Time-restricted feeding for team sports -
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Keywords: nutrition, running, intermittent fasting, time-restricted feeding, fasting Ramadan. Citation: Al-Nawaiseh AM, Bataineh MF, Kilani HA, Bellar DM and Judge LW Time-Restricted Feeding and Aerobic Performance in Elite Runners: Ramadan Fasting as a Model.
Received: 01 June ; Accepted: 25 August ; Published: 21 September Copyright © Al-Nawaiseh, Bataineh, Kilani, Bellar and Judge. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY.
The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice.
No use, distribution or reproduction is permitted which does not comply with these terms. Judge, lwjudge bsu. lymphocyte and neutrophils counts , leading to greater risk of illness and infection [ 11 , 12 ].
In the last two decades, different strategies, including nutrition, have been tested to overcome the immunosuppressive response in athletes. In addition, nutrient availability can directly impact immune processes during exercise and recovery from intense exercise [ 15 ].
For instance, long-term reduction of energy intake has been associated with greater susceptibility to illness in Olympic athletes [ 16 , 17 ]. Fasting has been consistently shown to reduce inflammation [ 18 ]; however, its effect on the immune system is still elusive.
As reported in a recent meta-analysis [ 19 ], performing intense exercise during Ramadan results in a variation of the immunological response, but further studies are required to explore its potential regulatory role on the immune system.
TRE can be performed with or without caloric restriction, and in the latter, individuals are allowed to consume their normal energy intake as long as they adhere to the specified window of time.
IL-6, TNF-α, Insulin, HDL-C, TG in resistance-trained males [ 21 ], and does not impair lean mass gain or performance improvements in resistance-trained females [ 22 ].
To our knowledge, there is no evidence regarding the effect of TRE on endurance sports or the impact that this type of diet can have on the immune system. The power expressed by an athlete reflects the speed of the race or the ability to climb a greater slope at the same speed.
On the other side, lower body weight of the athlete can be an advantageous factor considering that a lighter cyclist spends less energy to maintain the same speed and therefore gets less tired; or, as climbing is the true essence of this sport, a lighter athlete should be faster during a climb.
It therefore seems plausible that a dietary approach that allows weight loss, while maintaining the muscle functional characteristics, could be a winning strategy for endurance athletes. We hypothesized that TRE would reduce inflammatory markers and fat mass without affecting physical performance.
Sixteen healthy young men age: To be included in the study, subjects must have been cycling for at least three seasons in an elite team. Exclusion criteria were recent injuries, usage of steroids or corticosteroids or any other medical condition that could interfere with study procedures.
Subjects characteristics for each group are described in Table 1. All the participants read and signed an informed consent form describing all the study procedures approved by the ethical committee of the Department of Biomedical Sciences, University of Padova, and conformed to standards of the current Declaration of Helsinki.
Study analysis was conducted in a single blind design at the University of Padova. The experimental design is displayed in Fig. All participants were tested on two different days before and at the end of the 4-week experiment.
All participants started the experimental procedures in the month of January Experimental design. TRE, Time Restricted eating; ND, Normal Diet; GXT, Graded Exercise Testing, PPO, Peak Power Output. Subjects were also asked to keep the same routine of dinner before each visits.
At their arrival, body weight and height were measured and used to calculate body mass index BMI. Fat mass FM and fat-free mass FFM were assessed by Bioelectrical Impedance Analysis Human in Touch, DSMedica, Milano. Test—retest reliability for body composition obtained in our laboratory had an ICC of 0.
Through the analysis software, we obtained the values of FFM and FM. Resting energy expenditure REE and oxygen uptake VO 2 were measured via a standard open-circuit calorimetry max Encore 29 System, Vmax, Viasys Healthcare, Inc. Participants rested in the supine position on a comfortable surface and stayed awake for the entire test duration.
All samples were analyzed by a certified laboratory using the same reagent lot. A, Vercelli-Italy. The exact same breakfast was provided during the post test.
Each athlete used personal shoes with Kéo pedals; the height of the saddle has been positioned at the maximum level of comfort for each athlete and for the subsequent tests the same relative measure was always used. After applying a silicone mask to the face for the analysis of respiratory gases, subjects started the test.
This test was chosen because it represents the exercise intensity normally registered during a long-distance race. In addition, heart rate HR was collected at each minute of the test. At the end of the second visit, all subjects received their diet protocol, and the study intervention officially started the following day.
During the recruitment phase, all subjects completed a validated 7-day food diary for athletes [ 25 ] which was analyzed by nutritional software Dieta Ragionata 7. The team dietitian supervised most of the meals consumed and ensured that all participants followed the prescribed diet intervention.
