Study supports value of intermittent fasting combined with nutritional counseling

NEW YORK, Sept. 30 (UPI) -- Adults who engaged in intermittent fasting along with standard nutritional counseling gained better control of their blood sugar and lost more fat than those who only underwent counseling, a new study indicates.

The study, funded by the National Institutes of Health, was published Monday in Annals of Internal Medicine.

Investigators evaluated the effectiveness of time-restricted eating -- a form of intermittent fasting -- as a lifestyle intervention in adults with metabolic syndrome, which is a cluster of abnormalities that increases the risk for diabetes, stroke and heart disease.

These metabolic risk factors consisted of high blood pressure, high blood sugar, unhealthy cholesterol levels and abdominal fat.

Metabolic syndrome affects more than one-third of the U.S. population and more than 1 billion people globally. It goes hand in hand with prediabetes, the researchers noted.

People in this predicament have few treatment options to prevent prediabetes from progressing to full-blown type 2 diabetes, Dr. Pam Taub, a corresponding author of the study, told UPI.

"Metabolic syndrome and prediabetes represent a critical tipping point in which the risk for developing type 2 diabetes and heart disease is greatly increased," said Taub, director of preventive cardiology at the University of California-San Diego School of Medicine.

"Our research demonstrates that intervening with a lifestyle intervention like time-restricted eating at this important time point for patients with metabolic syndrome and prediabetes can have a meaningful impact on the trajectory of their overall health and reduce risk of future type 2 diabetes," she said.

Compared to standard nutritional counseling alone, three months of eight to 10 hours of personalized, time-restricted eating in patients with metabolic syndrome, including prediabetes, led to significant improvements in blood sugar, low-density lipoprotein, or bad cholesterol, and body fat composition.

The study analyzed data from 108 adult participants -- 56 women and 52 men with an average age of 59 -- who had completed the intervention.

Participants were selected on the basis of metabolic syndrome, elevated body mass index and blood sugar, signifying prediabetes.

Researchers randomly assigned participants to two groups. The first group received standardized lifestyle and nutritional recommendations along with advice to continue their eating patterns.

These nutritional recommendations applied to the second group, who also were instructed to follow a personalized eight- to 10-hour eating regimen.

For three months, researchers remotely monitored the intervention, as participants logged the timing of dietary intake in a mobile app daily.

The time-restricted eating group had a greater decrease in weight and a higher proportion of weight loss from fat. This outcome suggests that time-restricted eating likely poses a lower risk for muscle deterioration linked to weight loss.

As a cardiologist, based on this study, I would recommend time-restricted eating to those who meet the criteria for metabolic syndrome," Taub said.

"At a minimum, I would recommend everyone cut out late-night snacks."

Dr. Sumeet Jain, an endocrinologist at Rush University System for Health in Chicago, who was not involved in the study, said eating within two to three hours before bedtime greatly contributes to weight gain and worsens health.

Instead, he recommends following your hunger and eating more healthy food at dinner.

"Overall, this was a well-done study," Jain said, adding that many lower-quality studies rely on participants' memories, while this one used a phone app for logging dietary intake.

In addition, he noted that this study's funding came from the National Institutes of Health, a trusted source, not the food or pharmaceutical industry.

This study "provides a strong signal" that time-restricted eating is a reasonable approach for most people with metabolic syndrome and is not associated with harmful effects, said Dr. Joseph Rogers, a cardiologist and president and chief executive officer of the Texas Heart Institute in Houston.

"Lifestyle modification has always been and should remain the cornerstone of disease prevention," he said. "This intervention is a tangible and relatively simple step for patients with this condition to reduce their risk."

The results justify more research in larger numbers of people over longer periods to learn whether this strategy is sustainable and understand its true impact on cardiometabolic risk, Rogers added.

"There are millions of patients with undiagnosed metabolic syndrome and diabetes in the United States," said Dr. Jennifer Cheng, section chief of endocrinology at Hackensack Meridian Jersey Shore University Medical Center in Neptune City, N.J.

"They should be aware that just switching the timing of eating can make a significant difference in potentially reducing their risk of developing diabetes in the future," Cheng said.