Time-restricted eating may improve metabolic health in type 2 diabetes

While the debate about the efficacy of various dietary regimens continues, new research on the impact of a restricted eating protocol details the potential metabolic benefits of such an approach in adult patients with type 2 diabetes.

A randomized crossover trial evaluating a 3-week time-restricted feeding regimen, which restricted intake to a 10-hour period, compared with a control regimen, study results suggest that adherence to time-restricted feeding was associated with a reduction in 24-hour glucose levels and a nearly 3-hour increase in mean time spent in the normal glucose range.

“Time-restricted eating is a novel strategy to improve metabolic health and has been proposed to counteract the harmful effects of eating throughout the day by limiting food intake to daylight hours. To date, only a few studies have examined the metabolic effects of time-restricted eating in adults with type 2 diabetes,” the investigators wrote.

As major organizations, accrediting bodies, and educational institutions begin to emphasize the role of nutrition in disease management, research interest in dietary regimens has grown along with it. The current study, which was led by investigators from the NUTRIM School of Nutrition and Translational Metabolism Research at Maastricht University Medical Center, was designed to test the investigators’ hypothesis that impairments in metabolic rate in adults with type 2 diabetes were due to due to a disorder. -Cycle fasting eating and adhering to a time-restricted eating regimen may improve metabolic health beyond the purported weight loss benefits.

As such, the study was designed as a randomized crossover study to compare the effect of food restriction over a 10-h daily time frame for 3 weeks under free-living conditions on hepatic glycogen utilization and insulin sensitivity in adults with type 2 diabetes. Conducted between April 2019 and February 2021, the study enrolled 14 adults with type 2 diabetes. Patients had a mean age of 67.5±5.2 years, 50% were female and mean HbA1c was 6.4±0.7 % in base.[paretheeffectoflimitingfoodintaketoaf10-hourdailytimeframefor3weeksinfree-livingconditionsonhepaticglycogenutilizationandinsulinsensitivityinadultswithtype2diabetesConductedbetweenApril2019andFebruary2021thestudyenrolled14adultswithtype2diabetesThepatientshadmeanageof675±52years50%werefemaleandthemeanHbA1cwas64±07%atbaseline[paretheeffectoflimitingfoodintaketoaf10-hourdailytimeframefor3weeksinfree-livingconditionsonhepaticglycogenutilizationandinsulinsensitivityinadultswithtype2diabetesConductedbetweenApril2019andFebruary2021thestudyenrolled14adultswithtype2diabetesThepatientshadameanageof675±52years50%werefemaleandthemeanHbA1cwas64±07%atbaseline

As part of the study protocol, during the 3-week time-restricted eating intervention, participants were instructed to consume their typical diet within a 10-hour period during the day, with the last meal completed no later than 6 p.m.: 00. In the control group, volunteers were instructed to consume their typical diet for at least a 14-hour period each day. The investigators noted that all patients received a continuous glucose monitoring device at the beginning of each intervention period. In addition to hepatic glycogen levels and insulin sensitivity, the study also included other outcomes of interest, including glucose homeostasis, 24-hour energy expenditure, substrate oxidation, hepatic lipid content, and skeletal muscle mitochondrial capacity.

At the end of the trial, the results showed that liver glycogen content was similar between the restricted eating regimen and the control (0.15±0.01 vs 0.15±0.01 arbitrary units; P=.88) and had no significant impact on M values ​​with time-limited feeding compared to the control regimen (19.6±1.8 vs 17.7±1.8 μmol kg−1 min−1; P=.10). Furthermore, the results suggested that there was no significant effect on hepatic and peripheral insulin sensitivity with time-restricted feeding (P=.67 and P=.25, respectively).

However, the investigators observed an increase in insulin-induced nonoxidative glucose disposal with time-restricted feeding compared to the control regimen (4.3±1.1 vs. 1.5±1.7 μmol kg−1 min−1; P=.04). Further analysis also revealed that time-restricted eating was associated with increased time spent in the normoglycemic range (15.1±0.8 vs 12.2±1.1 hours per day; P=.01) as well as a decrease in fasting glucose (7.6±0.4 vs 8.6±0.4 mmol/l; P=.03) and 24-hour glucose levels (6.8±0.2 vs 7.6±0.3 mmol/l; P <.01). The investigators noted that while energy expenditure over a 24-hour period was not affected, a decrease in 24-hour glucose oxidation was observed with time-restricted eating (260.2±7.6 vs. 277.8±10 .7 grams per day; P=.04)

“Despite the lack of changes in hepatic glycogen and insulin sensitivity, we found that our 10-hour time-restricted feeding protocol reduced 24-hour glucose levels in individuals with type 2 diabetes, primarily driven by decreased of glucose at night,” the investigators wrote. . “Notably, time-restricted feeding also decreased overnight fasting glucose, increased time spent in the normal glucose range, and decreased time spent in the high glucose range, all of which are clinically relevant variables in type 2 diabetes .”

This study, “Three weeks of time-restricted eating improves glucose homeostasis in adults with type 2 diabetes but does not improve insulin sensitivity: a randomized crossover trial,” was published in Diabetology.

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