The current obesity epidemic is staggering in terms of its magnitude and public health impact. Current guidelines recommend continuous energy restriction (CER) along with a comprehensive lifestyle intervention as the cornerstone of obesity treatment, yet this approach produces modest weight loss on average. Recently, there has been increased interest in identifying alternative dietary weight loss strategies that involve restricting energy intake to certain periods of the day or prolonging the fasting interval between meals (i.e., intermittent energy restriction, IER). These strategies include intermittent fasting (IMF; >60% energy restriction on 2–3 days per week, or on alternate days) and time-restricted feeding (TRF; limiting the daily period of food intake to 8–10 h or less on most days of the week). Here, we summarize the current evidence for IER regimens as treatments for overweight and obesity. Specifically, we review randomized trials of ≥8 weeks in duration performed in adults with overweight or obesity (BMI ≥ 25 kg/m2) in which an IER paradigm (IMF or TRF) was compared to CER, with the primary outcome being weight loss. Overall, the available evidence suggests that IER paradigms produce equivalent weight loss when compared to CER, with 9 out of 11 studies reviewed showing no differences between groups in weight or body fat loss.
Objective: This trial aimed to evaluate the acceptability and efficacy of early timerestricted eating plus daily caloric restriction (E-TRE+DCR) compared with DCR alone within a behavioral weight-loss intervention. Methods: Participants (n = 81, 69 women, mean [SD] age: 38.0 [7.8] years, BMI: 34.1 [5.7] kg/m 2 ) were randomized to E-TRE (10-hour eating window starting within 3 hours of waking) plus DCR or DCR alone (~35% DCR) for 39 weeks. The primary outcome was body weight (measured with digital scale) at week 12. Secondary outcomes measured at week 12 included hemoglobin A1c, lipids, energy intake (photographic food records), physical activity (accelerometry), dietary adherence (questionnaires), and body composition (dual-energy x-ray absorptiometry). Weight and body composition were also assessed at week 39. Results: Mean [SD] weight loss was not different between groups at week 12
Accumulating evidence suggests that later timing of energy intake (EI) is associated with increased risk of obesity. In this study, 83 individuals with overweight and obesity underwent assessment of a 7-day period of data collection, including measures of body weight and body composition (DXA) and 24-h measures of EI (photographic food records), sleep (actigraphy), and physical activity (PA, activity monitors) for 7 days. Relationships between body mass index (BMI) and percent body fat (DXA) with meal timing, sleep, and PA were examined. For every 1 h later start of eating, there was a 1.25 (95% CI: 0.60, 1.91) unit increase in percent body fat (False Discovery Rate (FDR) adjusted p value = 0.010). For every 1 h later midpoint of the eating window, there was a 1.35 (95% CI: 0.51, 2.19) unit increase in percent body fat (FDR p value = 0.029). For every 1 h increase in the end of the sleep period, there was a 1.64 (95% CI: 0.56, 2.72) unit increase in percent body fat (FDR p value = 0.044). Later meal and sleep timing were also associated with lower PA levels. In summary, later timing of EI and sleep are associated with higher body fat and lower levels of PA in people with overweight and obesity.
Adolescence is marked by several key development-related changes, including neurocognitive changes. Cognitive abilities associated with self-regulation are not fully developed until late adolescence or early adulthood whereas tendencies to take risks and seek thrilling and novel experience seem to increase significantly throughout this phase, resulting in a discrepancy between increased susceptibility to poor regulation and lower ability to exercise self-control. Increased vulnerability to drug use initiation, maintenance, and dependence during adolescence may be explained based on this imbalance in the self-regulation system. In this paper, we highlight the relevance of schools as a setting for delivering adolescent drug use prevention programs that are based on recent findings from neuroscience concerning adolescent brain development. We discuss evidence from school-based as well as laboratory research that suggests that suitable training may improve adolescents’ executive brain functions that underlie self-regulation abilities and, as a result, help prevent drug use and abuse. We note that considerable further research is needed in order (1) to determine that self-regulation training has effects at the neurocognitive level and (2) to effectively incorporate self-regulation training based on neuropsychological models into school-based programming.
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