Further benefits As the studies show, the benefits of time-restricted eating are immense. In addition to the results documented in the experiments above, experiments also suggest 6 that time-restricted eating can lead to — increased daytime alertness; better mood; prevention or reversal of metabolic disease; improved liver function; lowered calorie intake; weight loss maintained for a year after the study ; and, lowered risk of breast cancer.

To make the time-restricted eating work harder, eat better To make time-restricted eating successful, eating nutritious, filling and delicious food is also key. Time-restricted eating: five practical steps Weight loss can be a powerful motivator, so before you begin, make a note of your weight.

Stay hydrated. Drinking plenty of water can keep the hunger at bay. You can also try adding fresh ginger, a slice of fresh lemon or lime to hot water or to sparkling water.

Black coffee and tea are fine to have during your fasting hours. Keep exercising: a fitness programme will help to keep you insulin-sensitive, which is key to preventing cravings from taking over.

However, avoid endurance or highly demanding exercise on a fast day. As soon as you have finished the last meal of the day, brush your teeth. Search for: SEARCH. NEVER MISS AN UPDATE Sign up to our Newsletter! Lose weight for better health with science-based methods and real, delicious food.

Weight loss for better health is easier than ever. Try our Programme for free today! More info. Nutritious products for busy days Shop Now.

Subscribe to our Newsletter Name. We use cookies to optimise our website and our service. Approximately 1 in 10 US residents have type 2 diabetes T2D.

Calorie restriction CR is generally encouraged as the first line of therapy to help people with T2D achieve their weight management goals and glycemic targets. Another approach that limits the timing of food intake instead of the number of calories consumed has recently been popularized.

This diet is termed time-restricted eating TRE and involves confining daily food intake to 6 to 10 hours and fasting for the remaining hours.

Only 2 TRE trials 7 , 8 to date have been conducted in adults with T2D. We hypothesized that the TRE group would achieve greater weight loss and larger reductions in HbA 1c levels, compared with a CR group and a control group.

The protocol for this randomized clinical trial was approved by the Office for the Protection of Research Subjects at the University of Illinois Chicago, and written informed consent was obtained from all participants. The full trial protocol and statistical analysis plan are provided in Supplement 1.

This study followed the Consolidated Standards of Reporting Trials CONSORT reporting guidelines. The trial was a 6-month, single-center, randomized clinical trial conducted at the University of Illinois Chicago between January 25, , and April 1, eFigure 1 in Supplement 2.

Inclusion criteria were as follows: previous diagnosis of T2D, HbA 1c levels between 6. Self-reported race and ethnicity data including Asian, Hispanic White, non-Hispanic Black, and non-Hispanic White were collected given that Hispanic and non-Hispanic Black adults have a high prevalence of T2D in the US.

Participants were randomized in a ratio to a TRE, CR, or control group. Randomization was performed by a stratified random sampling procedure by sex, age and years , BMI and , and HbA 1c level 6.

Participants were not blinded. Participants in the TRE group ate ad libitum between and pm daily and fasted from pm to pm the following day. During the 8-hour eating window, participants were not required to monitor caloric intake, and there were no restrictions on types or quantities of food consumed.

During the hour fasting window, participants were encouraged to drink plenty of water and were permitted to consume energy-free drinks. Participants self-monitored adherence to the eating window using a log in which they recorded the times that they started and stopped eating each day.

Total energy expenditure was calculated using the Mifflin equation. at the beginning of the trial to develop individualized weight loss meal plans and self-monitored adherence to their calorie target by logging food intake into an app every day.

Control participants were instructed to maintain their weight and usual eating and exercise habits. Control participants visited the research center at the same frequency as the intervention participants to provide outcome measurements.

Participants in the TRE, CR, and control groups met with the study dietitian weekly from baseline to month 3 by telephone or Zoom and then biweekly thereafter.

