The Effects of Time-Restricted Eating versus Standard Dietary Advice on Weight, Metabolic Health and the Consumption of Processed Food: A Pragmatic Randomised Controlled Trial in Community-Based Adults.

Nicholas Phillips,Daniel Aeberli,Didier Hans,Nathalie Schwab,Felix Naef,Satchidananda Panda,Julie Mareschal,Tinh-Hai Collet,Aude Gauthier-Jaques,Giada Ostinelli,Sylvie Borloz,Elena Gonzalez Rodriguez,Sylvie Umwali,Nicolas Rodondi,Emily Manoogian

doi:10.3390/nu13031042

Abstract

Weight loss is key to controlling the increasing prevalence of metabolic syndrome (MS) and its components, i.e., central obesity, hypertension, prediabetes and dyslipidaemia. The goals of our study were two-fold. First, we characterised the relationships between eating duration, unprocessed and processed food consumption and metabolic health. During 4 weeks of observation, 213 adults used a smartphone application to record food and drink consumption, which was annotated for food processing levels following the NOVA classification. Low consumption of unprocessed food and low physical activity showed significant associations with multiple MS components. Second, in a pragmatic randomised controlled trial, we compared the metabolic benefits of 12 h time-restricted eating (TRE) to standard dietary advice (SDA) in 54 adults with an eating duration > 14 h and at least one MS component. After 6 months, those randomised to TRE lost 1.6% of initial body weight (SD 2.9, p = 0.01), compared to the absence of weight loss with SDA (−1.1%, SD 3.5, p = 0.19). There was no significant difference in weight loss between TRE and SDA (between-group difference −0.88%, 95% confidence interval −3.1 to 1.3, p = 0.43). Our results show the potential of smartphone records to predict metabolic health and highlight that further research is needed to improve individual responses to TRE such as a shorter eating window or its actual clock time.

Highlights

The prevalence of the metabolic syndrome (MS) is increasing worldwide, affecting approximately 1 billion people [1]
We characterised the relationship between eating duration, unprocessed and processed food consumption, and metabolic health
We found that the number of unprocessed food events was positively associated with high-density lipoprotein (HDL) cholesterol and negatively associated with body mass index (BMI) and triglycerides

Summary

Introduction

The prevalence of the metabolic syndrome (MS) is increasing worldwide, affecting approximately 1 billion people [1]. Metabolic syndrome is a cluster of different clinical conditions (referred to as MS components, i.e., central obesity, elevated blood pressure (BP), impaired glucose tolerance, and dyslipidaemia) which share common mechanisms [2]. This puts a substantial proportion of the population at risk for cardio-metabolic diseases such as myocardial infarction, stroke, diabetes, and their long-term complications [3]. Current pharmacological options are not always efficacious and tolerated [5], and bariatric surgery is reserved for patients with severe obesity and requires close follow up [4] This explains the strong interest in new approaches to address isolated obesity (i.e., without comorbidities) or multiple MS components

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