually associated with mechanisms such as improved insulin sensitivity, increased fat oxidation, production of ketone bodies [molecules produced by the liver when the body starts to use fat as its main source of energy] and possible effects on the circadian rhythm and glucose metabolism", he explains.

However, these changes do not necessarily translate into clinical advantages. "These physiological phenomena are not synonymous with clinical superiority.

In practice, these potential mechanisms have not resulted in clinically relevant benefits beyond what is already obtained with calorie restriction and conventional dietary guidance. In the review itself, there was no proven superior 'magic metabolic advantage'", notes the Einstein doctor.

According to the expert, the main issue when choosing a dietary strategy is the ability to maintain it over time. As no subgroups with greater benefit were identified, the success of the method depends much more on individual adaptation than on any specific metabolic advantage.

"The profile that tends to benefit most is the patient who is able to adapt to eating schedule rules, adapt eating windows to the routine and sustain this pattern in the long term", points out Rafael Scarin.

Although the review did not identify a consistent increase in risks compared to traditional diets, some adverse effects may occur, especially when the method is not well monitored. Reported symptoms include fatigue, dizziness, excessive hunger, headache, nausea and hypoglycemia.

"Caution is also necessary in people with a history of eating disorders, risk of malnutrition or loss of muscle mass, in addition to those using medications that reduce blood glucose", warns the endocrinologist.

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Source: CNN