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Eating within 10-hour window may help stave off diabetes, heart disease

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In a collaborative effort, researchers from the Salk Institute and the University of California – San Diego School of Medicine found that a 10-hour time-restricted eating intervention, when combined with traditional medications, resulted in weight loss, reduced abdominal fat, lower blood pressure and cholesterol, and more stable blood sugar and insulin levels for participants.

The pilot study could lead to a new treatment option for metabolic syndrome patients who are at risk for developing life-altering and costly medical conditions such as diabetes. “We have found that combining time-restricted eating with medications can give metabolic syndrome patients the ability to better manage their disease,” says Satchidananda Panda, co-corresponding author and professor in Salk’s Regulatory Biology Laboratory. “Unlike counting calories, time-restricted eating is a simple dietary intervention to incorporate, and we found that participants were able to keep the eating schedule.”

Time-restricted eating (eating all calories within a consistent 10-hour window) supports an individual’s circadian rhythms and can maximise health benefits, as evidenced by previous research published by the Salk team. Circadian rhythms are the 24-hour cycles of biological processes that affect nearly every cell in the body. Increasingly, scientists are finding that erratic eating patterns can disrupt this system and increase the risk for metabolic syndrome and other metabolic disorders with such symptoms as increased abdominal fat, abnormal cholesterol or triglycerides, and high blood pressure and blood sugar levels.

“Eating and drinking everything (except water) within a consistent 10-hour window allows your body to rest and restore for 14 hours at night. Your body can also anticipate when you will eat so it can prepare to optimise metabolism,” says Emily Manoogian, the paper’s co-first author and a postdoctoral fellow in the Panda lab. “We wanted to know if controlling the timing of food intake to support circadian rhythms would improve the health of individuals that were already being treated for cardio-metabolic diseases.”

“We suspected a 10-hour eating intervention might be beneficial because of Satchidananda Panda’s pioneering work in animals, which showed that time-restricted eating led to dramatic health benefits, including a healthier metabolism,” adds Michael Wilkinson, co-first author, assistant clinical professor of medicine at UC San Diego School of Medicine and a cardiologist at UC San Diego Health.

The pilot study included 19 participants (13 men and 6 women) diagnosed with metabolic syndrome who self-reported eating during a time window of more than 14 hours per day. Additionally, 84% of participants were taking at least one medication such as a statin or an antihypertensive therapy. Study participants used the Panda lab’s myCircadianClock app to log when and what they ate during an initial 2-week baseline period followed by the three-month, 10-hour time-restricted eating intervention. Nearly 86% of participants correctly logged their food using the app, indicating high compliance throughout the study.

Participants did not report any adverse effects during the intervention. To reduce food intake to the 10-hour window, most participants delayed their first meal and advanced their last meal each day, so meals were not skipped. Although calories were not recommended to be reduced for the intervention, some participants did report eating less, likely due to the shorter eating window.

Overall, participants experienced improved sleep as well as a 3-4 percent reduction in body weight, body mass index, abdominal fat and waist circumference. Major risk factors for heart disease were diminished as participants showed reduced blood pressure and total cholesterol. Blood sugar levels and insulin levels also showed a trend toward improvement.

“Metabolism is closely linked with circadian rhythms, and knowing this, we were able to develop an intervention to help patients with metabolic syndrome without decreasing calories or increasing physical exercise,” says Pam Taub, co-corresponding author and associate professor of medicine at the UC San Diego School of Medicine and a cardiologist at UC San Diego Health. “If we can optimise circadian rhythms then we might be able to optimise the metabolic system.”

“Adapting this 10-hour time-restricted eating is an easy and cost-effective method for reducing symptoms of metabolic syndrome and improving health,” adds Panda. “By delaying the onset of diabetes by even one year in 1m people with prediabetes, the intervention could save roughly $9.6bn dollars in healthcare costs.”

The scientists are currently conducting a clinical trial funded by the National Institute of Diabetes and Digestive and Kidney Diseases to examine the benefits of time-restricted eating in a larger group of more than 100 participants with metabolic syndrome. The study includes additional measures that will help the researchers investigate changes in body composition and muscle function.

Abstract
In animal models, time-restricted feeding (TRF) can prevent and reverse aspects of metabolic diseases. Time-restricted eating (TRE) in human pilot studies reduces the risks of metabolic diseases in otherwise healthy individuals. However, patients with diagnosed metabolic syndrome often undergo pharmacotherapy, and it has never been tested whether TRE can act synergistically with pharmacotherapy in animal models or humans. In a single-arm, paired-sample trial, 19 participants with metabolic syndrome and a baseline mean daily eating window of ≥14 h, the majority of whom were on a statin and/or antihypertensive therapy, underwent 10 h of TRE (all dietary intake within a consistent self-selected 10 h window) for 12 weeks. We found this TRE intervention improves cardiometabolic health for patients with metabolic syndrome receiving standard medical care including high rates of statin and anti-hypertensive use. TRE is a potentially powerful lifestyle intervention that can be added to standard medical practice to treat metabolic syndrome.

Authors
Michael J Wilkinson, Emily NC Manoogian, Adena Zadourian, Hannah Lo, Savannah Fakhouri, Azarin Shoghi, Xinran Wang, Jason Gs Fleischer, Saket Navlakha, Satchidananda Panda, Pam R Taub

Salk Institute material

Cell Metabolism abstract

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