Calorie Restriction With or Without Time-Restricted Eating in Weight Loss
The New England Journal of Medicine (NEJM):
Obesity is a major global public health challenge. Weight loss by means of lifestyle modification has been documented to be the cornerstone of weight management. Daily calorie restriction is a well-established primary weight-loss strategy for obese patients.
However, most trials of dietary approaches to weight loss have reported modest (<5%) mean weight loss after 12 months, and long-term maintenance of weight loss remains a challenge. Thus, identification of alternative and feasible dietary interventions for weight loss is a major public health priority.
TAKE HOME MESSAGE:
Time-restricted eating (eating only between 8:00 a.m. and 4:00 p.m.) is an intermittent-fasting regimen that involves a shortened period of time for eating within each 24-hour period. The method has gained popularity because it is a weight-loss strategy that is simple to follow, which may enhance adherence.
Observational studies have suggested that the practice of eating meals later in the day was associated with weight gain and influenced the success of weight-loss therapy. Several pilot clinical studies showed that time-restricted eating resulted in reduction over time in the body weight and fat mass in patients with obesity.
Authors conducted a randomized clinical trial to assess time-restricted eating with calorie restriction as compared with daily calorie restriction alone for the effects on weight loss and metabolic risk factors in obese patients.
In this 12-month trial, authors found that the 8-hour time-restricted–eating regimen did not produce greater weight loss than the regimen of daily calorie restriction, with both regimens resulting in similar caloric deficits.
In addition, time-restricted eating and daily calorie restriction produced similar effects with respect to reductions in body fat, visceral fat, blood pressure, glucose levels, and lipid levels over the 12-month intervention period.
These results indicate that caloric intake restriction explained most of the beneficial effects seen with the time-restricted–eating regimen.
In this trial, authors found that the two weight-loss regimens that we evaluated had similar success in patients with obesity, regardless of whether they reduced their calorie consumption through time-restricted eating or through calorie restriction alone.
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BACKGROUND
The long-term efficacy and safety of time-restricted eating for weight loss are not clear.
METHODS
We randomly assigned 139 patients with obesity to time-restricted eating (eating only between 8:00 a.m. and 4:00 p.m.) with calorie restriction or daily calorie restriction alone. For 12 months, all the participants were instructed to follow a calorie-restricted diet that consisted of 1500 to 1800 kcal per day for men and 1200 to 1500 kcal per day for women. The primary outcome was the difference between the two groups in the change from baseline in body weight; secondary outcomes included changes in waist circumference, body-mass index (BMI), amount of body fat, and measures of metabolic risk factors.
RESULTS
Of the total 139 participants who underwent randomization, 118 (84.9%) completed the 12-month follow-up visit. The mean weight loss from baseline at 12 months was -8.0 kg in the time-restriction group and -6.3 kg in the daily-calorie-restriction group. Changes in weight were not significantly different in the two groups at the 12-month assessment (net difference, -1.8 kg). Results of analyses of waist circumferences, BMI, body fat, body lean mass, blood pressure, and metabolic risk factors were consistent with the results of the primary outcome. In addition, there were no substantial differences between the groups in the numbers of adverse events.
CONCLUSIONS
Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat or metabolic risk factors than daily calorie restriction.
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