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Rathomi HS, Mavaddat N, Katzenellenbogen JM, Thompson SC. "It just made sense to me!" A Qualitative Exploration of Individual Motivation for Time-Restricted Eating. Appetite 2024; 204:107751. [PMID: 39489342 DOI: 10.1016/j.appet.2024.107751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 10/22/2024] [Accepted: 10/30/2024] [Indexed: 11/05/2024]
Abstract
Time-Restricted Eating (TRE), a form of intermittent fasting, has gained popularity for weight control and metabolic health. It is not incorporated into dietary and clinical guidelines, and hence is generally not being recommended to the public. This qualitative study explores how individuals have discovered TRE as a form of dietary practice and their motivations for practising it. Using purposive and snowball sampling, we recruited 21 participants who had engaged in TRE for at least 3 months (range 3 months to over 5 years). In-depth interviews were conducted with an interview guide developed based on the Health Belief Model. We utilised an inductive coding process and thematic analysis to identify the factors motivating TRE adoption. Seven main themes emerged: (1) dissatisfaction and resistance to prior or traditional approaches, (2) perceived broader health benefits, (3) principles of TRE deemed logical, (4) low to no cost of adoption, (5) manageable psychosocial barriers, (6) being non-restrictive and easy to use, and (7) compatibility with personal lifestyle. This study provided insights into early phase of TRE adoption among individuals in real world settings. Future research should explore health practitioners' perspectives on TRE to better understand the acceptability and potential use of TRE as a weight management approach.
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Affiliation(s)
- Hilmi S Rathomi
- School of Population and Global Health, University of Western Australia; Faculty of Medicine, Universitas Islam Bandung, Indonesia.
| | | | | | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia; School of Allied Health, University of Western Australia
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Skarstad HMS, Haganes KL, Sujan MAJ, Gellein TM, Johansen MK, Salvesen KÅ, Hawley JA, Moholdt T. A randomized feasibility trial of time-restricted eating during pregnancy in people with increased risk of gestational diabetes. Sci Rep 2024; 14:22476. [PMID: 39341847 PMCID: PMC11439041 DOI: 10.1038/s41598-024-72913-y] [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] [Received: 06/13/2024] [Accepted: 09/11/2024] [Indexed: 10/01/2024] Open
Abstract
Time-restricted eating (TRE) is a nutritional intervention that confines the daily time-window for energy intake. TRE reduces fasting glucose concentrations in non-pregnant individuals, but whether this eating protocol is feasible and effective for glycemic control in pregnancy is unknown. The aim of this randomized controlled trial was to investigate the adherence to and effect of a 5-week TRE intervention (maximum 10 h daily eating window) among pregnant individuals at risk of gestational diabetes mellitus (GDM), compared with a usual-care control group. Participants underwent 2-h oral glucose tolerance tests and estimation of body composition, before and after the intervention. Interstitial glucose levels were continuously measured, and adherence rates and ratings of hunger were recorded daily. Thirty of 32 participants completed the trial. Participants allocated to TRE reduced their daily eating window from 12.3 (SD 1.3) to 9.9 (SD 1.0) h, but TRE did not affect glycemic measures, blood pressure, or body composition, compared with the control group. TRE increased hunger levels in the evening, but not in the morning, and induced only small changes in dietary intake. Adhering to a 5-week TRE intervention was feasible for pregnant individuals with increased risk of GDM but had no effect on cardiometabolic outcomes.
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Affiliation(s)
- Hanna M S Skarstad
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kamilla L Haganes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynecology, St. Olav's hospital, Trondheim, Norway
| | - Md Abu Jafar Sujan
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynecology, St. Olav's hospital, Trondheim, Norway
| | - Trine M Gellein
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mariell K Johansen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kjell Å Salvesen
- Department of Obstetrics and Gynecology, St. Olav's hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - John A Hawley
- Exercise and Nutrition Research Programme, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
- Department of Obstetrics and Gynecology, St. Olav's hospital, Trondheim, Norway.
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Zambrano C, González E, Salmeron D, Ruiz-Ojeda FJ, Luján J, Scheer FA, Garaulet M. Time-restricted eating affects human adipose tissue fat mobilization. Obesity (Silver Spring) 2024; 32:1680-1688. [PMID: 39073251 PMCID: PMC11357894 DOI: 10.1002/oby.24057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/11/2024] [Accepted: 04/16/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE Time-restricted eating (TRE), a dietary approach that confines food intake to specific time windows, has shown metabolic benefits. However, its impact on body weight loss remains inconclusive. The objective of this study was to investigate the influence of early TRE (eTRE) and delayed TRE (dTRE) on fat mobilization using human adipose tissue (AT) cultures. METHODS Subcutaneous AT was collected from 21 participants with severe obesity. We assessed fat mobilization by measuring glycerol release in AT culture across four treatment conditions: control, eTRE, dTRE, and 24-h fasting. RESULTS TRE had a significant impact on lipolysis (glycerol release [mean (SD)] in micromoles per hour per gram: control, 0.05 [0.003]; eTRE, 0.10 [0.006]; dTRE, 0.08 [0.005]; and fasting, 0.17 [0.008]; p < 0.0001). Both eTRE and dTRE increased lipolysis compared with the control group, with eTRE showing higher glycerol mobilization than dTRE during the overall 24-h time window, especially at the nighttime/habitual sleep episode (p < 0.0001). Further analysis of TRE based on fasting duration revealed that, independently of the time window, glycerol release increased with fasting duration (in micromoles per hour per gram: 8 h = 0.08 [0.001]; 12 h = 0.09 [0.008]; and 16 h of fasting = 0.12 [0.011]; p < 0.0001). CONCLUSIONS This study provides insights into the potential benefits of TRE on fat mobilization and may guide the design of future dietary strategies for weight management and metabolic health.
