Intermittent Fasting Plus Early Eating May Prevent Type 2 Diabetes

Individuals at increased risk of type 2 diabetes may be able to reduce their risk via a novel intervention combining intermittent fasting (IF) with early time-restricted eating, indicate the results of a randomized controlled trial.

The study involved more than 200 individuals randomized to one of three groups: eat only in the morning (from 8:00 AM to noon) followed by 20 hours of fasting 3 days per week and eat as desired on the other days; daily calorie restriction to 70% of requirements; or standard weight loss advice.

The IF plus early time-restricted eating intervention was associated with a significant improvement in a key measure of glucose control versus calorie restriction at 6 months, while both interventions were linked to benefits in terms of cardiovascular risk markers and body composition, compared with the standard weight loss advice.

However, the research, published in Nature Medicine, showed that the additional benefit of IF plus early time-restricted eating did not persist, and less than half of participants were still following the plan at 18 months, compared with almost 80% of those in the calorie-restriction group.

"Following a time-restricted, IF diet could help lower the chances of developing type 2 diabetes," said senior author Leonie K. Heilbronn, PhD, University of Adelaide, South Australia, in a press release.

This is "the largest study in the world to date, and the first powered to assess how the body processes and uses glucose after eating a meal," with the latter being a better indicator of diabetes risk than a fasting glucose test, added first author Xiao Tong Teong, a PhD student, also at the University of Adelaide.

"The results of this study add to the growing body of evidence to indicate that meal timing and fasting advice extends the health benefits of a restricted-calorie diet, independently from weight loss, and this may be influential in clinical practice," Teong added.

Adherence Difficult to IF Plus Early Time-Restricted Eating

Asked to comment, Krista Varady, PhD, said that the study design "would have been stronger if the time-restricted eating and IF interventions were separated" and compared.

"Time-restricted eating has been shown to naturally reduce calorie intake by 300-500 kcal/day," she told Medscape Medical News, "so I'm not sure why the investigators chose to combine [it] with IF. It...defeats the point of time-restricted eating."

Varady, who recently coauthored a review of the clinical application of intermittent fasting for weight loss, also doubted whether individuals would adhere to combined early time-restricted eating and IF. "In all honesty, I don't think anyone would follow this diet for very long," she said.

She added that the feasibility of this particular approach is "very questionable. In general, people don't like diets that require them to skip dinner with family/friends on multiple days of the week," explained Varady, professor of nutrition at the University of Illinois, Chicago.  "These regimens make social eating very difficult, which results in high attrition."

"Indeed, evidence from a recent large-scale observational study of nearly 800,000 adults shows that Americans who engage in time-restricted eating placed their eating window in the afternoon or evening," she noted.

Varady therefore suggested that future trials should test "more feasible time-restricted eating approaches," such as those with later eating windows and without "vigilant calorie monitoring."

"These types of diets are much easier to follow and are more likely to produce lasting weight and glycemic control in people with obesity and prediabetes," she observed.

A Novel Way to Cut Calories? 

The Australian authors say there is growing interest in extending the established health benefits of calorie restriction through new approaches such as timing of meals and prolonged fasting, with IF — defined as fasting interspersed with days of ad libitum eating — gaining in popularity as an alternative to simple calorie restriction.

Time-restricted eating, which emphasizes shorter daily eating windows in alignment with circadian rhythms, has also become popular in recent years, although the authors acknowledge that current evidence suggests any benefits over calorie restriction alone in terms of body composition, blood lipids, or glucose parameters are small.

To examine the combination of IF plus early time-restricted eating, in the direct trial, the team recruited individuals aged 35-75 years who had a score of at least 12 on the Australian Type 2 Diabetes Risk Assessment Tool but did not have a diagnosis of diabetes and had stable weight for more than 6 months prior to study entry.

The participants were randomized to one of three groups:IF plus early time-restricted eating, which allowed consumption of 30% of calculated baseline energy requirements between 8:00 AM and midday, followed by a 20-hour fast from midday on 3 nonconsecutive days per week. They consumed their regular diet on nonfasting days.Calorie restriction, where they consumed 70% of daily calculated baseline energy requirements each day and were given rotating menu plans, but no specific mealtimes.Standard care, where they were given a booklet on current guidelines, with no counseling or meal replacement.

