Severely restricting energy intake for 24 h does not affect markers of bone metabolism at rest or in response to re-feeding

Clayton, D.J. ORCID: 0000-0001-5481-0891, James, L.J., Sale, C. ORCID: 0000-0002-5816-4169, Templeman, I., Betts, J.A. and Varley, I. ORCID: 0000-0002-3607-8921, 2020. Severely restricting energy intake for 24 h does not affect markers of bone metabolism at rest or in response to re-feeding. European Journal of Nutrition. ISSN 1436-6207

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Intermittent energy restriction commonly refers to ad libitum energy intake punctuated with 24 h periods of severe energy restriction. This can improve markers of metabolic health but the effects on bone metabolism are unknown. This study assessed how 24 h severe energy restriction and subsequent refeeding affected markers of bone turnover.


In a randomised order, 16 lean men and women completed 2, 48 h trials over 3 days. On day 1, participants consumed a 24 h diet providing 100% [EB: 9.27 (1.43) MJ] or 25% [ER: 2.33 (0.34) MJ] of estimated energy requirements. On day 2, participants consumed a standardised breakfast (08:00), followed by an ad libitum lunch (12:00) and dinner (19:30). Participants then fasted overnight, returning on day 3. Plasma concentrations of C-terminal telopeptide of type I collagen (CTX), procollagen type 1 N-terminal propeptide (P1NP) and parathyroid hormone (PTH) were assessed as indices of bone metabolism after an overnight fast on days 1–3, and for 4 h after breakfast on day 2.


There were no differences between trials in fasting concentrations of CTX, P1NP or PTH on days 1–3 (P [greater than] 0.512). During both trials, consuming breakfast reduced CTX between 1 and 4 h (P [less than] 0.001) and PTH between 1 and 2 h (P [less than] 0.05), but did not affect P1NP (P = 0.773) Postprandial responses for CTX (P = 0.157), P1NP (P = 0.148) and PTH (P = 0.575) were not different between trials. Ad libitum energy intake on day 2 was greater on ER [12.62 (2.46) MJ] than EB [11.91 (2.49) MJ].


Twenty-four hour severe energy restriction does not affect markers of bone metabolism.

Item Type: Journal article
Publication Title: European Journal of Nutrition
Creators: Clayton, D.J., James, L.J., Sale, C., Templeman, I., Betts, J.A. and Varley, I.
Publisher: Springer Science and Business Media LLC
Date: 3 February 2020
ISSN: 1436-6207
Rights: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Divisions: Schools > School of Science and Technology
Record created by: Jill Tomkinson
Date Added: 18 Feb 2020 16:07
Last Modified: 18 Feb 2020 16:07

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