Abstract
The obesity epidemic and its metabolic consequences are a major public health problem both in the USA and globally. While the underlying causes are multifactorial, dysregulations within the brain–gut–microbiome (BGM) system play a central role. Normal eating behavior is coordinated by the tightly regulated balance between intestinal, extraintestinal and central homeostatic and hedonic mechanisms, resulting in stable body weight. The ubiquitous availability and marketing of inexpensive, highly palatable and calorie-dense food has played a crucial role in shifting this balance towards hedonic eating through both central (disruptions in dopaminergic signaling) and intestinal (vagal afferent function, metabolic toxemia, systemic immune activation, changes to gut microbiome and metabolome) mechanisms. The balance between homeostatic and hedonic eating behaviors is not only influenced by the amount and composition of the diet, but also by the timing and rhythmicity of food ingestion. Circadian rhythmicity affects both eating behavior and multiple gut functions, as well as the composition and interactions of the microbiome with the gut. Profound preclinical effects of intermittent fasting and time restricted eating on the gut microbiome and on host metabolism, mostly demonstrated in animal models and in a limited number of controlled human trials, have been reported. In this Review, we will discuss the effects of time-restricted eating on the BGM and review the promising effects of this eating pattern in obesity treatment.
Highlights
Obesity is defined as a body mass index (BMI) ≥30 kg/m2 and a BMI ≥40 kg/m2 is considered extreme obesity, with overweight classified as 25–29.9 kg/m [1]
The consumption of “comfort foods”, which generally occurs after dinner and often late at night can cause an immediate feeling of perceived relief from stress, many studies have shown that ingestion of highly palatable foods leads to increased autonomic responses, an increase in cortisol and ghrelin levels, and can disrupt the hypothalamic pituitary adrenal (HPA) axis, which have all been associated with a surge in cravings and unhealthy eating habits [41,43,44,45]
Preliminary studies in individuals undergoing bariatric surgery suggest that the changes that occur in the gut microbiome composition and microbial metabolism of aromatic amino acids and glutamate are associated with a reduction in appetite, food addiction and alteration in food preferences, suggesting a possible relationship between these metabolites and dietary behavior [66,67,68,69,70,71]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. As obesity rates hit peak levels, causing a major public health crisis, many Americans are looking to popular diet programs for a simple solution. Many Americans are looking for a simple solution for weight loss and decreasing their cardiovascular risk factors, most diet programs, which have recently increased in popularity, require a reduction in overall dietary intake. Changes in the timing of food intake, without caloric restriction, so called time-restricted eating (TRE), have been proposed as more effective long-term strategies to combat obesity and its metabolic complications [3]. TRE allows a combination of a ketogenic state during the 16–18 h without food intake (including the time of sleep) and the benefits of a healthy, largely plant based diet during the 6–8 h eating period that shows promising early effects as a sustainable strategy for maintaining optimal metabolic function. While numerous preclinical studies have shown the effects of (TRE) on the gut microbiome and on body weight, there is not sufficient clinical evidence to date to evaluate their long-term clinical effectiveness [4]
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