Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects of Alternate Day Fasting and Exercise on Body Weight, Visceral Fat, and Metabolic Parameters in Overweight or Obese Adults: A Randomized Controlled Trial
Brief Summary: Alternate day fasting is known to be helpful to control weight and have a positive effect on insulin resistance and cardiovascular risk factors. However, there have been no studies on weight reduction program combining alternate day fasting with exercise which preserves lean mass in Korea. The purpose of this randomized clinical trial is to examine the effects of alternate day fasting and exercise on weight reduction, visceral fat, and metabolic parameters in overweight or obese adults.


Options:
A: Inclusion Criteria:

* Age between 18 to 65 years old
* BMI between 30.0 and 49.9 kg/m2
* Previously sedentary or lightly active

Exclusion Criteria:

* Diabetic
* History of binge eating disorder
* Taking weight loss-inducing medications
* Not weight stable for 3 months prior to the study (weight gain or loss \> 4 kg)
* Perimenopausal or have an irregular menstrual cycle (menses that does not appear every 27-32 days)
* Pregnant or trying to become pregnant
* Night shift worker
* Smokers
B: Inclusion Criteria:

* Females;
* Aged between 18 and 59 years old;
* Body mass index equal or greater 25 kg/m²;
* Agree to sign the informed consent.

Exclusion Criteria:

* Any chronic health conditions (e.g. chronic renal failure, autoimmune, heart, and liver disease);
* Thyroid diseases or medications for its treatment;
* Medications known to affect total energy expenditure;
* Use of steroids, immunosuppressants or non-steroidal anti-inflammatory drugs, weight-loss medications, oral hypoglycemic agents or insulin and any medications that influence metabolic and/or inflammatory parameters;
* Previous surgery for weight loss;
* Pregnancy or breast-feeding;
* Smoking;
* Alcohol use (\>2 doses/day).
C: Inclusion Criteria:

* Men and women with overweight and class I obesity (N=12, Age=20-50 years; BMI 25-35 kg/m2)
* Low physical activity level (≤150 min/wk of moderate-to-vigorous activity);
* For Females- Not currently pregnant or lactating and not pregnant within the past 6 months
* Habitually consume food over a window of \>12 h/day;
* Pass a medical and physical screening performed by the study physician.
* Report a habitual, regular sleep-wake cycle for the month preceding screening that involved going to bed between 2200 and 0100h and getting up between 0600 and 0900 h with \>7 h and \<9.25 h in bed;
* Agree to eat control diets at imposed times for 1 week prior to the inpatient CTRC visits;
* Agree to keep a regular sleep/wake schedule for the duration of the study
* Possess a smart phone to install and utilize the meal timing application.

Exclusion Criteria:

* Subjects must not be currently participating in another research study that would influence their safe participation in this study. For example, subjects must not be participating in a research study in which they ingest experimental medication, or which involves blood samples, since both of these factors could increase risk of participation;
* Being considered unsafe to participate as determined by the study physician;
* Taking medications affecting weight, triglycerides, energy intake/energy expenditure, or sleep in the last 3 months;
* Having abnormal blood chemistry and/or hematology as deemed significant by the study physician;

  o Have one or more of the following out-of-range values measured on a fasting blood sample: glucose \> 126 mg/dl, HbA1c \> 6.5%, thyroid stimulating hormone \<0.5 or \>5.0 uU/ml. Subjects who may be anemic (hemoglobin \<14.5 g/dl men, \<12.3 g/dl women), have abnormal liver function tests (alanine amino transferase \> 47 U/l, aspartate aminotransferase, \> 47 U/l, alkaline phosphatase \<39 or \>117 U/l) or creatinine (\>1.1 mg/dl)
* Significant abnormality in clinical laboratory values
* Ever having a history of systemic, psychiatric, neurological disease, or drug and alcohol abuse;
* History of cardiovascular disease, diabetes, uncontrolled hypertension, untreated thyroid, renal, hepatic diseases, dyslipidemia or any other medical condition affecting weight or lipid metabolism;
* Score \> 18 on Beck Depression Index (BDI) will require further assessment by the study physician to determine if it is appropriate for the subject to participate in the study;
* Use of a continuous positive airway pressure (CPAP) device for the treatment of obstructive sleep apnea (OSA). A score of \>10 on the Epworth sleepiness scale or \>5 on the Pittsburgh Sleep Quality Index will require further assessment by the study physician to determine if it is appropriate for the subject to participate in the study;
* Being positive for human immunodeficiency virus or hepatitis B or C;
* Being a smoker or having been a smoker in the previous 6 months;
* Abnormal eating patterns identified by registered dietician interview (dietary fat\<15%, dietary fat\>45%, dietary protein \>30%);
* Working night shifts;
* Night eating syndrome (at least 25% of food intake is consumed after the evening meal and/or at least two episodes of nocturnal eating per week);
* Traveling \> 2 time zones 2 weeks prior to an inpatient CTRC study visit;
* Currently participating in any formal weight loss or physical activity programs or clinical trials.
* Having a clinically significant allergy (e.g., to food stuffs such as shellfish, peanuts);
* Celiac disease or known sensitivity to gluten (the metabolic kitchen is not gluten free certified and cannot accommodate this dietary restriction)
D: Inclusion Criteria:

* Age 20-65 years
* Body mass index (BMI) more than 23.0 kg/m² (overweight or obese for Asian populations, according to the World Health Organization)

Exclusion Criteria:

* Participants with weight gain more than 5kg in the last 3 months
* Participants with history of bariatric surgery
* Participants with secondary obesity, such as hypothyroidism
* Participants with uncontrolled hypertension or type 1 diabetes
* Participants who are taking anti-diabetic medications due to type 2 diabetes
* Participants with hepatic disease (AST or ALT ≥200 mg/dL)
* Participants with renal disease (serum creatinine ≥2.0 mg/dL)
* Participants with pancreatitis or related disorders
* Participants with acute infectious diseases (i.e., pneumonia, acute enteritis, or urinary infection)
* Participants with chronic inflammatory diseases (i.e., rheumatoid arthritis, or lupus)
* Participants with overeating behavior
* Participants with history of cardiovascular diseases
* Participants with history of cancer
* Participants who are taking anti-obesity, anti-diabetic, diuretic, central-nervous system, antidepressant, antipsychotic, or steroid medications
* Pregnant or lactating women
* Participants who intake more than 30 g of alcohol daily
* Night-time or shift-work workers
* Participants with chronic malabsorption syndrome or cholestasis
* Participants with other medical conditions that would preclude subjects from participating in exercise and physical test

Answer: D