Body weight, adherence, medication changes, and adverse events were recorded during these calls. Participants in the TRE and CR groups were also taught how to make general healthy food choices that conform to American Diabetes Association nutrition guidelines.

The medication management protocol was developed based on the literature. No medication adjustments were made for controls. All participants wore a continuous glucose monitor CGM [Dexcom G7; DexCom, Inc] for 10 days at baseline, month 3, and month 6. When participants were not wearing the CGM, they tested their blood glucose levels daily using a lancing device and glucose monitor.

The primary outcome of the study was percentage change in body weight among the TRE, CR, and control groups by month 6. Analytical methods are detailed in Supplement 1. Reporting of serious adverse events followed requirements mandated by the University of Illinois Office for Protection of Research Subjects Supplement 1.

P values generated from analyses of secondary outcomes were not adjusted for multiplicity and are considered descriptive.

We conducted an intention-to-treat analysis, which included data from all 75 participants who underwent randomization. Results are reported by intention-to-treat analysis unless indicated otherwise. A linear mixed model was used to assess time, group, and time × group effects for each outcome.

In each model, time and group effects and their interaction were estimated without imposing a linear time trend. In models for body weight, which was measured at 7 time points baseline and each of 6 months of follow-up , time was modeled with cubic splines. All models were adjusted for baseline use of sodium-glucose transport protein 2 inhibitors and glucagon-like peptide-1 receptor agonists to account for empirical baseline differences in medication use between treatment groups.

For each outcome variable, linear modeling assumptions were assessed with residual diagnostics. To account for the potential of nonuniform variances heteroskedasticity between treatment groups due to random chance, all CIs and P values from linear mixed models were calculated using robust variance estimators sandwich estimators.

To assess the effect of loss to follow-up on study findings, we conducted a sensitivity analysis using multiple imputation. Multiple imputation can incorporate observed data not otherwise accounted for in the model eg, using baseline insulin levels to impute missing time in euglycemic range to estimate multiple values for each missing data point and account for sampling variability.

Missing follow-up data were imputed under the assumption that systematic differences between missing and observed outcomes can be explained by baseline values of the outcome as well as baseline values of height and waist circumference and medication effect score and HbA 1c level for glycemic outcomes , and all previous time points of weight.

All analyses were performed using R software, version 4. We screened people and enrolled 75 participants Figure 1. Participants had a mean SD age of 55 12 years, mean SD BMI of 39 7 , and mean SD HbA 1c level of 8. The reasons for participant attrition included personal reasons, inability to contact, not wanting to be in the control group, and motor vehicle crash.

Both TRE and CR led to reductions in waist circumference by month 6, but not lean mass or visceral fat mass, compared with controls. Relative to controls, BMI decreased in the TRE group by month 6, but not the CR group.

Time in the euglycemic range and medication effect scores were not associated with treatment group in any pairwise comparisons at month 6 Table 2.

Medication use at baseline and month 6 is reported in eTable 1 in Supplement 2. Conclusions for body weight and HbA 1c level did not change from the primary analyses to the sensitivity analyses eTable 2 in Supplement 2 , demonstrating that the results are robust to misspecification of the missingness mechanism.

However, sensitivity analyses differed from primary analyses for some secondary outcomes: fat mass decreased in both the TRE and the CR groups by month 6 relative to controls rather than in the TRE group alone , and mean glucose levels decreased in the CR group only. Conclusions did not change between the primary analysis and sensitivity analysis for any other secondary outcome.

Changes in blood pressure, heart rate, total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride concentrations were observed. However, these changes were not associated with treatment group in any pairwise comparisons at month 6 Table 2.

Differences in dietary intake among groups are given in Table 3. The TRE group reported being adherent with their eating window a mean SD of 6. Participants in the TRE group reported finding their diet intervention easier to adhere to compared with CR group participants eFigure 3 in Supplement 2.

The daily eating window in the TRE group decreased from baseline to month 6 but remained unchanged in the CR and control groups Table 3. Dietary intake and physical activity did not differ over time or between groups Table 3. Occurrences of hypoglycemia and hyperglycemia did not differ between groups eTable 3 in Supplement 2.

