Cardiometabolic benefits of time-restricted eating may go beyond weight loss
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Key takeaways:
- The benefits of time-restricted eating extend beyond weight loss.
- Improved cholesterol and blood glucose were also reported.
- The mechanism behind these benefits may be related to ketosis.
The health benefits of time-restricted eating go beyond weight loss and may be most prominent in patients already with cardiometabolic syndrome at baseline, a speaker reported.
At the World Congress on Insulin Resistance, Diabetes & Cardiovascular Disease, Pam R. Taub, MD, FACC, founder and director of the Step Family Foundation Cardiac Rehabilitation and Wellness Center and professor of medicine at UC San Diego Health, discussed the cardiometabolic benefits of time-restricted eating and the potential underlying mechanism.
“The Nobel Prize a few years ago went to the scientist who discovered that all of the organs in our body had circadian clocks. We also know when we look at different hormones there is a diurnal variation. When you look at blood pressure, there is a diurnal variation. It’s important to pay attention to circadian biology, and this is also pertinent to how we’re eating,” Taub said during the presentation. “That’s really the concept of time-restricted eating. Restricting our eating to a certain period of the day and giving our cells a metabolic rest. When you do that, you call the cells to do important processes like cellular repair, autophagy, which is the vacuum cleaner for the cells.”
As an example of circadian biology, Taub stated that during the morning, the body’s melatonin drops, cortisol rises and is followed by peak insulin resistance, which could be capitalized on in patients’ lifestyle recommendations for time-restricted eating.
“[Intermittent fasting] gets blown out of proportion, especially on social media, where people are fasting every other day or going for a 72-hour fast, and it’s not that complicated,” Taub said. “The way I start with my patients, I say to them to move up their dinner, stop snacking after dinner, eliminate that midnight snack and eventually we will try to get them to fast for 12 hours and then 14 hours. It’s really just eliminating the constant eating some of these patients engage in.”
Taub said patients who engage in intermittent fasting or time-restricted eating consume 100 to 200 fewer calories per day, but the benefits go beyond weight loss. Patients could experience proportionately larger decreases in cardiometabolic health parameters such as LDL cholesterol.
In addition, Taub cited a recent trial published in the Annals of Internal Medicine, in which Taub and colleagues randomly assigned patients with metabolic syndrome to time-restricted eating and continuous glucose monitoring or standard care. The researchers observed an average decrease of 0.1 percentage points in HbA1c among participants assigned to time-restricted eating. Taub said the decrease was small, but that level of HbA1c reduction in participants with prediabetes was associated with a reduction in new-onset diabetes of approximately 58%.
On top of the LDL and HbA1c benefits, the researchers also observed reduced glycemic variability. “What we know from a cardiovascular perspective is, reduced glycemic variability leads to lower risk of heart failure and diabetes complications,” Taub said.
“Lifestyle therapy is the cornerstone and it’s free. We need to be telling people to do the evidence-based lifestyle strategies,” Taub said during the presentation. “Of course, we are all enamored by the GLP-1 receptor agonists, but we have to remember that there is a cost. In many of my patients that are on GLP-1 receptor agonists, I find that time-restricted eating synergizes with the drug and many times I can get them to lower doses.”
One potential mechanism by which time-restricted eating confers cardiometabolic benefit is its ability to cause a low-grade state of ketosis, which is associated with improved mitochondrial and endothelial function, she said.
“Everyone’s heard about the ketogenic diet, which I don’t recommend because the way you get to ketosis through that diet is typically very high-fat, unhealthy foods,” Taub said during the presentation. “You can do a ketogenic diet in a healthy way, but not many patients actually do that.
“What we really emphasize is [time-restricted eating is] not beneficial for everyone,” Taub said. “It’s really those people that have underlying metabolic disorders where you see the most benefit.”
Reference:
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Taub PR. Session 20: Diets and weight loss. Presented at: World Congress on Insulin Resistance, Diabetes & Cardiovascular Disease; Dec. 12-14, 2024; Los Angeles.
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