Fasting every other day doesn't lead to bigger weight loss than daily calorie-cutting—and is more difficult to maintain, a new study says.

This popular alternate-day diet is a type of intermittent fasting, which involves drastically reducing your calorie intake on some days (or during certain hours) and eating whatever you like on others. The theory is that it is easier to focus on eating fewer calories only some of the time, while the eating pattern improves cardiovascular risk factors, such as blood pressure, cholesterol, and insulin levels, more than daily calorie cutting.

The new study, from researchers at the University of Illinois at Chicago and published today in JAMA Internal Medicine, followed 100 obese people for a year, making it the largest and longest study to examine alternate-day fasting so far.  

Those who followed this intermittent fasting approach lost the same amount of weight, on average, as those who cut back on calories every day. Both groups dropped about 7 percent of their body weight after six months and regained about 1 percent of their weight during the following six-month weight maintenance phase.

“We can say that alternate-day fasting does produce clinically significant weight loss after a year, but it’s not better than a typical calorie-restricted diet,” says Krista A. Varady, Ph.D., associate professor of nutrition at the University of Illinois at Chicago and one of the study researchers.

“Alternate-day fasting gives you a break from dieting every day, which we thought people would like,” Varady says. It turns out, though, that it's a difficult diet regimen to stick to, she says.

Thirty-eight percent of the alternate-day fasters dropped out, compared with 29 percent of the regular dieters. And about half of the alternate-day eaters ended up downing more calories on their fasting days and fewer on the “feasting” days, which means they essentially followed the same plan as the regular dieters.

Does Intermittent Fasting Improve Health?

Cardiovascular disease risk factors—inflammatory markers and insulin, cholesterol, and blood pressure levels—which usually improve with weight loss, were similar in both groups as well, except for "bad" cholesterol (low-density lipoprotein, or LDL) levels, which were significantly higher in the fasters after a year.

“We did have a subgroup of people who had pre-diabetes, and they saw bigger improvements in insulin resistance, inflammatory factors, and triglyceride levels with alternate-day fasting,” says Varady, who hopes to explore that further in a future study. 

The Best Diet Is the One You’ll Stick With

Low-carb, high-fat, high-protein, alternate-day fasting—how do you know which type of diet will work for you?

“They can all work,” says researcher Marie-Pierre St-Onge, Ph.D., associate professor of nutritional medicine at Columbia University in New York City. “If it’s a diet that helps you feel full and less deprived, and it’s something you can adhere to, you should be able to lose weight.” Here are some other ways to get your eating plan to stick:

Play to your strengths. Alternate-day fasting may be a good plan for some people. “It doesn’t work well with people who are frequent snackers, but those who routinely go 5 or 6 hours without eating tend to do well with it,” Varady says. Find what suits your lifestyle and preferences.

Eat more veggies and fruits. In addition to being packed with health-promoting nutrients, veggies and fruits add bulk to your plate, so you feel like you’re eating more food but without the calories, St-Onge says.

Know your triggers. “Be aware of when, where, and why you’re susceptible to overeating,” St-Onge says. “We eat for so many reasons other than hunger, so stop and ask yourself why you want to eat right now.” Being mindful of your hunger level can also help you avoid subconscious cues to eat more, such as larger plates, “healthy” language on food labels, and watching television or surfing the web while eating.

Add protein if you decide to try intermittent fasting. Try to get 50 to 70 grams of protein on your fast day, which will help you feel fuller longer, Varady says. The current recommended dietary allowance for protein is 0.36 grams per pound of body weight. (That’s 56 grams of protein per day for a 155-pound person.)

Don’t drink your calories. Beverages are often high in calories, but liquids such as sodas, juices, and coffee drinks don’t register in the brain the same way solid foods do, so you don’t feel as full and you end up eating more, St-Onge says. Opt for water, black coffee, or unsweetened tea and chew your calories instead.

Front-load your meals. A study in the American Journal of Clinical Nutrition found that obese women who ate the bulk of their daily calories (50 percent) at lunch lost 3 pounds more over the 12-week study period than those who ate most of their calories at dinner. We need more research looking at meal timing, but it may have cardiovascular benefits in addition to helping with weight loss.