There were clinic visits every 2 weeks for the first 6 months of follow-up, and then monthly visits for 12 months. The two intervention groups had one-on-one diet counseling for the first 6 months. All groups were instructed to maintain their usual physical activity levels.

Two hundred and nine individuals were enrolled between September 26, 2018 and May 4, 2020. Their mean age was 58 years, and 57% were women. Mean body mass index (BMI) was 34.8 kg/m².

In all, 40.7% of participants were allocated to IF plus early time-restricted eating, 39.7% to calorie restriction, and the remaining 19.6% to standard care.

The results showed that IF plus early time-restricted eating was associated with a significantly greater improvement in the primary outcome of postprandial glucose area under the curve (AUC) at month 6 compared with calorie restriction, at –10.1 mg/dL/min versus –3.6 mg/dL/min (P = .03).

"To our knowledge, no [prior] studies have been powered for postprandial assessments of glycemia, which are better indicators of diabetes risk than fasting assessment," the authors underline.

IF plus early time-restricted eating was also associated with greater reductions in postprandial insulin AUC versus calorie restriction at 6 months (P = .04). However, the differences between the IF plus early time-restricted eating and calorie restriction groups for postmeal insulin did not remain significant at 18 months of follow-up.

Both IF plus early time-restricted eating and calorie restriction were associated with greater reductions in A1c levels at 6 months versus standard care, but there was no significant difference between the two active interventions (P = .46).

Both interventions were also associated with improvements in markers of cardiovascular risk versus standard care, such as systolic blood pressure at 2 months, diastolic blood pressure at 6 months, and fasting triglycerides at both time points, with no significant differences between the two intervention groups.

IF plus early time-restricted eating and calorie restriction were also both associated with greater reductions in BMI and fat mass in the first 6 months, as well as in waist circumference.

Calorie Restriction Easier to Stick to, Less Likely to Cause Fatigue 

When offered the chance to modify their diet plan at 6 months, 46% of participants in the IF plus early time-restricted eating group said they would maintain 3 days of restrictions per week, while 51% chose to reduce the restrictions to 2 days per week.

In contrast, 97% of those who completed the calorie-restriction plan indicated they would continue with their current diet plan.

At 18 months, 42% of participants in the IF plus early time-restricted eating group said they still undertook 2 to 3 days of restrictions per week, while 78% of those assigned to calorie restriction reported that they followed a calorie-restricted diet.

Fatigue was more common with IF plus early time-restricted eating, reported by 56% of participants versus 37% of those following calorie restriction, and 35% of those in the standard care group at 6 months. Headaches and constipation were more common in the intervention groups than with standard care.

The study was supported by a National Health and Medical Research Council Project Grant, an Australian Government Research Training Program Scholarship from the University of Adelaide, and a Diabetes Australia Research Program Grant.

No relevant financial relationships were declared.

Nat Med. Published online April 6, 2023. Full text

High Salt Intake Linked to Atherosclerosis Even With Normal Blood Pressure

A large study from Sweden concludes that a high salt intake is an important risk factor for atherosclerosis, even in the absence of hypertension.

The study, including more than 10,000 individuals between the ages of 50 and 64 years from the Swedish Cardiopulmonary bioImage Study, showed a significant link between dietary salt intake and the risk for atherosclerotic lesions in the coronary and carotid arteries, even in participants with normal blood pressure and without known cardiovascular disease.

The finding suggests that salt could be a damaging factor in its own right before the development of hypertension, the authors write. The results were published online March 30 in European Heart Journal Open.

It has been known for a long time that salt is linked to hypertension, but the role that salt plays in atherosclerosis has not been examined, first author, Jonas Wuopio, MD, Karolinska Institutet, Huddinge, and Clinical Research Center, Falun, Uppsala University, both in Sweden, told theheart.org | Medscape Cardiology.

"Hardly anyone looks at changes in the arteries' calcification, the atherosclerotic plaques and the association with salt intake," Wuopio said. "We had this exclusive data from our cohort, so we wanted to use it to close this knowledge gap."
The analysis included 10,788 adults ages 50 to 64 years, (average age, 58 years; 52% women) who underwent a coronary computed tomography angiography (CCTA) scan. The estimated 24-hour sodium excretion was used to measure sodium intake.

CCTA was used to obtain 3D images of the coronary arteries to measure the degree of coronary artery calcium as well as detect stenosis in the coronary arteries. Participants also had an ultrasound of the carotid arteries.

