Acceptability of Time-Limited Eating in Pediatric Weight Management

Abstract

BackgroundAdherence to dietary interventions is a significant barrier in the treatment of childhood obesity. Time-limited eating (TLE) is a simple dietary approach that limits food intake to a given number of consecutive hours per day, but parental and youth acceptability of TLE in youth with obesity is unknown. This study explored the feasibility of utilizing TLE among parents and youth attending pediatric weight management (PWM).MethodsMembers of COMPASS (Childhood Obesity Multi-Program Analysis and Study System) developed a survey to assess the acceptability of TLE in families attending PWM, which included patient characteristics, current diet and sleep schedules, and interests in trying TLE. The survey was administered electronically via REDCap or manually to parents of patients between the ages of 8-17 years old and to patients 11-17 years old attending one of five PWM practices in the COMPASS network.ResultsPatients (n=213) were 13.0 ± 2.5 years old, 58% female, 52% White, 22% Black, 17% Hispanic/Latino, and 47% reported a diagnosed psychological disorder. On average, parents reported their child’s daily eating spanned 12.5 ± 1.9 hours (7:35am - 8:05pm) and included 5.6 ± 1.6 eating bouts (meals + snacks). Most parents reported being likely to try TLE ≤12 hours/d (TLE12: 66%), which was similar to the likelihood of following a nutrient-balanced diet (59%). Likelihood was lower for TLE ≤10 hours/d (TLE10: 39%) or ≤8 hours/d (TLE8: 26%) (p<0.001 for both). Interest in TLE was not consistently related to patient age, sex, or ethnicity, but was lower in patients with a psychiatric diagnosis vs. no diagnosis (TLE8: 19% vs. 32%; p=0.034). Patients of parents who reported being likely to try TLE, compared to those unlikely to try TLE, had shorter eating windows (p<0.001) and ate fewer snacks (p=0.006).ConclusionsTwo-thirds of parents with children attending PWM programs report interest in TLE ≤12 hours/d regardless of demographic characteristics, but interest wanes when limiting eating to ≤10 or ≤8 hours per day. Time-limited eating appears to be a feasible option in PWM settings provided treatment options are individualized based on the interests and barriers of patients and their families.

Frequency of night eating syndrome and melatonin levels in the urine of adolescents

“…The prevalence of NES is quite variable among adolescents and university students: from 2.9 % to 5.7 % among US college students to 13.8 % among Turkish university students [26][27][28][29], and studies [30,31] indicate an even greater NES prevalence in connection with COVID-19 infection. In this study, the prevalence of NES was 11.5 %, which is slightly higher than in other studies [32,33]. The difference can be explained by the fact that adolescents have higher levels of stress and more sleep problems than other age groups.…”

Daily Duration of Eating for Children and Adolescents: A Systematic Review and Meta-Analysis

“…The 10 included studies had a total population of 4589 participants, with individual study sample sizes ranging from 22 to 2195. Ages of participants ranged from 6-20 years, with six studies involving adolescents (≥10 years) [16,29,[32][33][34]36], and four involving both children (≤9 years) and adolescents [15,28,35,37]. All studies included both sexes, 57.3% of participants were female.…”

“…Socioeconomic status was reported by seven studies, measured either by educational level or household income. Study populations were from the USA (n = 4) [15,16,33,37], Brazil (n = 1) [34], India (n = 1) [36], Germany (n = 2) [28,29], The Netherlands (n = 1) [32], and pan-European (n = 1) [35]. Seven studies were observational, with three being cross-sectional [15,34,35], three cohort studies [28,29,36] (with one described as a longitudinal, feasibility study [36]), and one case-control study [32].…”

“…Study populations were from the USA (n = 4) [15,16,33,37], Brazil (n = 1) [34], India (n = 1) [36], Germany (n = 2) [28,29], The Netherlands (n = 1) [32], and pan-European (n = 1) [35]. Seven studies were observational, with three being cross-sectional [15,34,35], three cohort studies [28,29,36] (with one described as a longitudinal, feasibility study [36]), and one case-control study [32]. Three studies were experimental, with two randomised clinical trials [16,37] (of which one was a pilot study [16]) and one randomised crossover trial [33], all with baseline data available.…”

“…Whilst TLE is shown to be beneficial in adults it is not known whether it is effective or safe in children or adolescents. To the best of the authors' knowledge, there are no studies investigating the effects of TLE in paediatric populations with only a few studies investigating feasibility of reducing eating windows (EW) in these populations [14][15][16].…”