The new findings, based primarily on 15 years of data from the National Health and Nutrition Examination Survey (NHANES), may argue against time-restricted diet interventions like intermittent fasting for patients with HF, researchers say.
The study's nearly 1000 participants on medical therapy for HF reported a mean daily eating window of 11 hours and daily average of four "eating occasions," defined as meals or snacks of at least 50 kcal.
A daily eating window of 11 or more hours, compared to less than 11 hours, corresponded to a greater than 40% drop in risk for CV mortality (P = .013) over 5 to 6 years.
The analysis adjusted for caloric intake, daily number of eating occasions, body mass index (BMI), history of CV disease and cancer, diabetes, and a slew of other potential confounders.
Prior evidence, mostly from healthy people, has suggested that extended fasting during the day is associated with less physical activity.
The findings add to earlier evidence from Billingsley's center that suggests that expanded daily time windows for eating, especially later final food rather than earlier first food, may help boost CV fitness for patients with obesity and HF with preserved ejection fraction.
The current study included 991 persons who entered the NHANES database from 2003 to 2018. The patients self-identified as having HF, reported taking medications commonly prescribed in HF, and provided at least two "reliable" dietary recalls.
The average age of the patients was 68 years, and they had had HF for a mean of 9.5 years; 47% were women, three fourths were White persons, two thirds had dyslipidemia, and a quarter had a history of cancer.
On average, their first eating occasion of the day was at about 8:30 AM, and the last occasion was at about 7:30 PM, for a time window of about 11 hours; daily calorie consumption averaged about 1830 kcal.
About 52% died over the mean follow-up of 69 months; about 44% of deaths were from CV causes.
In a model adjusted for demographics, BMI, smoking status, times of eating occasions, CV disease, diabetes, and cancer history, the all-cause mortality hazard ratio (HR) for time windows ≥11 hours vs <11 hours was 0.236 (95% CI, 0.078 – 0.715; P = .011).
The reduction was no longer significant on further adjustment for duration of HF, a score reflecting difficulty walking, nightly hours of sleep (which averaged 7.2 hours), daily number of eating occasions, and caloric intake.
But in the fully adjusted analysis, the HR for CV mortality for the longer vs shorter time window was 0.368 (95% CI, 0.169 – 0.803; P = .013).
https://www.medscape.com/viewarticle/997193
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