Both groups consumed their snack either before or after the daily training session. Every week, a dietitian contacted subjects in order to check the adherence to the diet protocol.
The study was conducted during the winter pre-competition season. Statistical analyses were performed using the statistical software GraphPad Prism version 7. Target sample size was obtained assuming an interaction of a Root Mean Square Standardized Effect RMSSE of 0.
Primary outcomes for the power analysis were VO 2 max, fat and fat-free mass. A two-way repeated-measures ordinary ANOVA was performed using time as the within-subject factor and diet as the between-subject factor in order to assess differences between groups over the course of the study.
When the ANOVA model produced significant main or interaction effects, Post-hoc analyses were performed using the Bonferroni test. This alteration appeared to be mainly due to a decrease in total body fat mass.
Fat-free mass was maintained in both groups TRE from Body composition analysis. a total body mass; b fat-free mass and c fat mass.
TRE, Time Restricted eating; ND, Normal Diet. No statistically significant interaction was found for resting metabolism analysis. Similar results were obtained when VO 2 was normalized by body weight Table 3.
No significant differences were observed between groups in any of the performance test outcomes. Data from blood biochemistry analysis are presented in Table 4. a White Blood Cells; b Neutrophils; c Lymphocytes and d Neutrophils-to-Lymphocytes ratio NTR.
In sports, intermittent fasting studies have mostly focused on Muslim athletes during the Ramadan period, a practice that requires abstention from food and liquid throughout the day and consumption of meals at night [ 6 , 7 ]. To our knowledge, this is the first study that has investigated the effect of TRE in a group of elite endurance athletes.
We confirm that TRE reduced anabolic hormones such as IGF-1 and testosterone without affecting fat-free mass or endurance sport performance. In addition, it seems that TRE may exert a protective effect on some aspects of the immune system in the context of exercise training.
We have recently demonstrated that the same TRE protocol used with resistance-trained athletes reduced total body weight and fat mass [ 21 ].
In the present study, we confirmed the positive effect of TRE on body composition. Total energy and nutrient intake were comparable between groups; for these reasons one possible explanation of the greater weight loss in the TRE group could be found in the increase in adiponectin.
Adiponectin stimulates PGC-1α expression and mitochondrial biogenesis through the AMPK kinase [ 28 ], stimulating adipogenesis. Lower levels of adiponectin are associated with obesity [ 29 ] and oxidative stress [ 30 ]; whilst elevated plasma concentration of this cytokine correlates with improved metabolism and resting energy expenditure [ 28 , 31 ].
We have however observed a reduction in REE after TRE diet, which might seem a counterproductive adaptation. A decrease in REE is a common result of weight loss programs that involve calorie restriction, and it normally correlates with a loss of FFM and especially to changes in its composition [ 32 , 33 ].
However, these studies are normally conducted in obese or overweight subjects not involved in any strenuous exercise program. In the present study, FFM was maintained and thus cannot explain the observed reduction in REE.
It is, however, possible that this reduction reflects a momentaneous thermogenic adaptation of body weight, as described by the mechanical model of Rosenbaum and Leibel [ 34 ], in which REE decreases with initial weight loss. It is possible that in athletes, in which body fat is very low, and the exercise energy expenditure is particularly high, even a small drop of body weight i.
It is also possible that during TRE protocol, subjects have slightly reduced their caloric intake, which might have increased the negative energy balance and reduced REE.
Each participant was strictly supervised by the personal team dietitian which ensured the adherence to diet protocol in terms of feeding window and caloric intake.
Unfortunately, we have not recorded the post treatment dietary assessment to confirm or exclude this possibility. Another explanation through which TRE may have improved body composition is linked to circadian clocks. The circadian control of food intake is situated in the hypothalamus which is synchronizes to the solar light—dark cycle.
At the molecular level, the actions of specific genes BMAL1, CLOCK are deputed to control the cell-autonomous circadian rhythms. However, fasting and feeding alternation can directly impact daily circadian rhythms through the activation of mTOR, AMPK, CREB, and AKT, which are key regulators of metabolism and nutrient homeostasis [ 35 ].
A proper arrangement of nutrient intake and abstention can thus severely influence body metabolism. In a recent study, Yasumoto et al.
In elite cyclists, the relation between PPO and body weight is an important contributing factor to sport performance. We have previously observed a drop of anabolic hormones after TRE [ 21 ], probably due to a reduced leptin-mediated control on the hypothalamo-hypophysial-gonadal axis.
It seems indeed that intermittent fasting regimen can exert an inhibitory effect on the Leydig cells responsible for the production of testosterone [ 37 , 38 ]. AMPK is a central metabolic regulator activated during low cellular energy status, when trigged it stimulates ATP production via fatty acid oxidation and glycolysis, while simultaneously inhibits anabolic processes.
