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

ObjectiveWe 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 MethodsThis 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.ResultsThe 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.ConclusionsThese 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.</p