Ilaria Rosella Pagliaro 4:3 intermittent fasting led to greater weight loss in overweight or obese adults compared to daily calorie restriction
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A randomized clinical trial has shown that 4:3 intermittent fasting, combined with full behavioral support, led to slightly greater weight loss compared to daily calorie restriction in overweight or obese adults. The findings were published in the prestigious journal Annals of Internal Medicine.
What is 4:3 intermittent fasting?
4:3 intermittent fasting is a type of cyclical fasting that alternates three days per week of modified fasting with four days of mindful, unrestricted eating. It is called “4:3” because, over a seven-day week, four days allow normal eating while three days involve calorie restriction.
How the 4:3 fasting plan works
- On the three non-consecutive fasting days, participants follow a strict low-calorie regimen, consuming about 20% of their daily energy needs — roughly 500 to 600 calories per day.
- During the four non-fasting days, there are no strict calorie limits, but healthy and balanced food choices are still encouraged, avoiding overeating.
The study design
A research team from the University of Colorado School of Medicine enrolled 165 overweight or obese adults, randomly assigning them to one of two groups: one following 4:3 intermittent fasting and the other following daily calorie restriction.
The study lasted 12 months, during which both groups received group behavioral support, a free gym membership, and guidelines to complete at least 300 minutes of physical activity per week.
Participants in the intermittent fasting group were instructed to follow an 80% calorie restriction on three non-consecutive days per week, while eating freely — yet mindfully — on the other four days. The daily calorie restriction group was set a target to create an approximately 34.3% energy deficit each day.
All participants were provided with detailed nutritional guidance aiming for a macronutrient distribution of 55% carbohydrates, 15% protein, and 30% fat, along with practical instructions for calorie counting.
Better results with intermittent fasting
At the end of 12 months, those in the intermittent fasting group experienced a 7.6% reduction in body weight, compared to a 5% reduction in the daily calorie restriction group.
Moreover, 58% of the fasting participants achieved at least a 5% weight loss, versus 47% in the calorie restriction group.
In addition to weight loss, intermittent fasting led to improvements in key cardiometabolic parameters, including:
- Systolic blood pressure
- Total cholesterol and LDL (“bad”) cholesterol levels
- Fasting blood glucose
According to the authors, these findings suggest that intermittent fasting may promote better adherence because it does not require daily calorie counting or continuous restriction. Therefore, it should be considered among evidence-based dietary strategies for weight management.
Source: Eurekalert