Interestingly, ferritin appeared to decrease in ND but not in TRE, although this was not statistically significant. Ferritin not only reflects iron stores but is also used as an index of exercise tolerance [ 42 , 43 ].
A drop of ferritin in endurance athletes can occur during the initial months of training [ 44 ], although TRE seems to blunt this effect. Endurance elite athletes present lower leucocytes counts, neutrophils and monocytes plasma concentration compared to other sports, probably due to the inflammatory adaptive response to aerobic training [ 45 ].
These decreases in components of the immune system may contribute to the susceptibility to bacterial and upper respiratory infection [ 46 , 47 ].
Exercise increases pro-inflammatory cytokines such as IL-6, IL-1β; TNF-α , which mediate the communication between immune and non-immune cells in order to elicit repair processes.
As a result, the immune response temporarily decreases, with total leucocytes and neutrophils increasing whilst lymphocytes decrease. We already reported a modulation of some inflammatory markers after TRE IL-6 and IL-1β and TNF-α [ 21 ], whilst others did not observe any changes of these cytokines in healthy young men [ 51 ].
In the present study, IL-6 appeared to decrease in TRE and increase in ND even if not significantly. Moreover, the ratio of neutrophils-to-lymphocytes NLR is a biomarker of systemic inflammation largely used in clinical practice, which correlates with the circulating level of C-reactive protein CRP [ 52 , 53 ].
Interestingly, while post-intervention leucocytes appeared lower than baseline in both groups, they were significantly reduced only in the ND group.
It is known that short-term caloric restriction can compromise the immune system response [ 15 , 54 ], however, the present experiment did not reduce the energy intake. This is the first time that TRE has been correlated to the immune response to exercise training, and it seems that TRE may possibly have a protective effect, attenuating the reduction in leucocytes count and thus potentially preventing the susceptibility to infections in young elite endurance athletes.
Some limitations of the present study should be taken into account. One is the reduced number of subjects involved, and secondly the usage of an interview methodology to determine energy and macronutrient composition.
This approach has known weaknesses and may have played a role in the observed outcomes. Moreover, TRE may help the function of the immune system, attenuating the decrease of leucocytes that typically occurs in high-trained individuals, although further investigation is warranted.
This kind of dietary regimen could be adopted by endurance athletes to reduce body fat mass. Our preliminary data may suggest that TRE could be a proper dietary regimen in particular during the pre-season training that normally occurs during the winter season, in which the training-induced depression of immune system increases the respiratory infection susceptibility.
Waterhouse J. Effects of Ramadan on physical performance: chronobiological considerations. Br J Sports Med. Article PubMed Google Scholar. Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG 3rd, et al.
Flipping the metabolic switch: understanding and applying the health benefits of fasting. Paoli A, Tinsley G, Bianco A, Moro T.
The influence of meal frequency and timing on health in humans: the role of fasting. Meng H, Zhu L, Kord-Varkaneh H, Santos HO, Tinsley GM, Fu P. Effects of intermittent fasting and energy-restricted diets on lipid profile: a systematic review and meta-analysis. Article CAS PubMed Google Scholar.
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JAMA Intern Med. Article PubMed PubMed Central Google Scholar. Burke LM, King C. Ramadan fasting and the goals of sports nutrition around exercise.
J Sports Sci. Chaouachi A, Leiper JB, Chtourou H, Aziz AR, Chamari K. The effects of Ramadan intermittent fasting on athletic performance: recommendations for the maintenance of physical fitness.
Abaïdia AE, Daab W, Bouzid MA. Effects of Ramadan fasting on physical performance: a systematic review with meta-analysis. While the impact might be small, it could make the difference for elite athletes, and intermittent fasting would preclude this.
Given that high-level athletes require much more nutrition than non-elite athletes and must spread out these nutrients across the day when they have multiple daily sessions, this time-restricted approach seems to be a sub-optimal option.
However for recreational athletes who train for shorter durations and with less intensity—and therefore have lower energy demands—intermittent fasting may be appropriate, especially for weight management.
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Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. Since retiring, Craig has been working as Head of Sports Science at DNAFit, along with a number of other consultancy roles, including sports coaching.
However, if I have not consumed enough calories the previous day I will likely struggle until I am burning ketones as my primary fuel — but it can take a while before this kicks in.
So long as my calorie intake is sufficient, all is well. My mind is clear, I feel light and sharp, both physically and mentally.
ironically this is the case today! I have found intermittent fasting very useful but must be mindful to replace energy once it is burnt. Which, as you said, can be difficult, especially if you need significant calories. Craig, thank you for this outstanding article. With all the new scientific information regarding the benefits of intermittent fasting it can become confusing for athletes who are training and need optimal fuel and energy for sustained performance.