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Affiliation(s)
- Carolina Zambrano
- Department of Physiology, Regional Campus of International Excellence, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia, IMIB-Arrixaca-UMU, University Clinical Hospital 30120, Murcia, Spain
| | - Elena González
- Department of Nutrition and integrative physiology, University of Utah, Salt Lake City, Utah, United States
| | - Diego Salmeron
- Biomedical Research Institute of Murcia, IMIB-Arrixaca-UMU, University Clinical Hospital 30120, Murcia, Spain
- Health and Social Sciences Department, University of Murcia, Murcia, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Francisco Javier Ruiz-Ojeda
- Institute of Nutrition and Food Technology “José Mataix,” Center of Biomedical Research, University of Granada, Granada, Spain
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, Granada, Spain
| | - Juan Luján
- General Surgery Service, Hospital Quiron salud Murcia, Spain
| | - Frank A.J.L Scheer
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States
- Broad Institute of Massachusetts Institute of Technology (M.I.T.) and Harvard, Cambridge, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Marta Garaulet
- Department of Physiology, Regional Campus of International Excellence, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia, IMIB-Arrixaca-UMU, University Clinical Hospital 30120, Murcia, Spain
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States
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Bohlman C, McLaren C, Ezzati A, Vial P, Ibrahim D, Anton SD. The effects of time-restricted eating on sleep in adults: a systematic review of randomized controlled trials. Front Nutr 2024; 11:1419811. [PMID: 39144285 PMCID: PMC11322763 DOI: 10.3389/fnut.2024.1419811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 07/18/2024] [Indexed: 08/16/2024] Open
Abstract
Introduction Time-restricted eating (TRE), a dietary pattern reducing the duration of daily food consumption, has recently gained popularity. Existing studies show the potential benefits of TRE for cardiometabolic health. Uncertainty remains about whether these benefits are solely from altered meal timing or influences on other health behaviors, including sleep. Despite growing scientific interest in the effects of TRE on sleep parameters, the topic has not been systematically explored. Methods This review examined the effects of TRE interventions (daily fasting duration ≥14 h) lasting at least 8 weeks on objective and subjective sleep parameters. Six randomized control trials were identified through Pubmed, Embase, Google Scholar, and Scopus through September 2023. Results Of the included studies, three employed objective sleep measures using wearables and five studies assessed sleep subjectively through self-report questionnaires. Only one study reported significant improvements in subjective sleep quality following a TRE intervention. Additionally, one study found significant decreases in sleep duration, two studies found significant decreases in sleep efficiency, and one found significant increases in sleep onset latency. Discussion Current evidence indicates that short to mid-term TRE does not typically worsen sleep parameters. However, some populations may experience reduced sleep disturbances, while others may experience reductions in sleep efficiency. Longer duration studies with objective sleep assessments are needed to better understand the effects of TRE on sleep parameters.
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Affiliation(s)
- Carly Bohlman
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Christian McLaren
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Armin Ezzati
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States
- Department of Food, Nutrition, Dietetics, and Health, Kansas State University, Manhattan, KS, United States
| | - Patricia Vial
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Daniel Ibrahim
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Stephen D. Anton
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
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Raji OE, Kyeremah EB, Sears DD, St-Onge MP, Makarem N. Chrononutrition and Cardiometabolic Health: An Overview of Epidemiological Evidence and Key Future Research Directions. Nutrients 2024; 16:2332. [PMID: 39064774 PMCID: PMC11280377 DOI: 10.3390/nu16142332] [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] [Received: 06/06/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Chrononutrition is a rapidly evolving field of nutritional epidemiology that addresses the complex relationship between temporal eating patterns, circadian rhythms, and metabolic health, but most prior research has focused on the cardiometabolic consequences of time-restricted feeding and intermittent fasting. The purpose of this topical review is to summarize epidemiological evidence from observational and intervention studies regarding the role of chrononutrition metrics related to eating timing and regularity in cardiometabolic health preservation and cardiovascular disease prevention. Observational studies are limited due to the lack of time-stamped diet data in most population-based studies. Findings from cohort studies generally indicate that breakfast skipping or the later timing of the first eating occasion, a later lunch and dinner, and a greater proportion of caloric intake consumed in the evening are associated with adverse cardiometabolic outcomes, including higher risk for coronary heart disease, hypertension, type 2 diabetes, obesity, dyslipidemia, and systemic inflammation. Randomized controlled trials are also limited, as most in the field of chrononutrition focus on the cardiometabolic consequences of time-restricted feeding. Overall, interventions that shift eating timing patterns to earlier in the day and that restrict evening caloric intake tend to have protective effects on cardiometabolic health, but small sample sizes and short follow-up are notable limitations. Innovation in dietary assessment approaches, to develop low-cost validated tools with acceptable participant burden that reliably capture chrononutrition metrics, is needed for advancing observational evidence. Culturally responsive pragmatic intervention studies with sufficiently large and representative samples are needed to understand the impact of fixed and earlier eating timing schedules on cardiometabolic health. Additional research is warranted to understand the modifiable determinants of temporal eating patterns, to investigate the role of chrononutrition in the context of other dimensions of diet (quantity, quality, and food and nutrition security) in achieving cardiometabolic health equity, and to elucidate underlying physiological mechanisms.
