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In a randomized trial of 187 adults with obesity, participants assigned to intermittent fasting lost more weight than those receiving standard care, and combining fasting with supervised exercise also improved body-fat outcomes. The program did not produce a statistically significant greater reduction in liver fat than standard care, and the short-term weight and body-composition differences were no longer detectable one year later.
A 12-week randomized trial involving 187 adults with obesity found that intermittent fasting, including when paired with supervised exercise, was associated with greater weight loss than standard care, while the combined program also reduced body fat more than standard care or exercise alone. The study, published in Nature Communications, did not find a statistically significant added reduction in liver fat from the interventions compared with standard care.
Researchers led by the University of Granada’s Joint University Institute for Sport and Health assigned participants to one of four groups: standard care, intermittent fasting, supervised exercise, or fasting combined with exercise. About half of the participants were women. Over the 12-week program, all groups received education on the Mediterranean diet and physical activity. Participants assigned to fasting ate within an eight-hour daily window; the exercise program combined supervised strength training with high-intensity aerobic exercise.
The main study objective was to assess changes in liver fat, measured by MRI, and cardiovascular health. Liver fat decreased in all four groups, but the researchers found no statistically significant differences between standard care and the interventions, or among the three intervention groups. Participants in both fasting groups lost an average of about 2.2 kilograms more than those receiving standard care. The fasting-and-exercise group also lost more body fat than the standard-care and exercise-only groups.
Both groups assigned to exercise improved cardiorespiratory fitness, a measure related to cardiovascular health. In a follow-up one year after the program ended, researchers found no differences between groups in liver-fat changes, and the earlier differences in weight and body composition were no longer detectable. The report does not establish that every participant responded in the same way, or that the results would persist with a longer program.
Weight Loss Did Not Persist at Follow-Up
The findings suggest that adding an eating-time limit to lifestyle support may produce a modest additional weight benefit over 12 weeks for adults with obesity, while supervised exercise can improve fitness. The combination’s body-fat result may interest clinicians and researchers evaluating lifestyle programs that address more than scale weight.
But the trial’s primary liver-fat comparison was not statistically significant, and the measured weight and body-composition differences had disappeared by the one-year follow-up. The results therefore do not show that the combined approach provides lasting weight loss or a greater overall liver-fat reduction. They point to the importance of studying how benefits might be maintained, rather than treating a short-term change as a durable outcome.
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How the TEMPUS Trial Was Designed
The work was conducted as part of the TEMPUS project by the University of Granada’s PROFITH research group, in collaboration with the Granada Institute for Biomedical Research, two Granada university hospitals, and Spain’s biomedical research networks focused on obesity and healthy aging. The study was funded by Spain’s MICIU/AEI and the European Regional Development Fund.
The paper, by Clavero-Jimeno and colleagues, is titled “Effects of time-restricted eating and supervised exercise on intrahepatic fat and cardiometabolic health in adults with obesity: the TEMPUS randomized controlled trial.” Its design compared fasting and exercise separately and together against standard care, with the same general diet and activity education provided across groups. This allows the reported outcomes to be considered against a shared lifestyle-education baseline.
The researchers also examined whether results differed by sex. In men, the combination group showed a greater liver-fat reduction than standard care; that difference was not observed among women. However, the authors cautioned that these subgroup analyses alone cannot establish that the intervention works differently by sex.
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Durability and Liver-Fat Effects
The results leave open whether a longer or sustained program could produce lasting differences in weight, body composition, or liver fat. At the one-year follow-up, the initial group differences in weight and body composition were no longer detectable, and no between-group difference in liver-fat change was found. The supplied report does not specify how many participants completed each follow-up assessment or provide the detailed estimates and confidence intervals needed to judge the precision of those results.
The sex-specific liver-fat finding among men should also be treated cautiously: the authors said the analyses do not establish a different effect by sex. The report notes that about 30% of participants with fatty liver at baseline in the combined group no longer met the study’s diagnostic criteria after the program, compared with 6.5% in standard care. That comparison does not override the overall finding of no statistically significant between-group difference in liver-fat change.
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Longer Programs and Maintenance Strategies
The researchers say further work should examine longer-lasting interventions, particularly among people who begin with high levels of liver fat, and test strategies that help participants maintain benefits after a program ends. The available report does not announce a specific next trial or timetable.
For now, the published findings describe outcomes from one 12-week randomized study and its one-year follow-up. They do not show that fasting plus exercise is suitable for every person with obesity or that it replaces individualized care. Readers considering changes to eating patterns or exercise should discuss personal health decisions with a qualified health professional.
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Key Questions
How many people took part in the trial?
The study enrolled 187 adults with obesity, approximately half of them women. They were randomly assigned to standard care, intermittent fasting, supervised exercise, or a combination of fasting and exercise.
How was intermittent fasting carried out?
Participants assigned to fasting concentrated their meals within an eight-hour window each day during the 12-week program. All four groups also received education on Mediterranean-diet eating and physical activity.
Did fasting and exercise reduce liver fat more than standard care?
No statistically significant difference in liver-fat change was found between the interventions and standard care. Liver fat decreased in all four groups. A subgroup result among men was reported, but the authors said it does not establish that the intervention works differently by sex.
Did the weight-loss differences last?
The study reported that the differences in weight and body composition seen at the end of 12 weeks were no longer detectable one year after the program. The researchers called for more work on maintaining benefits.
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