In Reply Dr Portillo-Sanchez and colleagues have pointed to limitations in our study1 that, although previously discussed in the main article, are important enough to merit extra discussion. These limitations include sample size, dropout rate in the alternate-day fasting group, and (mostly) metabolically healthy trial participants. Dr Portillo-Sanchez and colleagues express concern that these limitations threaten the validity of the study results—that is, that alternate-day fasting does not produce superior adherence, weight loss, weight loss maintenance, or cardioprotection vs daily calorie restriction.1
Trepanowski JF, Ravussin E, Varady KA. Sample Size Matters When Drawing Conclusions on Alternate-Day Fasting Diet—Reply. JAMA Intern Med. 2017;177(11):1701. doi:10.1001/jamainternmed.2017.5866
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