Time-restricted feeding’s effect on overweight and obese patients with chronic kidney disease stages 3-4: A prospective non-randomized control pilot study

Abstract

BackgroundTime-restricted feeding (TRF) has become a popular weight loss method in recent years. It is widely used in the nutritional treatment of normal obese people and obese people with chronic diseases such as diabetes mellitus and hypertension, and has shown many benefits. However, most TRF studies have excluded chronic kidney disease (CKD) patients, resulting in a lack of sufficient evidence-based practice for the efficacy and safety of TRF therapy for CKD. Therefore, we explore the efficacy and safety of TRF in overweight and obese patients with moderate-to-severe stage CKD through this pilot study, and observe patient compliance to assess the feasibility of the therapy.MethodsThis is a prospective, non-randomized controlled short-term clinical trial. We recruited overweight and obese patients with CKD stages 3-4 from an outpatient clinic and assigned them to either a TRF group or a control diet (CD) group according to their preferences. Changes in renal function, other biochemical data, anthropometric parameters, gut microbiota, and adverse events were measured before the intervention and after 12 weeks.ResultsThe change in estimated glomerular filtration rate (eGFR) before and after intervention in the TRF group (Δ = 3.1 ± 5.3 ml/min/1.73m2) showed significant improvement compared with the CD group (Δ = -0.8 ± 4.4 ml/min/1.73m2). Furthermore, the TRF group had a significant decrease in uric acid (Δ = -70.8 ± 124.2 μmol/L), but an increase in total protein (Δ = 1.7 ± 2.5 g/L), while the changes were inconsistent for inflammatory factors. In addition, the TRF group showed a significant decrease in body weight (Δ = -2.8 ± 2.9 kg) compared to the CD group, and body composition indicated the same decrease in body fat mass, fat free mass and body water. Additionally, TRF shifted the gut microbiota in a positive direction.ConclusionPreliminary studies suggest that overweight and obese patients with moderate-to-severe CKD with weight loss needs, and who were under strict medical supervision by healthcare professionals, performed TRF with good compliance. They did so without apparent adverse events, and showed efficacy in protecting renal function. These results may be due to changes in body composition and alterations in gut microbiota.

Nourishing the gut: the impact of diet on host–gut microbiota interaction

“…Diet-induced changes in GM often raise questions about the potential role of meal frequency and timing on health outcomes mediated by shifts in the intestinal microbial communities. To address this knowledge gap, Lao et al conducted a study including 28 subjects with overweight or obesity and assigned them to either the time-restricted feeding (TRF) group or a control group receiving a highquality low-protein diet with no restrictions on what time they could eat each day [33]. TRF is a dietary pattern that restricts food consumption to a specific time window each day, typically lasting from 8 to 12 h, with the remaining hours designated as a fasting period.…”

Impact of Time-Resricted Feeding and Aerobic Exercise Combination on Promotes Myokine Levels and Improve Body Composition in Obese Women

“…TRF for 16/8 has been proven to be effective in reducing body weight, improving body composition (Schroder et al, 2021) and reducing the risk of cardiometabolic disease in obese individuals (Cienfuegos et al, 2020). Studies conducted on chronic kidney failure sufferers who are obese have also proven that TRF is beneficial in improving body composition and changing gut microbiota, without causing side effects on kidney function (Lao et al, 2023). This is supported by the fact that TRF is able to increase the metabolic process of nutrients and maintain fitness and muscle function (Kang et al, 2022).…”