The Effects of Time Restricted Feeding on Overweight, Older Adults: A Pilot Study

Anton, Stephen D.; Lee, Stephanie A.; Donahoo, William T.; McLaren, Christian; Manini, Todd M.; Leeuwenburgh, Christiaan; Pahor, Marco

doi:10.3390/nu11071500

Cited by 162 publications

(199 citation statements)

References 30 publications

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“…Self-reported mean adherence to the TRF regimen was 84%, measured by daily eating time logs [22]. Few adverse events were reported during this intervention.…”

Section: Resultsmentioning

confidence: 89%

“…This study provides exciting preliminary data on the potential beneficial effects and feasibility of TRF in older adults with very few risks associated with the intervention. In addition to the previously reported weight loss outcome and high adherence to the intervention [22], most participants adjusted relatively easily to the fasting window of 14-18 hours. Adverse effects were rare and were quickly remedied.…”

Section: Discussionmentioning

confidence: 89%

“…As described previously [22], ten overweight, sedentary, older adults aged 65 and older with mild to moderate functional limitations were recruited to participate in the Time to Eat pilot study. All participants were living independently in the community.…”

Section: Methodsmentioning

confidence: 99%

“…Primary outcomes were feasibility, tolerability, and safety in overweight, sedentary older adults over four weeks using a single-arm pre-post design. Secondary outcomes included changes in body weight, waist circumference, cognitive and physical function, health-related quality of life, and adverse events [22]. The overarching goal of the present study was to evaluate participant perspectives who were enrolled in the Time to Eat pilot study regarding the real-world advantages, disadvantages, and challenges to adopting a TRF eating pattern via weekly phone interviews, a diet satisfaction survey, and an exit interview during the study.…”

Section: Methodsmentioning

confidence: 99%

“…Several clinical trials now indicate that a TRF eating pattern can reduce fat mass with retention of lean mass in younger and middle-aged adults [18][19][20][21]; however, the effects of TRF are not well understood in adults aged 65 and older. We recently reported that a four-week TRF eating pattern was sufficient to induce weight loss and produce small but clinically meaningful improvements in physical function in overweight older adults [22]. Although these findings are promising, they are limited by the short duration of the intervention.…”

Section: Introductionmentioning

confidence: 99%

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Determinants of Adherence in Time-Restricted Feeding in Older Adults: Lessons from a Pilot Study

et al. 2020

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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.

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“…Self-reported mean adherence to the TRF regimen was 84%, measured by daily eating time logs [22]. Few adverse events were reported during this intervention.…”

Section: Resultsmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Determinants of Adherence in Time-Restricted Feeding in Older Adults: Lessons from a Pilot Study

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Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity

et al. 2020

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IMPORTANCEThe efficacy and safety of time-restricted eating have not been explored in large randomized clinical trials.OBJECTIVE To determine the effect of 16:8-hour time-restricted eating on weight loss and metabolic risk markers. INTERVENTIONSParticipants were randomized such that the consistent meal timing (CMT) group was instructed to eat 3 structured meals per day, and the time-restricted eating (TRE) group was instructed to eat ad libitum from 12:00 PM until 8:00 PM and completely abstain from caloric intake from 8:00 PM until 12:00 PM the following day. DESIGN, SETTING, AND PARTICIPANTSThis 12-week randomized clinical trial including men and women aged 18 to 64 years with a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 27 to 43 was conducted on a custom mobile study application. Participants received a Bluetooth scale. Participants lived anywhere in the United States, with a subset of 50 participants living near San Francisco, California, who underwent in-person testing. MAIN OUTCOMES AND MEASURESThe primary outcome was weight loss. Secondary outcomes from the in-person cohort included changes in weight, fat mass, lean mass, fasting insulin, fasting glucose, hemoglobin A 1c levels, estimated energy intake, total energy expenditure, and resting energy expenditure.RESULTS Overall, 116 participants (mean [SD] age, 46.5 [10.5] years; 70 [60.3%] men) were included in the study. There was a significant decrease in weight in the TRE (−0.94 kg; 95% CI, −1.68 to −0.20; P = .01), but no significant change in the CMT group (−0.68 kg; 95% CI, -1.41 to 0.05, P = .07) or between groups (−0.26 kg; 95% CI, −1.30 to 0.78; P = .63). In the in-person cohort (n = 25 TRE, n = 25 CMT), there was a significant within-group decrease in weight in the TRE group (−1.70 kg; 95% CI, −2.56 to −0.83; P < .001). There was also a significant difference in appendicular lean mass index between groups (−0.16 kg/m 2 ; 95% CI, −0.27 to −0.05; P = .005). There were no significant changes in any of the other secondary outcomes within or between groups. There were no differences in estimated energy intake between groups.CONCLUSIONS AND RELEVANCE Time-restricted eating, in the absence of other interventions, is not more effective in weight loss than eating throughout the day.TRIAL REGISTRATION ClinicalTrials.gov Identifiers: NCT03393195 and NCT03637855

