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Diabetes, Cardiovascular Risks, and Lipoproteins · Journal article
Frontiers in Nutrition · September 9, 2026
Encouraging direction, but not yet definitive.
In 35 obese adults, a 62-day phased alternate-day modified fasting intervention reduced body weight by 7.02% but was accompanied by loss of lean mass (22.68% of total weight loss) and transient hyperuricemia (8.85% increase, P = 0.047) during the intensive phase. The elevation in uric acid correlated with concurrent soft lean mass loss, raising safety concerns that require investigation in larger, controlled trials.
Single-arm uncontrolled observational trial. Adults with obesity: 20 males, 15 females; mean age 36.23 ± 8.98 years; baseline body weight 100.02 ± 16.89 kg; baseline BMI 35.47 ± 4.15 kg/m². Setting and specific eligibility criteria beyond obesity not detailed.. Intervention: Alternate day modified fasting (ADMF) in two phases: 32-day high-controlled fasting phase followed by 30-day low-controlled fasting phase. Specific caloric or macronutrient targets not detailed in source.. n = 35. China (inferred from description of Chinese population; specific centre(s) not named)..
Body weight decreased by −6.83 ± 4.26 kg (−7.02%, P < 0.001) over 62 days Fat free mass loss represented 22.68% of total weight loss during the full intervention Uric acid increased transient by +27.30 ± 79.60 μmol/L (+8.85% from baseline, P = 0.047) during high-controlled fasting phase
Follow-up limited to 62 days; no long-term safety or efficacy data beyond 2 months.
The findings suggest that while alternate-day modified fasting can achieve weight loss, the loss of lean muscle mass and transient hyperuricemia raise safety concerns that warrant monitoring and investigation of muscle-preserving modifications before widespread clinical adoption.
A single-centre, uncontrolled 62-day trial in a small Chinese population showing weight loss with concerning transient hyperuricemia and muscle loss; results are real but require confirmation in larger, controlled studies with longer follow-up.
As stated by the source record.
Quoted from the source exactly as published.
The findings suggest that while alternate-day modified fasting can achieve weight loss, the loss of lean muscle mass and transient hyperuricemia raise safety concerns that warrant monitoring and investigation of muscle-preserving modifications before widespread clinical adoption.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background Obesity has become a significant contributor to non-communicable diseases worldwide, making it imperative to explore effective weight-loss methods. Alternate day modified fasting (ADMF) has emerged as a popular approach, but its effects on uric acid (UA) dynamics and body composition in Chinese populations remain unclear. This study aimed to investigate whether ADMF could change body composition and cardiometabolic parameters in individuals with obesity, and to analyze the correlation between changes in body composition indices and UA levels. Methods A total of 35 adults were recruited and completed a 62-day trial, which consisted of a 32-day high-controlled fasting phase (HCFP) and a 30-day low-controlled fasting phase (LCFP). Body composition was measured by bioelectrical impedance analysis, and blood pressure (BP) and metabolic parameters were assessed at baseline, day 16, day 32, and day 62. Results Of the 35 participants (20 males, 15 females; mean age 36.23 ± 8.98 years; baseline body weight 100.02 ± 16.89 kg; baseline BMI 35.47 ± 4.15 kg/m 2 ), body weight decreased significantly over the entire 62-day ADMF intervention (absolute loss: −6.83 ± 4.26 kg; −7.02%, P < 0.001). The proportion of total weight loss attributable to fat free mass (FFM) was 22.68%. During HCFP, weight decreased by −6.38% (absolute loss: −6.29 ± 3.11 kg, P < 0.001), with significant reductions in body fat mass (BFM, −11.14%, P < 0.001), FFM (−3.32 %, P < 0.001), visceral fat area (VFA, −13.10%, P < 0.001), and waist circumference (WC, −5.35%, P < 0.001). However, significant losses in soft lean mass (SLM; −3.40%, P < 0.001) and fat free mass (FFM; −3.32%, P < 0.001) were observed during HCFP, with partial improvement during LCFP (SLM: +0.73%, P = 0.031; FFM: +0.78%, P = 0.022). A transient but significant increase in UA occurred during HCFP (+27.30 ± 79.60 umol/L, +8.85% from baseline, P = 0.047), which subsequently decreased during LCFP (−33.70 ± 72.48 μmol/L, −6.67% from Day 32 to Day 62, P = 0.012). This UA elevation was correlated with concurrent loss of SLM ( r = −0.340, P = 0.025). Conclusion A phased ADMF intervention was associated with effective reduction in adiposity and improvement in cardiometabolic risk factors. However, the transient hyperuricemia and lean muscle loss during the intensive phase suggest that UA monitoring and muscle-preserving strategies may be considered to optimize the safety and efficacy of ADMF protocols.
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