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Time-restricted Eating Fails As Weight-loss Intervention

Discussion in 'Dietetics' started by D. Sayed Morsy, Sep 29, 2020.

  1. D. Sayed Morsy

    D. Sayed Morsy Bronze Member

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    Time-restricted eating, in the absence of other interventions, is not an effective way to lose weight.

    In a randomized controlled trial, time-restricted eating (TRE) did not lead to greater weight loss when compared with the typical eating pattern of three meals per day, nor did it lead to any relevant metabolic changes.

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    TRE is "attractive as a weight-loss option in that it does not require tedious and time-consuming methods such as calorie-counting or adherence to complicated diets," Dr. Ethan Weiss of the University of California, San Francisco, and colleagues note in JAMA Internal Medicine.

    But it can't be recommended based on results of their study, they say.

    The TREAT trial included 116 men and women aged 18 to 64 years (mean age, 46.5) who were overweight or obese, with BMIs ranging from 27 to 43.

    Over 12 weeks, 59 people in the TRE group were told to eat ad libitum from 12:00 p.m. until 8:00 p.m. and eat nothing from 8:00 p.m. until 12:00 p.m. the following day (16 hours fast and eight hours eat). Only noncaloric beverages were permitted outside of the eating widow.

    The 57 people in the control group were told to eat three structured meals per day. Snacking between meals was allowed.

    Self-reported adherence to the two eating patterns was high; 84% of people in the TRE said they only ate within in the eight-hour window, and 92% of the control group said they didn't miss any meals.

    After 12 weeks, TRE was associated with only a modest decrease (1.17%) in weight that was not significantly different from the decrease in the control group (0.75%). There were also no significant between-group differences in the secondary outcomes of fat mass, fasting insulin, glucose, hemoglobin A1C, or blood lipids.

    However, the TRE group experienced a significant decrease in appendicular lean mass (ALM) that was not seen in the control group.

    "Appendicular lean mass is correlated with nutritional and physical status, and reduced ALM can lead to weakness, disability, and impaired quality of life. This serves as a caution for patient populations at risk sarcopenia because TRE could exacerbate muscle loss," Dr. Weiss and colleagues write.

    "Together, the results of this study (1) do not support the efficacy of TRE for weight loss, (2) highlight the importance of control interventions, and (3) offer caution about the potential effects of TRE on ALM. Future studies should be aimed at understanding the effects of early vs late TRE and protein intake or timing as a means to offset the loss in ALM," they conclude.

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