Time-Restricted Eating: Any Better Than All-Day Eating? - MedPage Today

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Time-restricted eating -- a type of intermittent fasting -- proved no better for weight loss than eating consistent meals throughout the day, a new study found.

In a randomized trial of 116 individuals with overweight or obesity, there was no significant difference between the amount of weight lost with time-restricted eating versus regularly eating throughout the day (between-group difference -0.26 kg [-0.57 lb], 95% CI -1.30 to 0.78 kg, P=0.63), reported Ethan Weiss, MD, of the University of California San Francisco, and colleagues.

After 12 weeks, both groups did lose some weight from baseline, 2.07 lbs in the time-restricting eating group (0.94 kg, 95% CI -1.68 to -0.20 kg, P=0.01) and 1.5 lbs in the consistent-meal group (0.68 kg, 95% CI -1.41 to 0.05, P=0.07), as shown in the team's study online in JAMA Internal Medicine.

But there were no significant differences in secondary measures (changes in weight, fat mass, lean mass, fasting insulin, fasting glucose, hemoglobin A1c levels, estimated energy intake, total energy expenditure, and resting energy expenditure).

Specifically, as measured by dual-energy x-ray absorptiometry, there was no significant difference in the change in whole body fat mass between the two groups (-0.48 kg [-1.06 lbs], 99.7% CI -1.75 to 0.79 kg, P=0.30). Similarly, there were no between-group difference in the amount of lean mass after 12 weeks (-0.75 kg [-1.65 lbs], 99.7% CI -1.96 to 0.45 kg, P=0.09).

Markers of cardiovascular health were also similar between groups, with no significant between-group difference in systolic blood pressure (2.17 mm Hg, 95% CI -3.18 to 7.52, P=0.43) or diastolic blood pressure (-1.08 mm Hg, 95% CI -6.67 to 4.52, P=0.71).

The only significant difference seen between the two groups was a significant decrease in appendicular lean mass in the time-restricted eating group (-0.47 kg [-1.04 lbs], 95% CI -0.82 to -0.12 kg, P=0.009).

"Our results are consistent with a prior study demonstrating that a recommendation to skip breakfast does not affect weight outcomes in patients trying to lose weight but contradict previous reports describing the beneficial effects of [time-restricted eating] on weight loss and other metabolic risk markers," Weiss and co-authors wrote.

In addition, they noted, the possible different eating windows with time-restricted eating could potentially lead to differing metabolic outcomes, the researchers added.

For the analysis, the time-restricted eating group was prescribed a 16:8-hour eating window. Participants were instructed to eat as much as they wanted from 12:00 p.m. to 8:00 p.m. and then eat zero calories between 8:00 p.m. through 12:00 p.m. the next day. Outside of this eating window, only zero-calorie beverages were allowed.

This participant group was compared with another group who followed a consistent meal-timing schedule and instructed to eat three structured meals per day, with snacking between meals allowed.

Neither group was given recommendations for caloric intake, macronutrient intake, or physical activity; all participants were adults ages 18 to 64 and had baseline a body mass index of 27 to 43.

"Although the prescribed (12-8 p.m.) eating window is likely more attractive and more amenable to long-term adherence, it might not be optimal for the metabolic advantages of [time-restricted eating]," the researchers wrote, citing a previous study that found significant improvements in glycemic control and cardiovascular parameters with a 6-hour eating window.

"Future studies should be aimed at understanding the effects of early vs late [time-restricted eating] and protein intake or timing as a means to offset the loss in [appendicular lean mass]," the researchers concluded.

• 

  Kristen Monaco is a staff writer, focusing on endocrinology, psychiatry, and dermatology news. Based out of the New York City office, she’s worked at the company for nearly five years.

Disclosures

The study was funded by the University of California San Francisco (UCSF), Cardiology Division's Cardiology Innovations Award Program and the National Institute of Diabetes and Digestive and Kidney Diseases, with additional support from the James Peter Read Foundation.

Weiss reported grants from the National Institutes of Health and the James Peter Read Foundation and nonfinancial support from Mocacare and IHealth labs during the conduct of the study; he also is a cofounder and equity stake holder of Keyto, and owns stock and was formerly on the board of Virta. Co-authors reported financial relationships with Keyto outside of the study, UCSF, Medifast, and Tanita.

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