Time-restricted eating lowers glucose, improves time in the range of type 2 diabetes

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Adults with type 2 diabetes had lower fasting glucose and increased time in the range with a 10-hour time-restricted eating window compared to a 14-hour eating window, according to study data. hours or more

In the findings of a randomized crossover study published in Diabetologia, a cohort of adults with type 2 diabetes spent more time in normoglycemia while participating in a time-restricted diet without decreasing energy expenditure or substrate oxidation compared with an extended eating window. However, the researchers observed no difference in insulin sensitivity between the two eating patterns.

Adults with type 2 diabetes had a longer time interval with a 10-hour restricted eating window compared to a 14-hour eating window. Data were derived from Andriessen C, et al. Diabetology 2022; doi:10.1007/s00125-022-05752-z.

“Limiting food intake to a daily time period of 10 hours is a feasible approach to improve glucose homeostasis in adults with type 2 diabetes compared with 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 more (50% women; mean age, 67.5 years). Participants were randomly assigned to either a time-restricted eating intervention in which all food had to be consumed within a 10-hour window that concluded no later than 6 pm or an intervention control in which the daily diet was consumed for at least 14 hours. All participants were asked to eat their usual diet, maintain normal physical activity and sleep patterns, and maintain a stable weight. The intervention period lasted 3 weeks, after which participants entered a 4-week washout period before switching to the opposite intervention for an additional 3 weeks.

“Most previous studies of time-restricted eating limited food intake to very extreme time windows of 6 to 8 hours,” Andriessen said. “Here, we evaluated a more feasible time-restricted feeding protocol of 10 hours during the day. In addition, the study rigorously investigated the possible metabolic mechanisms that may be involved in the beneficial metabolic effects of feeding with time constraints”.

Food intake and sleep time were recorded using diaries. Continuous glucose monitoring was used to measure glycemic outcomes. Liver glycogen was measured by magnetic resonance spectroscopy. A two-step hyperinsulinemic-euglycemic clamp was used to assess insulin resistance. Participants resided in a breathing 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 an average of 1 kg of body weight during the time-restricted feeding intervention (P < 0.01), whereas no weight loss was observed in the control arm. Body composition was comparable on day 19 between the two interventions. The researchers observed no differences in liver glycogen or insulin sensitivity between the two feeding patterns.

In an analysis of CGM data, mean 24-hour glucose was lower during time-restricted feeding compared with the control feeding pattern (6.8 mmol/L vs. 7.6 mmol/L ; P < 0.01). Mean time in range was 3 hours longer during time-restricted feeding compared with control (15.1 hours/day vs. 12.2 hours/day; P = 0.01).

Plasma glucose was lower with time-restricted feeding compared with control on day 20 (7.6 mmol/L vs. 8.6 mmol/L; P = 0.03) and day 21 (8 mmol/L vs. 8.9 mmol/L; P = .04). Energy expenditure was similar between the two feeding patterns, whereas 24-h carbohydrate oxidation was lower with time-restricted feeding compared with control (260.2 g/day vs. 277.8 g/day; P = 0.04).

Andriessen said longer-term studies with a larger study population are needed to confirm the findings.

“Our study supports the use of a 10-hour daytime restricted feeding regimen as an additional strategy for the treatment of type 2 diabetes, as it was safe and feasible for our participants,” he said. Andriessen said. “We recommend that adults with type 2 diabetes check with their GP if they want to use a time-restricted eating regimen.”

For more information:

Charlotte Andriessen, MSc, can be contacted at c.andriessen@maastrichtuniversity.nl.

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