After adjusting for age, sex, and study site (the study was done at Uppsala and Malmö), the researchers found that rising salt consumption was linked with increasing atherosclerosis in a linear fashion in both the coronary and carotid arteries.

Each 1000 mg rise in sodium excretion was associated with a 9% increased occurrence of carotid plaque (odds ratio [OR], 1.09; P < .001; confidence interval [CI], 1.06 - 1.12), a higher coronary artery calcium score (OR, 1.16; P < .001; CI, 1.12 - 1.19), and a 17% increased occurrence of coronary artery stenosis (OR, 1.17; P < .001; CI, 1.13 - 1.20).

The association was abolished, though, after adjusting for blood pressure, they note. Their "interpretation is that the increase in blood pressure from sodium intake, even below the level that currently defines arterial hypertension, is an important factor that mediates the interplay between salt intake and the atherosclerotic process," they write. "As we observed an association in individuals with normal blood pressure, one possible explanation for these findings is that the detrimental pathological processes begin already prior to the development of hypertension," they note, although they caution that no causal relationships can be gleaned from this cross-sectional study. 

They also reported no sign of a "J-curve"; participants with the lowest levels of sodium excretion had the lowest occurrence of both coronary and carotid atherosclerosis, which contradicts findings in some studies that found very low sodium linked to increased cardiovascular disease–related events.

"There have been some controversies among researchers regarding very low intake, where some say very low salt intake can increase the risk of cardiovascular disease, but we could not find this in this study," Wuopio said.

"Our study is confirming that excess salt is not a good thing, but the fact that it is linked to atherosclerosis, even in the absence of hypertension, was a bit of a surprise," he said.

"I will be telling my patients to follow the advice given by the World Health Organization and other medical societies, to limit your intake of salt to approximately 1 teaspoon, even if your blood pressure is normal."

Maciej Banach, MD, Medical University of Lodz, and Stanislaw Surma, MD, Faculty of Medical Sciences in Katowice, both in Poland, write that excessive dietary salt intake is a well-documented cardiovascular risk factor, and that the association is explained in most studies by increased blood pressure.

"We should look more extensively on the role of dietary salt, as it affects many pathological mechanisms, by which, especially with the coexistence of other risk factors, atherosclerosis may progress very fast," they write."The results of the study shed new light on the direct relationship between excessive dietary salt intake and the risk of ASCVD [atherosclerotic cardiovascular disease], indicating that salt intake might be a risk factor for atherosclerosis even prior to the development of hypertension," they conclude.

Some Diets Better Than Others for Heart Protection

A new analysis of randomized trials suggests that the Mediterranean diet and low-fat diets probably reduce the risk of death and nonfatal myocardial infarction (MI) in adults at increased risk for cardiovascular disease (CVD), while the Mediterranean diet also likely reduces the risk of stroke.

Five other popular diets appeared to have little or no benefit with regard to these outcomes.

"These findings with data presentations are extremely important for patients who are skeptical about the desirability of diet change," write the authors, led by Giorgio Karam, with University of Manitoba, Winnipeg, Canada.

The results were published online March 29 in The BMJ.

Dietary guidelines recommend various diets along with physical activity or other cointerventions for adults at increased CVD risk, but they are often based on low-certainty evidence from nonrandomized studies and on surrogate outcomes.

Several meta-analyses of randomized controlled trials with mortality and major CV outcomes have reported benefits of some dietary programs, but those studies did not use network meta-analysis to give absolute estimates and certainty of estimates for adults at intermediate and high risk, the authors note.

For this study, Karam and colleagues conducted a comprehensive systematic review and network meta-analysis in which they compared the effects of seven popular structured diets on mortality and CVD events for adults with CVD or CVD risk factors.

The seven diet plans were the Mediterranean, low fat, very low fat, modified fat, combined low fat and low sodium, Ornish, and Pritikin diets. Data for the analysis came from 40 randomized controlled trials that involved 35,548 participants who were followed for an average of 3 years.

There was evidence of "moderate" certainty that the Mediterranean diet was superior to minimal intervention for all-cause mortality (odds ratio [OR], 0.72), CV mortality (OR, 0.55), stroke (OR, 0.65), and nonfatal MI (OR, 0.48).

