TDNet Discover

Background: Cardiovascular disease (CVD) is the leading cause of death in the US. It includes coronary heart disease, peripheral artery disease, and stroke, which are largely attributable to modifiable risk factors. Several of these modifiable risks such as obesity, poor diet, and dyslipidemia can be targeted with therapeutic life changes. One such therapeutic life change is dietary pattern modification;studies have shown it can directly decrease these factors and therefore reduce CVD deaths. Early time-restricted-eating (eTRE) is a regimen consisting of eating for an 8-hour period beginning early in the morning. It is a particularly promising potential therapeutic life change that can assist in reducing certain modifiable risk factors. Purpose: To identify the evidence supporting eTRE in decreasing cardiometabolic risk factors leading to CVD risk reduction. Methods: An evidence-based medicine systematic review was conducted by searching Cochrane Library, Academic Search Complete, and PubMed databases and utilizing the phrases “timerestricted fasting,” “intermittent fasting,” “time-restricted feeding,” “metabolic syndrome,” and “cardiometabolic.” The search limits were the following: within the last 10 years, peer-reviewed, full text, systematic literature review, meta-analysis, and randomized controlled trials. Studies included had to be focused on the adult population and published within 5 years. Those studies consisting of religious fasting such as Ramadan and animal studies were excluded. Quality assessments were performed to narrow the search down to the three final studies. Afterwards, data extraction tools were created, performed, and reviewed to qualitatively analyze the final studies chosen. Results: A systematic review (SR) and two randomized-control trials (RCT) were included in this review with a total of 623 participants. These articles studied various regimens such as eTRE, mid-day TRE (mTRE), and delayed TRE (dTRE). Adherence and tolerability were evaluated in several studies and overall TRE was well tolerated with high adherence rates. However, no significant differences were found between eTRE and other forms of TRE. Body weight and body fat mass were found to be significantly reduced in participants adhering to an eTRE regimen. Blood pressure was considerably reduced in hypertensive participants;however, no significant changes were found in normotensive participants. A general reduction of fasting blood glucose and insulin was observed, though in healthier participants the reduction was not considerable. There were no clear effects of TRE on lipid level reduction. A marked decrease in inflammatory markers was noted in eTRE participants. Conclusion: Significant evidence was found supporting eTRE as a beneficial method in reducing several modifiable cardiometabolic risks. These results, however, are based on short-term studies, with the mean duration of TRE being 6.7 weeks. Thus, additional studies including longer eTRE regimens are needed to determine if eTRE has the same effects on cardiometabolic risk factors on a long-term basis.