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Affiliation(s)
- Oluwatimilehin E. Raji
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA; (O.E.R.); (E.B.K.)
| | - Esther B. Kyeremah
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA; (O.E.R.); (E.B.K.)
| | - Dorothy D. Sears
- College of Health Solutions, Arizona State University, Tempe, AZ 85287, USA;
- Department of Medicine, University of California San Diego School of Medicine, La Jolla, CA 92093, USA
- Department of Family Medicine, University of California San Diego School of Medicine, La Jolla, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA
| | - Marie-Pierre St-Onge
- Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA;
- Sleep Center of Excellence, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA; (O.E.R.); (E.B.K.)
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6
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Dietvorst C, Kroon J, Slebe R, Serlie MJ, Berk KA, Rutters F. Challenges in Providing an Overview of Results of Intermittent Fasting Interventions on Diabetes Parameters. Comment on Silva et al. Effects of Intermittent Fasting on Regulation of Metabolic Homeostasis: A Systematic Review and Meta-Analysis in Health and Metabolic-Related Disorders. J. Clin. Med. 2023, 12, 3699. J Clin Med 2024; 13:4091. [PMID: 39064131 PMCID: PMC11278055 DOI: 10.3390/jcm13144091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024] Open
Abstract
We hereby comment on the systematic review "Effects of Intermittent Fasting on Regulation of Metabolic Homeostasis: A Systematic Review and Meta-Analysis in Health and Metabolic-Related Disorders" by Silva et al [...].
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Affiliation(s)
- Carmen Dietvorst
- Department of Internal Medicine, Division of Dietetics, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands; (C.D.)
| | - Jur Kroon
- Department of Endocrinology and Metabolism and Amsterdam Gastroenterology Metabolism Endocrinology Institute, Amsterdam University Medical Center, 1081 BT Amsterdam, The Netherlands; (J.K.)
| | - Romy Slebe
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre, 1105 AZ Amsterdam, The Netherlands
| | - Mireille J. Serlie
- Department of Endocrinology and Metabolism and Amsterdam Gastroenterology Metabolism Endocrinology Institute, Amsterdam University Medical Center, 1081 BT Amsterdam, The Netherlands; (J.K.)
- Section of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA
| | - Kirsten A. Berk
- Department of Internal Medicine, Division of Dietetics, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands; (C.D.)
| | - Femke Rutters
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre, 1105 AZ Amsterdam, The Netherlands
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Goldman DM, Warbeck CB, Waterfall TJ, Sud A, Quarshie M, Craddock JC. Plant-based and Early Time-restricted Eating for Prevention and Treatment of Type 2 Diabetes in Adults: A Narrative Review. Can J Diabetes 2024; 48:341-347. [PMID: 38513822 DOI: 10.1016/j.jcjd.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
Type 2 diabetes (T2D) is a significant public health challenge for which effective lifestyle interventions are needed. A growing body of evidence supports the use of both plant-based eating patterns and early time-restricted eating (eTRE) for the prevention and treatment of T2D, but research has not yet explored the potential of these dietary strategies in combination. In this narrative review, we assessed the evidence by which plant-based diets, in conjunction with eTRE, could support T2D care. The electronic databases MEDLINE and the Web of Science were searched for relevant articles published throughout the last decade. Observational research has shown that healthy plant-based eating patterns and eTRE are associated with reductions in T2D risk. Interventional trials demonstrated that plant-based diets promote improvements in glycated hemoglobin, insulin resistance, glycemic management, and cardiometabolic risk factors. These changes may be mediated, in part, by reductions in oxidative stress, dietary acid load, and hepatocellular and intramyocellular lipids. The eTRE strategies were also shown to improve insulin resistance and glycemic management, and mechanisms of action included enhanced regulation of circadian rhythm and increased metabolic flexibility. Integrating these dietary strategies may produce additive benefits, mediated by reduced visceral adiposity and beneficial shifts in gut microbiota composition. However, potential barriers to concurrent implementation of these interventions may exist, including social challenges, scheduling constraints, and tolerance. Prospective trials are needed to examine their acceptability and clinical effects.
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Affiliation(s)
| | - Cassandra B Warbeck
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Adam Sud
- Plant-Based for Positive Change, Austin, Texas, United States
| | | | - Joel C Craddock
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
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Brogi S, Tabanelli R, Puca S, Calderone V. Intermittent Fasting: Myths, Fakes and Truth on This Dietary Regimen Approach. Foods 2024; 13:1960. [PMID: 38998465 PMCID: PMC11241639 DOI: 10.3390/foods13131960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 06/17/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
Intermittent fasting (IF) has been indicated as a valuable alternative to the classical caloric restriction dietary regimen for lowering body weight and preventing obesity-related complications, such as metabolic syndrome and type II diabetes. However, is it effective? In this review article, we analyzed over 50 clinical studies in which IF, conducted by alternate day fasting (ADF) or time-restricted feeding (TRF), was compared with the caloric restriction approach. We evaluated the different roles of IF in treating and preventing human disorders such as metabolic syndrome, type II diabetes, and some types of cancer, as well as the usefulness of IF in reducing body weight and cardiovascular risk factors such as hypertension. Furthermore, we explored the cellular pathways targeted by IF to exert their beneficial effects by activating effector proteins that modulate cell functions and resistance to oxidative stress. In contrast, we investigated concerns regarding human health related to the adoption of IF dietary regimens, highlighting the profound debate surrounding weight loss regimens. We examined and compared several clinical trials to formulate an updated concept regarding IF and its therapeutic potential.
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Affiliation(s)
- Simone Brogi
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy; (R.T.); (S.P.); (V.C.)
- Bioinformatics Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Rita Tabanelli
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy; (R.T.); (S.P.); (V.C.)
| | - Sara Puca
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy; (R.T.); (S.P.); (V.C.)
| | - Vincenzo Calderone
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy; (R.T.); (S.P.); (V.C.)