Your article explains well the nuances of the fasting practice as well as the need for athletes in training to resume their fuel and high protein intake throughout the day.
This article gives me the confidence to resume my training and fuel regime to obtain peak performance especially when training for a rigorous endurance event carrying heavy weight.
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Fasting has garnered interest since research in animals has shown that those consuming fewer calories tended to live longer, says craigm Click To Tweet The research on intermittent fasting is somewhat scarce, with intervention studies both low in number and participants.
Insights from Athletes Observing Ramadan Of course, athletes are always looking for the next edge they can gain over their competitors, and intermittent fasting potentially represents such an edge.
Intermittent Fasting and Adaptation In fact, more recent research suggests that, for some athletes, periods of time with less—or even no—energy intake may help enhance performance.
If you train in the morning, intermittent fasting may compromise training adaptations, performance, says craigm. When I was competing in bobsleigh, I weighed 95kg and trained for hours daily.
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The purpose of the current study is to investigate the effect of fasting during Ramadan i. Moreover, the authors hypothesized that distance running performance will be positively impacted by Ramadan fasting in elite distance runners.
Fifteen trained male distance runners who observed Ramadan participated in this study. Each participant reported to the human performance lab on two occasions pre-Ramadan and the last week of Ramadan.
In each visit, participants performed a graded exercise test ffeeding the treadmill 13 and their VO 2Heart Rate, time to exhaustion, RPE, and running speed were recorded. Detailed anthropometrics, food records, sleep diary, and exercise logs were kept for the entire period of the study.
All participants were active runners i. After being informed of the procedures and potential risks involved in the investigation, an IRB-approved informed consent document was signed by each participant before the commencement of the study.
Participants were not instructed to alter their training duration, intensity, or frequency. The daily fasting period was equal to or exceeding 15 h. During the study, subjects consumed a tean before dawn at ~0, with testing sessions beginning 4—4.
The study was an observational design. All procedures were approved by the Hashemite University Institutional Review Board IRB number Before the study, participants were informed of the study's purpose, along with any associated risks and benefits.
In accordance sporte the university institutional review board, and the Declaration of Helsinki, participants gave written informed consent and completed a health history questionnaire before the first test session.
All data was collected in the Human Performance Laboratory at Hashemite University. Participants completed three visits a familiarization visit and two testing visits on different days to undertake the study protocol as indicated below.
On visit one 2 weeks before Ramadananthropometric characteristics, health status, blood pressure and heart rate were assessed. Briefly, participants were familiarized with the testing protocol and tools.
Shortly after that, and following a 25—30 min resting period, the participants' blood pressure and resting heart rate HR rest measurements were conducted while seated, Time-resrricted readings were recorded, and their average was used to determine blood pressure and HR rest.
On visit 2 3 days Time-reetricted Ramadan: Pre-Fasting and visit 33 end of the fourth week of Ramadan: End-Fasting preparations feeeding as described previously, and a Conconi 13 graded exercise test GXT to exhaustion began following a min rest and a 5-tomin warm-up period.
All time to exhaustion running trials were performed at approximately the same time of day between am and amto avoid discrepancies in results caused by testing time. Oxygen consumption VO 2and carbon dioxide production VCO 2 were calculated breath by breath using a respiratory metabolic cart Quark PFT 2, COSMED.
Rome, Italy. Heart rate and rate of perceived exertion RPE were obtained at the end of each stage 6—20, Borg scale chart.
Participants' heart rate was monitored throughout the entire period of each Tume-restricted using a chest strap heart rate monitor Polar Electro, Oulu, Finland.
Time to exhaustion was considered the point at which participants triggered the emergency stop, the termination signal, or failed to stay within safe range of the safety harness.
Time to exhaustion was considered valid if participants achieved at least two of the tteam criteria at the point of exercise termination:.
Plateau in VO 2 with increasing speed. Heart rate within 10 beats of the age predicted maximal heart rate. RPE value more than or equal to Body mass BM was measured with the use of a digital scale SECA, Hamburg, Taem to the nearest 0. Height was determined with the use of a stadiometer SECA, Hamburg, Germany to the nearest 0.
Measurements were compliant with the recommendations of the International Society for the Advancement of Kinanthropometry Guidelines. Body fat BFbody fat percentage, fat free mass FFMand total body water TBW were assessed with the use of four electrode bioelectrical impedance system InBody, Inbody Seoul, Korea.
