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Post-hoc analysis finds both continuous and intermittent calorie restriction reduce weight in type 2 diabetesTwo calorie-restricted diets helped people with type 2 diabetes lose weight in a small study

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Key Takeaway
Consider both calorie restriction diets for weight loss in type 2 diabetes, but note post-hoc limitations.

This post-hoc analysis of RCTs included 67 participants with type 2 diabetes and overweight or obesity (mean age 60 years, 56% female) in the Netherlands. It compared a 3-month continuous calorie-restricted (CCR) diet (750 kcal per day) to an intermittent calorie-restricted (ICR) diet (eating window between 8AM and 6PM and 1300-1500 kcal per day).

Main results showed weight decreased significantly in both groups: CCR from 102.8 ± 17.1 kg to 97.7 ± 16.3 kg, and ICR from 107.3 ± 17.5 kg to 100.5 ± 15.2 kg (p < 0.001 for both). Fat mass decreased significantly in both groups (CCR: 39.7 ± 7.7% to 36.2 ± 7.8%; ICR: 38.5 ± 9.0% to 35.8 ± 8.6%, p < 0.001 for both), while fat-free mass increased significantly (CCR: 59.6 ± 8.1% to 64.9 ± 9.9%, p = 0.001; ICR: 61.5 ± 9.1% to 64.1 ± 8.7%, p = 0.002). Resting energy expenditure decreased significantly only in the CCR group (2006 ± 377 kcal to 1820 ± 348 kcal, p < 0.001), and HbA1c decreased significantly only in the CCR group (61.0 [52.0-74.0] mmol/mol to 54.0 [43.0-66.0] mmol/mol, p = 0.028). Diabetes medication use decreased significantly in both groups (CCR: 2.41 [1.11-3.25] to 1.62 [0.62-2.36], p = 0.007; ICR: 0.38 [0.0-1.35] to 0.25 [0.0-0.67], p = 0.036). No significant between-group differences were observed in these parameters.

Safety data were limited; adverse events and tolerability were not reported, but discontinuations showed a dropout rate of 19% for CCR and 0% for ICR. Key limitations include the post-hoc design, which limits direct comparison, and the small sample size. Practice relevance is restrained: both diets appear promising for weight and metabolic improvements in this population, with ICR potentially more feasible due to lower dropout, but evidence is preliminary and causal inferences should be avoided.

Researchers looked at two different calorie-restricted diets for people with type 2 diabetes who were also overweight or obese. The study involved 67 participants in the Netherlands, with an average age of 60 and about 56% women. They followed either a continuous calorie-restricted diet (eating 750 calories per day) or an intermittent calorie-restricted diet (eating within a 10-hour window and 1300-1500 calories per day) for 3 months.

Both groups lost weight and body fat, while gaining fat-free mass like muscle. They also used less diabetes medication. The continuous diet group saw improvements in blood sugar control and resting energy expenditure, but the intermittent diet group did not show these specific changes. Importantly, there were no big differences between the two diets in terms of outcomes, except that more people dropped out of the continuous diet group (19% vs. 0% in the intermittent group). Safety concerns were not reported, but the higher dropout rate suggests the continuous diet might be harder to stick to.

This study has limitations because it was a post-hoc analysis, meaning it re-analyzed data from previous trials rather than being designed from the start to compare these diets. This makes the results less certain. Readers should know that both diets showed promise for short-term weight loss and health benefits in this small group, but we don't know if one is better long-term or for everyone. More research is needed to confirm these findings and understand the best approach for managing type 2 diabetes with diet.

What this means for you:
Two diets helped with weight loss in a small study, but more research is needed to know which is better.

Study Details

Study typeRct
Sample sizen = 41
EvidenceLevel 2
Follow-up3.0 mo
PublishedApr 2026
View Original Abstract ↓
BACKGROUND & AIMS: Various dietary approaches, such as continuous calorie-restricted (CCR) diets and, more recent, intermittent calorie-restricted (ICR) diets have demonstrated success in weight management and glycaemic control in people with type 2 diabetes. However, there are concerns about disproportionate decrease in fat-free mass (FFM) and consequently in resting energy expenditure (REE), with inconsistent results to date. Therefore, the aim of the present study was to evaluate the effects of a 3-month CCR diet and ICR diet on body composition and REE in people with type 2 diabetes and overweight or obesity. METHODS: In this post-hoc analysis of two ongoing trials (E-DIET and TIMED) in the Netherlands, we included people with type 2 diabetes and overweight or obesity that underwent a 3-month CCR diet (750 kcal per day) or ICR diet (eating window between 8AM and 6PM and 1300-1500 kcal per day). We measured differences in body composition, REE and glycaemic control over time within and (exploratively) between the groups. RESULTS: Sixty-seven participants (mean age 60 years; 56 % female; CCR: n = 41; ICR: n = 26) were included in the study. After three months, both interventions resulted in significant improvements in body composition, with a decrease in weight (CCR: 102.8 ± 17.1 kg to 97.7 ± 16.3 kg, p < 0.001; ICR: 107.3 ± 17.5 kg to 100.5 ± 15.2 kg, p < 0.001) and fat mass (CCR: 39.7 ± 7.7 % to 36.2 ± 7.8 %, p < 0.001; ICR: 38.5 ± 9.0 % to 35.8 ± 8.6 %, p < 0.001) while FFM increased (CCR: 59.6 ± 8.1 % to 64.9 ± 9.9 %, p = 0.001; ICR: 61.5 ± 9.1 % to 64.1 ± 8.7 %, p = 0.002). REE decreased significantly only in the CCR group (2006 ± 377 kcal to 1820 ± 348 kcal, p < 0.001). HbA1c decreased significantly from 61.0 [52.0-74.0] mmol/mol to 54.0 [43.0-66.0] mmol/mol, p = 0.028) in the CCR group, whereas a significant reduction in diabetes medication use (Medication Effect Score, MES) was seen in both groups (CCR: 2.41 [1.11-3.25] to 1.62 [0.62-2.36], p = 0.007; ICR: 0.38 [0.0-1.35] to 0.25 [0.0-0.67], p = 0.036), indicating improved diabetes control in both groups. No significant differences were observed between the two groups in all parameters except for dropout rate, which was 19 % for CCR and 0 % for ICR (p = 0.016). CONCLUSIONS: Both CCR and ICR improved body composition after three months in individuals with type 2 diabetes and overweight or obesity, without excessive fat-free mass loss. While direct comparison is limited by the post-hoc design, both diets appear promising, with a lower dropout rate in ICR suggesting greater feasibility. Further research should assess long-term effects and underlying mechanisms.
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