Findings of this randomized clinical trial show that 8-hour TRE produced greater weight loss when compared with CR and a control condition. Despite the greater weight loss achieved by the TRE group, reductions in HbA 1c levels were similar in the TRE and CR groups compared with the control group.

Participants in the TRE group found it easier to adhere to their intervention and achieved greater overall energy restriction compared with the CR group.

Medication effect score did not change in any group, and no serious adverse events were reported. Only 2 clinical trials 7 , 8 to date have examined how TRE affects body weight in patients with T2D.

Che and colleagues 8 demonstrated that 12 weeks of hour TRE without calorie counting reduced body weight by 3. Likewise, Andriessen et al 7 showed that 9-hour TRE produced 1. The weight loss produced by our 8-hour TRE intervention was slightly greater 4.

In contrast, the weight loss by the CR group was not significant relative to the control or TRE group. Since CR is commonly prescribed as a first-line intervention in T2D, it is likely that our participants had already tried calorie counting in the past, without success.

Time-restricted eating may have served as a refreshing alternative to CR, in that it only required patients to count time instead of calories, which may have bolstered overall adherence and weight loss in the TRE group. Our findings for HbA 1c levels are comparable to other TRE trials in T2D 7 , 8 and the Look AHEAD Action for Health in Diabetes study, which implemented daily CR.

However, both TRE and CR led to comparable reductions in waist circumference a surrogate marker of visceral fat mass. Evidence suggests that visceral fat mass may be a stronger factor associated with changes in glycemic control than body weight alone.

Our findings also show that TRE is safe in patients who are using either diet alone or medications to control their T2D. Hispanic and non-Hispanic Black adults are among the racial and ethnic groups with the highest prevalence of T2D in the US. Time-restricted eating is an appealing approach to weight loss in that it can be adopted at no cost, allows patients to continue consuming familiar foods, and does not require complicated calorie counting.

Since the literature on TRE is still quite limited, 26 our trial may help to improve the health of groups with a high prevalence of T2D by filling in these critical knowledge gaps.

Our study has some limitations, which include the relatively short trial duration and the lack of blinding of participants. Moreover, a higher percentage of participants in the TRE group were using sodium-glucose transport protein 2 inhibitors and glucagonlike peptide-1 receptor agonists at baseline.

These medications could have influenced our body weight findings, 27 even though participants had stable weight before enrollment.

To control for these confounding variables, we accounted for the use of these medications in the analyses of our primary and secondary outcomes.

In addition, we relied on self-reported dietary intake. Last, TRE itself can be associated with greater self-monitoring and lower caloric intake, so although these effects were noted in the TRE group, these are expected as part of the intervention.

This randomized clinical trial found that 8-hour TRE without calorie counting was an effective alternative diet strategy for weight loss and lowering of HbA 1c levels compared with daily calorie counting in a sample of adults with T2D and obesity.

Published: October 27, The amount of time it takes to recover from weight loss surgery depends on the type of surgery and surgical technique you receive. New research suggests that running may not aid much with weight loss, but it can help you keep from gaining weight as you age.

Here's why. New research finds that bariatric surgery is an effective long-term treatment to help control high blood pressure. Most people associate stretch marks with weight gain, but you can also develop stretch marks from rapid weight loss.

New research reveals the states with the highest number of prescriptions for GLP-1 drugs like Ozempic and Wegovy.

Mounjaro is a diabetes medication that may help with weight loss. Here's what you need to know about purchasing it without insurance. Eating up to three servings of kimchi each day is linked to a reduced rate of obesity among men, according to a new study.

This study is observational…. A Quiz for Teens Are You a Workaholic? How Well Do You Sleep? Health Conditions Discover Plan Connect. Health News Fact Checked How Eating Only Between 7 a. Can Help With Weight Loss and Blood Pressure. By Elizabeth Pratt on August 8, — Fact checked by Dana K.

