Original Research
1 October 2024

Time-Restricted Eating in Adults With Metabolic Syndrome: A Randomized Controlled Trial

Publication: Annals of Internal Medicine
Visual Abstract. Time-Restricted Eating in Adults With Metabolic Syndrome
Time-restricted eating (TRE) has been shown to produce weight loss and may provide cardiometabolic benefits, but prior studies have focused on relatively healthy adults with obesity. This clinical trial examines the effectiveness of TRE on glycemic control among adults with metabolic syndrome.

Abstract

Background:

Time-restricted eating (TRE), limiting daily dietary intake to a consistent 8 to 10 hours without mandating calorie reduction, may provide cardiometabolic benefits.

Objective:

To determine the effects of TRE as a lifestyle intervention combined with current standard-of-care treatments on cardiometabolic health in adults with metabolic syndrome.

Design:

Randomized controlled trial. (ClinicalTrials.gov: NCT04057339)

Setting:

Clinical research institute.

Participants:

Adults with metabolic syndrome including elevated fasting glucose or hemoglobin A1c (HbA1c; pharmacotherapy allowed).

Intervention:

Participants were randomly assigned to standard-of-care (SOC) nutritional counseling alone (SOC group) or combined with a personalized 8- to 10-hour TRE intervention (≥4-hour reduction in eating window) (TRE group) for 3 months. Timing of dietary intake was tracked in real time using the myCircadianClock smartphone application.

Measurements:

Primary outcomes were HbA1c, fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance, and glycemic assessments from continuous glucose monitors.

Results:

108 participants from the TIMET study completed the intervention (89% of those randomly assigned; 56 women, mean baseline age, 59 years; body mass index of 31.22 kg/m2; eating window of 14.19 hours). Compared with SOC, TRE improved HbA1c by −0.10% (95% CI, −0.19% to −0.003%). Statistical outcomes were adjusted for age. There were no major adverse events.

Limitation:

Short duration, self-reported diet, potential for multiple elements affecting outcomes.

Conclusion:

Personalized 8- to 10-hour TRE is an effective practical lifestyle intervention that modestly improves glycemic regulation and may have broader benefits for cardiometabolic health in adults with metabolic syndrome on top of SOC pharmacotherapy and nutritional counseling.

Primary Funding Source:

National Institutes of Health.

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Supplemental Material

Supplementary Material

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John Cary MD FACP3 October 2024
Fasting to target

Thank you to the authors for studying this. I do something similar: I have my type 2 diabetes patients fast to 123, eat and repeat. If they are able to execute that, I wean off the diabetes medication at a pace to sustain a weight loss of about 2 pounds per week. Once they have weaned off all their diabetes medications they then fast to 99, eat and repeat. It is so simple and so immediately effective that it can be highly motivational for some people, and the CGM has made it practical for many. About 10% of my overweight type 2 diabetes patients are able to achieve a nearly-normal glucose without medication using this simple technique.

Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine

History

Published online: 1 October 2024

Keywords

Authors

Affiliations

Emily N.C. Manoogian, PhD https://orcid.org/0000-0001-9718-9310
Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, California (E.N.C.M., M.O., K.L., N.R.G., S.P.)
Michael J. Wilkinson, MD https://orcid.org/0000-0002-3800-7369
Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California (M.J.W., J.N., D.V., A.R., A.P., P.R.T.)
Monica O’Neal, BS
Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, California (E.N.C.M., M.O., K.L., N.R.G., S.P.)
Kyla Laing, BS
Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, California (E.N.C.M., M.O., K.L., N.R.G., S.P.)
Justina Nguyen, BS
Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California (M.J.W., J.N., D.V., A.R., A.P., P.R.T.)
Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California (M.J.W., J.N., D.V., A.R., A.P., P.R.T.)
Ashley Rosander, BS
Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California (M.J.W., J.N., D.V., A.R., A.P., P.R.T.)
Aryana Pazargadi, MPH
Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California (M.J.W., J.N., D.V., A.R., A.P., P.R.T.)
Nikko R. Gutierrez, BS
Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, California (E.N.C.M., M.O., K.L., N.R.G., S.P.)
Department of Cognitive Science, University of California, San Diego, La Jolla, California (J.G.F.)
Shahrokh Golshan, PhD
Department of Psychiatry, University of California, San Diego, La Jolla, California (S.G.).
Satchidananda Panda, PhD https://orcid.org/0000-0002-7855-0091
Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, California (E.N.C.M., M.O., K.L., N.R.G., S.P.)
Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California (M.J.W., J.N., D.V., A.R., A.P., P.R.T.)
Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH) and other funders.
Acknowledgment: The authors thank all participants for their time and participation in the study. The authors also thank Hannah C. Lo, Adena Zadourian, Cameron Ormiston, and Juancarlos Cancilla for their assistance in study initiation and patient recruitment.
Financial Support: The study was funded by National Institutes of Health (NIH) R01 DK118278 (principal investigator [PI], Dr. Taub). Dr. Manoogian was supported by the Larry L. Hillblom Postdoctoral Fellowship and Drs. Manoogian and Wilkinson were also supported by a Larry L. Hillblom Foundation Network Grant. Dr. Wilkinson was supported by a KL2 career development award from the University of California, San Diego (UCSD) Altman Clinical and Translational Research Institute (ACTRI) (partial support via NIH KL2TR001444). This research was partially supported by the UCSD ACTRI. The ACTRI is funded by awards issued by the National Center for Advancing Translational Sciences, NIH UL1TR001442. The research conducted in Dr. Panda’s laboratory was partially supported by NIH grants R01CA258221 (PI, Dr. Panda) and Salk Institute Cancer Center grant NIH P30CA014195. The myCircadianClock app was partially supported by Robert Wood Johnson Foundation grant 76014 (PI, Dr. Panda).
Data Sharing Statement: The following data will be made available with publication: Deidentified participant data, available at https://data.mendeley.com. Deidentified data used for findings in the publication will be made openly available online. Any other data or material requests will be fulfilled at the discretion of Dr. Panda and Dr. Taub. Types of Analysis: Data will be made available for any purpose. Restrictions: None.
Corresponding Author: Satchidananda Panda, PhD, The Salk Institute for Biological Studies, 10010 North Torrey Pines Road, La Jolla, CA 92137 (e-mail, [email protected]); and Pam R. Taub, MD, Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, 9300 Campus Point Drive, Mail Code #7414, La Jolla, CA 92037 (e-mail, [email protected]).
Author Contributions: Conception and design: E.N.C. Manoogian, M.J. Wilkinson, S. Golshan, S. Panda, P.R. Taub.
Analysis and interpretation of the data: E.N.C. Manoogian, M.J. Wilkinson, M. O’Neal, K. Laing, D. Van, S. Golshan, S. Panda, P.R. Taub.
Drafting of the article: E.N.C. Manoogian, S. Golshan, S. Panda, P.R. Taub.
Critical revision of the article for important intellectual content: E.N.C. Manoogian, M.J. Wilkinson, S. Panda, P.R. Taub.
Final approval of the article: E.N.C. Manoogian, M.J. Wilkinson, M. O’Neal, K. Laing, J. Nguyen, D. Van, A. Rosander, A. Pazargadi, N.R. Gutierrez, J.G. Fleischer, S. Golshan, S. Panda, P.R. Taub.
Provision of study materials or patients: D. Van, A. Rosander, A. Pazargadi, N.R. Gutierrez, P.R. Taub.
Statistical expertise: J.G. Fleischer, S. Golshan.
Obtaining of funding: S. Panda, P.R. Taub.
Administrative, technical, or logistic support: E.N.C. Manoogian, M. O’Neal, K. Laing, J. Nguyen, D. Van, A. Rosander, A. Pazargadi, N.R. Gutierrez, S. Panda.
Collection and assembly of data: E.N.C. Manoogian, M.J. Wilkinson, M. O’Neal, K. Laing, J. Nguyen, D. Van, A. Rosander, A. Pazargadi, N.R. Gutierrez, S. Panda, P.R. Taub.
This article was published at Annals.org on 1 October 2024.

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Emily N.C. Manoogian, Michael J. Wilkinson, Monica O’Neal, et al. Time-Restricted Eating in Adults With Metabolic Syndrome: A Randomized Controlled Trial. Ann Intern Med. [Epub 1 October 2024]. doi:10.7326/M24-0859

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