Time-Restricted Eating to Reduce Cardiovascular Risk Among Older Breast Cancer Survivors

Kirkham, Amy A.; Ford, Katherine L.; Topolnyski, Jordan; Silva, Bruna Ramos da; Paterson, D. Ian; Prado, Carla M.; Joy, Anil A.; Boulé, Normand G.; Pituskin, Edith; Haykowsky, Mark J.; Thompson, Richard B.

doi:10.1016/j.jaccao.2022.03.002

Cited by 10 publications

(23 citation statements)

References 5 publications

(5 reference statements)

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“…We previously reported that body mass decreased by a median of 1.0 kg (interquartile range −2.3 to 0.2 kg) [24]. We also previously reported that whole‐body fat mass and visceral AT volume were significantly reduced by this intervention [24].…”

Section: Resultsmentioning

confidence: 71%

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

Kirkham

Ford

Silva

et al. 2023

Obesity

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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.

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Section: Resultsmentioning

confidence: 71%

“…In a research letter, we previously reported the adherence and changes in calorie intake reported here [24].…”

Section: Resultsmentioning

confidence: 99%

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

Kirkham

Ford

Silva

et al. 2023

Obesity

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“…Overweight/obesity are well established risk factors for T2D, several cancer diagnoses and CVD. Within the recent TRE literature, weight loss and fat loss continue to be the most consistently reported positive health effects (Table 1) [13,14 ▪▪ ,15 ▪ ,16,17,22–28,29 ▪▪ ,30–36]. Numerous recent studies in individuals with overweight/obesity have also reported improvements to each component of the metabolic syndrome (waist circumference, fasting glucose, triglycerides, HDL and blood pressure), while others have failed to find any effect (Table 1).…”

Section: Summary Of Recent Evidencementioning

confidence: 99%

“…To date, there have been three single-arm TRE studies published among individuals with a history of cancer. In the first, Kirkham et al [15 ▪ ] assessed an 8-h (1200 to 2000 h) weekday-only TRE protocol for 8 weeks among 22 breast cancer survivors who had completed anthracycline-based chemotherapy 3 ± 1 year prior. Adherence to this protocol was 98%, and the Framingham 10-year cardiovascular disease risk, total body fat mass and visceral adipose tissue all decreased by the end of intervention.…”

Section: Summary Of Recent Evidencementioning

confidence: 99%

Cardiometabolic health impacts of time-restricted eating: implications for type 2 diabetes, cancer and cardiovascular diseases

Kirkham

Parr

Kleckner

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewTime-restricted eating (TRE) entails consuming energy intake within a 4- to 10-h window, with the remaining time spent fasting. Although studies have reported health benefits from TRE, little is known about the impact of TRE on common chronic diseases such as type 2 diabetes, cancer and cardiovascular disease. This review summarizes and critically evaluates the most recent TRE research findings relevant to managing and treating these chronic diseases.Recent findingsMost recent TRE studies have been in populations with overweight/obesity or metabolic syndrome; two have been in populations with diabetes, three in cancer survivors and none in populations with cardiovascular disease. Collectively, these studies showed that participants could adhere to TRE and TRE is well tolerated. These studies also showed preliminary efficacy for improved glucose regulation and insulin sensitivity, a reduction in body fat and blood pressure, reduced cardiovascular risk scores and increased quality of life. More research is required to define the most effective TRE protocol (i.e. length and timing of eating window, intervention duration).SummaryTRE has demonstrated benefits on cardiovascular, metabolic and clinical outcomes relevant to the underlying pathophysiology, but there are limited data on TRE implemented specifically within populations with diabetes, cancer or cardiovascular disease.

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“…TRE is also feasible, with adherence typically > 85 % among adults with obesity, metabolic syndrome or diabetes (18) . We recently demonstrated feasibility, safety and participant acceptability of 8 weeks of TRE in breast cancer survivors 3 years postchemotherapy (24) . Our intervention also resulted in a 5 % reduction in visceral fat, a 1•0 kg decrease in whole-body fat mass, and a 15 % relative reduction in the Framingham 10-year CVD risk score (24) .…”

mentioning

confidence: 99%

Rationale and design of IMPACT-women: a randomised controlled trial of the effect of time-restricted eating, healthy eating and reduced sedentary behaviour on metabolic health during chemotherapy for early-stage breast cancer

et al. 2022

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Metabolic dysfunction and excess accumulation of adipose tissue are detrimental side effects from breast cancer treatment. Diet and physical activity are important treatments for metabolic abnormalities, yet patient compliance can be challenging during chemotherapy treatment. Time-restricted eating (TRE) is a feasible dietary pattern where eating is restricted to 8 hours/day with water-only fasting for the remaining 16 hours. The objective of this study is to evaluate the effect of a multimodal intervention consisting of TRE, healthy eating, and reduced sedentary time during chemotherapy treatment for early-stage (I-III) breast cancer on accumulation of visceral fat (primary outcome), other fat deposition locations, metabolic syndrome, and CVD risk (secondary outcomes) compared to usual care. The study will be a two-site, two-arm, parallel-group superiority randomized control trial enrolling 130 women scheduled for chemotherapy for early-stage breast cancer. The intervention will be delivered by telephone including 30-60-minute calls with a registered dietitian who will provide instructions on TRE, education and counselling on healthy eating, and goal setting for reducing sedentary time. The comparison group will receive usual cancer and supportive care including a single group-based nutrition class, and healthy eating and physical activity guidelines. Magnetic resonance imaging, blood draws, and assessment of blood pressure will be performed at baseline, after chemotherapy (primary end-point), and 2-year follow-up. If our intervention is successful in attenuating the effect of chemotherapy on visceral fat accumulation and cardiometabolic dysfunction, it has the potential to reduce risk of cardiometabolic disease and related mortality among breast cancer survivors.

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Time-Restricted Eating to Reduce Cardiovascular Risk Among Older Breast Cancer Survivors

Cited by 10 publications

References 5 publications

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

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

Cardiometabolic health impacts of time-restricted eating: implications for type 2 diabetes, cancer and cardiovascular diseases

Rationale and design of IMPACT-women: a randomised controlled trial of the effect of time-restricted eating, healthy eating and reduced sedentary behaviour on metabolic health during chemotherapy for early-stage breast cancer

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