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Lok R, Qian J, Chellappa SL. Sex differences in sleep, circadian rhythms, and metabolism: Implications for precision medicine. Sleep Med Rev 2024; 75:101926. [PMID: 38564856 DOI: 10.1016/j.smrv.2024.101926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/16/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
The number of individuals experiencing sleep loss has exponentially risen over the past decades. Extrapolation of laboratory findings to the real world suggests that females are more affected by extended wakefulness and circadian misalignment than males are. Therefore, long-term effects such as sleep and metabolic disorders are likely to be more prevalent in females than in males. Despite emerging evidence for sex differences in key aspects of sleep-wake and circadian regulation, much remains unknown, as females are often underrepresented in sleep and circadian research. This narrative review aims at highlighting 1) how sex differences systematically impinge on the sleep-wake and circadian regulation in humans, 2) how sex differences in sleep and circadian factors modulate metabolic control, and 3) the relevance of these differences for precision medicine. Ultimately, the findings justify factoring in sex differences when optimizing individually targeted sleep and circadian interventions in humans.
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Affiliation(s)
- Renske Lok
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
| | - Jingyi Qian
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Females's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Sarah L Chellappa
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom.
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Akbar Z, Shi Z. Unfavorable Mealtime, Meal Skipping, and Shiftwork Are Associated with Circadian Syndrome in Adults Participating in NHANES 2005-2016. Nutrients 2024; 16:1581. [PMID: 38892514 PMCID: PMC11173982 DOI: 10.3390/nu16111581] [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] [Received: 04/24/2024] [Revised: 05/08/2024] [Accepted: 05/11/2024] [Indexed: 06/21/2024] Open
Abstract
The concept of Circadian Syndrome (CircS) aims to emphasize the circadian disruptions underlying cardiometabolic conditions. Meal timing and shiftwork may disrupt circadian rhythms, increasing cardiometabolic risk. This study aimed to assess the associations of meal timing, meal skipping, and shiftwork with CircS in US adults and explore effect modifications by sociodemographic and lifestyle factors. CircS was defined using Metabolic Syndrome components in addition to short sleep and depression symptoms. Data from 10,486 participants of the National Health and Nutrition Examination Survey 2005-2016 were analyzed cross-sectionally. Mealtime was assessed by calculating the midpoint of intake between breakfast and dinner and dichotomizing it into favorable mealtime (between 12:30 and 13:15) and unfavorable mealtime using a data-driven approach. Meal skippers were categorized separately. Participants working evening, night, or rotating shifts were classified as shift workers. In the multivariable logistic regression analysis, an unfavorable mealtime, meal skipping, and shiftwork were associated with a higher likelihood of CircS (OR = 1.24; 95%CI 1.07-1.44, OR = 1.39; 95%CI 1.16-1.67, and OR = 1.37; 95%CI 1.01-1.87, respectively). Subgroup analyses revealed no significant interactions between meal timing, meal skipping, or shiftwork and socioeconomic status or lifestyle regarding CircS. These findings highlight the importance of aligning mealtimes with circadian rhythms for improved circadian health.
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Affiliation(s)
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar;
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11
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Maruthur NM, Pilla SJ, White K, Wu B, Maw MTT, Duan D, Turkson-Ocran RA, Zhao D, Charleston J, Peterson CM, Dougherty RJ, Schrack JA, Appel LJ, Guallar E, Clark JM. Effect of Isocaloric, Time-Restricted Eating on Body Weight in Adults With Obesity : A Randomized Controlled Trial. Ann Intern Med 2024; 177:549-558. [PMID: 38639542 DOI: 10.7326/m23-3132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Time-restricted eating (TRE) lowers body weight in many studies. Whether TRE induces weight loss independent of reductions in calorie intake, as seen in rodent studies, is unknown. OBJECTIVE To determine the effect of TRE versus a usual eating pattern (UEP) on body weight in the setting of stable caloric intake. DESIGN Randomized, isocaloric feeding study. (ClinicalTrials.gov: NCT03527368). SETTING Clinical research unit. PARTICIPANTS Adults with obesity and prediabetes or diet-controlled diabetes. INTERVENTION Participants were randomly assigned 1:1 to TRE (10-hour eating window, 80% of calories before 1 p.m.) or UEP (≤16-hour window, ≥50% of calories after 5 p.m.) for 12 weeks. Both groups had the same nutrient content and were isocaloric with total calories determined at baseline. MEASUREMENTS Primary outcome was change in body weight at 12 weeks. Secondary outcomes were fasting glucose, homeostatic model assessment for insulin resistance (HOMA-IR), glucose area under the curve by oral glucose tolerance test, and glycated albumin. We used linear mixed models to evaluate the effect of interventions on outcomes. RESULTS All 41 randomly assigned participants (mean age, 59 years; 93% women; 93% Black race; mean BMI, 36 kg/m2) completed the intervention. Baseline weight was 95.6 kg (95% CI, 89.6 to 101.6 kg) in the TRE group and 103.7 kg (CI, 95.3 to 112.0 kg) in the UEP group. At 12 weeks, weight decreased by 2.3 kg (CI, 1.0 to 3.5 kg) in the TRE group and by 2.6 kg (CI, 1.5 to 3.7 kg) in the UEP group (average difference TRE vs. UEP, 0.3 kg [CI, -1.2 to 1.9 kg]). Change in glycemic measures did not differ between groups. LIMITATION Small, single-site study; baseline differences in weight by group. CONCLUSION In the setting of isocaloric eating, TRE did not decrease weight or improve glucose homeostasis relative to a UEP, suggesting that any effects of TRE on weight in prior studies may be due to reductions in caloric intake. PRIMARY FUNDING SOURCE American Heart Association.
