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@ARTICLE{Schbel:141907,
      author       = {R. Schübel$^*$ and J. Nattenmüller$^*$ and D. Sookthai
                      and T. Nonnenmacher$^*$ and M. E. Graf$^*$ and L. Riedl and
                      C. L. Schlett and O. von Stackelberg and T. S. Johnson$^*$
                      and D. Nabers and R. Kirsten and M. Kratz and H.-U. Kauczor
                      and C. M. Ulrich and R. Kaaks$^*$ and T. Kühn$^*$},
      title        = {{E}ffects of intermittent and continuous calorie
                      restriction on body weight and metabolism over 50 wk: a
                      randomized controlled trial.},
      journal      = {The American journal of clinical nutrition},
      volume       = {108},
      number       = {5},
      issn         = {1938-3207},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {DKFZ-2018-02164},
      pages        = {933 - 945},
      year         = {2018},
      abstract     = {Although preliminary evidence suggests that intermittent
                      calorie restriction (ICR) exerts stronger effects on
                      metabolic parameters, which may link obesity and major
                      chronic diseases, compared with continuous calorie
                      restriction (CCR), there is a lack of well-powered
                      intervention studies.We conducted a randomized controlled
                      trial to test whether ICR, operationalized as the '5:2
                      diet,' has stronger effects on adipose tissue gene
                      expression, anthropometric and body composition measures,
                      and circulating metabolic biomarkers than CCR and a control
                      regimen.One hundred and fifty overweight and obese
                      nonsmokers [body mass index (kg/m2) ≥25 to <40, $50\%$
                      women], aged 35-65 y, were randomly assigned to an ICR group
                      (5 d without energy restriction and 2 d with $75\%$ energy
                      deficit, net weekly energy deficit $∼20\%),$ a CCR group
                      (daily energy deficit $∼20\%),$ or a control group (no
                      advice to restrict energy) and participated in a 12-wk
                      intervention phase, a 12-wk maintenance phase, and a 26-wk
                      follow-up phase.Loge relative weight change over the
                      intervention phase was $-7.1\% ± 0.7\%$ (mean ± SEM)
                      with ICR, $-5.2\% ± 0.6\%$ with CCR, and
                      $-3.3\% ± 0.6\%$ with the control regimen
                      (Poverall < 0.001, PICR vs. CCR = 0.053). Despite
                      slightly greater weight loss with ICR than with CCR, there
                      were no significant differences between the groups in the
                      expression of 82 preselected genes in adipose tissue
                      implicated in pathways linking obesity to chronic diseases.
                      At the final follow-up assessment (week 50), weight loss was
                      $-5.2\% ± 1.2\%$ with ICR, $-4.9\% ± 1.1\%$ with CCR,
                      and $-1.7\% ± 0.8\%$ with the control regimen
                      (Poverall = 0.01, PICR vs. CCR = 0.89). These effects
                      were paralleled by proportional changes in visceral and
                      subcutaneous adipose tissue volumes. There were no
                      significant differences between ICR and CCR regarding
                      various circulating metabolic biomarkers.Our results on the
                      effects of the '5:2 diet' indicate that ICR may be
                      equivalent but not superior to CCR for weight reduction and
                      prevention of metabolic diseases. This trial was registered
                      at clinicaltrials.gov as NCT02449148.},
      cin          = {C020},
      ddc          = {570},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30475957},
      doi          = {10.1093/ajcn/nqy196},
      url          = {https://inrepo02.dkfz.de/record/141907},
}