Highlights
- •Time-restricted eating (TRE) is a dietary strategy to improve glycaemic control.
- •TRE reduced 24-h total area under the curve from continuous glucose monitoring.
- •TRE reduced time above range by ∼10% and consequently increased time in range.
- •TRE improved postprandial glucose measures.
Abstract
Aims
Examine the effect of 5 d/wk, 9-h time-restricted eating (TRE) protocol on 24-h glycaemic
control in adults with type 2 diabetes (T2D).
Methods
Nineteen adults with T2D (10 F/9 M; 50 ± 9 y, HbA1c 7.6% (60 mmol/mol), BMI ∼34 kg/m2) completed a pre-post non-randomised trial comprising of a 2-wk Habitual monitoring
period followed by 9-h (10:00–19:00 h) TRE for 4-wk. Glycaemic control was assessed
via continuous glucose monitoring (CGM; for mean 24-h glucose concentrations, 24-h
total area under the curve (AUC) and glucose variability metrics), with dietary records
and physical activity monitoring. Changes in CGM measures, dietary intake and physical
activity were assessed with linear mixed-effects models.
Results
TRE did not alter dietary energy intake, macronutrient composition or physical activity,
but reduced the daily eating window (−2 h 35 min, P < 0.001). Compared to the Habitual period, 24-h glucose concentrations (mean, SD)
and AUC decreased in the 4-wk TRE period (mean: -0.7 ± 1.2 mmol/L, P = 0.02; SD: -0.2 ± 0.3 mmol/L, P = 0.01; 24-h AUC: -0.9 ± 1.4 mmol/L⋅h−1 P = 0.01). During TRE, participants spent 10% more time in range (3.9–10.0 mmol/L;
P = 0.02) and 10% less time above range (>10.0 mmol/L; P = 0.02).
Conclusions
Adhering 5 d/wk. to 9-h TRE improved glycaemic control in adults with T2D, independent
of changes in physical activity or dietary intake.
Clinical Trial Registration: Australia New Zealand Clinical Trial Registry, ACTRN12618000938202.
Keywords
Abbreviations:
AUC (Area under the curve), BMI (Body mass index), CGM (Continuous glucose monitor), CV (Coefficient of variation), eTRE (Early time restricted eating), FSL (FreeStyle Libre), HbA1c (Glycated haemoglobin), iAUC (Incremental area under the curve), LMM (Linear mixed model), MAD (Median absolute deviation), sGVP (Standardised glycaemic variability percentage), T2D (Type 2 diabetes), TAR (Time above range (hyperglycaemia)), TIR (Time in range (normoglycaemia)), TRE (Time restricted eating)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Diabetes Research and Clinical PracticeAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The effects of time restricted feeding on overweight, older adults: a pilot study.Nutrients. 2019; 11: 1500https://doi.org/10.3390/nu11071500
- A smartphone app reveals erratic diurnal eating patterns in humans that can be modulated for health benefits.Cell Metab. 2015; 22: 789-798https://doi.org/10.1016/j.cmet.2015.09.005
- Adherence to time-restricted feeding and impact on abdominal obesity in primary care patients: results of a pilot study in a pre–post design.Nutrients. 2019; 11: 2854https://doi.org/10.3390/nu11122854
- Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: a pilot study.Nutr Healthy Aging. 2018; 4: 345-353https://doi.org/10.3233/NHA-170036
- A pilot feasibility study exploring the effects of a moderate time-restricted feeding intervention on energy intake, adiposity and metabolic physiology in free-living human subjects.J Nutr Sci. 2018; : 7https://doi.org/10.1017/jns.2018.13
- Short-term time-restricted feeding is safe and feasible in non-obese healthy midlife and older adults.GeroScience. 2020; https://doi.org/10.1007/s11357-020-00156-6
- Time-restricted eating as a nutrition strategy for individuals with type 2 diabetes: a feasibility study.Nutrients. 2020; 12: 3228https://doi.org/10.3390/nu12113228
- Time-restricted feeding without reducing caloric intake prevents metabolic diseases in mice fed a high-fat diet.Cell Metab. 2012; 15: 848-860https://doi.org/10.1016/j.cmet.2012.04.019
- Reprogramming of the circadian clock by nutritional challenge.Cell. 2013; 155: 1464-1478https://doi.org/10.1016/j.cell.2013.11.034
- Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes.Cell Metab. 2018; 27: 1212-1221.e3https://doi.org/10.1016/j.cmet.2018.04.010
- Early time-restricted feeding improves 24-hour glucose levels and affects markers of the circadian clock, aging, and autophagy in humans.Nutrients. 2019; 11: 1234https://doi.org/10.3390/nu11061234
- Time-restricted feeding improves glucose tolerance in men at risk for type 2 diabetes: a randomized crossover trial.Obesity (Silver Spring). 2019; 27: 724-732https://doi.org/10.1002/oby.22449
- A delayed morning and earlier evening time-restricted feeding protocol for improving glycemic control and dietary adherence in men with overweight/obesity: a randomized controlled trial.Nutrients. 2020; 12: 505https://doi.org/10.3390/nu12020505