On an absolute basis (per 1000 over 5 years), the Mediterranean diet let to 17 fewer deaths from any cause, 13 fewer CV deaths, seven fewer strokes, and 17 fewer nonfatal MIs.

There was evidence of moderate certainty that a low-fat diet was superior to minimal intervention for prevention of all-cause mortality (OR, 0.84; nine fewer deaths per 1000) and nonfatal MI (OR, 0.77; seven fewer deaths per 1000). The low-fat diet had little to no benefit with regard to stroke reduction.

The Mediterranean diet was not "convincingly" superior to a low-fat diet for mortality or nonfatal MI, the authors note.

The absolute effects for the Mediterranean and low-fat diets were more pronounced in adults at high CVD risk. With the Mediterranean diet, there were 36 fewer all-cause deaths and 39 fewer CV deaths per 1000 over 5 years.

The five other dietary programs generally had "little or no benefit" compared with minimal intervention. The evidence was of low to moderate certainty.

The studies did not provide enough data to gauge the impact of the diets on angina, heart failure, peripheral vascular events, and atrial fibrillation.

The researchers say that strengths of their analysis include a comprehensive review and thorough literature search and a rigorous assessment of study bias. In addition, the researchers adhered to recognized GRADE methods for assessing the certainty of estimates.

Limitations of their work include not being able to measure adherence to dietary programs and the possibility that some of the benefits may have been due to other factors, such as drug treatment and support for quitting smoking.

The study had no specific funding. The authors have disclosed no relevant financial relationships. 

BMJ. Published online March 29, 2023. Full text

Parkinson Disease

Parkinson disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed, but not halted, by treatment. The 2 major neuropathologic findings in Parkinson disease are loss of pigmented dopaminergic neurons of the substantia nigra pars compacta and the presence of Lewy bodies and Lewy neurites.

Signs and symptoms

Initial clinical symptoms of Parkinson disease include the following:

• Tremor
  
• Subtle decrease in dexterity
  
• Decreased arm swing on the first-involved side
  
• Soft voice
  
• Decreased facial expression
  
• Sleep disturbances
  
• Rapid eye movement (REM) behavior disorder (RBD; a loss of normal atonia during REM sleep)
  
• Decreased sense of smell
  
• Symptoms of autonomic dysfunction (eg, constipation, sweating abnormalities, sexual dysfunction, seborrheic dermatitis)
  
• A general feeling of weakness, malaise, or lassitude
  
• Depression or anhedonia
  
• Slowness in thinkin

Onset of motor signs include the following:

• Typically asymmetric
  
• The most common initial finding is a resting tremor in an upper extremity
  
• Over time, patients experience progressive bradykinesia, rigidity, and gait difficulty
  
• Axial posture becomes progressively flexed and strides become shorter
  
• Postural instability (balance impairment) is a late phenomenon

Nonmotor symptoms

Nonmotor symptoms are common in early Parkinson disease. Recognition of the combination of nonmotor and motor symptoms can promote early diagnosis and thus early intervention, which often results in a better quality of life.

Diagnosis

Parkinson disease is a clinical diagnosis. No laboratory biomarkers exist for the condition, and findings on routine magnetic resonance imaging and computed tomography scans are unremarkable.

Clinical diagnosis requires the presence of 2 of 3 cardinal signs:

• Resting tremor
  
• Rigidity
  
• Bradykinesia
  

Management

The goal of medical management of Parkinson disease is to provide control of signs and symptoms for as long as possible while minimizing adverse effects.

Symptomatic drug therapy

• Usually provides good control of motor signs of Parkinson disease for 4-6 years
  
• Levodopa/carbidopa: The gold standard of symptomatic treatment
  
• Monoamine oxidase (MAO)–B inhibitors: Can be considered for initial treatment of early disease
  
• Other dopamine agonists (eg, ropinirole, pramipexole): Monotherapy in early disease and adjunctive therapy in moderate to advanced disease
  
• Anticholinergic agents (eg, trihexyphenidyl, benztropine): Second-line drugs for tremor only
  

Treatment for nonmotor symptoms

• Sildenafil citrate (Viagra): For erectile dysfunction
  
• Polyethylene glycol: For constipation
  
• Modafinil: For excessive daytime somnolence
  
• Methylphenidate: For fatigue (potential for abuse and addiction)
  

