Time-restricted eating decreases glucose, improves time in range in type 2 diabetes
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Adults with type 2 diabetes had lower fasting glucose and increased time in range with a time-restricted eating window of 10 hours compared with an eating window of 14 hours or longer, according to study data.
In findings from a randomized crossover study published in Diabetologia, a cohort of adults with type 2 diabetes spent more time with normoglycemia while partaking in time-restricted eating without a decrease in energy expenditure or substrate oxidation compared with an extended eating window. However, researchers did not observe a difference in insulin sensitivity between the two eating patterns.
“Limiting food intake to a 10-hour daily time frame is a feasible approach to improve glucose homeostasis in adults with type 2 diabetes as compared to spreading food intake over at least 14 hours per day,” Charlotte Andriessen, MSc, a PhD student in the department of nutrition and movement sciences at Maastricht University in the Netherlands, told Healio.
Andriessen and colleagues enrolled 14 adults aged 50 to 75 years with type 2 diabetes and a BMI of 25 kg/m2 or higher (50% women; mean age, 67.5 years). Participants were randomly assigned to a time-restricted eating intervention in which all food had to be consumed within a 10-hour window that concluded no later than 6 p.m. or a control intervention in which each day’s diet was consumed during at least 14 hours. All participants were asked to eat their habitual diet, maintain normal physical activity and sleep patterns, and to remain weight stable. The intervention period lasted 3 weeks, after which participants entered into a 4-week washout period before crossing over to the opposite intervention for an additional 3 weeks.
“Most previous time-restricted eating studies limited food intake to very extreme 6- to 8-hour time windows,” Andriessen said. “Here, we assessed a more feasible time-restricted eating protocol of 10 hours during daytime. In addition, the study rigorously investigated the possible metabolic mechanisms that may be involved in the beneficial metabolic effects of time-restricted eating.”
Food intake and sleep time were recorded using diaries. Continuous glucose monitoring was used to measure glycemic outcomes. Hepatic glycogen was measured using magnetic resonance spectroscopy. A hyperinsulinemic-euglycemic two-step clamp was used to assess insulin resistance. Participants resided in a respiration chamber for 36 hours on day 19 of each intervention to measure energy expenditure and substrate oxidation. Fasting plasma metabolites were measured on days 20 and 21 of each intervention.
The study cohort lost a mean 1 kg of body weight during the time-restricted eating intervention (P < .01) whereas no weight loss was observed in the control arm. Body composition was comparable at day 19 between the two interventions. Researchers observed no differences in hepatic glycogen or insulin sensitivity between the two eating patterns.
In an analysis of CGM data, mean 24-hour glucose was lower during time-restricted eating compared with the control eating pattern (6.8 mmol/L vs. 7.6 mmol/L; P < .01). Mean time in range was 3 hours longer during time-restricted eating compared with control (15.1 hours/day vs. 12.2 hours/day; P = .01).
Plasma glucose was lower with time-restricted eating compared with control on day 20 (7.6 mmol/L vs. 8.6 mmol/L; P = .03) and on day 21 (8 mmol/L vs. 8.9 mmol/L; P = .04). Energy expenditure was similar between the two eating patterns, whereas 24-hour carbohydrate oxidation was lower with time-restricted eating compared with control (260.2 g/day vs. 277.8 g/day; P = .04).
Andriessen said longer-term studies with a larger study population are needed to confirm the findings.
“Our study does support the use of a 10-hour daytime time-restricted eating regimen as an additional strategy for the treatment of type 2 diabetes since it was safe and feasible for our participants to follow,” Andriessen said. “We do recommend adults with type 2 diabetes to consult with their general practitioner if they want to employ a time-restricted eating regimen.”
For more information:
Charlotte Andriessen, MSc, can be reached at c.andriessen@maastrichtuniversity.nl.
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