Time restricted eating effective as a modest weight loss strategy for obese adults

1. Practicing time-restricted eating achieved modest weight loss in adults with obesity after 12 weeks.

Evidence Rating Level: 2 (Good)

Resistant hypertension, which is uncontrolled despite maximal medical therapy, affects up to 10% of patients diagnosed with hypertension. Renal artery denervation has been demonstrated in a number of smaller, nonrandomized and/or unblinded studies to significantly reduce blood pressure in patients with resistant hypertension. About 10% of morbidity and mortality in the UK results from ill health due to obesity. Intermittent fasting has shown promising results in both animals and humans for weight loss, as well as improvements in glucose metabolism and lipid profiles in people. However, this approach, which alternates total or partial energy restriction with non-restricted energy, is restrictive and demanding, and therefore not used in clinical practice. Time-restricted eating (TRE), or the 16:8 diet, is a less severe format which limits dieters to consume only within an 8-hour window every day. Small samples and varying results and trial protocols in previous studies give little information on the true effects of TRE on weight and lipid profile. In this pilot cohort study, 50 participants with obesity (mean age 50 years old, mean BMI = 35, 74% female) were asked to only eat during an 8-hour window every day, while water, diet drinks, or coffee or tea without sugar or milk were permitted for the remaining 16 hours. Participants completed questionnaires and had their weight taken at baseline, 6 weeks, and 12 weeks, in addition to their blood pressure and lipid profile measured at the beginning and end of the study. Weekly phone calls monitored their adherence from weeks 2-5. With the primary outcome as adherence, 80% and 78% provided data at 6 and 12 weeks, with 58% of participants continuing to adhere to TRE on at least 5 days/week by week 12. Those who provided follow-up data and adhered to the TRE intervention for at least 5 days/week recorded greater weight loss at 6 and 12 weeks, with 2.5+ 1.7 kg vs 1.0 + 1.3kg (p=0.003) at 6 weeks and 3.5+ 2.7 kg vs 1.3+ 2.0 kg, p=0.001 at 123 weeks. Overall, 26% of participants lost at least 5% of their body weight by 12 weeks. No effect on blood pressure or lipid profile was observed. The most common barriers to adherence reported were related to social activity, such as dining out, having visitors, and having drinks after work, while participants reported planning ahead, using distraction, and/or drinking water or black coffee to cope with hunger. While the magnitude of weight loss from TRE intervention was modest, previous studies using more complex regimens produced similar results. Overall, these findings are encouraging and conducting a randomized controlled trial using a similar TRE protocol with a longer follow-up could further support these results.

Click to read the study in PLOSONE

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