Nonalcoholic Fatty Liver Disease

Alternate-Day Fasting, Exercise Is Effective for Patients With Obesity, NAFLD

Alternate-day fasting may reduce body weight and fat mass in adults with obesity and nonalcoholic fatty liver disease (NAFLD), according to the results of a recent study presented at ObesityWeek 2020.

“This is the first human trial to compare the effects of [alternate-day fasting] plus endurance exercise, [alternate-day fasting] alone, endurance exercise alone versus a no intervention control, on body weight and metabolic disease risk factors in participants with obesity and NAFLD,” the researchers wrote.

A total of 18 participants who had obesity and NAFLD were randomly assigned to a group for 12 weeks. Included was an alternate-day fasting group, which alternated between a 600 kcal “fast day” and a “feast day” of ad libitum caloric intake; an exercise group of endurance exercise for 60 minutes 5 times per week; a combination group of both alternate-day fasting and exercise group requirements; and a control group where participants consumed their usual diet.

The results indicated that the alternate-day fasting group lost an average of 6 ± 1 kg of body weight, and the combination group lost an average 5 ± 1 kg of body weight. However, body weight was not reduced in the exercise group or the control group.

Similarly, the alternate-day fasting group lost an average of 6 ± 1 kg of fat mass, and the combination group lost an average of 4 ± 2 kg of fat mass, but fat mass did not decrease in the exercise or control groups.

The alternate-day fasting and combination groups were also highly adherent with the 600 kcal fast day energy goal. This was observed for the 2 groups both at baseline and week 12, respectively.

Free fat mass, blood pressure, heart rate, and habitual physical activity (steps per day) did not change significantly between the groups and the controls. 

“These preliminary findings suggest that the combination [alternate-day fasting] plus exercise and [alternate-day fasting] alone may be effective nonpharmacological therapies to reduce body weight and fat mass,” the researchers concluded. “However, neither the combination intervention nor [alternate-day fasting] alone had any effect on metabolic risk factors such as blood pressure or heart rate in participants with NAFLD.”


—Leigh Precopio



Ezpeleta M, Gabel K, Cienfuegos S, et al. Effect of diet combined with exercise on body weight in adults with obesity and NAFLD. Paper presented at: ObesityWeek2020; November 2-6, 2020; Virtual.