Johnson · Free radical biology & medicine 2007 · Uncontrolled before-and-after trial · n=10

Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma.

Cited 613 times in the scientific literature.

Level 4 - case-series / case-control

Uncontrolled single-arm before-and-after pilot trial

PubMed 17291990 · doi:10.1016/j.freeradbiomed.2006.12.005 · record verified 2026-08-30

What was done

Ten adults with BMI > 30 and moderate asthma followed an alternate-day calorie restriction (ADCR) regimen for 8 weeks, alternating between ad libitum eating days and restriction days (<20% of baseline caloric intake). Investigators evaluated asthma control, symptom scores, and quality of life (ACQ, ASUI, mini-AQLQ), daily morning peak expiratory flow (PEF), and pre- and post-bronchodilator spirometry at baseline and 8 weeks. Blood was analyzed for metabolic parameters (beta-hydroxybutyrate, leptin, lipids), oxidative stress markers (8-isoprostane, nitrotyrosine, protein carbonyls, 4-hydroxynonenal adducts), and inflammatory markers (TNF-alpha, BDNF).

What was found

Nine of the 10 participants completed the diet, losing an average of 8% of initial body weight. Asthma symptom scores, control, quality of life, and morning PEF improved significantly within 2 weeks and remained improved throughout 8 weeks (exact numerical values not reported in abstract). Pre- and post-bronchodilator spirometry did not change. Calorie restriction days showed increased beta-hydroxybutyrate and reduced leptin, alongside decreases in serum cholesterol, triglycerides, TNF-alpha, BDNF, and all measured oxidative stress markers, with an increase in uric acid.

Why it matters

This pilot study provides preliminary proof-of-concept that alternate-day fasting is feasible in overweight asthmatic individuals and may decrease systemic oxidative and inflammatory burden alongside weight loss.

Limits

The study is very small (n=10) and lacks a control group (such as standard continuous calorie restriction or standard care), precluding causal attribution of symptom improvements beyond placebo effect or non-specific weight loss. Spirometry showed no objective improvement. Long-term adherence and safety beyond 8 weeks were not evaluated.

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