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Affiliation(s)
- Nisa M Maruthur
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore; and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland (N.M.M., L.J.A., E.G., J.M.C.)
| | - Scott J Pilla
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore; and Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland (S.J.P.)
| | - Karen White
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland (K.W.)
| | - Beiwen Wu
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (B.W.)
| | - May Thu Thu Maw
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of General Internal Medicine, University of Maryland Capital Region Medical Center, Largo, Maryland (M.T.T.M.)
| | - Daisy Duan
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland (D.D.)
| | - Ruth-Alma Turkson-Ocran
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and General Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts (R.-A.T.)
| | - Di Zhao
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health Baltimore; and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland (D.Z.)
| | - Jeanne Charleston
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore; and Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland (J.C.)
| | - Courtney M Peterson
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, Alabama (C.M.P.)
| | - Ryan J Dougherty
- Center on Aging & Health, Johns Hopkins University, Baltimore; and Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland (R.J.D.)
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health Baltimore; and Center on Aging & Health, Johns Hopkins University, Baltimore, Maryland (J.A.S.)
| | - Lawrence J Appel
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore; and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland (N.M.M., L.J.A., E.G., J.M.C.)
| | - Eliseo Guallar
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore; and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland (N.M.M., L.J.A., E.G., J.M.C.)
| | - Jeanne M Clark
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore; and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland (N.M.M., L.J.A., E.G., J.M.C.)
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12
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Wells RG, Neilson LE, McHill AW, Hiller AL. Dietary fasting and time-restricted eating in Huntington's disease: therapeutic potential and underlying mechanisms. Transl Neurodegener 2024; 13:17. [PMID: 38561866 PMCID: PMC10986006 DOI: 10.1186/s40035-024-00406-z] [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] [Received: 11/15/2023] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
Huntington's disease (HD) is a devastating neurodegenerative disorder caused by aggregation of the mutant huntingtin (mHTT) protein, resulting from a CAG repeat expansion in the huntingtin gene HTT. HD is characterized by a variety of debilitating symptoms including involuntary movements, cognitive impairment, and psychiatric disturbances. Despite considerable efforts, effective disease-modifying treatments for HD remain elusive, necessitating exploration of novel therapeutic approaches, including lifestyle modifications that could delay symptom onset and disease progression. Recent studies suggest that time-restricted eating (TRE), a form of intermittent fasting involving daily caloric intake within a limited time window, may hold promise in the treatment of neurodegenerative diseases, including HD. TRE has been shown to improve mitochondrial function, upregulate autophagy, reduce oxidative stress, regulate the sleep-wake cycle, and enhance cognitive function. In this review, we explore the potential therapeutic role of TRE in HD, focusing on its underlying physiological mechanisms. We discuss how TRE might enhance the clearance of mHTT, recover striatal brain-derived neurotrophic factor levels, improve mitochondrial function and stress-response pathways, and synchronize circadian rhythm activity. Understanding these mechanisms is critical for the development of targeted lifestyle interventions to mitigate HD pathology and improve patient outcomes. While the potential benefits of TRE in HD animal models are encouraging, future comprehensive clinical trials will be necessary to evaluate its safety, feasibility, and efficacy in persons with HD.
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Affiliation(s)
- Russell G Wells
- Department of Neurology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
| | - Lee E Neilson
- Department of Neurology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
- Neurology and PADRECC VA Portland Health Care System, Portland, OR, 97239, USA
| | - Andrew W McHill
- Sleep, Chronobiology and Health Laboratory, School of Nursing, Oregon Health & Science University, Portland, OR, 97239, USA
- Oregon Institute of Occupational Health Sciences, Oregon Health & Sciences University, Portland, OR, 97239, USA
| | - Amie L Hiller
- Department of Neurology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
- Neurology and PADRECC VA Portland Health Care System, Portland, OR, 97239, USA
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13
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Cheung K, Chan V, Chan S, Wong MMH, Chung GKK, Cheng WY, Lo K, Zeng F. Effect of Intermittent Fasting on Cardiometabolic Health in the Chinese Population: A Meta-Analysis of Randomized Controlled Trials. Nutrients 2024; 16:357. [PMID: 38337642 PMCID: PMC10857210 DOI: 10.3390/nu16030357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
The efficacy of intermittent fasting (IF), as an emerging weight management strategy, in improving cardiometabolic health has been evaluated in various populations, but that among Chinese individuals has not been systematically studied. A comprehensive search on multiple databases was performed to identify eligible randomized controlled trials (RCTs) up to October 2022. The primary outcome was post-intervention weight loss, and secondary outcomes included changes in cardiometabolic indicators. Effect estimates were meta-analyzed using a random-effects model. In total, nine RCTs with 899 Chinese participants were included. Time-restricted eating was the most adopted IF protocol in this study (six out of nine), followed by alternate-day fasting. The IF intervention significantly reduced body weight, body mass index, body fat mass, homeostatic model assessment of insulin resistance, low-density lipoprotein cholesterol, and triglycerides when compared with control groups. However, no statistically significant reductions in waist circumference, total cholesterol, high-density lipoprotein cholesterol, fasting glucose, systolic blood pressure, and diastolic blood pressure were found. To sum up, IF can be a weight management strategy and may improve the cardiometabolic health of Chinese adults, but more long-term trials using different IF strategies are required to generate robust evidence of its efficacy.
