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This study investigates a novel dietary approach called Intermittent Carbohydrate Restriction (ICR), which involves reducing carbohydrate intake on selected days of the week while allowing habitual eating on other days. Previous research suggests that intermittent dietary strategies may improve metabolic health and support better adherence compared to continuous calorie restriction.
In this single-arm feasibility study, 40 healthy adults will follow the ICR protocol for 4 weeks. Outcomes including body weight, body fat percentage, waist circumference, and resting metabolic rate will be measured before and after the intervention. Dietary adherence, changes in habitual intake, and participant experiences will be assessed through food diaries, 24-hour recalls, questionnaires, and exit interviews.
The primary aim is to evaluate the acceptability and adherence to the ICR protocol in free-living conditions. Secondary aims include exploring its effects on body composition and diet-related behaviours, with the goal of informing future long-term dietary interventions.
Intermittent energy restriction (IER) has shown to improve postprandial metabolic systems and cognitive function, with superiority in dietary adherence compared with continuous energy restriction (CER)(1-3). A gap in current research is the impact of intermittent carbohydrate restriction (ICR) compared with IER in line with the carbohydrate-insulin model. Novel research (UEC 2019 008 FHMS) has explored the acute effects of ICR on postprandial metabolic systems and found engagement of the same underlying mechanisms with superior outcomes in glucose and lipid metabolism, compared with IER. Unpublished data supports the superiority of ICR over IER in dietary adherence due to perceived increased flexibility and reduced restrictions. However, a novel intermittent carbohydrate restricted diet has not been studied chronically, specifically exploring effects adherence and compliance on free living condition and its effect on body composition and food preference. This study primarily aims to explore the acceptability and compliance to ICR, and secondarily aims to explore its effect on behaviour change and body composition in free living condition in health adults. 40 participants (female and male) will follow a single arm novel intermittent carbohydrate diet protocol for 4 weeks. Weight, height, body fat %, waist circumference and resting energy expenditure values will be measured before and after the intervention. Compliance and the effects of dieting on the habitual food intake will be measured using food diaries and 24hr food recalls. Perceptions of participants' towards ICR and their experiences of dieting will be measured using questionnaires and an exit interview. This study will provide vital information for implementing flexible and adaptable dieting strategy, which can provide improvements to physical health in the long-term.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single-Arm Intermittent Carbohydrate Restriction Intervention | Experimental | Participants in this single-arm feasibility study will follow a structured intermittent carbohydrate restriction (ICR) dietary protocol for four weeks. The ICR approach includes two non-consecutive low-carbohydrate days (≤40g/day) and five habitual eating days per week. The intervention is designed to assess dietary adherence, acceptability, and impact on body composition and food preferences in free-living healthy adults. Data will be collected through anthropometric measurements, dietary assessments (food diaries and 24-hour recalls), and participant-reported outcomes via questionnaires and exit interviews. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intermittent Carbohydrate Restriction (ICR) Protocol | Behavioral | A novel intermittent carbohydrate restriction (ICR) protocol involving two consecutive low-carbohydrate days (approximately 10% total energy from carbohydrate) followed by five non-restricted days per week, sustained over a 4-week period. Participants receive individualised dietary guidance and support materials to promote adherence in free-living conditions |
| Measure | Description | Time Frame |
|---|---|---|
| Adherence to the ICR protocol | Assessed quantitatively as the proportion of participants who successfully follow the prescribed dietary regimen (≥75% of prescribed LC-Ds completed over 4 weeks), measured through 24-hour recalls. | Throughout the 4-week intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Change in body weight (kg) | Measured before and after the 4-week intervention using standard anthropometric techniques. | Baseline (Week 1) and Week 4 (Final study day) |
| Changes in resting energy expenditure (kcal/day) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kevin Wells, Dr | University of Surrey | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Surrey | Guildford | Surrey | GU2 7XH | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40111529 | Background | Biyikoglu H, Robertson MD, Collins AL. Isolating the acute metabolic effects of carbohydrate restriction on postprandial metabolism with or without energy restriction: a crossover study. Eur J Nutr. 2025 Mar 20;64(3):133. doi: 10.1007/s00394-025-03646-5. | |
| 41536043 | Derived | Biyikoglu H, Tse YT, Ding R, Mold FE, Collins AL. Exploring Adherence and Acceptability of an Intermittent Carbohydrate Restriction Regime (ICARB) in Free-Living Adults: A Feasibility Study. J Hum Nutr Diet. 2026 Feb;39(1):e70188. doi: 10.1111/jhn.70188. |
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| ID | Term |
|---|---|
| D002985 | Clinical Protocols |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D016020 | Epidemiologic Study Characteristics |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
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single-arm feasibility study
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Assessed via indirect calorimetry before and after the intervention. Includes respiratory quotient (RQ) as a metabolic indicator.
| Baseline (Week 1) and Week 4 (Final study day) |
| Change in daily energy intake (kcal/day) | Assessed via food diaries and 24-hour dietary recalls. | Baseline (Week 1) and Week 4 (Final study day) |
| Participant experiences with the ICR intervention (qualitative interview) | Exploratory assessment of participants' behavioral and psychological responses to the ICR intervention, including perceived changes in food preferences and attitudes toward carbohydrate-containing foods . Data will be collected via semi-structured exit interviews and analysed using thematic analysis. | Week 4 (final study day) |
| Change in body fat percentage (%) | Measured before and after the 4-week intervention using [method, e.g., bioelectrical impedance](streamdown:incomplete-link) | Baseline (Week 1) and Week 4 (Final study day) |
| Change in waist circumference (cm) | Measured before and after the 4-week intervention at the midpoint between the iliac crest and lowest rib. | Baseline (Week 1) and Week 4 (Final study day) |
| Change in respiratory quotient (VCO₂/VO₂) | Assessed via indirect calorimetry before and after the intervention. | Baseline (Week 1) and Week 4 (Final study day) |
| Change in macronutrient distribution (% total energy intake) | Assessed via food diaries and 24-hour dietary recalls. | Throughout the 4-week intervention |
| Change in micronutrient distribution (% total energy intake) | Assessed via food diaries and 24-hour dietary recalls. | Throughout the 4-week intervention |
| Change in vegetable intake (servings/day) | Assessed via food diaries and 24-hour dietary recalls. | Throughout the 4-week intervention |
| Change in oily fish intake (g/week) | Assessed via food diaries and 24-hour dietary recalls. | Throughout the 4-week intervention |
| D017530 | Health Care Quality, Access, and Evaluation |