- Effects of 4- and 6-h time-restricted feeding on weight and cardiometabolic health: a randomized controlled trial in adults with obesity.Cell Metab. 2020; (S1550413120303193)https://doi.org/10.1016/j.cmet.2020.06.018
- Ten-hour time-restricted eating reduces weight, blood pressure, and atherogenic lipids in patients with metabolic syndrome.Cell Metab. 2020; 31: 92-104.e5https://doi.org/10.1016/j.cmet.2019.11.004
- Metabolism and the circadian clock converge.Physiol Rev. 2013; 93: 107-135https://doi.org/10.1152/physrev.00016.2012
- Impact of circadian disruption on glucose metabolism: implications for type 2 diabetes.Diabetologia. 2020; 63: 462-472https://doi.org/10.1007/s00125-019-05059-6
- Divided consumption of late-night-dinner improves glycemic excursions in patients with type 2 diabetes: a randomized cross-over clinical trial.Diabetes Res Clin Pract. 2017; 129: 206-212https://doi.org/10.1016/j.diabres.2017.05.010
- Associations between eating habits and glycemic control and obesity in Japanese workers with type 2 diabetes mellitus.DMSO. 2018; 11: 647-658https://doi.org/10.2147/DMSO.S176749
- Diurnal variation of oral glucose tolerance: a possible pointer to the evolution of diabetes mellitus.BMJ. 1969; 2: 341-344https://doi.org/10.1136/bmj.2.5653.341
- Modulation of glucose regulation and insulin secretion by circadian rhythmicity and sleep.J Clin Investig. 1991; 88: 934-942https://doi.org/10.1172/JCI115396
- Magnitude of the dawn phenomenon and its impact on the overall glucose exposure in type 2 diabetes: is this of concern?.Diabetes Care. 2013; 36: 4057-4062https://doi.org/10.2337/dc12-2127
- Significance of HbA1c test in diagnosis and prognosis of diabetic patients.Biomark Insight. 2016; 11 (BMI.S38440)https://doi.org/10.4137/BMI.S38440
- Time-restricted feeding improves blood glucose and insulin sensitivity in overweight patients with type 2 diabetes: a randomised controlled trial.Nutr Metab (Lond). 2021; 18: 88https://doi.org/10.1186/s12986-021-00613-9
- Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range.Diabetes Care. 2019; 42: 1593-1603https://doi.org/10.2337/dci19-0028
- Three weeks of time-restricted eating improves glucose homeostasis in adults with type 2 diabetes but does not improve insulin sensitivity: a randomised crossover trial.Diabetologia. 2022; https://doi.org/10.1007/s00125-022-05752-z
- GLU: a software package for analysing continuously measured glucose levels in epidemiology.Int J Epidemiol. 2020; 49: 744-757https://doi.org/10.1093/ije/dyaa004
- Eating two larger meals a day (breakfast and lunch) is more effective than six smaller meals in a reduced-energy regimen for patients with type 2 diabetes: a randomised crossover study.Diabetologia. 2014; 57: 1552-1560https://doi.org/10.1007/s00125-014-3253-5
- Variability in daily eating patterns and eating jetlag are associated with worsened cardiometabolic risk profiles in the American Heart Association go red for women strategically focused research network.JAHA. 2021; 10e022024https://doi.org/10.1161/JAHA.121.022024
- The relationship of hemoglobin A1C to time-in-range in patients with diabetes.Diabetes Technol Ther. 2019; 21: 81-85https://doi.org/10.1089/dia.2018.0310
- Glycemic variability: adverse clinical outcomes and how to improve it?.Cardiovasc Diabetol. 2020; 19: 102https://doi.org/10.1186/s12933-020-01085-6
- The time of day and the proportions of macronutrients eaten are related to total daily food intake.Br J Nutr. 2007; 98: 1077-1083https://doi.org/10.1017/S0007114507754296
- Timing of food intake predicts weight loss effectiveness.Int J Obes (Lond). 2013; 37: 604-611https://doi.org/10.1038/ijo.2012.229
- Fasting until noon triggers increased postprandial hyperglycemia and impaired insulin response after lunch and dinner in individuals with type 2 diabetes: a randomized clinical trial.Diabetes Care. 2015; 38: 1820-1826https://doi.org/10.2337/dc15-0761
- Eating dinner Early improves 24-h blood glucose levels and boosts lipid metabolism after breakfast the next day: a randomized cross-over trial.Nutrients. 2021; 13: 2424https://doi.org/10.3390/nu13072424
- Prolonged nightly fasting and breast cancer risk: findings from NHANES (2009-2010).Cancer Epidemiol Biomarkers Prev. 2015; 24: 783-789https://doi.org/10.1158/1055-9965.EPI-14-1292
- Use of professional-mode flash glucose monitoring, at 3-month intervals, in adults with type 2 diabetes in general practice (GP-OSMOTIC): a pragmatic, open-label, 12-month, randomised controlled trial.Lancet Diabetes Endocrinol. 2020; 8: 17-26https://doi.org/10.1016/S2213-8587(19)30385-7
- The effect of real-time continuous glucose monitoring on glycemic control in patients with type 2 diabetes mellitus.J Diabetes Sci Technol. 2011; 5: 668-675https://doi.org/10.1177/193229681100500320
Article info
Publication history
Published online: February 02, 2023
Accepted:
January 23,
2023
Received in revised form:
January 16,
2023
Received:
September 4,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
