CARDIOVASCULAR disease (CVD) remains a leading global cause of illness and death, with excess weight a major contributing risk factor. Dietary strategies such as intermittent fasting and calorie restriction are increasingly recommended to improve cardiovascular health, yet direct comparisons between these approaches in real-world settings have been limited.
A new longitudinal cohort study compared the cardiovascular effects of a 5:2 intermittent fasting (IF) regimen with traditional daily calorie restriction (CR) in adults with overweight or obesity. The findings offer useful insights for healthcare professionals advising patients on sustainable dietary interventions.
Real-World Data From Adults With Overweight and Obesity
The study drew on data from the Iranian National Obesity Registry and included 82 adults, most of whom were women, with an average age of 36 years. Participants followed either a 5:2 IF plan (consuming 500–600 kcal on two non-consecutive fasting days per week) or a daily calorie restriction plan with a 500–1000 kcal energy deficit.
Over a three-month period, researchers assessed a range of cardiovascular risk markers, including blood pressure, lipid profiles, blood glucose measures, and long-term cardiovascular risk scores.
Intermittent Fasting Shows Modest Advantages
Both dietary approaches led to meaningful improvements in cardiovascular parameters. Mean arterial pressure and rate-pressure product, indicators of cardiac workload, declined significantly in both groups by week 12. These findings suggest that reducing overall calorie intake, regardless of method, can positively affect heart health.
However, participants following 5:2 intermittent fasting showed greater improvements in some key measures. Compared with the calorie restriction group, the IF group had significantly lower systolic blood pressure, pulse pressure, and 30-year Framingham cardiovascular risk scores. Triglyceride levels also fell significantly only in the intermittent fasting group.
Importantly, other metabolic markers, including cholesterol fractions and glycaemic indices, improved similarly in both groups, with no statistically significant differences.
What This Means for Clinical Practice
For healthcare professionals, these findings suggest that intermittent fasting and calorie restriction are both effective options for improving short-term cardiovascular health in adults with overweight or obesity. The 5:2 intermittent fasting approach may offer additional benefits for blood pressure control and long-term cardiovascular risk, which could be relevant for patients at elevated CVD risk.
However, the authors note that the study was relatively small and short in duration. Larger, longer-term trials are needed to confirm whether these differences translate into sustained cardiovascular benefit.
In practice, dietary choice should be individualised. Factors such as patient preference, adherence, lifestyle compatibility, and comorbidities remain central when recommending intermittent fasting or calorie restriction as part of a heart-healthy weight management plan.
Reference
Abdollahpour N et al. Comparative effects of intermittent fasting and calorie restriction on cardiovascular health in adults with overweight or obesity. Sci Rep. 2025; DOI:10.1038/s41598-025-32673-9.
