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Moderate calorie restriction improves cardiometabolic risk factors in healthy individuals
  1. Teck K Khong,
  2. James Kimpton
  1. Clinical Pharmacology, St George's University of London, London, UK
  1. Correspondence to Dr Teck K Khong, Clinical Pharmacology, St George's University of London, London, UK; tkhong{at}

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Commentary by: Dr James Kimpton and Dr Teck Khong Clinical Pharmacology, St George's, University of London, UK

Series Editor: Dr Teck Khong, DTB Associate Editor Clinical Pharmacology, St George's, University of London, UK

Commentary on: Kraus WE, Bhapkar M, Huffman KM, et al. 2 years of calorie restriction and cardiometabolic (CALERIE): exploratory outcomes of a multicentre, phase 2, randomised controlled trial. Lancet Diabetes Endocrinol 2019; 7: 673–83

Key learning points

  • A randomised controlled trial assessed the effect of 25% calorie restriction on multiple cardiometabolic risk factors in young and middle-aged, healthy non-obese adults.

  • The intervention group received intensive dietary and behavioural support and was followed up over 2 years.

  • Sustained adherence to calorie restriction was challenging with an average reduction of 12% (equivalent to 297 kcal/day) and a drop-out rate of 18% over 2 years.

  • Calorie restriction resulted in reductions in weight and blood pressure and improvements in various cardiometabolic risk factors.

  • Sustained moderate calorie restriction offers promise for long-term population health benefits.


The Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trial showed that in healthy non-obese young and middle-aged individuals, with clinically normal risk factors at baseline, 2 years of moderate calorie restriction with adequate nutrition led to improvements in multiple cardiometabolic risk factors.1

Study details

CALERIE was a 2-year randomised controlled trial conducted between 2007 and 2010 at three centres in the USA to evaluate the effects of a 25% calorie restriction in young and middle-aged (21–50 years) healthy non-obese (body mass index [BMI] 22.0–27.9 kg/m2) individuals.1 2 Almost 11 000 people volunteered for initial screening but approximately 58% were subsequently excluded …

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  • Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).

  • Provenance and peer review Commissioned; internally peer reviewed.