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Affiliation(s)
- Katy Cheung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China (G.K.-K.C.)
| | - Vicky Chan
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hong Kong 100872, China; (V.C.); (W.-Y.C.)
| | - Stephanie Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China (G.K.-K.C.)
| | - Martin Ming Him Wong
- Institute of Epidemiology and Health Care, University College London, London WC1E 6BT, UK;
| | - Gary Ka-Ki Chung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China (G.K.-K.C.)
| | - Wai-Yin Cheng
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hong Kong 100872, China; (V.C.); (W.-Y.C.)
- Research Institute for Future Food, The Hong Kong Polytechnic University, Hong Kong 100872, China
| | - Kenneth Lo
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hong Kong 100872, China; (V.C.); (W.-Y.C.)
- Research Institute for Future Food, The Hong Kong Polytechnic University, Hong Kong 100872, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 100872, China
| | - Fangfang Zeng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, China
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14
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ElSayed NA, Aleppo G, Bannuru RR, Beverly EA, Bruemmer D, Collins BS, Darville A, Ekhlaspour L, Hassanein M, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S77-S110. [PMID: 38078584 PMCID: PMC10725816 DOI: 10.2337/dc24-s005] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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15
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Dote-Montero M, Merchan-Ramirez E, Oses M, Echarte J, Clavero-Jimeno A, Alcantara J, Camacho-Cardenosa A, Cupeiro R, Rodríguez-Miranda MDLN, López-Vázquez A, Amaro-Gahete FJ, González Cejudo MT, Martin-Olmedo JJ, Molina-Fernandez M, García Pérez PV, Contreras-Bolívar V, Muñoz-Garach A, Andreo-López MC, Carneiro-Barrera A, Miranda-Ferrúa E, Zugasti A, Petrina E, Álvarez de Eulate N, Goñi E, Ribelles MJ, Brugos CA, Izquierdo C, Fernández-Puggioni V, Galbete A, Villanueva A, Medrano M, Alfaro-Magallanes VM, Muñoz-Torres M, Martín-Rodríguez JL, Idoate F, Cabeza R, Ruiz JR, Labayen I. Efficacy of different 8 h time-restricted eating schedules on visceral adipose tissue and cardiometabolic health: A study protocol. Nutr Metab Cardiovasc Dis 2024; 34:177-187. [PMID: 37949715 DOI: 10.1016/j.numecd.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/18/2023] [Accepted: 09/18/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND AND AIMS To investigate the efficacy and feasibility of three different 8 h time-restricted eating (TRE) schedules (i.e., early, late, and self-selected) compared to each other and to a usual-care (UC) intervention on visceral adipose tissue (VAT) and cardiometabolic health in men and women. METHODS AND RESULTS Anticipated 208 adults (50% women) aged 30-60 years, with overweight/obesity (25 ≤ BMI<40 kg/m2) and with mild metabolic impairments will be recruited for this parallel-group, multicenter randomized controlled trial. Participants will be randomly allocated (1:1:1:1) to one of four groups for 12 weeks: UC, early TRE, late TRE or self-selected TRE. The UC group will maintain their habitual eating window and receive, as well as the TRE groups, healthy lifestyle education for weight management. The early TRE group will start eating not later than 10:00, and the late TRE group not before 13:00. The self-selected TRE group will select an 8 h eating window before the intervention and maintain it over the intervention. The primary outcome is changes in VAT, whereas secondary outcomes include body composition and cardiometabolic risk factors. CONCLUSION This study will determine whether the timing of the eating window during TRE impacts its efficacy on VAT, body composition and cardiometabolic risk factors and provide insights about its feasibility.
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Affiliation(s)
- Manuel Dote-Montero
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain.
| | - Elisa Merchan-Ramirez
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Maddi Oses
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Jon Echarte
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Antonio Clavero-Jimeno
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Jma Alcantara
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Alba Camacho-Cardenosa
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Rocío Cupeiro
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain; LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | | | - Alejandro López-Vázquez
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Francisco J Amaro-Gahete
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Centro de Investigación Biomédica en Red: Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Juan J Martin-Olmedo
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Marcos Molina-Fernandez
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | | | - Victoria Contreras-Bolívar
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
| | - Araceli Muñoz-Garach
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Centro de Investigación Biomédica en Red: Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - María C Andreo-López
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
| | | | - Emiliano Miranda-Ferrúa
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Ana Zugasti
- Servicio de Endocrinología y Nutrición, Hospital Universitario de Navarra, Pamplona, Spain
| | - Estrella Petrina
- Servicio de Radiología, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Elena Goñi
- Servicio de Medicina Nuclear, Hospital Universitario de Navarra, Pamplona, Spain
| | - María Jesús Ribelles
- Servicio de Medicina Nuclear, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Claudia Izquierdo
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Victoria Fernández-Puggioni
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Arkaitz Galbete
- Universidad Pública de Navarra-Navarrabiomed-Hospital Universitario de Navarra, Redissec, Instituto de Investigacion Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Arantxa Villanueva
- Smart Cities Institute, Public University of Navarre, Pamplona, Spain; Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | - María Medrano
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Víctor Manuel Alfaro-Magallanes
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain; LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Manuel Muñoz-Torres
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain; Department of Medicine, University of Granada, 18016 Granada, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | | | - Rafael Cabeza
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Centro de Investigación Biomédica en Red: Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Idoia Labayen
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigación Biomédica en Red: Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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Črešnovar T, Habe B, Jenko Pražnikar Z, Petelin A. Effectiveness of Time-Restricted Eating with Caloric Restriction vs. Caloric Restriction for Weight Loss and Health: Meta-Analysis. Nutrients 2023; 15:4911. [PMID: 38068769 PMCID: PMC10708501 DOI: 10.3390/nu15234911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
Time-restricted eating (TRE) is an increasingly popular dietary strategy for weight loss. Recent studies suggest that combining TRE with caloric restriction (CR) may have more favorable effects on both physical and biochemical aspects when compared with CR alone. Therefore, we performed a meta-analysis to compare the effects of TRE with CR vs. CR alone on anthropometric and biochemical measures in overweight or obese adults. We reviewed articles from PubMed, Web of science, EMBASE, and the Cochrane Library published before 25 May 2023. The meta-analysis incorporated data from seven randomized controlled trials of nine interventions, with a total of 231 participants in the TRE with CR group and 227 participants in the CR-only group. Data were analyzed using RewMan version 5.4.1. All results in our meta-analysis were described as mean difference (MD) with 95% confidence interval (Cl). Results showed that TRE with CR compared to CR alone resulted in significantly greater reductions in body weight (MD: -2.11 kg, 95% CI: -2.68 kg to -1.54 kg, p = < 0.00001, I2 = 42%), body fat mass (MD: -0.75 kg, 95% CI: -1.35 kg to -0.16 kg, p = 0.01; I2 = 0%), and waist circumference (MD: -1.27 cm, 95% CI: -2.36 cm to -0.19 cm, p = 0.02, I2 = 0%), while no additional impact of TRE in combination with CR in comparison to CR on serum biochemical parameters were found. Our results suggest that the improvement in biochemical parameters are mainly caused by CR, while improvements in anthropometric parameters are further enhanced by TRE.
