New obesity treatment: Fasting, exercise and low carb diet - The NOT-FED study

Due to high rates of obesity in Canada, weight loss is an important primary care challenge. Recent innovations in strategies include intermittent fasting and low-carbohydrate diets, with limited research in a rural setting.

This prospective 1-year observational study provided patients in Sioux Lookout, Northwestern Ontario with information on fasting and low-carbohydrate diets. Patients were recommended to attend every 3 months for measurements of weight, waist circumference, body mass index (BMI) and blood pressure. Initial and 6-month bloodwork included A1c and Lipids. A survey of health status and diet was administered at 6 months.

Of the 94 initial registrants, 36 participants completed 1 year and achieved a 9% weight loss and an 8.6% decrease in BMI and waist circumference. Most participants were female with an average age of 60 years. Clinically insignificant changes in blood pressure and serology were observed. Participants reported few side effects and good compliance with intermittent fasting, averaging 15 h/day, 6 days/week. As in other dietary studies, the dropout rate was high at 62%.

This low-resource initiative was successful in assisting self-selected patients at a rural primary care clinic to achieve significant weight loss at 1-year. This approach is practical and is fertile ground for ongoing research.