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Sepúlveda B, Marín A, Burrows R, Sepúlveda A, Chamorro R. It's About Timing: Contrasting the Metabolic Effects of Early vs. Late Time-Restricted Eating in Humans. Curr Nutr Rep 2024; 13:214-239. [PMID: 38625630 DOI: 10.1007/s13668-024-00532-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE OF REVIEW Time-restricted eating (TRE), a form of intermittent fasting, restricts feeding time across the day, imposing a daily 'eating window'. The time of day when the eating window occurs could result in differential metabolic effects. Here, we describe recent intervention studies in humans assessing the metabolic consequences of an early- (i.e., eating window starting in the early morning) vs. late (i.e., eating window starting after midday)-TRE protocol. RECENT FINDINGS Well-controlled studies indicate that both TRE protocols effectively reduce body weight and improve altered glucose metabolism, lipid profile, inflammation, or blood pressure levels. An early-TRE (e-TRE) might have a further positive impact on improving blood glucose, insulin levels, and insulin resistance. However, the studies directly assessing the metabolic consequences of an early- vs. late-TRE have shown dissimilar findings, and more well-controlled clinical trials are needed on the metabolic benefits of these two types of TRE. Evidence suggests that an e-TRE might have enhanced metabolic results, particularly regarding glucose homeostasis. More long-term studies, including larger sample sizes, are needed to assess the metabolic, circadian, and adherence benefits, together with socio-cultural acceptance of both TRE approaches.
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Affiliation(s)
- Bernardita Sepúlveda
- School of Nutrition and Dietetics, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Andrea Marín
- School of Nutrition and Dietetics, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Raquel Burrows
- Food and Nutrition Unit, Luis Calvo Mackenna Hospital, Santiago, Chile
| | - Alejandro Sepúlveda
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Rodrigo Chamorro
- Department of Nutrition, Faculty of Medicine, Universidad de Chile, Av. Independencia 1027, Independencia, Santiago, Chile.
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Fernández-Rodríguez R, Garrido-Miguel M, Bizzozero-Peroni B, Díaz-Goñi V, Rodríguez-Gutiérrez E, Guzmán-Pavón MJ, Meseguer-Henarejos AB, Torres-Costoso A. Time-Restricted Eating and Bone Health: A Systematic Review with Meta-Analysis. Nutrients 2024; 16:876. [PMID: 38542787 PMCID: PMC10974430 DOI: 10.3390/nu16060876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/05/2024] Open
Abstract
Time-restricted eating (TRE) has emerged as a dietary strategy that restricts food consumption to a specific time window and is commonly applied to facilitate weight loss. The benefits of TRE on adipose tissue have been evidenced in human trials and animal models; however, its impact on bone tissue remains unclear. To systematically synthesize and examine the evidence on the impact of TRE on bone health (bone mineral content (BMC), bone mineral density (BMD), and bone turnover factors), PubMed, Scopus, Cochrane CENTRAL, and Web of Science databases were systematically explored from inception to 1 October 2023 searching for randomized controlled trials (RCTs) aimed at determining the effects of TRE on bone health in adults (≥18 years). The Cochrane Handbook and the PRISMA recommendations were followed. A total of seven RCTs involving 313 participants (19 to 68 years) were included, with an average length of 10.5 weeks (range: 4 to 24 weeks). Despite the significant weight loss reported in five out of seven studies when compared to the control, our meta-analysis showed no significant difference in BMD (g/cm2) between groups (MD = -0.009, 95% CI: -0.026 to 0.009, p = 0.328; I2 = 0%). BMC and bone turnover markers between TRE interventions and control conditions were not meta-analyzed because of scarcity of studies (less than five). Despite its short-term benefits on cardiometabolic health, TRE did not show detrimental effects on bone health outcomes compared to those in the control group. Nevertheless, caution should be taken when interpreting our results due to the scarcity of RCTs adequately powered to assess changes in bone outcomes.
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Affiliation(s)
- Rubén Fernández-Rodríguez
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
| | - Miriam Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 16002 Cuenca, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, 02006 Albacete, Spain
| | - Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
- Instituto Superior de Educación Física, Universidad de la República, Rivera 40000, Uruguay
| | - Valentina Díaz-Goñi
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
| | - Eva Rodríguez-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 16002 Cuenca, Spain
| | - María José Guzmán-Pavón
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, 45071 Toledo, Spain;
| | | | - Ana Torres-Costoso
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (V.D.-G.); (E.R.-G.); (A.T.-C.)
