New findings suggest that time-restricted eating during the earlier part of the day may be beneficial for weight loss and reduced blood pressure.
On average, studies have produced mixed results on intermittent fasting, the practice of alternating eating with extended fasting, and time-restricted feeding.
In a randomized clinical trial, participants ate regular meals from 7 AM to 3 PM. The group eating all their calories in the morning was more successful at losing weight and lowering blood pressure than the 12-hour group. This study suggests eTRE may be the way to go.
Shalender Bhasin, MBBS, finds the findings of this study do not match those of the previous trial published in April, which compared TRE to ad-lib eating.
The scientific premise and preclinical data on the effects of TRE are promising. The inconsistency among studies renders it hard to draw strong inferences from these well-conducted but relatively small trials, says Dr. Bhasin.
Need for larger and longer trials of TRE
In the future, long-term randomized clinical trials will fully evaluate whether the benefits of using restricted calorie diet and exercise programs outweigh any risks.
Simon Steenson, Ph.D., a nutrition scientist at British Nutrition Foundation, said the strength of this new study is that it employed a trial design and had a high number of participants compared to many previous trials.
However, previous research in China also shows the need for large long-term trials to examine cardiovascular and weight loss, including trials.
Still, Dr. Steenson said, “Some individuals may find that this fits better with their lifestyle and preferences. For those who have trouble reducing overall calorie intake quickly, time-restricted feeding might be one option for decreasing the number of calories consumed. Ultimately, it is up to each person to find the best approach to reducing their daily caloric intake.”
Differences weightloss, and diastolic BP, but not all measures
The study population included 90 adults seen at a weight loss clinic in Birmingham, AL August 2018 to December 2019. None of the subjects had diabetes.
Participants were randomized to either eTRE (with the 7 AM to PM eating window) or a control schedule with eating across 12 hours or more, mimicking U.S. median mealtimes. All participants received 30-minute weight-loss counseling sessions at baseline and weeks 2, 6, and 10. They followed a diet of 500 kcal/day below their resting energy expenditure with exercise of 75-150 minutes per week.
The eTre group in the past 14 weeks attended transit duty a mean of six days per week, lower than the traditional ratio of 6.3 days among controls (P = .03), and adherence declined by about 0.4 days per week in the eTre group (P = .001).
At 14 weeks, the eTRE group lost -6.3kg, and the controls lost -4.0kg of weight, but the difference between the groups was significant at -2.3 kg (p=.002).
The new study has no difference in overall weight loss, whether fat or muscle mass. There are also no significant differences with changes in other body composition parameters such as visceral fat and waist circumference.
Diastolic blood pressure rose by a tiny amount, 4mmHg, in the eTRE group, compared to controls at 14 weeks. There were no significant differences in systolic blood pressure, heart rate, glucose, A1c levels, insulin levels, measures of insulin resistance, and plasma lipids.
During the study, there was no difference in physical activity, energy intake, or dietary macronutrient composition. However, a weight-loss modeling study shows that the experimental group reduced their typical daily intake by about 214 calories compared to the control group (P = .04).
In a secondary analysis of the 59 participants who completed this study, eTRE was also more effective at reducing body fat. P=.047 and trunk fat. P=.03
The study was supported by grants from the National Center for Advancing Translational Sciences of the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases. Dr Bhasin has reported receiving grants to his institution for research, which Dr Bhasin is the principal investigator from AbbVie, Aditum, MIB, OPKO, and FPT, receiving personal fees from XyOne and M-Labs & Research but not AbbVie. Dr Steenson has declared funding in support of the British Nutrition Foundation that comes from diverse sources.
Source: https://www.mdedge.com/endocrinology/article/256907/obesity/early-time-restricted-eating-ups-weight-loss-jury-still-out
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