Share on Pinterest Researchers eating in the morning and afternoon only can help with weight loss. Time of day matters. Benefits besides weight loss.

On The Fast Online Programme , we have made this easy for you. Whether you opt to follow a schedule or an calorie diet, or simply want to eat a healthy Mediterranean-style diet, our recipes are designed to combine perfectly with time-restricted eating.

We also have two meal a day plans available for those looking to reduce their eating window further, making sure your protein targets continue to be reached within two meals, instead of three. Time-restricted eating Time-restricted eating, or TRE, is very straightforward.

How does it work? Name Required. Email Required. Further benefits As the studies show, the benefits of time-restricted eating are immense. In addition to the results documented in the experiments above, experiments also suggest 6 that time-restricted eating can lead to — increased daytime alertness; better mood; prevention or reversal of metabolic disease; improved liver function; lowered calorie intake; weight loss maintained for a year after the study ; and, lowered risk of breast cancer.

To make the time-restricted eating work harder, eat better To make time-restricted eating successful, eating nutritious, filling and delicious food is also key. Time-restricted eating: five practical steps Weight loss can be a powerful motivator, so before you begin, make a note of your weight.

Stay hydrated. Drinking plenty of water can keep the hunger at bay. You can also try adding fresh ginger, a slice of fresh lemon or lime to hot water or to sparkling water. Black coffee and tea are fine to have during your fasting hours.

Keep exercising: a fitness programme will help to keep you insulin-sensitive, which is key to preventing cravings from taking over. However, avoid endurance or highly demanding exercise on a fast day. As soon as you have finished the last meal of the day, brush your teeth.

Search for: SEARCH. NEVER MISS AN UPDATE Sign up to our Newsletter! Lose weight for better health with science-based methods and real, delicious food. Weight loss for better health is easier than ever. Try our Programme for free today! More info. Nutritious products for busy days Shop Now.

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In contrast, the weight loss by the CR group was not significant relative to the control or TRE group. Since CR is commonly prescribed as a first-line intervention in T2D, it is likely that our participants had already tried calorie counting in the past, without success.

Time-restricted eating may have served as a refreshing alternative to CR, in that it only required patients to count time instead of calories, which may have bolstered overall adherence and weight loss in the TRE group. Our findings for HbA 1c levels are comparable to other TRE trials in T2D 7 , 8 and the Look AHEAD Action for Health in Diabetes study, which implemented daily CR.

However, both TRE and CR led to comparable reductions in waist circumference a surrogate marker of visceral fat mass. Evidence suggests that visceral fat mass may be a stronger factor associated with changes in glycemic control than body weight alone. Our findings also show that TRE is safe in patients who are using either diet alone or medications to control their T2D.

Hispanic and non-Hispanic Black adults are among the racial and ethnic groups with the highest prevalence of T2D in the US. Time-restricted eating is an appealing approach to weight loss in that it can be adopted at no cost, allows patients to continue consuming familiar foods, and does not require complicated calorie counting.

Since the literature on TRE is still quite limited, 26 our trial may help to improve the health of groups with a high prevalence of T2D by filling in these critical knowledge gaps.

Our study has some limitations, which include the relatively short trial duration and the lack of blinding of participants. Moreover, a higher percentage of participants in the TRE group were using sodium-glucose transport protein 2 inhibitors and glucagonlike peptide-1 receptor agonists at baseline.

These medications could have influenced our body weight findings, 27 even though participants had stable weight before enrollment. To control for these confounding variables, we accounted for the use of these medications in the analyses of our primary and secondary outcomes.

In addition, we relied on self-reported dietary intake. Last, TRE itself can be associated with greater self-monitoring and lower caloric intake, so although these effects were noted in the TRE group, these are expected as part of the intervention. This randomized clinical trial found that 8-hour TRE without calorie counting was an effective alternative diet strategy for weight loss and lowering of HbA 1c levels compared with daily calorie counting in a sample of adults with T2D and obesity.

