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Accepted manuscript

The impact of intermittent energy restriction on women’s health

Published online by Cambridge University Press:  11 February 2025

Michelle Harvie*
Affiliation:
Division of Cancer Sciences, The University of Manchester, Manchester, UK Department of Dietetics, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK. Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie NHS Foundation Trust, University of Manchester, Manchester, UK
Mai Haiba
Affiliation:
Division of Cancer Sciences, The University of Manchester, Manchester, UK Department of Dietetics, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK.
*
Corresponding author: Michelle Harvie, michelle.harvie@manchester.ac.uk; telephone 0161 291 5815
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Abstract

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Intermittent energy restricted diets are used amongst women with overweight and obesity and a healthy weight. For those with overweight and obesity weight control is typically achieved through daily energy restriction (DER) which has reduced adherence and attenuated metabolic benefits over time. Several intermittent energy restriction (IER) regimens have been developed aiming to promote maintained weight loss and additional weight independent metabolic benefits including the 5:2 diet, alternate day fasting (ADF) and time restricted eating (TRE). This review summarises the potential benefits or harms of these regimens for managing women’s health. 5:2 and ADF diets have equivalent long term (≥6-month) adherence, weight loss and metabolic benefits to DER. Current limited evidence suggests IER is a safe weight loss intervention for women which does not affect reproductive or bone health, increase eating disorders or disturb sleep. Adherence and weight loss with both IER and DER are lower amongst younger women compared to older women and men. Weight loss with ADF and TRE have respectively improved symptoms of polycystic ovarian syndrome and premenstrual syndrome but there is no evidence of weight independent effects of IER on these conditions. There is little evidence of the benefits and/or harms of IER amongst healthy weight women in whom there is a greater potential for adverse effects on reproductive and bone health, fat free mass, eating disorders and sleep. Further research benefits of IER for weight control and metabolic health as well as harms is required.

Type
Review Article
Copyright
© The Authors 2025. Published by Cambridge University Press on behalf of The Nutrition Society