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Effectiveness of Early Time-Restricted Eating for Weight Loss, Fat Loss, and Cardiometabolic Health in Adults With Obesity

et al. 2022

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IMPORTANCEIt is unclear how effective intermittent fasting is for losing weight and body fat, and the effects may depend on the timing of the eating window. This randomized trial compared time-restricted eating (TRE) with eating over a period of 12 or more hours while matching weight-loss counseling across groups.OBJECTIVE To determine whether practicing TRE by eating early in the day (eTRE) is more effective for weight loss, fat loss, and cardiometabolic health than eating over a period of 12 or more hours. DESIGN, SETTING, AND PARTICIPANTSThe study was a 14-week, parallel-arm, randomized clinical trial conducted between August 2018 and April 2020. Participants were adults aged 25 to 75 years with obesity and who received weight-loss treatment through the Weight Loss Medicine Clinic at the University of Alabama at Birmingham Hospital.INTERVENTIONS All participants received weight-loss treatment (energy restriction [ER]) and were randomized to eTRE plus ER (8-hour eating window from 7:00 to 15:00) or control eating (CON) plus ER (Ն12-hour window). MAIN OUTCOMES AND MEASURESThe co-primary outcomes were weight loss and fat loss. Secondary outcomes included blood pressure, heart rate, glucose levels, insulin levels, and plasma lipid levels.RESULTS Ninety participants were enrolled (mean [SD] body mass index, 39.6 [6.7]; age, 43 [11] years; 72 [80%] female). The eTRE+ER group adhered 6.0 (0.8) days per week. The eTRE+ER intervention was more effective for losing weight (−2.3 kg; 95% CI, −3.7 to −0.9 kg; P = .002) but did not affect body fat (−1.4 kg; 95% CI, −2.9 to 0.2 kg; P = .09) or the ratio of fat loss to weight loss (−4.2%; 95% CI, −14.9 to 6.5%; P = .43). The effects of eTRE+ER were equivalent to reducing calorie intake by an additional 214 kcal/d. The eTRE+ER intervention also improved diastolic blood pressure (−4 mm Hg; 95% CI, −8 to 0 mm Hg; P = .04) and mood disturbances, including fatigue-inertia, vigor-activity, and depression-dejection. All other cardiometabolic risk factors, food intake, physical activity, and sleep outcomes were similar between groups. In a secondary analysis of 59 completers, eTRE+ER was also more effective for losing body fat and trunk fat than CON+ER. CONCLUSIONS AND RELEVANCEIn this randomized clinical trial, eTRE was more effective for losing weight and improving diastolic blood pressure and mood than eating over a window of 12 or more hours at 14 weeks.TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03459703

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The Effects of Time Restricted Feeding on Overweight, Older Adults: A Pilot Study

Cited by 162 publications

References 30 publications

Determinants of Adherence in Time-Restricted Feeding in Older Adults: Lessons from a Pilot Study

Determinants of Adherence in Time-Restricted Feeding in Older Adults: Lessons from a Pilot Study

Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity

Effectiveness of Early Time-Restricted Eating for Weight Loss, Fat Loss, and Cardiometabolic Health in Adults With Obesity

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