Trial reportCell metabolism2023
Effect of alternate day fasting combined with aerobic exercise on non-alcoholic fatty liver disease: A randomized controlled trial.
Trial report in Cell metabolism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 16 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
102 citing papers in PubMed, 16 syntheses or guidelines pooled it, 147 citations in OpenAlex.
- Effects of Calorie Restriction With and Without Strength, Endurance or Mixed Training on Fat-Free and Skeletal Muscle Mass in Overweight or Obese Individuals-A Systematic Review With Pairwise Meta-Analysis and Network Meta-Analysis of Randomized Controlled Studies.Diabetes, obesity & metabolism · 2026Pooled it
- The impact of dietary interventions on liver health biomarkers in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD): a systematic literature review and meta-analysis of randomized controlled trials.European journal of nutrition · 2026Pooled it
- Optimal dosage of exercise combined with intermittent fasting for body composition and cardiometabolic health in adults: a systematic review and multilevel meta-analysis.Frontiers in nutrition · 2026Pooled it
- The impact of long-term exercise on liver function, fatty liver progression, and related metabolic markers in NAFLD patients: a meta-analysis of randomized controlled trials.Frontiers in nutrition · 2026Pooled it
- Comparative efficacy of different diet modalities on metabolic profiles and liver functions in metabolic dysfunction-associated fatty liver disease: a network meta-analysis.BMC gastroenterology · 2025Pooled it
- Pooled it
- Gut Microbiota and Liver Health: Meta-Analysis ofInternational journal of molecular sciences · 2025Pooled it
- Additional Effect of Exercise to Intermittent Fasting on Body Composition and Cardiometabolic Health in Adults With Overweight/obesity: A Systematic Review and Meta-analysis.Current obesity reports · 2025Pooled it
- Intermittent fasting strategies and their effects on body weight and other cardiometabolic risk factors: systematic review and network meta-analysis of randomised clinical trials.BMJ (Clinical research ed.) · 2025Pooled it
- Comparison of the impact of exercise training combined with dietary intervention vs. dietary intervention alone in patients with obesity and metabolic syndrome-a systematic review.Frontiers in nutrition · 2025Pooled it
- Aerobic Exercise and Weight Loss in Adults: A Systematic Review and Dose-Response Meta-Analysis.JAMA network open · 2024Pooled it
- Comparing caloric restriction regimens for effective weight management in adults: a systematic review and network meta-analysis.The international journal of behavioral nutrition and physical activity · 2024Pooled it
- Combined versus independent effects of exercise training and intermittent fasting on body composition and cardiometabolic health in adults: a systematic review and meta-analysis.Nutrition journal · 2024Pooled it
- Progress and hotspot of diet or exercise therapy in the treatment of non-alcoholic fatty liver disease.Frontiers in nutrition · 2024Pooled it
- EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Obesity facts · 2024Guideline
- The impacts of Ramadan fasting for patients with non-alcoholic fatty liver disease (NAFLD): a systematic review.Frontiers in nutrition · 2023Pooled it
- Flexible time-restricted eating combined with exercise in a free-living setting for middle-aged women with overweight/obesity: a randomized controlled trial.Nature communications · 2025Trial
- Effect of a ketogenic diet, time-restricted eating, or alternate-day fasting on weight loss in adults with obesity: a randomized clinical trial.BMC medicine · 2025Trial
- Circulating Proteomics Identifies a Dynamic Profile of Hepatic Steatosis During Metabolic Intervention.Journal of the American Heart Association · 2025Trial
- Trial
42 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
Innovative non-pharmacological lifestyle strategies to treat non-alcoholic fatty liver disease (NAFLD) are critically needed. This study compared the effects of alternate day fasting (ADF) combined with exercise to fasting alone, or exercise alone, on intrahepatic triglyceride (IHTG) content. Adults with obesity and NAFLD (n = 80, 81% female, age: 23-65 years) were randomized to 1 of 4 groups for 3 months: combination of ADF (600 kcal/2,500 kJ "fast day" alternated with an ad libitum intake "feast day") and moderate-intensity aerobic exercise (5 session per week, 60 min/session); ADF alone; exercise alone; or a no-intervention control group. By month 3, IHTG content was significantly reduced in the combination group (-5.48%; 95% CI, -7.77% to -3.18%), compared with the exercise group (-1.30%; 95% CI, -3.80% to 1.20%; p = 0.02) and the control group (-0.17%; 95% CI, -2.17% to 1.83%; p < 0.01) but was not significantly different versus the ADF group (-2.25%; 95% CI, -4.46% to -0.04%; p = 0.05). Body weight, fat mass, waist circumference, and alanine transaminase (ALT) levels significantly decreased, while insulin sensitivity significantly increased in the combination group compared with the control group. Lean mass, aspartate transaminase (AST), HbA1c, blood pressure, plasma lipids, liver fibrosis score, and hepatokines (fetuin-A, FGF-21, and selenoprotein P) did not differ between groups. Combining intermittent fasting with exercise is effective for reducing hepatic steatosis in patients with NAFLD but may offer no additional benefit versus fasting alone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.