Time-Restricted Eating and Metabolic Syndrome: Current Status and Future Perspectives

Abstract

Metabolic syndrome (MetS) occurs in ~30% of adults and is associated with increased risk of cardiovascular disease and diabetes mellitus. MetS reflects the clustering of individual cardiometabolic risk factors including central obesity, elevated fasting plasma glucose, dyslipidemia, and elevated blood pressure. Erratic eating patterns such as eating over a prolonged period per day and irregular meal timing are common in patients with MetS. Misalignment between daily rhythms of food intake and circadian timing system can contribute to circadian rhythm disruption which results in abnormal metabolic regulation and adversely impacts cardiometabolic health. Novel approaches which aim at restoring robust circadian rhythms through modification of timing and duration of daily eating represent a promising strategy for patients with MetS. Restricting eating period during a day (time-restricted eating, TRE) can aid in mitigating circadian disruption and improving cardiometabolic outcomes. Previous pilot TRE study of patients with MetS showed the feasibility of TRE and improvements in body weight and fat, abdominal obesity, atherogenic lipids, and blood pressure, which were observed despite no overt attempt to change diet quantity and quality or physical activity. The present article aims at giving an overview of TRE human studies of individuals with MetS or its components, summarizing current clinical evidence for improving cardiometabolic health through TRE intervention in these populations, and presenting future perspectives for an implementation of TRE to treat and prevent MetS. Previous TRE trials laid the groundwork and indicate a need for further clinical research including large-scale controlled trials to determine TRE efficacy for reducing long-term cardiometabolic risk, providing tools for sustained lifestyle changes and, ultimately, improving overall health in individuals with MetS.

The Effects of Time-Restricted Eating versus Standard Dietary Advice on Weight, Metabolic Health and the Consumption of Processed Food: A Pragmatic Randomised Controlled Trial in Community-Based Adults

“…One form of intermittent fasting, called time-restricted eating (TRE), limits energy intake to certain daily time intervals without restrictions on calories or macronutrients [8,9]. In human studies, TRE can lead to weight loss even without deliberate calorie restriction [10][11][12][13][14], which could result from a loss of both lean and fat mass [15]. Changes to glucose metabolism have also been observed, with mixed effects on HbA1c [11,16], fasting glucose [17], insulin sensitivity [18] or the area under the curve of continuous glucose measurement [19].…”

Pilot Clinical Trial of Time-Restricted Eating in Patients with Metabolic Syndrome

“…Moreover, TRE effects on metabolic, inflammatory, and oxidative stress biomarkers have been poorly investigated, so further evidence is needed regarding potential post-TRE improvements in oxidative stress, inflammation, and atherosclerosis [37,41,44,50,60]. In addition, more data on potential benefits of TRE on circadian-related metabolic and neuroendocrine biomarkers, BP, and daily rhythms of behavior such as eating window, meal timing, sleep, and physical activity would be desirable [63][64][65].…”

Dysglycemia and Abnormal Adiposity Drivers of Cardiometabolic-Based Chronic Disease in the Czech Population: Biological, Behavioral, and Cultural/Social Determinants of Health

“…Intensive research is needed for constant updating of current prevention guidelines and ensuring their proper, homogeneous delivery to patients. For example, further clinical studies are essential to investigate whether restricting daily eating periods could mitigate circadian disruptions, promote weight loss, and improve cardiometabolic outcomes [95,96].…”