Isocaloric Time-Restricted Eating May Not Induce Weight Loss in Patients with Obesity

Though previous analysis has reported decreased physique weight with time-restricted consuming, findings from a latest randomized, isocaloric feeding examine counsel restricted meals timing could not have a notable influence on weight or glycemic outcomes relative to common consuming patterns.¹

The examine was printed in Annals of Inner Medication and featured in a plenary session on the 2024 American Faculty of Physicians (ACP) Inner Medication assembly in Boston, the place lead investigator Nisa Maruthur, MD, MHS, affiliate professor at Johns Hopkins Medication, offered an summary of the analysis and its key findings.¹

Based on the US Facilities for Illness Management and Prevention (CDC), the US weight problems prevalence was 41.9% in 2017 – March 2020.² The CDC cites wholesome consuming, bodily exercise, optimum sleep, and stress discount as key issues for attaining and sustaining a wholesome weight.³ Nonetheless, not too long ago, many have pointed to the potential influence of the timing of consuming.

“Misalignment of meals timing with circadian rhythms contributes to adiposity and impaired glucose homeostasis in experimental fashions, elevating the chance that altering the timing of consuming may very well be a viable intervention for weight problems,” Maruthur and colleagues wrote.¹

To find out the impact of time-restricted consuming versus a common consuming sample on physique weight within the setting of steady caloric consumption, investigators carried out a randomized, isocaloric feeding examine of adults with weight problems and prediabetes or diet-controlled diabetes. For inclusion, sufferers had been required to be 18 – 69 years of age; have hemoglobin A 1c (HbA1c) 5.7% – 6.4% or HbA1c 6.5% – 6.9% with out use of any diabetes drugs; physique mass index (BMI) 30 – 50 kg/m2; steady remedy routine for hypertension, if current, for the previous 6 months; and willingness to regulate timing of consuming, eat examine weight loss plan and nothing else, and full examine measurements.¹

After excluding people with clinically vital sleep or circadian rhythm issues; individuals routinely following a time-restricted consuming window of 10 hours or much less; individuals with estimated glomerular filtration fee < 30 mL/min/1.73 m2; and individuals with continual well being situations or use of medicines which may have an effect on glucose ranges, physique weight, or adherence, investigators enrolled 41 eligible sufferers. Individuals had been randomly assigned in a 1:1 ratio to time-restricted consuming or common consuming sample for 12 weeks.¹

These within the time-restricted group had been instructed to eat all of their energy between 8 a.m. and 6 p.m., with 80% by 1 p.m, whereas contributors within the common consuming group had been instructed to eat all of their energy between 8 a.m. and midnight, with the bulk after 5 p.m.¹

Of word, each teams had the identical nutrient content material and had been isocaloric with complete energy decided at baseline, and had been instructed to eat breakfast, lunch, dinner, and a snack. Individuals had been offered particular directions on the timing of those meals, which had been ready within the examine metabolic kitchen supervised by analysis dietitians.¹

Information was collected at clinic visits scheduled at baseline after which at 4, 8, and 12 weeks after the beginning of the intervention. Investigators used standardized questionnaires to gather information on demographics, socioeconomic standing, medical historical past, concomitant drugs, and opposed occasion information. Individuals recorded their adherence to really helpful timing of consuming and examine diets in a diary.¹

The first end result was change in physique weight at 12 weeks. Secondary outcomes included fasting glucose, homeostatic mannequin evaluation for insulin resistance (HOMA-IR), glucose space beneath the curve by oral glucose tolerance take a look at, and glycated albumin.¹

Among the many cohort, the imply age was 59 years, 93% of contributors had been feminine, 93% of contributors had been Black, and the imply BMI was 36 kg/m2. Baseline weight was 95.6 kg (210.8 lbs; 95% CI, 89.6 – 101.6 kg) within the time-restricted group and 103.7 kg (228.6 lbs; CI, 95.3 – 112.0 kg) within the common consuming group.¹

Individuals ate all of their meals inside half-hour of the really helpful time window on 96.0% and 95.6% of examine days within the time-restricted and common consuming teams, respectively. Adherence to the examine weight loss plan occurred on 92.8% and 94.6% of examine days within the time-restricted and common consuming teams, respectively.¹

Within the time-restricted consuming group, the imply distinction in weight from baseline to 12 weeks was 2.3 kg (5 lbs; CI, 3.5 – 1.0 kg). Within the common consuming apply group, the imply distinction in weight from baseline to 12 weeks was 2.6 kg (5.7 lbs; CI, 3.7 – 1.5 kg), a 0.3 kg distinction (0.66 lbs; CI, 1.2 – 1.9 kg) in comparison with the time-restricted group.¹

Investigators famous adjustments in glycemic measures additionally didn’t differ between teams, and there have been no clinically related adjustments in blood stress or lipids. Moreover, no treatment-related opposed occasions had been reported in both group.¹

Investigators highlighted the single-site examine design with a small pattern measurement of primarily Black girls, baseline variations in weight between teams, and reliance on day by day diaries to measure adherence to time-restricted consuming as key limitations to those findings.¹

Nonetheless, they concluded, “Within the setting of isocaloric consumption of a nutritious diet amongst individuals with weight problems and impaired glucose homeostasis, 10-hour TRE mixed with consuming earlier within the day didn’t lower weight or enhance glucose homeostasis relative to a UEP of consuming later within the day.”

References

1. ^{Maruthur NM, Pilla SJ, White Okay, et al. Impact of Isocaloric, Time-Restricted Consuming on Physique Weight in Adults With Weight problems. Ann Intern Med. doi:10.7326/M23-3132}
2. ^{US Facilities for Illness Management and Prevention. Grownup Weight problems Info. Chubby & Weight problems. Could 17, 2022. Accessed April 21, 2024. https://www.cdc.gov/weight problems/information/grownup.html}
3. ^{US Facilities for Illness Management and Prevention. Wholesome Weight, Diet, and Bodily Exercise. June 9, 2023. Accessed April 21, 2024. https://www.cdc.gov/healthyweight/index.html}