Feasibility and Cardiometabolic Effects of Time-Restricted Eating in Patients with Metabolic Syndrome

Author:

Świątkiewicz Iwona1ORCID,Nuszkiewicz Jarosław2ORCID,Wróblewska Joanna2ORCID,Nartowicz Małgorzata3,Sokołowski Kamil2,Sutkowy Paweł2ORCID,Rajewski Paweł45ORCID,Buczkowski Krzysztof6ORCID,Chudzińska Małgorzata7ORCID,Manoogian Emily N. C.8ORCID,Taub Pam R.1ORCID,Woźniak Alina2ORCID

Affiliation:

1. Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA 92037, USA

2. Department of Medical Biology and Biochemistry, Collegium Medicum, Nicolaus Copernicus University, 85-092 Bydgoszcz, Poland

3. Clinical Nutrition Team, Oncology Center—Professor Franciszek Łukaszczyk Memorial Hospital, 85-796 Bydgoszcz, Poland

4. Center for Obesity and Metabolic Disorders Treatment, 85-676 Bydgoszcz, Poland

5. Faculty of Health Sciences, University of Health Sciences in Bydgoszcz, 85-067 Bydgoszcz, Poland

6. Department of Family Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland

7. Department of Nutrition and Dietetics, Collegium Medicum, Nicolaus Copernicus University, 85-626 Bydgoszcz, Poland

8. Regulatory Biology Laboratory, Salk Institute for Biological Studies, La Jolla, CA 92037, USA

Abstract

Metabolic syndrome (MetS) and a prolonged daily eating window (EW) are associated with circadian rhythm disruption and increased cardiometabolic risk. Misalignment between circadian timing system and daily rhythms of food intake adversely impacts metabolic regulatory mechanisms and cardiovascular function. Restricting the daily EW by imposing an eating–fasting cycle through time-restricted eating (TRE) can restore robust circadian rhythms, support cellular metabolism, and improve cardiometabolic health. The aim of this study was to assess a feasibility of 12-week TRE intervention with self-selected 10 h EW and effects of TRE on EW duration, cardiometabolic outcomes, daily rhythms of behavior, and wellbeing in Polish patients with MetS and EW ≥ 14 h/day. Dietary intake was monitored with a validated myCircadianClock application (mCC app). Adherence to TRE defined as the proportion of days recorded with mCC app in which participants satisfied 10-h TRE was the primary outcome. A total of 26 patients (aged 45 ± 13 years, 62% women, 3.3 ± 0.5 MetS criteria, EW 14 ± 1.5 h/day) were enrolled. Coexistence of increased waist circumference (WC) (96% of patients), elevated fasting plasma glucose (FPG) (77%), and elevated blood pressure (BP) (69%) was the most common MetS pattern (50%). TRE intervention (mean duration of 81.6 ± 12.6 days) led to reducing daily EW by 28% (p < 0.0001). Adherence to TRE was 87 ± 13%. Adherence to logging food intake on mCC app during TRE was 70 ± 27%. Post TRE, a decrease in body weight (2%, 1.7 ± 3.6 kg, p = 0.026), body mass index (BMI) (1%, 0.5 ± 1.2 kg/m2, p = 0.027), WC (2%, 2.5 ± 3.9 cm, p = 0.003), systolic BP (4%, 4.8 ± 9.0 mmHg, p = 0.012), FPG (4%, 3.8 ± 6.9 mg/dL, p = 0.037), glycated hemoglobin (4%, 0.2 ± 0.4%, p = 0.011), mean fasting glucose level from continuous glucose monitor (CGM) (4%, 4.0 ± 6.1 mg/dL, p = 0.002), and sleepiness score (25%, 1.9 ± 3.2 points, p = 0043) were observed. A significant decrease in body weight (2%), BMI (2%), WC (3%), mean CGM fasting glucose (6%), sleepiness score (27%), and depression score (60%) was found in patients with mean post-TRE EW ≤ 10 h/day (58% of total), and not in patients with EW > 10 h/day. Adherence to TRE was higher in patients with post-TRE EW ≤ 10 h/day vs. patients with EW > 10 h/day (94 ± 6% vs. 77 ± 14%, p = 0.003). Our findings indicate that 10-h TRE was feasible in the European MetS population. TRE resulted in reducing daily EW and improved cardiometabolic outcomes and wellbeing in patients with MetS and prolonged EW. Use of the mCC app can aid in implementing TRE. This pilot clinical trial provides exploratory data that are a basis for a large-scale randomized controlled trial to determine the efficacy and sustainability of TRE for reducing cardiometabolic risks in MetS populations. Further research is needed to investigate the mechanisms of TRE effects, including its impact on circadian rhythm disruption.

Publisher

MDPI AG

Reference65 articles.

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