Esophagus to Small Intestine

N Engl J Med. 2022;386(16):1495–504

Liu D, Huang Y, Huang C, Yang S, Wei X, Zhang P, Guo D, Lin J, Xu B, Li C, He H, He J, Liu S, Shi L, Xue Y, Zhang H

Calorie restriction with or without time-restricted eating in weight loss

Background: The long-term efficacy and safety of time-restricted eating for weight loss are not clear.
Methods: The authors randomly assigned 139 patients with obesity to time-restricted eating (eating only between 8:00 a.m. and 4:00 p.m.) with calorie restriction or daily calorie restriction alone. For 12 months, all the participants were instructed to follow a calorie-restricted diet that consisted of 1500–1800 kcal per day for men and 1200–1500 kcal per day for women. The primary outcome was the difference between the 2 groups in the change from baseline in body weight; secondary outcomes included changes in waist circumference, body-mass index (BMI), amount of body fat, and measures of metabolic risk factors.
Results: Of the total 139 participants who underwent randomization, 118 (84.9%) completed the 12-month follow-up visit. The mean weight loss from baseline at 12 months was -8.0 kg (95% confidence interval [CI]: -9.6 to -6.4) in the time-restriction group and -6.3 kg (95% CI: -7.8 to -4.7) in the daily-calorie-restriction group. Changes in weight were not significantly different in the 2 groups at the 12-month assessment (net difference, -1.8 kg; 95% CI: -4.0–0.4; p = 0.11). Results of analyses of waist circumferences, BMI, body fat, body lean mass, blood pressure, and metabolic risk factors were consistent with the results of the primary outcome. In addition, there were no substantial differences between the groups in the numbers of adverse events.

Conclusions: Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily calorie restriction.

Dr. H. Zhang, Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangdong Provincial Key Laboratory of Shock and Microcirculation, State Key Laboratory of Organ Failure Research, Guangzhou, China,

DOI: DOI: 10.1056/nejmoa2114833

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