Reliability and validity of the measurement system has been reported in the literature 6. Anthropometric measurements were obtained on each visit after subjects rested for a period of 30 min following their scheduled arrival time and before beginning the warmup.
Participants were instructed to keep psorts food records and exercise logs. The food records provided full details about ingested food and fluids along with time of consumption, preparation method, meal type, and Tine-restricted mood. This software platform is routinely used in to validate other diet assessment tools Exercise logs contained details about type of event, training duration, training intensity, and provided information about frequency of training.
Exercise logs were analyzed using Sportlyzer Sportlyzer LLC. Exercise energy expenditure EEE was estimated using the Compendium of Physical Activities The Daily Sleep Diary Loughborough University, Loughborough, UK was used to evaluate each participant's subjective daily sleep score.
The sleep diary consisted of a brief eight item questionnaire, evaluating the sleep time and quality. This and sprts instruments have been reported feedin in the literature During this study, sleep diary records were collected at two different times, one before at the start of the study visit and one during at the end of study visit.
The questionnaire was completed by each participant for the entire period of the study. The two sets of records were treated separately i. Sleep diaries that show bedtime and awake time and daytime napping during the weekdays and at weekends was obtained together with the total sleep duration in a h period i.
Comparison was administered for the difference in fog duration before and feedig Ramadan. All data is presented as means ± standard deviation SD and was analyzed using SPSS version Once the assumption of normality was confirmed using the Shapiro-Wilk test, parametric tests were performed.
For anthropometric measures, sleep duration, and dietary variables, dependent sample t -test was used to detect significant differences between the two trials. For the RPE, VO2, and HR data, a two-way [Time pre and end of Ramadan x Speed] ANOVA with repeated measures was used.
When appropriate, paired t -test was used for pair-wise comparisons. Cohen's d effect size for pairwise tests and partial eta squared ηp 2 for repeated measures analyses were calculated to assess the magnitude of difference between the time points. Effect sizes were considered small at 0.
Assessment of changes in body mass and body composition are presented in Table 1. Table 1. Assessment of changes in body weight and body composition during Ramadan fasting. Table 2 shows changes in nutrients intake while fasting during Ramadan. Spkrts expected, a significant decrease in carbohydrate intake, lipid intake, water intake, and caloric intake was detected at the end of Ramadan when compared with pre-Ramadan values with effect size ranging from medium to large d : 0.
Time-resyricted, protein intake was not significantly affected by Ramadan fasting. Table 2. Assessment of changes in caloric, water, and macronutrients intake during Ramadan fasting.
Furthermore, time to exhaustion pre: 1, post: 1,
: Time-restricted feeding for team sports| Intermittent Fasting for Athletes: What Does the Research Say? | Participants had a mean SD BMI of Adverse events in both groups were mild see eAppendix in Supplement 1. Unfortunately, because of the COVID pandemic, we were unable to collect postintervention data on primary and secondary outcomes in 11 participants see eMethods in Supplement 1. There were also no statistically significant differences in the changes in fat-free mass, trunk fat, visceral fat, waist circumference, or appendicular lean mass Table 2. There were no statistically significant differences in systolic blood pressure, heart rate, glucose levels, insulin levels, HOMA-IR, HOMA-β, hemoglobin A 1c level, or plasma lipid levels Table 2. All other mood and sleep end points were similar between groups eFigures 1 and 2 in Supplement 1. All other primary and secondary outcomes were similar between groups eTable 3 in Supplement 1. We conducted a randomized weight-loss trial comparing TRE with eating over a period of 12 or more hours where both groups received the same weight-loss counseling. Our data suggest that eTRE is feasible, as participants adhered 6. Despite the challenges of navigating evening social activities and occupational schedules, adherence to eTRE was similar to that of other TRE interventions approximately 5. Furthermore, we found that eTRE was acceptable for many patients. The key finding of this study is that eTRE was more effective for losing weight than eating over a period of 12 or more hours. In our trial, the eTRE group lost an additional 2. However, our study had better post hoc statistical power owing to less variability in weight loss. Therefore, our results are not incompatible. Furthermore, our eTRE group extended their daily fasting by twice as much, fasting an extra 4. Most previous studies report that TRE reduces energy intake and does not affect physical activity. On the other hand, we found no evidence of selective fat loss, as measured by the ratio of fat loss to weight loss. Also, total fat loss was not statistically significant in the main intention-to-treat analysis. Our finding of a difference in weight loss but not fat loss was likely due to lower statistical power because DEXA scans were performed only twice whereas body weight was measured 8 times and using a conservative imputation approach. In a secondary analysis of completers, eTRE was indeed better for losing body fat and trunk