Implementation of weekday time‐restricted eating to improve metabolic health in breast cancer survivors with overweight/obesity

Abstract

Objective: This study aimed to evaluate the implementation of telephone-based delivery of weekday-only time-restricted eating (TRE), its preliminary efficacy for metabolic outcomes, and concurrent lifestyle changes.Methods: Twenty-two breast cancer survivors aged 60+ years with overweight/obesity completed an 8-week feasibility study of 12 to 8 PM weekday-only ad libitum TRE. The intervention was delivered by one registered dietitian call, twice-daily automated text messages asking about eating start and stop times, and three support phone calls. Magnetic resonance imaging, venipuncture, and 3 days of diet records and accelerometry were performed at baseline and after intervention.Results: Participants had a mean age of 66 (SD 5) years with BMI of 31.8 (4.8) kg/m 2 .Intervention implementation was successful, including excellent adherence (98%), participant acceptability, and a low symptom profile and cost ($63/participant). There were no significant changes in individual components of metabolic syndrome, lipid profile, or hemoglobin A 1c , despite clinically relevant changes occurring within individual participants. Magnetic resonance imaging-derived hepatic steatosis and thigh myosteatosis did not change. Dietary intake changes included reduced energy (À22%) and protein (À0.2 g/kg). Physical activity and sleep did not change.Conclusions: Eight weeks of telephone-delivered weekday TRE is a feasible, acceptable, low-symptom, and low-cost intervention. Future studies may consider a longer intervention length for more consistent metabolic improvements and counseling to enhance protein intake.

The effect of time of eating on cardiometabolic risk in primary and secondary prevention of cardiovascular disease

“…76 Some trials suggest a detrimental impact of intermittent fasting on lean or FFM, 16,26,29,30 and physical activity 12,21,29,30,69 but other trials have shown no concerning alterations in either physical activity 18,19,23,31,63,64 or body composition. [6][7][8]22,23,31,51,55,60,64,66,69,70,75,90 Very few trials have assessed the impact of these interventions on sleep, 12,29,59,62,73 cardiorespiratory fitness 11,17,63,66 and muscular strength 11,68,69 and more work is needed to understand the impact of intermittent fasting on these risk factors.…”

“…6,8,10,11,[13][14][15]19,25,26,29,65,66 With poor reporting on diet in many intermittent fasting trials, changes in dietary quality as a result of the intervention(s) are often left unas- window is similar to their baseline. 76 Some trials suggest a detrimental impact of intermittent fasting on lean or FFM, 16,26,29,30 and physical activity 12,21,29,30,69 but other trials have shown no concerning alterations in either physical activity 18,19,23,31,63,64 or body composition. [6][7][8]22,23,31,51,55,60,64,66,69,70,75,90 Very few trials have assessed the impact of these interventions on sleep, 12,29,59,62,73 c...…”

“…12,21,29,30,69 Additionally, in another trial no reduction in physical activity was noted but comparison group increased activity to a greater extent. 37 Other TRE trials 18,19,31,63,64 and cADF 23 trials have not shown a decrease in physical activity. Clear differences do not exist between these trials in terms of length of intervention, number, sex or weight status of participants at baseline or method of measuring the physical activity.…”

“…Only one of the 10 participants enrolled discontinued the study for reasons unrelated to the intervention 11 . Kirkham et al assigned 22 breast cancer survivors to 8 weeks of 16:8 TRE 22,63 . After 8 weeks, participants lost ~1 kg, most of which was FM upon measurement by BIA.…”

“…11 Kirkham et al assigned 22 breast cancer survivors to 8 weeks of 16:8 TRE. 22,63 After 8 weeks, participants lost ~1 kg, most of which was FM upon measurement by BIA. In particular, magnetic resonance imaging demonstrated a reduction in visceral fat mass of 5 � 7%.…”