Deep brain stimulation

• Surgical procedure of choice for Parkinson disease
  
• Does not involve destruction of brain tissue
  
• Reversible
  
• Can be adjusted as the disease progresses or adverse events occur
  
• Bilateral procedures can be performed without a significant increase in adverse events
  

Prognosis

Before the introduction of levodopa, Parkinson disease caused severe disability or death in 25% of patients within 5 years of onset, 65% within 10 years, and 89% within 15 years. The mortality rate from Parkinson disease was 3 times that of the general population matched for age, sex, and racial origin. With the introduction of levodopa, the mortality rate dropped approximately 50%, and longevity was extended by many years. This is thought to be due to the symptomatic effects of levodopa, as no clear evidence suggests that levodopa stems the progressive nature of the disease.

The American Academy of Neurology notes that the following clinical features may help predict the rate of progression of Parkinson disease :
Older age at onset and initial rigidity/hypokinesia can be used to predict (1) a more rapid rate of motor progression in those with newly diagnosed Parkinson disease and (2) earlier development of cognitive decline and dementia; however, initially presenting with tremor may predict a more benign disease course and longer therapeutic benefit from levodopa
A faster rate of motor progression may also be predicted if the patient is male, has associated comorbidities, and has postural instability/gait difficulty (PIGD)
Older age at onset, dementia, and decreased responsiveness to dopaminergic therapy may predict earlier nursing home placement and decreased survival
Patient Education

Patients with Parkinson disease should be encouraged to participate in decision making regarding their condition. In addition, individuals and their caregivers should be provided with information that is appropriate for their disease state and expected or ongoing challenges. Psychosocial support and concerns should be addressed and/or referred to a social worker or psychologist as needed.

Prevention of falls should be discussed. The UK National Institute for Health and Clinical Excellence has several guidance documents including those for patients and caregivers.

Other issues that commonly need to be addressed at appropriate times in the disease course include cognitive decline, personality changes, depression, dysphagia, sleepiness and fatigue, and impulse control disorders. Additional information is also often needed for financial planning, insurance issues, disability application, and placement (assisted living facility, nursing home).

55 countries facing serious health worker shortages – World Health Organisation

The World Health Organisation has said that no less than 55 countries are struggling with serious health worker shortages as they continue to seek better-paid opportunities in wealthier nations.

They continue to seek better-paid opportunities in wealthier nations that have stepped up efforts to recruit them amid the COVID-19 pandemic.

According to WHO, African nations have been worst hit by the phenomenon, with 37 countries on the continent facing health worker shortages.

“Health workers shortage have threatened their chances of achieving universal health care by 2030 – a key Sustainable Development Goals pledge.’’

The actions of wealthy countries that belong to the Organisation for Economic Cooperation and Development come under scrutiny in the WHO alert, among other regions.

“Within Africa, it’s a very vibrant economy that is creating new opportunities,” Dr Jim Campbell, the Director responsible for health worker policy at WHO, said in a statement on Tuesday.

“The Gulf States have traditionally been reliant on international personnel and then some of the OECD high-income countries have really accelerated their recruitment and employment to respond to the pandemic and respond to the loss of lives, the infections, the absences of workers during the pandemic”.

To help countries protect their vulnerable healthcare systems, WHO has issued an updated health workforce support and safeguards list, which highlights nations with low numbers of qualified healthcare staff.

“These countries require priority support for health workforce development and health system strengthening, along with additional safeguards that limit active international recruitment,” the WHO insisted.

Supporting the call for universal healthcare for all countries in line with the SDGs, WHO Director-General, Dr Tedros Ghebreyesus, called on all countries to respect the provisions in the WHO health workforce support and safeguards list.

“Health workers are the backbone of every health system, and yet 55 countries with some of the world’s most fragile health systems, do not have enough and many are losing their health workers to international migration,” he added.

Although many countries do respect existing WHO guidelines on the recruitment of health care workers, the principle is not accepted wholesale, WHO warned.

“What we are seeing is that the majority of countries are respecting those provisions by not actively recruiting from these (vulnerable) countries,” Campbell said.

“But there is also a private recruitment market that does exist and we’re looking to them to also reach some of the global standards that are anticipated in terms of their practice and behaviour.”

Mechanisms also exist for governments or other individuals to notify WHO if they are “worried” about the behaviour of recruiters, the WHO official said.

