Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Overweight and Obese Adults: The TREAT Randomized Clinical Trial

Lowe DA, Wu N, Rohdin-Bibby L, et al. (2021) JAMA Internal Medicine
Title and abstract of Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Overweight and Obese Adults: The TREAT Randomized Clinical Trial

Key Takeaway

16:8 TRE without other guidance produced modest weight loss but no significant improvements in metabolic markers compared to consistent meal timing alone.

Summary

The TREAT trial was a rigorous RCT testing 16:8 time-restricted eating in overweight adults, with some unexpected results that tempered enthusiasm for TRE as a weight loss intervention.

Study Design:

  • 116 overweight/obese adults
  • Randomized to 16:8 TRE (eating 12pm-8pm) vs. 3 structured meals
  • 12-week intervention
  • No specific dietary guidance beyond timing
  • Subset had DXA body composition and metabolic testing

Results:

Weight Loss:

  • TRE group: -0.94 kg
  • Control group: -0.68 kg
  • Difference not statistically significant

Body Composition (concerning finding):

  • TRE group lost more lean mass (appendicular lean mass decreased)
  • This suggests protein timing/distribution may matter
  • Potential issue with skipping breakfast and front-loading calories late

Metabolic Markers:

  • No significant differences in fasting glucose, insulin, HbA1c
  • No significant differences in lipids
  • No differences in blood pressure

Important Context:

This study used a late eating window (12pm-8pm) without protein guidance. The loss of lean mass suggests that how TRE is implemented matters, simply restricting time without attention to protein distribution may not be optimal.

Conclusions:

TRE is not a "magic bullet" for weight loss. Benefits may depend on window timing (earlier may be better), protein distribution, and overall diet quality. This study highlights the importance of combining TRE with adequate protein and possibly earlier eating windows.

Methods

  • Randomized controlled trial
  • 116 overweight/obese adults
  • TRE group: eat only noon-8pm
  • Control: eat at normal times
  • 12-week intervention

Key Results

  • TRE weight loss: -0.94 kg (vs -0.68 kg control)
  • Difference not statistically significant
  • TRE lost more lean mass (appendicular lean mass decreased)
  • No difference in metabolic markers (glucose, insulin, HbA1c, lipids)

Figures

Limitations

  • Modest compliance in TRE group
  • No control over what was eaten
  • Lean mass loss concerning
  • Short duration (12 weeks)
  • Late eating window (12pm-8pm) may not be optimal

Related Interventions

Related Studies

Source

View on PubMed →

DOI: 10.1001/jamainternmed.2020.4153