Abstract
Due to its simplicity, time-limited eating (TLE) may represent a more feasible approach for treating adolescents with obesity compared to other caloric restriction regimens. This pilot study examines the feasibility and safety of TLE combined with continuous glucose monitoring (CGM) in adolescents. Fifty adolescents with BMI ≥95th percentile were recruited to complete a 12-week study. All received standard nutritional counseling, wore a CGM daily, and were randomized to: (1) Prolonged eating window: 12 h eating/12 h fasting + blinded CGM; (2) TLE (8 h eating/16 h fasting, 5 days per week) + blinded CGM; (3) TLE + real-time CGM feedback. Recruitment, retention, and adherence were recorded as indicators of feasibility. Weight loss, dietary intake, physical activity, eating behaviors, and quality of life over the course of the intervention were explored as secondary outcomes. Forty-five participants completed the study (16.4 ± 1.3 years, 64% female, 49% Hispanic, 75% public insurance). There was high adherence to prescribed eating windows (TLE 5.2 d/wk [SD 1.1]; control 6.1 d/wk [SD 1.4]) and daily CGM wear (5.85 d/wk [SD 4.8]). Most of the adolescents (90%) assigned to TLE reported that limiting their eating window and wearing a CGM was feasible without negative impact on daily functioning or adverse events. There were no between-group difference in terms of weight loss, energy intake, quality of life, physical activity, or eating behaviors. TLE combined with CGM appears feasible and safe among adolescents with obesity. Further investigation in larger samples, with a longer intervention duration and follow-up assessments are needed.
Highlights
In the United States, one in five adolescents has obesity, and 30–50% of those go on to develop early onset type 2 diabetes, which is associated with a high risk of complications [1,2,3,4]
Given that adolescents with obesity are at high risk of binge eating disorder (BED) symptoms, our goal was to screen participants at baseline to ensure appropriate referrals are made in a timely manner
We evaluated whether adolescents randomized to the time-limited eating (TLE) + real-time continuous glucose monitor (CGM)
Summary
In the United States, one in five adolescents has obesity, and 30–50% of those go on to develop early onset type 2 diabetes, which is associated with a high risk of complications [1,2,3,4]. Multiple trials, conducted globally, in adult populations have examined the efficacy of various fasting regimens, including alternate day fasting, fasting mimicking diet, and time-restricted eating (TRE) [15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31]. The feasibility and effectiveness of TRE in adolescents has been questioned due to concerns of poor adherence, fear of iatrogenic adverse events (such as increased disordered eating behaviors [33,34,35,36]), and consequences on development. TRE may result in greater intervention adherence than comprehensive and costly approaches, while preserving autonomy and dietary preferences [35]
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