{"doi":"10.3390/nu13010211","title":"Alternate Day Fasting Combined with a Low Carbohydrate Diet: Effect on Sleep Quality, Duration, Insomnia Severity and Risk of Obstructive Sleep Apnea in Adults with Obesity","abstract":"<jats:p>Background: Alternate day fasting combined with a low carbohydrate diet (ADF-LC) is an effective weight loss regimen. Whether the weight loss induced by ADF-LC can improve sleep, remains unknown. Objective: This study examined the effect an ADF-LC diet on sleep quality, duration, insomnia severity and the risk of obstructive sleep apnea. Methods: Adults with obesity (n = 31) participated in ADF (600 kcal “fast day”; ad libitum intake “feast day”) with a low-carbohydrate diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period. Results: Reductions in body weight (−5 ± 1 kg, p &lt; 0.001) and fat mass (−4 ± 1 kg, p &lt; 0.01) were noted during the weight loss period, and these reductions were sustained during the weight maintenance period. Lean mass and visceral fat remained unchanged. The Pittsburgh Sleep Quality Index (PSQI) score indicated poor sleep quality at baseline (6.4 ± 0.7) with no change by month 3 or 6, versus baseline. ISI score indicated subthreshold insomnia at baseline (8.5 ± 1.0), with no change by month 3 or 6, versus baseline. The percent of subjects with high risk of obstructive sleep apnea at baseline was 45%, with no change by month 3 or 6. Wake time, bedtime, and sleep duration remained unchanged. Conclusion: The ADF-LC diet does not impact sleep quality, duration, insomnia severity or the risk of obstructive sleep apnea in adults with obesity.</jats:p>","journal":"Nutrients","year":2021,"id":616122,"datarank":0.48283137373023016,"base_score":3.2188758248682006,"endowment":3.2188758248682006,"self_citation_contribution":0.48283137373023016,"citation_network_contribution":0.0,"self_endowment_contribution":0.48283137373023016,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":24,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":225431,"name":"Kelsey Gabel","orcid":"0000-0003-4613-8892","position":1,"is_corresponding":false},{"id":225430,"name":"Sofia Cienfuegos","orcid":"0000-0002-2225-527X","position":2,"is_corresponding":false},{"id":225433,"name":"Mark Ezpeleta","orcid":"0000-0002-0746-2414","position":3,"is_corresponding":false},{"id":225434,"name":"Eric Wiseman","orcid":"0000-0001-6823-5066","position":4,"is_corresponding":false},{"id":1588340,"name":"Krista A. Varady","orcid":null,"position":5,"is_corresponding":false},{"id":225432,"name":"Faiza Kalam","orcid":"0000-0003-4326-4009","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Alternate Day Fasting Combined with a Low Carbohydrate Diet: Effect on Sleep Quality, Duration, Insomnia Severity and Risk of Obstructive Sleep Apnea in Adults with Obesity","abstract":"<jats:p>Background: Alternate day fasting combined with a low carbohydrate diet (ADF-LC) is an effective weight loss regimen. Whether the weight loss induced by ADF-LC can improve sleep, remains unknown. Objective: This study examined the effect an ADF-LC diet on sleep quality, duration, insomnia severity and the risk of obstructive sleep apnea. Methods: Adults with obesity (n = 31) participated in ADF (600 kcal “fast day”; ad libitum intake “feast day”) with a low-carbohydrate diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period. Results: Reductions in body weight (−5 ± 1 kg, p &lt; 0.001) and fat mass (−4 ± 1 kg, p &lt; 0.01) were noted during the weight loss period, and these reductions were sustained during the weight maintenance period. Lean mass and visceral fat remained unchanged. The Pittsburgh Sleep Quality Index (PSQI) score indicated poor sleep quality at baseline (6.4 ± 0.7) with no change by month 3 or 6, versus baseline. ISI score indicated subthreshold insomnia at baseline (8.5 ± 1.0), with no change by month 3 or 6, versus baseline. The percent of subjects with high risk of obstructive sleep apnea at baseline was 45%, with no change by month 3 or 6. Wake time, bedtime, and sleep duration remained unchanged. Conclusion: The ADF-LC diet does not impact sleep quality, duration, insomnia severity or the risk of obstructive sleep apnea in adults with obesity.</jats:p>","is_dataset_classified":null,"base_score":3.2188758248682006,"endowment":3.2188758248682006,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"33450908","pmcid":"PMC7828375","openalex_id":"https://openalex.org/W3119889025","authors":[],"funders":[{"funder_name":"Nestlé Health Science","grant_id":"NA","title":null},{"funder_name":"NCI NIH HHS","grant_id":"T32 CA193193","title":null}],"total_grants":2,"fwci":2.0559,"citation_percentile":0.86787918,"influential_citations":0,"citation_trend":[{"year":2021,"count":2},{"year":2022,"count":3},{"year":2023,"count":7},{"year":2024,"count":6},{"year":2025,"count":5},{"year":2026,"count":1}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.mdpi.com/2072-6643/13/1/211/pdf?version=1610528967","host_type":"journal"},{"url":"https://www.mdpi.com/2072-6643/13/1/211/pdf?version=1610528967","host_type":"publisher"},{"url":"https://www.mdpi.com/2072-6643/13/1/211/pdf","host_type":"publisher"},{"url":"https://doi.org/10.3390/nu13010211","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/33450908","host_type":"repository"},{"url":"https://doaj.org/article/6b68042ceb7a4aa7bfde32ab21f533e3","host_type":"repository"},{"url":"http://europepmc.org/pmc/articles/PMC7828375","host_type":"repository"},{"url":"https://dx.doi.org/10.3390/nu13010211","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/7828375","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC7828375","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC7828375?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Diet and metabolism studies","Dietary Effects on Health","Sleep and related disorders"],"mesh_terms":["Adolescent","Adult","Aged","Body Composition","Body Weight","Disease Susceptibility","Fasting","Female","Humans","Sleep Initiation and Maintenance Disorders","Male","Middle Aged","Obesity","Risk Factors","Sleep","Time Factors","Weight Loss","Exercise","Risk Assessment","Sleep Apnea, Obstructive","Diet, Carbohydrate-Restricted","Young Adult"],"keywords":["Medicine","Insomnia","Weight loss","Obesity","Obstructive sleep apnea","Body mass index","Internal medicine","Pittsburgh Sleep Quality Index","Bedtime","Sleep apnea","Apnea","Endocrinology","Sleep quality","Psychiatry","Intermittent Fasting","Low Carbohydrate Diet","Alternate Day Fasting"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-02T22:00:32.789062Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}