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Effect of “5:2 regimens”: energy-restricted diet or low-volume high-intensity interval training combined with resistance exercise on glycemic control and cardiometabolic health in adults with overweight/obesity and type 2 diabetes: A three-arm, randomized controlled trial

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posted on 2024-04-18, 18:12 authored by Mian Li, Jie Li, Yu Xu, Jinli Gao, Qiuyu Cao, Yi Ding, Zhuojun Xin, Ming Lu, Xiaoting Li, Haihong Song, Jue Shen, Tianzhichao Hou, Ruixin He, Ling Li, Zhiyun Zhao, Min Xu, Jieli Lu, Tiange Wang, Shuangyuan Wang, Hong Lin, Ruizhi Zheng, Jie Zheng, Callum John Baker, Shenghan Lai, Nathan Anthony Johnson, Guang Ning, Stephen Morris Twigg, Weiqing Wang, Yan Liu, Yufang Bi

Objective

We aimed to examine the effects of “5:2 regimens” diet (2-day/week of energy restriction by formula diet) or exercise (2-day/week of high-intensity interval training and resistance training) intervention compared with routine lifestyle education (control) on glycemic control and cardiometabolic health among adults with overweight/obesity and type 2 diabetes.

Research Design and Methods

This two-center, open-label, three-arm, parallel-group, randomized controlled trial recruited 326 participants with overweight/obesity and type 2 diabetes, and randomized them into a 12-week of diet intervention (N=109), exercise intervention (N=108), or lifestyle education (control) (N=109). The primary outcome was the change of glycemic control measured as glycated hemoglobin (HbA1c) between the diet or exercise intervention groups and the control group after a 12-week intervention.

Results

The diet intervention significantly reduced HbA1c level (%) after the 12-week intervention (−0.72, 95% confidence interval (CI) −0.95 to −0.48), compared with the control group (−0.37, 95% CI −0.60 to −0.15) (diet vs. control: −0.34, 95% CI −0.58 to −0.11, p=0.007). The reduction in HbA1c level in the exercise intervention group (−0.46, 95% CI −0.70 to −0.23) did not significantly differ from the control group (exercise vs. control: −0.09, 95% CI −0.32 to 0.15, p=0.47). The exercise intervention group was superior in maintaining lean body mass. Both diet and exercise interventions induced improvements in adiposity and hepatic steatosis.

Conclusions

These findings suggested that the medically supervised 5:2 energy-restricted diet could provide an alternative strategy for improving glycemic control, and the exercise regimen improved body composition, although inadequate to improve glycemic control.