Overview

• Researchers pooled 99 randomized trials with over 6,500 adults (average BMI 31) and found all intermittent fasting and continuous restriction diets outperformed unrestricted eating.
• Alternate-day fasting produced an additional 1.29 kg weight loss versus daily calorie restriction but did not reach the study’s 2 kg clinical significance benchmark.
• Alternate-day fasting also yielded modest reductions in total and LDL cholesterol compared with time-restricted eating, with no clear benefits for blood sugar or HDL cholesterol.
• Differences between time-restricted eating, whole-day fasting and continuous restriction were deemed trivial, raising questions about the long-term sustainability of intermittent fasting methods.
• Authors noted high heterogeneity and predominantly short trial durations as limitations and called for longer follow-up studies to confirm these findings.