Published: October 27, Open Access: This is an open access article distributed under the terms of the CC-BY-NC-ND License. JAMA Network Open. Corresponding Author: Krista A. Varady, PhD, Department of Kinesiology and Nutrition, University of Illinois Chicago, W Taylor St, Chicago, IL varady uic.

Author Contributions: Dr Varady had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Acquisition, analysis, or interpretation of data: Pavlou, Cienfuegos, Ezpeleta, Ready, Corapi, Wu, Lopez, Tussing-Humphreys, Oddo, Alexandria, Sanchez, Unterman, Chow, Vidmar, Varady. Critical review of the manuscript for important intellectual content: Pavlou, Cienfuegos, Lin, Ezpeleta, Ready, Corapi, Lopez, Gabel, Tussing-Humphreys, Oddo, Alexandria, Sanchez, Unterman, Chow, Vidmar, Varady.

Administrative, technical, or material support: Pavlou, Cienfuegos, Lin, Ready, Lopez, Sanchez, Unterman, Vidmar. Conflict of Interest Disclosures: Ms Ready reported being a member of the Certified Diabetes Care and Education Specialist for the Academy of Nutrition and Dietetics and being employed as a clinician at Ascension Medical Group Weight Loss Solutions and Diabetes Education outside the submitted work.

Dr Chow reported receiving nonfinancial support from DexCom Inc outside the submitted work. Dr Vidmar reported receiving consulting fees from Rhythm Pharmaceuticals Inc, Hippo Technologies Inc, and Guidepoint Inc and grant funding from DexCom Inc, outside the submitted work.

Dr Varady reported receiving grant funding from the National Institute of Diabetes and Digestive and Kidney Diseases NIDDK of the National Institutes of Health NIH during the conduct of the study; receiving personal fees from the NIH for serving on the data and safety monitoring boards for the Health, Aging and Later-Life Outcomes and Dial Health studies; receiving author fees from Pan MacMillan for The Fastest Diet ; and serving as the associate editor for nutrition reviews from Elsevier outside the submitted work.

No other disclosures were reported. Data Sharing Statement: See Supplement 3. full text icon Full Text. Download PDF Comment. Top of Article Key Points Abstract Introduction Methods Results Discussion Conclusion Article Information References. Visual Abstract. RCT: Efficacy of Time-Restricted Eating in Adults With Type 2 Diabetes.

View Large Download. Figure 2. Change in Body Composition and Glycemic Control in the Study Groups. Table 1. Baseline Characteristics of the Study Participants a.

Table 2. Body Weight, Glycemic Control, and Cardiometabolic Risk Factors a. Table 3. Dietary Intake and Physical Activity. Supplement 1. Trial Protocol. Supplement 2. eTable 1. Medication Use at Baseline and Month 6 eTable 2. Multiple Imputation Sensitivity Analysis Results eTable 3.

Adverse Events During the Intervention eFigure 1. Experimental Design eFigure 2. Adherence to the Diet Interventions eFigure 3. Supplement 3. Data Sharing Statement. Centers for Disease Control and Prevention. Type 2 diabetes. Reviewed April 18, Accessed April 18, Evert AB, Dennison M, Gardner CD, et al.

Nutrition therapy for adults with diabetes or prediabetes: a consensus report. doi: Wilkinson MJ, Manoogian ENC, Zadourian A, et al. Ten-hour time-restricted eating reduces weight, blood pressure, and atherogenic lipids in patients with metabolic syndrome.

Cienfuegos S, Gabel K, Kalam F, et al. Effects of 4- and 6-h time-restricted feeding on weight and cardiometabolic health: a randomized controlled trial in adults with obesity. Gabel K, Hoddy KK, Haggerty N, et al.

Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: a pilot study. Liu D, Huang Y, Huang C, et al. Calorie restriction with or without time-restricted eating in weight loss.