fat than eating over a window of 12 or more hours. The eTRE intervention increased fat loss by an additional 1. The eTRE intervention was also more effective than eating over a period of 12 or more hours for lowering diastolic blood pressure. The effects were clinically significant and on par with those of the DASH Dietary Approaches to Stop Hypertension diet 64 and endurance exercise. For comparison, 1 previous controlled feeding study reported that eTRE reduces blood pressure, 17 while other TRE studies are mixed but lean null. Indeed, blood pressure has a pronounced circadian rhythm, 68 and circadian misalignment elevates blood pressure in humans. The eTRE intervention was not more effective for improving other fasting cardiometabolic end points. However, studies on other versions of TRE report more mixed results. We also had larger variability in fasting insulin level relative to our previous trial. Our study has a few limitations, including being modest in duration, enrolling mostly women, and not achieving our intended sample size, partly owing to the COVID pandemic. Also, we measured physical activity by self-report, not by accelerometry, which may have limited our ability to detect differences in physical activity between groups. Finally, we measured cardiometabolic end points only in the fasting state. Future research should investigate glycemic end points in the postprandial state or over a hour period. In this randomized clinical trial, eTRE was more effective for losing weight and lowering diastolic blood pressure than eating over a period of 12 or more hours at 14 weeks. The eTRE intervention may therefore be an effective treatment for both obesity and hypertension. It also improves mood by decreasing fatigue and feelings of depression-dejection and increasing vigor, and those who can stick with eTRE lose more body fat and trunk fat. However, eTRE did not affect most fasting cardiometabolic risk factors in the main intention-to-treat analysis. This trial also lays important groundwork for future IF research. Therefore, future clinical trials will need to enroll much larger sample sizes—up to approximately participants—to determine whether IF affects body composition and cardiometabolic health. Future studies should investigate whether the timing and duration of the eating window affect these results, as well as determine who can adhere to eTRE vs who cannot and would instead benefit from other meal-timing interventions. The eTRE intervention should be further tested as a low-cost, easy-to-implement approach to improve health and treat disease. Published Online: August 8, Corresponding Author: Courtney M. Peterson, PhD, University of Alabama at Birmingham, University Blvd, Webb , Birmingham, AL cpeterso uab. Author Contributions: Drs Peterson and Richman had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Jamshed and Steger contributed equally to this work as co—first authors. Critical revision of the manuscript for important intellectual content: All authors. Administrative, technical, or material support: Jamshed, Steger, Bryan, Hanick, Martin, Peterson. Conflict of Interest Disclosures: Dr Martin reported grants from the National Institutes of Health NIH during the conduct of the study and personal fees scientific advisory board member from Wondr Health outside the submitted work. Dr Peterson reported grants from the NIH during the conduct of the study. No other disclosures were reported. Resources and support were also provided by 2 Nutrition Obesity Research Center NORC grants P30 DK; P30 DK , a Diabetes Research Center DRC grant P30 DK , an NIH Predoctoral T32 Obesity Fellowship to Mr Hanick T32 HL , and the Louisiana Clinical and Translational Science Center LA CaTS; U54 GM The statistician was later changed prior to beginning data analysis. The sponsors had no other roles in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Meeting Presentation: Results from preliminary analyses, which did not use linear mixed modeling, were presented at ObesityWeek and a handful of invited seminars. Full analyses, which included linear mixed models for adherence and weight loss, were conducted later. Data Sharing Statement: See Supplement 4. Additional Contributions: We thank the UAB Weight Loss Medicine clinic staff, and Karin Crowell, RD Department of Medicine, UAB , especially, for their support and dedication in conducting this study. We also thank Karissa Neubig, RD Pennington Biomedical Research Center , and Tulsi Patel, BS UAB , for their help in measuring dietary intake and tracking adherence. Ms Crowell and Ms Neubig received no compensation beyond that of their regular employment. Ms Patel received a small stipend. full text icon Full Text. Download PDF Comment. Top of Article Key Points Abstract Introduction Methods Results Discussion Conclusions Article Information References. Visual Abstract. Effectiveness of Early Time-Restricted Eating for Weight Loss, Fat Loss, and Cardiometabolic Health in Adults With Obesity. View Large Download. Figure 1. Participant Flow Diagram. Figure 2. Adherence, Satisfaction, and Acceptability. Figure 3. Weight Loss and Body Composition. Table 1. Baseline Characteristics. Table 2. Body Composition and Cardiometabolic Risk Factors. Audio Author Interview Effectiveness of Early Time-Restricted Eating for Weight Loss and Fat Loss in Adults With Obesity. Subscribe to Podcast. Supplement 1. Adverse Events eTable 1. Baseline Characteristics of Completers Versus Non-Completers eTable 2. Food Intake and Physical Activity eTable 3. Completers-Only Analysis of Primary and Secondary Outcomes eFigure 1. Mood eFigure 2. Supplement 2. Trial Protocol. Supplement 3. Statistical Analysis Plan. Supplement 4. Data Sharing Statement. Smyers ME, Koch LG, Britton SL, Wagner JG, Novak CM. Enhanced weight and fat loss from long-term intermittent fasting in obesity-prone, low-fitness rats. doi: Gotthardt JD, Verpeut JL, Yeomans BL, et al. Intermittent fasting promotes fat loss with lean mass retention, increased hypothalamic norepinephrine content, and increased neuropeptide Y gene expression in diet-induced obese male mice. Hutchison AT, Liu B, Wood RE, et al. Effects of intermittent versus continuous energy intakes on insulin sensitivity and metabolic risk in women with overweight. Byrne NM, Sainsbury A, King NA, Hills AP, Wood RE. Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study. Catenacci VA, Pan Z, Ostendorf D, et al. A randomized pilot study comparing zero-calorie alternate-day fasting to daily caloric restriction in adults with obesity. Harvie M, Wright C, Pegington M, et al. The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women. Keenan S, Cooke MB, Belski R. The effects of intermittent fasting combined with resistance training on lean body mass: a systematic review of human studies. Kessler CS, Stange R, Schlenkermann M, et al. Moro T, Tinsley G, Bianco A, et al. Razavi R, Parvaresh A, Abbasi B, et al. The alternate-day fasting diet is a more effective approach than a calorie restriction diet on weight loss and hs-CRP levels. Tinsley GM, Moore ML, Graybeal AJ, et al. Time-restricted feeding plus resistance training in active females: a randomized trial. Schübel R, Nattenmüller J, Sookthai D, et al. Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial. Antoni R, Johnston KL, Steele C, Carter D, Robertson MD, Capehorn MS. 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| Time-Restricted Feeding and Aerobic Performance in Elite Runners: Ramadan Fasting as a Model | Consulting with Sugar consumption and diet-related diseases Top-rated fat blocker the field of teaam science, nutrition, and sports medicine Authentic culinary experience Time-resgricted advisable Time-restrlcted making any specific dietary recommendations for athletes. It also feedinng mood by decreasing fatigue and feelings of depression-dejection and increasing vigor, and those who can stick with eTRE lose more body fat and trunk fat. Plateau in VO 2 with increasing speed. Article PubMed Google Scholar Svendsen IS, Taylor IM, Tønnessen E, Bahr R, Gleeson M. Interestingly, while post-intervention leucocytes appeared lower than baseline in both groups, they were significantly reduced only in the ND group. |
| What is intermittent fasting? | Mujika I, Chaouachi A, Chamari K. No use, distribution or reproduction is permitted which does not comply with these terms. Fat-free mass was maintained in both groups TRE from At the molecular level, the actions of specific genes BMAL1, CLOCK are deputed to control the cell-autonomous circadian rhythms. Endurance performance: can a short, sharp shock work wonders? RPE value more than or equal to |
| Time-restricted eating to boost endurance: Could late meals help? | But can athletes benefit from shuttering their kitchens at night and delaying their morning oatmeal? Here's what the science has unearthed about trimming your feeding window to better align with your ticking biological clock. As the term suggests, time-restricted eating consists of limiting daily nutrient consumption to a set amount of time during a hr period as a means of extending the time spent in a fasted state beyond what is now normal in society. Common feeding windows used are 12, 8 and 4 hours. Various behavioral and physiological pathways follow a predetermined hour cycle known as the circadian rhythm. Molecular clocks are present in almost every cell. And the time of food intake is emerging as a dominant agent that affects circadian clocks in metabolic organs. The belief is that, just like erratic light exposure, erratic eating patterns can throw natural rhythms such as metabolic processes out of whack - known as circadian disruption. Eating erratically and for too many hours daily can provoke chronic circadian disruption or a type of feeding 'jet-lag' which is believed by time-restricted eating proponents to be a driver of weight gain, poor sleep, increased risk of developing chronic disease and, in the end, a shorter life. Maybe even less of a chance to reach fitness goals. In contrast to early humans who may have never had a guaranteed meal, most modern bipedals start cramming in calories upon waking and don't stop until shortly before calling it a night. These findings might suggest that athletes tend to positively adapt to Ramadan fasting toward the end of the month. Indeed, several published studies that investigated the effect of Ramadan fasting reported a negative influence on endurance performance when exercise testing was carried out within the first two weeks of Ramadan fasting 22 , The current study showed a lack of a significant change in Peak VO 2 despite a significant reduction in training volume during the fasting period. The current results are consistent with the results of a previous study 28 that reported consistency in VO 2 max in world class non-fasting Kayakers following 5 weeks of reduced training, preceded by a period of tapering for 4 weeks. Such findings might suggest that a reduction in training volume for the entire period of the holy month of Ramadan should not alter maximal aerobic power from a scientific and training standpoint. The current study results showed comparable values for oxygen consumption along with lower heart rate values when comparing pre-Ramadan with Ramadan fasting values while performing the graded exercise test. These