Research Presented At ENDO 2025 Shows IER Offers Metabolic Advantages

New research presented at the Endocrine Society’s annual meeting (ENDO 2025) in San Francisco has found that intermittent energy restriction (IER) may be more effective than other dietary approaches for managing type 2 diabetes in people with obesity.

The study compared IER with time-restricted eating (TRE) and continuous energy restriction (CER), all known strategies to improve metabolic health.

Led by Dr Haohao Zhang, chief physician at The First Affiliated Hospital of Zhengzhou University, China, the study involved 90 adults with type 2 diabetes and obesity, randomly assigned to one of the three diet plans.

Trained nutritionists monitored all participants over 16 weeks, ensuring a consistent weekly calorie intake.

The results showed that all three groups improved in HbA1c levels and weight loss. However, the IER group recorded the greatest reductions in fasting blood glucose and triglycerides. They also showed marked improvement in whole-body insulin sensitivity, measured by the Matsuda index.

IER typically involves scheduled periods of reduced calorie intake and differs from intermittent fasting (IF), which often includes complete or near-complete food abstinence.

The version studied here followed a 5:2 pattern, two non-consecutive days per week of calorie restriction.

Study design & key findings

• Of the 90 enrolled, 63 completed the study; 45 men, 18 women.
• The average age was 36.8 years, with a baseline BMI of 31.7 kg/m².
• The IER group saw the highest adherence rate at 85%, compared to 84% in CER and 78% in TRE.
• Mild hypoglycaemia occurred in two patients each in the IER and TRE groups, and three in the CER group.

Liver enzymes and uric acid levels remained unchanged across all groups.

Dr Zhang highlighted the clinical value of these findings, stating, “This study provides robust scientific evidence to help clinicians tailor dietary strategies for patients with obesity and type 2 diabetes.”

He added that the strong adherence rates in the IER group suggest it is a feasible and sustainable approach.

With rising rates of obesity and type 2 diabetes globally, dietary interventions like IER may offer a practical and effective solution.

As research continues, strategies that combine metabolic benefit with real-world adherence could become key tools in diabetes care.

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