The WHO health workforce support and safeguard list does not prohibit international recruitment but recommends that governments involved in such programmes are informed about the impact on the health system in countries where they source qualified health professionals.

Intermittent fasting may change how your DNA is expressed

Mice who only ate at specific times of the day experienced “profound” changes in genetic expression, leading to health benefits like reduced risk of obesity and inflammation, new research found.

To an extent, it’s not about  what you eat as much as when you eat it — so says recent research that sheds new light on the benefits of intermittent fasting. 

The study, published Tuesday in journal Cell Metabolism, found that mice fed only during certain blocks of time experienced “profound” changes in gene expression. Nearly 80 per cent of all genes were impacted in some way, the paper reads.

The changes resulted in a plethora of health benefits, the authors wrote, including: improved blood sugar regulation, decreased risk of obesity and even a reversal of certain hallmarks of ageing.
You can think of a gene as the blueprint for a specific protein, written in DNA. When a gene is expressed, the blueprint is converted into its protein product by cellular machinery. Because proteins are responsible for most cellular functions from fat metabolism to immune response, even slight changes in gene expression could leave a massive impact.

According to the research, restricting when mice could eat reshaped when and to what extent certain genes were expressed — for example, some organs learned to switch on the genes for regulating blood sugar when it came feeding time, and to repress them when it was time to fast.

The researchers say their findings opened the door for further research into how dietary interventions might impact our genes and what this means for those suffering from issues like diabetes, heart disease and cancer.

What is time-restricted eating?

Shaunak Deota, first author of the study and a post-doctoral fellow at the Salk Institute for Biological Studies in San Diego, explained time-restricted eating as “eating consistently in a narrow window of 8 to 10 hours” when one is most active and fasting the remainder of the day. Intermittent fasting is a form of this practice, he said.

By feeding and fasting at the same time every day, we are reinforcing a biological rhythm in our bodies, Deota said: “Our body is getting the food at the same time every day, so all our organ systems know when the food is going to come and they’re prepared for it.”

Previous studies have shown that time-restricted eating may reduce the risk of obesity and diabetes, help to improve cardiovascular health, provide benefits for gut function and cardiovascular health and more.

Deota’s research now contributes, to his knowledge, the first “holistic” look at how time-restricted eating impacts the body as a system.

To achieve their results, the researchers put two groups of mice on the same high-calorie diet. One group was only allowed to eat during a nine-hour window when they were most active. The other could feed whenever they wanted.

After seven weeks, the mice on a time-restricted diet gained less weight than their counterparts, despite eating the same amount of food. 

The researchers then killed 48 of the mice — 24 from each group — to investigate the diet’s impact on the body. They sacrificed two mice from each group every two hours over a 24-hour period, noting how their organ systems changed over time.

How time-restricted eating changes the body

After studying the mouse organs, Deota and his team made a “pretty surprising” discovery; mice on the time-restricted diet had synchronized their gene expression with their feeding schedules.

“That is important because these genes will get translated into proteins,” Deota said. “Those proteins are helping our body to anticipate that there is food coming.”

According to their paper, roughly 70 per cent of all mouse genes fell into rhythm with the feeding schedule. Come mealtime, individual organs could promote genes in charge of nutrient metabolism while suppressing those responsible for inflammatory signalling and immune activation.

Moreover, the scientists found the diet reversed several hallmarks of aging, leading to reduced inflammation, increased cellular housekeeping, improved RNA and protein balance and more.

“Molecularly speaking, we saw a lot of pathways which are activated by (the time-restricted diet) in multiple organ systems. And a lot of these pathways actually have been implicated in improving health and leading to a longer, healthy life,” Deota said.

The limitations

All that being said, we need to remember these results were seen in mice, not humans — we’re still a long way off from demonstrating the same phenomenon happens in people, said Dani Renouf, a registered dietitian at St. Paul’s Hospital in Vancouver. For now, these results represent a “wonderful start to a conversation.”

“We’re just prototyping at this point because we’re using animal models and looking at things on a cellular level,” she said. “In order to now make conclusions in human beings, we need to take several steps before we can definitively do that with time restricted-eating.”

Renouf also noted the experiments took place in a tightly controlled environment. Real life is messy and chaotic, she said, and will likely influence results.

On the flip side, Deota believes “most of these benefits can be translated to humans” because his lab’s findings line up with what clinical studies into time-restricted eating have discovered.