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Time-Restricted Eating Rivals Mediterranean Diet but Falls Short for Visceral Fat Loss

by Daisy

Despite its high adherence and safety, time-restricted eating (TRE) does not surpass the Mediterranean diet for visceral fat loss. However, it shows promise in other areas, such as subcutaneous fat reduction and glucose control.

Study Overview

A recent study published in Nature Medicine evaluated the effects of different time-restricted eating windows—early, late, and self-selected—on managing visceral adipose tissue (VAT) in overweight or obese individuals. The study, a randomized controlled trial, compared these TRE interventions with a Mediterranean diet-based usual care (UC) program over 12 weeks.

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Key Findings

While TRE was found to be safe, feasible, and well-tolerated, it did not show additional benefits for managing VAT compared to the Mediterranean diet-based UC program. These results suggest that caloric restriction and overall dietary adherence may be more significant factors for reducing VAT than the timing of food consumption. Interestingly, participants in the early TRE group showed notable reductions in subcutaneous adipose tissue (SAT), highlighting the selective benefits of meal timing on certain fat depots.

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Background on Obesity and Time-Restricted Eating

Obesity, defined by a body mass index (BMI) greater than 30, is a growing global concern, affecting approximately 43% of adults as of 2022. The condition is linked to numerous health risks, including diabetes, cardiovascular diseases, and certain cancers. Traditionally, dietary interventions—such as the Mediterranean diet—have been integral to obesity management. However, time-restricted eating (TRE), a newer dietary approach, is gaining attention as a potential alternative. TRE involves limiting food intake to a specific time window, typically less than 10 hours per day, with the rest of the day spent fasting. While promising, research on the specific impacts of TRE on different fat depots and overall health remains limited.

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Study Design and Methodology

This study recruited 197 overweight or obese adults (ages 30-60) between April and December 2022. The participants were randomly assigned to four groups: UC, early TRE, late TRE, and self-selected TRE. Over the course of 12 weeks, each group adhered to their respective eating schedules, with the UC group following a standard Mediterranean diet education program.

The primary outcome of the study was the reduction in VAT, measured using Magnetic Resonance Imaging (MRI). Secondary outcomes included changes in intermuscular adipose tissue, SAT, fasting glucose levels, and body weight.

Study Findings

The results showed that all TRE groups experienced a reduction in body weight—ranging from 2.4 kg to 3.1 kg—compared to the UC group, who lost an average of 1.6 kg. However, there were no statistically significant differences in VAT between any of the TRE groups and the UC group. This indicates that TRE, regardless of timing, does not provide an additional advantage over the Mediterranean diet and UC for managing visceral fat.

Notably, participants in the early TRE group saw a 5% greater reduction in SAT compared to other groups. Additionally, fasting glucose levels were significantly lower in the early TRE group (-6 mg/dL to -8 mg/dL) compared to the other cohorts, suggesting that early TRE may offer benefits for glycemic control.

Safety and Adherence

The study reported high adherence rates (85-88%) across all TRE cohorts, demonstrating the feasibility and acceptance of TRE, even in cultures with later dining habits, such as Spain. Mild adverse events, such as headaches and colitis, were rare, indicating that TRE is a safe and well-tolerated intervention.

Conclusions

The study concludes that while TRE—especially early TRE—can be effective for improving SAT, weight management, and glucose control, it does not offer superior benefits for reducing VAT compared to a Mediterranean diet. VAT is a key risk factor for cardiovascular diseases and may require alternative interventions for effective management.

While TRE shows promise in certain areas, the lack of significant effects on VAT suggests that traditional approaches to dietary adherence, such as the Mediterranean diet, may remain more effective for long-term fat loss. The study’s relatively short duration, modest sample size, and lack of diversity in the UC group call for further research to fully understand the long-term effects of TRE and its potential role in obesity management.

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