Effects of 4- and 6-h Time-Restricted Feeding on Weight and Cardiometabolic Health: A Randomized Controlled Trial in Adults with Obesity.

The long-term efficacy and safety of time-restricted eating for weight loss are not clear. Download a PDF of the Research Summary. We randomly assigned 139 patients with obesity to time-restricted eating (eating only between 8:00 a.m. and 4:00 p.m.) with calorie restriction or daily calorie restriction alone. For 12 months, all the participants were instructed to follow a calorie-restricted diet that consisted of 1500 to 1800 kcal per day for men and 1200 to 1500 kcal per day for women. The primary outcome was the difference between the two groups in the change from baseline in body weight; secondary outcomes included changes in waist circumference, body-mass index (BMI), amount of body fat, and measures of metabolic risk factors. Of the total 139 participants who underwent randomization, 118 (84.9%) completed the 12-month follow-up visit. The mean weight loss from baseline at 12 months was −8.0 kg (95% confidence interval [CI], −9.6 to −6.4) in the time-restriction group and −6.3 kg (95% CI, −7.8 to −4.7) in the daily-calorie-restriction group. Changes in weight were not significantly different in the two groups at the 12-month assessment (net difference, −1.8 kg; 95% CI, −4.0 to 0.4; P=0.11). Results of analyses of waist circumferences, BMI, body fat, body lean mass, blood pressure, and metabolic risk factors were consistent with the results of the primary outcome. In addition, there were no substantial differences between the groups in the numbers of adverse events. Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily calorie restriction. (Funded by the National Key Research and Development Project [No. 2018YFA0800404] and others; ClinicalTrials.gov number, NCT03745612.) QUICK TAKE VIDEO SUMMARYTime-Restricted Eating for Weight Loss 01:44 

Calorie Restriction with or without Time-Restricted Eating in Weight Loss

https://www.gastrojournal.org/article/S0016-5085(20)35505-0/pdf

Metabolism and Metabolic Disorders and the Microbiome: The Intestinal Microbiota Associated With Obesity, Lipid Metabolism, and Metabolic Health: Pathophysiology and Therapeutic Strategies

BACKGROUND
The long-term efficacy and safety of time-restricted eating for weight loss are not clear.


METHODS
We randomly assigned 139 patients with obesity to time-restricted eating (eating only between 8:00 a.m. and 4:00 p.m.) with calorie restriction or daily calorie restriction alone. For 12 months, all the participants were instructed to follow a calorie-restricted diet that consisted of 1500 to 1800 kcal per day for men and 1200 to 1500 kcal per day for women. The primary outcome was the difference between the two groups in the change from baseline in body weight; secondary outcomes included changes in waist circumference, body-mass index (BMI), amount of body fat, and measures of metabolic risk factors.


RESULTS
Of the total 139 participants who underwent randomization, 118 (84.9%) completed the 12-month follow-up visit. The mean weight loss from baseline at 12 months was -8.0 kg (95% confidence interval [CI], -9.6 to -6.4) in the time-restriction group and -6.3 kg (95% CI, -7.8 to -4.7) in the daily-calorie-restriction group. Changes in weight were not significantly different in the two groups at the 12-month assessment (net difference, -1.8 kg; 95% CI, -4.0 to 0.4; P = 0.11). Results of analyses of waist circumferences, BMI, body fat, body lean mass, blood pressure, and metabolic risk factors were consistent with the results of the primary outcome. In addition, there were no substantial differences between the groups in the numbers of adverse events.


CONCLUSIONS
Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily calorie restriction. (Funded by the National Key Research and Development Project [No. 2018YFA0800404] and others; ClinicalTrials.gov number, NCT03745612.).

Calorie Restriction with or without Time-Restricted Eating in Weight Loss.

Time-Restricted Eating: Benefits, Mechanisms, and Challenges in Translation

Clinical application of intermittent fasting for weight loss: progress and future directions

Background:Time restricted feeding is a form of intermittent fasting where participants shorten the daily window in which they eat.Aim:This is the first study to examine the effects of intermittent...

Effect of time restricted feeding on the gut microbiome in adults with obesity: A pilot study:

Time-restricted eating (TRE) is a form of intermittent fasting that involves confining the eating window to 4–10 h and fasting for the remaining hours of the day. The purpose of this review is to summarize the current literature pertaining to the effects of TRE on body weight and cardiovascular disease risk factors. Human trial findings show that TRE reduces body weight by 1–4% after 1–16 weeks in individuals with obesity, relative to controls with no meal timing restrictions. This weight loss results from unintentional reductions in energy intake (~350–500 kcal/day) that occurs when participants confine their eating windows to 4–10 h/day. TRE is also effective in lowering fat mass, blood pressure, triglyceride levels, and markers of oxidative stress, versus controls. This fasting regimen is safe and produces few adverse events. These findings suggest that TRE is a safe diet therapy that produces mild reductions in body weight and also lowers several key indicators of cardiovascular disease in participants with obesity.

Time-Restricted Eating to Improve Cardiovascular Health

Objective Alternate day fasting (ADF) is a popular weight loss regimen. Whether carbohydrate restriction can enhance the weight loss achieved with ADF remains unclear. Accordingly, this study examined the effect of ADF combined with a low-carbohydrate diet on body weight and metabolic disease risk factors. Methods Adults with obesity (n = 31) participated in ADF (600 kcal "fast day" alternated with an ad libitum "feast day") with a low-carbohydrate background diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period. Results Body weight decreased (-5.5 ± 0.5%; P < .001) during the weight loss period (month 0-3) but remained stable (P = .57) during the weight maintenance period (month 4-6). Net weight loss by month 6 was -6.3 ± 1.0%. Fat mass was reduced (P < .01) by month 6, while lean mass and visceral fat mass remained unchanged. Total cholesterol and low-density lipoprotein (LDL) cholesterol levels decreased (P < .05) by -6 ± 2% and - 8 ± 3%, respectively, by month 6. Systolic blood pressure was also reduced (P = .03) by -7 ± 3 mm Hg. Fasting insulin decreased (P = .03) by -24 ± 8% by month 6 relative to baseline. High-density lipoprotein (HDL) cholesterol, triglycerides, diastolic blood pressure, heart rate, fasting glucose, homeostatic model assessment of insulin resistance (HOMA-IR), and haemoglobin A1C (HbA1c) remained unchanged. Conclusions These findings suggest that ADF combined with a low-carbohydrate diet is effective for weight loss, weight maintenance, and improving certain metabolic disease risk factors such as LDL cholesterol, blood pressure, and fasting insulin. While these preliminary findings are promising, they still require confirmation by a randomized control trial.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/osp4.367

Mark Ezpeleta

Papers

Effects of 4- and 6-h Time-Restricted Feeding on Weight and Cardiometabolic Health: A Randomized Controlled Trial in Adults with Obesity.

Clinical application of intermittent fasting for weight loss: progress and future directions

Effect of time restricted feeding on the gut microbiome in adults with obesity: A pilot study:

Time-Restricted Eating to Improve Cardiovascular Health

Alternate day fasting combined with a low-carbohydrate diet for weight loss, weight maintenance, and metabolic disease risk reduction.