Abstract
BackgroundTime Limited Eating (TLE) is an effective strategy for management of obesity in adults, but there is a paucity of data that have examined its use in the clinical management of children with obesity. A TLE approach involves interspersing normal daily caloric intake with periods of prolonged calorie restriction several times per week. TLE may actually be more feasible, non-stigmatizing, flexible and effective in children, especially for adolescents, compared to alternatives like daily caloric or macronutrient restriction. This is because TLE removes the need for intensive counting of daily calorie intake or macronutrient content and focuses on a straightforward task of consuming food during a pre-specified time period. Also it avoids periods of extended caloric restriction which may interfere with growth and/or risk evoking development of eating behaviors. This case series describes four patients who trialed a TLE approach in a clinical weight management clinic and describes BMI reduction at 4 months.Case PresentationTo date, 4 patients, ages 5–15, with varying underlying pathologies (i.e. Bardet Biedl Syndrome (BBS), previously healthy, craniopharyngioma and epilepsy) have tried a TLE type approach (16-hour fast/8-hour feed for 3–5 days per week) for 4 months and have demonstrated an average decrease in their BMI z-score compared to baseline of −0.24 SD. Patients and their families reported high degrees of satisfaction with this dietary approach.ConclusionsFamilies were very satisfied with the TLE intervention and reported it was feasible, flexible and sustainable to implement in a real life setting and associated with decreased zBMI. Further investigation is required to determine if this approach is effective in both the short and long term as a weight management technique.
Highlights
As the prevalence of pediatric obesity continues to rise, there remains a great need to identify effective, sustainable and feasible dietary interventions for this high risk population [1, 2]
Families were very satisfied with the Time limited eating (TLE) intervention and reported it was feasible, flexible and sustainable to implement in a real life setting and associated with decreased zBMI
The patient and families were very satisfied with the intervention and reported it was feasible, flexible and sustainable to implement in a real life setting
Summary
As the prevalence of pediatric obesity continues to rise, there remains a great need to identify effective, sustainable and feasible dietary interventions for this high risk population [1, 2]. Novel dietary approaches like TLE have been shown to be effective for weight loss and improve glycemic control in adults with obesity. A recent study, the first reported to date, by Jebeile et al evaluated the use of TLE on BMI change in adolescents and found it be a feasible, effective and acceptable dietary strategy in this population [10]. This case series explores the use of TLE as a clinical alternative dietary intervention for the management of pediatric obesity from one multi-disciplinary weight management clinic based in a Division of Pediatric Endocrinology at Children’s Hospital of Los Angeles. The patient and families were very satisfied with the intervention and reported it was feasible, flexible and sustainable to implement in a real life setting
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