The impacts of daily caloric restriction, intermittent fasting, and intuitive or mindful eating on physiological outcomes, disordered eating, and method sustainability in adult women: a comparative literature review

Background: Intermittent fasting (IF), daily caloric restriction (DCR), and intuitive eating or mindful eating (IE/ME) are common dietary approaches with growing scientific literature, yet their comparative effects in women remain unclear. Aim: This thesis aimed to compare IF, DCR, IE and ME in women, focusing on physiological health outcomes, risk of disordered eating, and adherence and feasibility. Methods: A structured review - comprising a systematic search, quality appraisal, and narrative synthesis - was conducted. Studies were identified through PubMed and Scopus, with inclusion criteria focusing on studies with at least 50% adult female participants or sex-specific findings, and outcomes related to physiological outcomes (i.e. body composition, cardiometabolic markers), disordered eating tendencies, and method sustainability. The study-selection process was documented using the PRISMA 2020 flow diagram. Data was extracted and synthesized thematically. Results: Research demonstrated a metabolic equivalency between DCR and intensive IF protocols regarding changes in weight, body composition, and cardiometabolic markers, suggesting that overall energy deficit is the primary physiological driver. However, early time-restricted eating windows showed potential for reducing fasting glucose and blood pressure. DCR/IF was typically very feasible, although long-term sustainability proved challenging in trials over 1 year. While DCR/IF often reported decreased disordered eating, they were consistently associated with increased cognitive restraint. Conversely, IE/ME interventions consistently reduced disordered eating without increasing restraint, although their impacts on physiological measures were modest or inconsistent. IE/ME was also shown to be feasible, however adherence may improve by utilizing online formats and increasing frequency of sessions to reduce socioeconomic barriers. Conclusion: While DCR/ IF are effective short-term tools for managing weight and cardiometabolic risk in adult women, their long-term efficacy is limited by significant attrition and increased cognitive restraint. In contrast, IE/ME approaches provide superior and more sustainable outcomes for psychological well-being and disordered eating prevention. These findings highlight the necessity of moving toward personalized nutrition models that consider a woman’s behavioral risk profile. Future research should utilize long-term, sex-specific trials to further explore the synergistic potential of combining IE/ME approaches with moderate metabolic interventions.