Though aggressive diet and lifestyle intervention are considered a first-line therapy for treating metabolic syndrome, these approaches are rarely sufficient in managing the disease. Patients must often be treated using pharmacologic measures as symptoms worsen. Researchers have recently proposed the use of time-restricted eating (TRE) in conjunction with these measures in order to support the body’s natural circadian rhythm with regular cycles of feeding and fasting. Researchers found that synergistic use of TRE with pharmacotherapy improved cardiometabolic health in patients with metabolic syndrome, according to results published in Cell Metabolism.
The study included 19 participants with metabolic syndrome and a baseline daily eating window of ≥14 hours. During the study, the patients self-selected a 10-hour window for TRE (all dietary intake) for 12 weeks, reducing the duration of their eating window by around 28%. They logged their caloric intake using a smartphone app called myCircadianClock, beginning with a 2-week baseline period before moving into the 12-week study period. Though TRE has been previously shown to contribute to fatigue and increased hunger in rare cases, most people participating in TRE saw their hunger decrease over time and experienced increased energy levels after continuing with TRE. None of the participants in the current study reported adverse effects of TRE.
Over the 12 weeks, the researchers found that the patients reported significant reductions in body weight with an average change of ~275 g/week, which also contributed to a significant reduction in BMI. Participants showed significant reductions in total cholesterol, one of the cardiovascular disease risk factors. There was also a trend toward reduction in low-density lipoprotein, a particle associated with cardiovascular risk. Systolic and diastolic blood pressure levels were reduced with TRE as well. However, this may have been due to patients concurrently receiving anti-hypertensive therapy. Though the patients reported no significant changes in duration of sleep, they did report improved restfulness in the morning.
Limitations of the study included the small sample size, lack of a control arm, and varied baseline values. The use of a smartphone app to record dietary behavior may also have had an effect on said behavior.
Though the study did not find a significant correlation between weight changes and metabolic improvements, the researchers posit that TRE may have improved the efficacy of the pharmacotherapy that the patients also underwent during the TRE study. By maintaining consistent daily rhythms of eating and fasting, patients may be able to improve rhythms in other areas in conjunction with medication.
Wilkinson MJ, Manoogian ENC, Zadourian A, et al. Ten-hour time-restricted eating reduces weight, blood pressure, and atherogenic lipids in patients with metabolic syndrome. Cell Metab. 2020;31(1):92-104.e5.