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, 45071 Toledo, Spain;
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Lao BN, Luo JH, Xu XY, Fu LZ, Tang F, Ouyang WW, Xu XZ, Wei MT, Xiao BJ, Chen LY, Wu YF, Liu XS. Time-restricted feeding's effect on overweight and obese patients with chronic kidney disease stages 3-4: A prospective non-randomized control pilot study. Front Endocrinol (Lausanne) 2023; 14:1096093. [PMID: 37082115 PMCID: PMC10111616 DOI: 10.3389/fendo.2023.1096093] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/17/2023] [Indexed: 04/22/2023] Open
Abstract
Background Time-restricted feeding (TRF) has become a popular weight loss method in recent years. It is widely used in the nutritional treatment of normal obese people and obese people with chronic diseases such as diabetes mellitus and hypertension, and has shown many benefits. However, most TRF studies have excluded chronic kidney disease (CKD) patients, resulting in a lack of sufficient evidence-based practice for the efficacy and safety of TRF therapy for CKD. Therefore, we explore the efficacy and safety of TRF in overweight and obese patients with moderate-to-severe stage CKD through this pilot study, and observe patient compliance to assess the feasibility of the therapy. Methods This is a prospective, non-randomized controlled short-term clinical trial. We recruited overweight and obese patients with CKD stages 3-4 from an outpatient clinic and assigned them to either a TRF group or a control diet (CD) group according to their preferences. Changes in renal function, other biochemical data, anthropometric parameters, gut microbiota, and adverse events were measured before the intervention and after 12 weeks. Results The change in estimated glomerular filtration rate (eGFR) before and after intervention in the TRF group (Δ = 3.1 ± 5.3 ml/min/1.73m2) showed significant improvement compared with the CD group (Δ = -0.8 ± 4.4 ml/min/1.73m2). Furthermore, the TRF group had a significant decrease in uric acid (Δ = -70.8 ± 124.2 μmol/L), but an increase in total protein (Δ = 1.7 ± 2.5 g/L), while the changes were inconsistent for inflammatory factors. In addition, the TRF group showed a significant decrease in body weight (Δ = -2.8 ± 2.9 kg) compared to the CD group, and body composition indicated the same decrease in body fat mass, fat free mass and body water. Additionally, TRF shifted the gut microbiota in a positive direction. Conclusion Preliminary studies suggest that overweight and obese patients with moderate-to-severe CKD with weight loss needs, and who were under strict medical supervision by healthcare professionals, performed TRF with good compliance. They did so without apparent adverse events, and showed efficacy in protecting renal function. These results may be due to changes in body composition and alterations in gut microbiota.
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Affiliation(s)
- Bei-ni Lao
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Jiang-hong Luo
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Xue-yi Xu
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Li-zhe Fu
- Chronic Disease Management Outpatient, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Fang Tang
- Chronic Disease Management Outpatient, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Wen-wei Ouyang
- Key Unit of Methodology in Clinical Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Xin-zhu Xu
- Nutritional Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Meng-ting Wei
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Bing-jie Xiao
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Lin-yi Chen
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yi-fan Wu
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- *Correspondence: Yi-fan Wu, ; Xu-sheng Liu,
| | - Xu-sheng Liu
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- *Correspondence: Yi-fan Wu, ; Xu-sheng Liu,
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Abstract
Obesity and the associated metabolic syndrome is considered a pandemic whose prevalence is steadily increasing in many countries worldwide. It is a complex, dynamic, and multifactorial disorder that presages the development of several metabolic, cardiovascular, and neurodegenerative diseases, and increases the risk of cancer. In patients with newly diagnosed cancer, obesity worsens prognosis, increasing the risk of recurrence and decreasing survival. The multiple negative effects of obesity on cancer outcomes are substantial, and of great clinical importance. Strategies for weight control have potential utility for both prevention efforts and enhancing cancer outcomes. Presently, time-restricted eating (TRE) is a popular dietary intervention that involves limiting the consumption of calories to a specific window of time without any proscribed caloric restriction or alteration in dietary composition. As such, TRE is a sustainable long-term behavioral modification, when compared to other dietary interventions, and has shown many health benefits in animals and humans. The preliminary data regarding the effects of time-restricted feeding on cancer development and growth in animal models are promising but studies in humans are lacking. Interestingly, several short-term randomized clinical trials of TRE have shown favorable effects to reduce cancer risk factors; however, long-term trials of TRE have yet to investigate reductions in cancer incidence or outcomes in the general population. Few studies have been conducted in cancer populations, but a number are underway to examine the effect of TRE on cancer biology and recurrence. Given the simplicity, feasibility, and favorable metabolic improvements elicited by TRE in obese men and women, TRE may be useful in obese cancer patients and cancer survivors; however, the clinical implementation of TRE in the cancer setting will require greater in-depth investigation.
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Affiliation(s)
- Manasi Das
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Medicine, Division of Endocrinology and Metabolism, University of California, La Jolla, San Diego, CA, USA
| | - Nicholas J G Webster
- VA San Diego Healthcare System, San Diego, CA, USA. .,Department of Medicine, Division of Endocrinology and Metabolism, University of California, La Jolla, San Diego, CA, USA. .,Moores Cancer Center, University of California, La Jolla, San Diego, CA, USA.
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