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Affiliation(s)
| | | | | | - Ana Petelin
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia; (T.Č.); (B.H.); (Z.J.P.)
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Mishra S, Persons PA, Lorenzo AM, Chaliki SS, Bersoux S. Time-Restricted Eating and Its Metabolic Benefits. J Clin Med 2023; 12:7007. [PMID: 38002621 PMCID: PMC10672223 DOI: 10.3390/jcm12227007] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/26/2023] [Accepted: 11/04/2023] [Indexed: 11/26/2023] Open
Abstract
Newer management strategies are being evaluated to treat obesity, which continues to increase worldwide. After 12 h of fasting, the body switches from glucose to fat metabolism, regulating protein synthesis and autophagy. These cellular responses are central to the metabolic benefits of time-restricted eating (TRE), independent of calorie restriction and weight loss, and they have heightened interest in TRE regimens. Controversy remains, however, regarding the benefits of TRE regimens. We reviewed the current literature and concluded that TRE is equivalent to calorie restriction for weight loss and has positive effects for patients with diseases such as nonalcoholic fatty liver disease, cancer, and cardiovascular disease.
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Affiliation(s)
- Sneha Mishra
- Division of Community Internal Medicine Mayo Clinic, Scottsdale, AZ 85259, USA; (P.A.P.); (A.M.L.); (S.S.C.); (S.B.)
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18
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Hegedus E, Vu MH, Salvy SJ, Bakhsh J, Goran MI, Raymond JK, Espinoza JC, Vidmar AP. Randomized controlled feasibility trial of late eight-hour time restricted eating for adolescents with type 2 diabetes. J Acad Nutr Diet 2023; 124:S2212-2672(23)01629-5. [PMID: 39492410 PMCID: PMC11507361 DOI: 10.1016/j.jand.2023.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/15/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2024]
Abstract
BACKGROUND No trial to date has tested the effects of late time-restricted eating (lTRE) on glycemic control or body composition in adolescents with type 2 diabetes (T2D). OBJECTIVE The objective of the current study was to examine the feasibility, acceptability, and preliminary efficacy of lTRE compared to a prolonged eating window in adolescents with T2D. DESIGN A 12-week, randomized, controlled, feasibility study of lTRE compared to control in adolescents with obesity and new onset T2D was conducted. PARTICIPANTS/SETTING Eligible participants were 13-21 years old; with a diagnosis of T2D, on metformin monotherapy, recruited from Children's Hospital Los Angeles, between January 2021 and December of 2022. From 36 eligible participants, 27 were enrolled (75% recruitment rate; age: 16.5 ± 1.7 years, HbA1c: 6.6 ± 0.9%, 22/27 [81%] Hispanic, 17/27 [63%] female, 23/27 [85%] public insurance; all p-values >.05), and 23 of 27 completed the protocol. INTERVENTION Participants wore a continuous glucose monitor (CGM) daily and were randomized to one of two meal-timing schedules for 12-weeks: (1) lTRE (eating all food between 12:00 PM and 20:00 PM without calorie counting or recommended daily caloric intake) or (2) Control (eating over a period of 12 or more hours per day). MAIN OUTCOME MEASURES Study recruitment, retention and adherence to intervention arms were captured to operationalize feasibility. Glucose control (HbA1c), weight loss (%BMIp95), total body fat mass on DEXA, sleep, and dietary intake were explored as secondary outcomes. STATISTICAL ANALYSIS Analyses were based on the intention to treat (ITT) population. Between-group differences in clinical outcomes were assessed using mixed-effects longitudinal regression models. RESULTS Overall adherence to the 8-hr lTRE was 6.2 ± 1.1 d/wk and Control was 5.9 ± 0.9 d/wk. Participants assigned to lTRE indicated that limiting their eating window did not negatively affect their daily functioning and no adverse events were reported. In this pilot study, lTRE led to a reduction in %BMIp95 (-3.4%-95%CI:‒6.1, ‒0.7, p = 0.02), HbA1c (-0.4%, 95%CI:‒0.9, ‒0.01, p = .06), and ALT (-31.1 U/L, 95%CI:‒60, ‒2, p = .05) within the group. There was no significant difference observed between lTRE and control across these measures (all p > .05). The lTRE group had a ‒271.4 (95% CI, ‒565.2, 5.2) kcal/day energy reduction compared to a +293.2 (95% CI: 30.4, 552.7) kcal/day increase in Control (p = .01). There were no significant changes observed in sleep or eating behaviors over the study period between groups. CONCLUSIONS Recruitment and retention rates suggest a trial of lTRE in adolescents with T2D was feasible. lTRE was seen as acceptable by participants and adherence was high. A revised intervention, building on the successful elements of this pilot alongside adapting implementations strategies to augment adherence and engagement, should therefore be considered.
