Barriers to adherence in time-restricted eating clinical trials: An early preliminary review

Abstract

Time-restricted eating (TRE) has shown potential benefits in optimizing the body's circadian rhythms and improving cardiometabolic health. However, as with all dietary interventions, a participant's ability to adhere to the protocol may be largely influenced by a variety of lifestyle factors. In TRE trials that reported participants' rates of adherence, the percentage of total days with successful adherence to TRE ranged from 47% to 95%. The purpose of this review is to (1) summarize findings of lifestyle factors affecting adherence to TRE clinical trials outside of the lab, and (2) explore a recommended set of behavioral intervention strategies for the application of TRE. A literature search on Pubmed was conducted to identify clinical TRE studies from 1988 to October 5, 2022, that investigated TRE as a dietary intervention. 21 studies included daily self-monitoring of adherence, though only 10 studies reported a combination of family, social, work, and miscellaneous barriers. To maximize participant adherence to TRE and increase the reliability of TRE clinical trials, future studies should monitor adherence, assess potential barriers, and consider incorporating a combination of behavioral intervention strategies in TRE protocols.

Intermittent Fasting After ST-Segment–Elevation Myocardial Infarction Improves Left Ventricular Function: The Randomized Controlled INTERFAST-MI Trial

“…This corresponds approximately to the adherence seen in other studies with comparable intervention. 24 Only 3 patients decided to voluntarily cross over to the regular diet group after 3 months.…”

Time‐restricted eating for chronodisruption‐related chronic diseases

“…Previous studies showed that TRE adherence rates ranged from 47% to 95%. 181 To get around this, future trials might need to tailor their protocol to potentials barriers such as social life, work schedule, cultural and religious influences. Moreover, it is desirable to choose eating intervals of 6-10 h so that participants can eat within a reasonable time frame.…”

“…Furthermore, adherence to TRE is one of the biggest long‐term concerns. Previous studies showed that TRE adherence rates ranged from 47% to 95% 181 . To get around this, future trials might need to tailor their protocol to potentials barriers such as social life, work schedule, cultural and religious influences.…”