The effect of alternate-day caloric restriction on the metabolic consequences of eight days' bed rest in healthy lean men: a randomized trial

Background: Physical activity and alternate-day fasting/caloric restriction may both ameliorate aspects of the metabolic syndrome, such as insulin resistance, visceral fat mass accumulation, and cognitive impairment, by overlapping mechanisms. Objective: To test the hypothesis that alternate-day caloric restriction (ADCR) with overall energy balance would reduce insulin resistance and accumulation of visceral fat, in addition to improving cognitive functions, after eight consecutive days in bed. Design: Healthy, lean men (n = 20) were randomized to 1) 8 days' bed rest with 3 daily iso-energetic meals (control group, n = 10); and 2) 8 days' bed rest with 25% of total energy requirements every other day and 175% of total energy requirements every other day (ADCR group). Oral glucose tolerance testing, DXA scans, magnetic resonance imaging of the abdomen and brain, VO₂ max, and tests for cognitive function were performed before and after bed rest. In addition, daily fasting blood samples and 24 h glucose profiles by continuous glucose monitoring system were assessed during the 8 days bed rest period. Results: Bed rest induced insulin resistance, visceral fat accumulation, and worsening of mood. No positive effects emerged from ADCR on these negative health outcomes. Compared to the control group, ADCR was associated with improved and steadier glycemic control on fasting days, and higher glycemic fluctuation and indices of insulin resistance on overeating days. Conclusions: In contrast to our hypothesis, the metabolic impairment induced by eight days of bed rest was not counteracted by ADCR with overall energy balance.

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