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Affiliation(s)
- Elizabeth Hegedus
- Children's Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism
| | - My H Vu
- Children's Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, the Saban Research Institute Biostatics Core
| | - Sarah Jeanne Salvy
- Department of Population and Public Health Sciences, University of Southern California
| | - Jomanah Bakhsh
- Children's Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism; Department of Population and Public Health Sciences, University of Southern California
| | - Michael I Goran
- Children's Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism
| | - Jennifer K Raymond
- Children's Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism
| | - Juan C Espinoza
- Research Center for Health Equity, Cedars-Sinai Medical Center, Department of Medicine, Samuel Oschin (C)omprehensive Cancer Institute, (4)Lurie Children's Hospital, Department of Pediatrics
| | - Alaina P Vidmar
- Children's Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism.
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19
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Marjot T, Tomlinson JW, Hodson L, Ray DW. Timing of energy intake and the therapeutic potential of intermittent fasting and time-restricted eating in NAFLD. Gut 2023; 72:1607-1619. [PMID: 37286229 PMCID: PMC10359613 DOI: 10.1136/gutjnl-2023-329998] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/14/2023] [Indexed: 06/09/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) represents a major public health concern and is associated with a substantial global burden of liver-related and cardiovascular-related morbidity and mortality. High total energy intake coupled with unhealthy consumption of ultra-processed foods and saturated fats have long been regarded as major dietary drivers of NAFLD. However, there is an accumulating body of evidence demonstrating that the timing of energy intake across a the day is also an important determinant of individual risk for NAFLD and associated metabolic conditions. This review summarises the available observational and epidemiological data describing associations between eating patterns and metabolic disease, including the negative effects of irregular meal patterns, skipping breakfast and night-time eating on liver health. We suggest that that these harmful behaviours deserve greater consideration in the risk stratification and management of patients with NAFLD particularly in a 24-hour society with continuous availability of food and with up to 20% of the population now engaged in shiftwork with mistimed eating patterns. We also draw on studies reporting the liver-specific impact of Ramadan, which represents a unique real-world opportunity to explore the physiological impact of fasting. By highlighting data from preclinical and pilot human studies, we present a further biological rationale for manipulating timing of energy intake to improve metabolic health and discuss how this may be mediated through restoration of natural circadian rhythms. Lastly, we comprehensively review the landscape of human trials of intermittent fasting and time-restricted eating in metabolic disease and offer a look to the future about how these dietary strategies may benefit patients with NAFLD and non-alcoholic steatohepatitis.
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Affiliation(s)
- Thomas Marjot
- Oxford Centre for Diabetes Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, Churchill Hospital, University of Oxford, Oxford, UK
- Oxford Liver Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jeremy W Tomlinson
- Oxford Centre for Diabetes Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, Churchill Hospital, University of Oxford, Oxford, UK
| | - Leanne Hodson
- Oxford Centre for Diabetes Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, Churchill Hospital, University of Oxford, Oxford, UK
| | - David W Ray
- Oxford Centre for Diabetes Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, Churchill Hospital, University of Oxford, Oxford, UK
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
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Gilden AH, Catenacci VA. Time-Restricted Eating for Treatment of Obesity? The Devil Is in the (Counseling) Details. Ann Intern Med 2023. [PMID: 37364267 DOI: 10.7326/m23-1396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Affiliation(s)
- Adam H Gilden
- Anschutz Health and Wellness Center and Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Victoria A Catenacci
- Anschutz Health and Wellness Center and Division of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado
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21
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Harris C, Czaja K. Can Circadian Eating Pattern Adjustments Reduce Risk or Prevent Development of T2D? Nutrients 2023; 15:nu15071762. [PMID: 37049602 PMCID: PMC10096926 DOI: 10.3390/nu15071762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/30/2023] [Accepted: 04/01/2023] [Indexed: 04/07/2023] Open
Abstract
Type 2 diabetes (T2D) is a chronic condition that occurs in insulin-resistant people with reduced glucose uptake. It is contributed to and exacerbated by a poor diet that results in accumulation of adipose tissue, high blood sugar, and other metabolic issues. Because humans have undergone food scarcity throughout history, our species has adapted a fat reserve genotype. This adaptation is no longer beneficial, as eating at a higher frequency than that of our ancestors has had a significant effect on T2D development. Eating at high frequencies disrupts the circadian clock, the circadian rhythm, and the composition of the gut microbiome, as well as hormone secretion and sensitivity. The current literature suggests an improved diet requires meal consistency, avoiding late-night eating, low meal frequency, and fasting to increase metabolic health. In addition, fasting as a treatment for T2D must be used correctly for beneficial results. Early time-restricted eating (TRE) provides many benefits such as improving insulin resistance, cognitive function, and glycemic control. Alternate-day fasting (ADF), 5:2 fasting, and long-term fasting all have benefits; however, they may be less advantageous than early TRE. Therefore, eating pattern adjustments can be used to reduce T2D if used correctly.
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Affiliation(s)
- Carlee Harris
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Krzysztof Czaja
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
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