Andriessen C, Fealy CE, Veelen A, et al. Three weeks of time-restricted eating improves glucose homeostasis in adults with type 2 diabetes but does not improve insulin sensitivity: a randomised crossover trial.

Che T, Yan C, Tian D, Zhang X, Liu X, Wu Z. Time-restricted feeding improves blood glucose and insulin sensitivity in overweight patients with type 2 diabetes: a randomised controlled trial. Mifflin MD, St Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO.

A new predictive equation for resting energy expenditure in healthy individuals. Carter S, Clifton PM, Keogh JB. Effect of intermittent compared with continuous energy restricted diet on glycemic control in patients with type 2 diabetes: a randomized noninferiority trial.

Grajower MM, Horne BD. Clinical management of intermittent fasting in patients with diabetes mellitus. Mayer SB, Jeffreys AS, Olsen MK, McDuffie JR, Feinglos MN, Yancy WS Jr.

Two diets with different haemoglobin A 1c and antiglycaemic medication effects despite similar weight loss in type 2 diabetes.

National Institutes of Health. Automated self-administered hour ASA24® dietary assessment tool. Huber PJ. The behavior of maximum likelihood estimates under nonstandard conditions. In: Le Cam LM, Neyman J, eds.

Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability. Univerisity of California Press; ;5. Mansournia MA, Nazemipour M, Naimi AI, Collins GS, Campbell MJ. Reflection on modern methods: demystifying robust standard errors for epidemiologists.

White H. A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity. Jayedi A, Zeraattalab-Motlagh S, Shahinfar H, Gregg EW, Shab-Bidar S. Effect of calorie restriction in comparison to usual diet or usual care on remission of type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.

Norris SL, Zhang X, Avenell A, et al. Long-term effectiveness of lifestyle and behavioral weight loss interventions in adults with type 2 diabetes: a meta-analysis. Yang J, Xia Y, Sun Y, et al. Effect of lifestyle intervention on HbA 1c levels in overweight and obese adults with type 2 diabetes across ethnicities: a systematic review and meta-analysis of randomized controlled trials.

Pi-Sunyer X, Blackburn G, Brancati FL, et al; Look AHEAD Research Group. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the Look AHEAD trial. Han TS, Al-Gindan YY, Govan L, Hankey CR, Lean MEJ.

Associations of BMI, waist circumference, body fat, and skeletal muscle with type 2 diabetes in adults. Zhen J, Liu S, Zhao G, et al. Association of waist circumference with haemoglobin A 1c and its optimal cutoff for identifying prediabetes and diabetes risk in the Chinese population.

Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over year follow-up: the Diabetes Prevention Program Outcomes Study. Kim J, Hur MH. The effects of dietary education interventions on individuals with type 2 diabetes: a systematic review and meta-analysis.

Cheng YJ, Kanaya AM, Araneta MRG, et al. Prevalence of diabetes by race and ethnicity in the United States, Turner BE, Steinberg JR, Weeks BT, Rodriguez F, Cullen MR. Wilding JPH, Batterham RL, Calanna S, et al; STEP 1 Study Group. Once-weekly semaglutide in adults with overweight or obesity.

Schoeller DA, Thomas D, Archer E, et al. Self-report-based estimates of energy intake offer an inadequate basis for scientific conclusions. Time-Restricted Eating Tested for Weight Loss in Type 2 Diabetes. See More About Nutrition, Obesity, Exercise Lifestyle Behaviors Diet Diabetes Diabetes and Endocrinology Obesity.

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One shortcoming with intermittent-fasting studies: many do not evaluate long term outcomes such as non-alcoholic fatty liver disease and dyslipidemia, particularly in the populations with increased global cardiovascular risk.

CONFLICT OF INTEREST: None Reported. This Issue. Views 48, Citations 0. Comments 1. View Metrics. X Facebook More LinkedIn. Cite This Citation Pavlou V , Cienfuegos S , Lin S, et al.