Abstract
Time-restricted feeding (TRF) is a type of intermittent fasting in which no calories are commonly consumed for approximately 12–18 hours on a daily basis. The health benefits of this eating pattern have been shown in overweight adults, with improvements in cardiometabolic risk factors as well as the preservation of lean mass during weight loss. Although TRF has been well studied in younger and middle-aged adults, few studies have evaluated the effects of TRF in older adults. Thus, the goal of this study was to evaluate older-adult perspectives regarding the real-world advantages, disadvantages, and challenges to adopting a TRF eating pattern among participants aged 65 and over. A four-week single-arm pre- and post-test design was used for this clinical pilot trial TRF intervention study. Participants were instructed to fast for approximately 16 h per day with the daily target range between 14 and 18 h. Participants were provided with the TRF protocol at a baseline visit, along with a pictorial guide that depicted food items and beverages that were allowed and not allowed during fasting windows to reinforce that calorie-containing items were to be avoided. The trial interventionist called each participant weekly to promote adherence, review the protocol, monitor for adverse events, and provide support and guidance for any challenges faced during the intervention. Participants were instructed to complete daily eating time logs by recording the times at which they first consumed calories and when they stopped consuming calories. At the end of the intervention, participants completed an exit interview and a study-specific Diet Satisfaction Survey (Table 1) to assess their satisfaction, feasibility, and overall experience with the study intervention. Of the 10 participants who commenced the study (mean age = 77.1 y; 6 women, 4 men), nine completed the entire protocol. Seven of the ten participants reported easy adjustment to a 16-hour fast and rated the difference from normal eating patterns as minimal. Eight participants reported no decrease in energy during fasting periods, with greater self-reported activity levels in yardwork and light exercise. Adverse events were rare, and included transient headaches, which dissipated with increased water intake, and dizziness in one participant, which subsided with a small snack. The findings of the current trial suggest that TRF is an eating approach that is well tolerated by most older adults. Six participants, however, did not fully understand the requirements of the fasting regimen, despite being provided with specific instructions and a pictorial guide at a baseline visit. This suggests that more instruction and/or participant contact is needed in the early stages of a TRF intervention to promote adherence.
Highlights
Aging is often associated with a host of biological changes that contribute to a progressive decline in cognitive and physical function, frequently leading to a loss of independence and increased risk of mortality
While prolongation of life remains an important public health goal, of even greater significance is the extension of healthspan, often defined as continued intact functional capacity, and delay of the physiological changes that result in disease and disability [3,4]
We recently reported that a four-week Time-restricted feeding (TRF) eating pattern was sufficient to induce weight loss and produce small but clinically meaningful improvements in physical function in overweight older adults [22]
Summary
Aging is often associated with a host of biological changes that contribute to a progressive decline in cognitive and physical function, frequently leading to a loss of independence and increased risk of mortality. While prolongation of life remains an important public health goal, of even greater significance is the extension of healthspan, often defined as continued intact functional capacity, and delay of the physiological changes that result in disease and disability [3,4]. For these reasons, there is a longstanding interest in understanding the biopsychosocial and functional determinants of successful aging [5]. Many factors can contribute to functional decline, loss of muscle mass (sarcopenia) in particular, has been consistently linked to functional decline during aging [6]. In a recent multi-ethnic study (MEMOSA—Multi-Ethnic Molecular determinants of Sarcopenia) involving participants from Singapore, the UK, and Jamaica [9], the genome-wide transcriptomic profiles of skeletal muscle biopsies in 119 older men diagnosed with sarcopenia compared with age-matched controls were examined using high-coverage RNA sequencing
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