findings agree with previously published results that also show no significant changes in oxygen consumption and lower heart rate because of Ramadan fasting 20 , In contrast, short-term fasting i. The findings in Ramadan fasting athletes may suggest that prolonged fasting periods have different effects on aerobic performance indicators in comparison with either shorter fasting periods or non-fasting athletes. Similarly, RPE values in the current study were not altered across all running speeds due to Ramadan fasting, which was in contrast with previous studies. The disparity in RPE values between the current study and previous studies may be attributed to the fact that participants' fasting in the current study was voluntarily conducted, thus it may not have added an extra psychological burden. The lack of an increase in RPE during Ramadan fasting may also explain the improved time-to-exhaustion values achieved by fasting participants in the current study. This ability to outperform non-fasting values can be justified by psychological means such as Hormesis 32 — In the present study, body mass, body fat mass, and lean body mass, despite the long hours of Ramadan fasting, were not significantly changed Table 1. Concerning dietary pattern and energy expenditure, the present study showed a significant reduction in carbohydrates, lipids, water, and caloric intake. The absence of changes in body mass and composition can be explained by our findings which identified a decline in daily training duration and intensity and the reduced exercise caloric expenditure which resulted in a comparable energy availability value. This result was in agreement with results from previous studies that reported no change in body mass during Ramadan fasting when comparable energy availability values were maintained 31 , Additionally, Mujika 36 suggested that athletes and trained subjects could maintain their lean body mass and muscular strength after reducing training loads. They also projected that the reduced training load could decrease the risk of dehydration i. The reduced risk of dehydration may help athletes to preserve their energy levels for quality workouts and training As shown in Figure 2 , sleeping duration was not changed between pre-Ramadan and during Ramadan for our group of athletes. This represents a difference between athletes and non-athletes who observed Ramadan from a similar age group that demonstrated reduced total sleeping hours during Ramadan Muslim athletes managed to maintain their regular sleep duration, based on the results of the present study. It is important to acknowledge the strengths and limitations of the current research. To date, the impact of fasting on elite distance runners has not been investigated. Limitations for the present work include sample size, lack of a control group, lack of data on training intensity and reliance on some self-reported data. A larger sample would have served to increase the statistical power for this research. A control group would have allowed for the effect of training to be determined on the study outcomes, however; given the mandatory nature of Ramadan fasting a control group of similar individuals was not feasible. The success of food records and exercise logs depends on the memory, cooperation, and the communication ability of the subject s. Participants may have attempted to present themselves and their answers in a more positive light, and participants potentially may have worried about the perceived repercussions caused from their responses. Fasting during the holy month of Ramadan is one of the mandatory practices in the Islamic religion. The restrictions on meal timing and frequency in conjunction with hypohydration during the daylight hours pose a challenge for the Muslim athlete to be able to maintain proper nutrients and energy availability for training. Given the results of the present study, a strategy of adjusting training intensity and duration may be considered to help maintain the quality of training during times of fasting. The present study also suggests that training might be optimized if it occurs during the morning hours approximately 4 h after the pre-dawn meal. The results of the present study showed a lack of a significant change in Peak VO 2 , despite a significant reduction in training volume, and time-to-exhaustion and running speed were actually improved under fasting conditions. Despite the long hours of Ramadan fasting, body mass, body fat mass, and lean body mass, were not significantly changed. Therefore, a decline in daily training duration and intensity and the resultant reduced exercise caloric expenditure may explain the promising results in the present study. Coaches must closely monitor training results and make adjustments as needed to ensure their athletes are being properly prepared for training and competition in the most effective and safe manner. The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. AA-N: conception and design of study and data acquisition. MB: data collection and design of study. HK: data interpretation and critical revisions. DB: statistical analysis and data interpretation. LJ: critical revisions and data interpretation. All authors contributed to the article and approved the submitted version. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Rodrigues JAL, Yamane AC, Gonçalves TCP, Kalva-Filho C, Papoti M, Júnior CRB. Fed and fasted states on heart rate variability, hemodynamic heart rate and blood pressure in adults submitted to moderate aerobic exercise. IJC Heart Vasc. doi: PubMed Abstract CrossRef Full Text Google Scholar. 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