Effectiveness of Early Time-Restricted Eating for Weight Loss, Fat Loss, and Cardiometabolic Health in Adults With Obesity: A Randomized Clinical Trial
Jamshed H, Steger FL, Bryan DR, Richman JS, Warriner AH, Hanick CJ, Martin CK, Salvy SJ, Peterson CM
JAMA internal medicine · 217 citations
How it was studied
- Design
- Randomized controlled trial (classified by our AI screen)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Government
- National Heart, Lung, and Blood Institute
- Government
- National Institute of Diabetes and Digestive and Kidney Diseases
- Government
- NIDDK NIH HHS
- Government
- NHLBI NIH HHS
- Grants
- National Heart, Lung, and Blood Institute (T32HL105349)); National Institute of Diabetes and Digestive and Kidney Diseases (P30 DK-072476); National Institute of Diabetes and Digestive and Kidney Diseases (P30-DK-056336)
Based on 4 listed funder(s).
Publication
- Published
- 2022-08-08 · JAMA Intern Med · vol. 182 · issue 9 · p. 953
- Publisher
- American Medical Association
- Cited
- 285 citations · more than 100% of similar papers · 25.1× the field average
- Impact
- Top 10% most cited in its field
- References
- 76 works
- Access
- Open access (repository copy)
- Research areas
- Dietary Effects on Health · Enhanced Recovery After Surgery · Circadian rhythm and melatonin
- Keywords
- Weight loss, Medicine, Body mass index, Randomized controlled trial, Obesity, Weight change, Internal medicine, Very low calorie diet, Physical therapy
- MeSH
- adipose tissue, humans, cardiovascular diseases, obesity, weight loss, fasting, adult, female, male
9 authors
From US, PK
- Humaira JamshedUniversity of Alabama at Birmingham; Habib University
- Felicia L. StegerUniversity of Alabama at Birmingham; University of Kansas Medical Center
- David R. BryanUniversity of Alabama at Birmingham
- Joshua RichmanUniversity of Alabama at Birmingham
- Amy H. WarrinerUniversity of Alabama at Birmingham
- Cody J. HanickUniversity of Alabama at Birmingham
Abstract
Importance
It is unclear how effective intermittent fasting is for losing weight and body fat, and the effects may depend on the timing of the eating window. This randomized trial compared time-restricted eating (TRE) with eating over a period of 12 or more hours while matching weight-loss counseling across groups.
Objective
To determine whether practicing TRE by eating early in the day (eTRE) is more effective for weight loss, fat loss, and cardiometabolic health than eating over a period of 12 or more hours.
Design, setting, and participants
The study was a 14-week, parallel-arm, randomized clinical trial conducted between August 2018 and April 2020. Participants were adults aged 25 to 75 years with obesity and who received weight-loss treatment through the Weight Loss Medicine Clinic at the University of Alabama at Birmingham Hospital.
Interventions
All participants received weight-loss treatment (energy restriction [ER]) and were randomized to eTRE plus ER (8-hour eating window from 7:00 to 15:00) or control eating (CON) plus ER (≥12-hour window).
Main outcomes and measures
The co-primary outcomes were weight loss and fat loss. Secondary outcomes included blood pressure, heart rate, glucose levels, insulin levels, and plasma lipid levels.
Results
Ninety participants were enrolled (mean [SD] body mass index, 39.6 [6.7]; age, 43 [11] years; 72 [80%] female). The eTRE+ER group adhered 6.0 (0.8) days per week. The eTRE+ER intervention was more effective for losing weight (-2.3 kg; 95% CI, -3.7 to -0.9 kg; P = .002) but did not affect body fat (-1.4 kg; 95% CI, -2.9 to 0.2 kg; P = .09) or the ratio of fat loss to weight loss (-4.2%; 95% CI, -14.9 to 6.5%; P = .43). The effects of eTRE+ER were equivalent to reducing calorie intake by an additional 214 kcal/d. The eTRE+ER intervention also improved diastolic blood pressure (-4 mm Hg; 95% CI, -8 to 0 mm Hg; P = .04) and mood disturbances, including fatigue-inertia, vigor-activity, and depression-dejection. All other cardiometabolic risk factors, food intake, physical activity, and sleep outcomes were similar between groups. In a secondary analysis of 59 completers, eTRE+ER was also more effective for losing body fat and trunk fat than CON+ER.
Conclusions and relevance
In this randomized clinical trial, eTRE was more effective for losing weight and improving diastolic blood pressure and mood than eating over a window of 12 or more hours at 14 weeks.
Trial registration
ClinicalTrials.gov Identifier: NCT03459703.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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