For the study, participants kept to an 8- to 10-hour window of eating, a dietary practice called time-restricted eating or intermittent fasting.
Taub said time-restricted eating offers an accessible, cost-effective, and sustainable intervention for the average patient.
Metabolic syndrome can result in patients developing a wider waistline and elevated glucose, high blood pressure, and high cholesterol levels. The condition affects approximately one third of Americans, or about 112 million people.
To determine the efficacy of time-restricted eating, Taub and her colleagues examined data from 54 participants who completed the 12-week intervention. Adults were eligible if they had metabolic syndrome plus an elevated A1c (between 5.7% and 7.0%) or fasting glucose (between 5.56 and 6.95 mmol/L), in line with prediabetes. Management medications were allowed.
The standard-of-care group (n = 54) received nutritional counseling from a registered dietician. Participants in the intermittent group also received this intervention but were additionally instructed to eat within the 8- to 10-hour timeframe and to stop intake of food 3 hours before bedtime.
Baseline levels of glycemic regulation were comparable between groups. Medication use was also similar, with 6% of participants taking metformin for prediabetes, 48% for hyperlipidemia, and 69% taking at least one drug for cardiometabolic health. Participants overall had a body mass index (BMI) of 31.22 and a mean age of 56 years, and a little over half were women.
The primary outcomes were A1c and glycemic parameters, such as fasting glucose, fasting insulin, and homeostatic model assessment for insulin resistance (HOMA-IR). Secondary outcomes included lipid profile, C-reactive protein (CRP), and trunk fat.
From baseline to 3 months, the time-restricted-eating group experienced reductions in A1c by 0.12% while the standard-of-care group saw a 0.02 reduction, a -1.7 relative reduction (between-group difference [BGD], -0.10%; 95% CI, -0.19% to -0.003%).
Fasting glucose, fasting insulin, and HOMA-IR all showed greater reductions for the time-restricted-eating group than the standard-of-care group but were not statistically significant.
The time-restricted-eating group also showed greater decreases than the standard-of-care group in weight (BGD, -1.66; 95% CI, -3.00 to -0.32) and BMI (BGD, -0.77; 95% CI, -1.37 to -0.17). Body fat and trunk fat also decreased more in the time-restricted-eating group.
The researchers observed no significant changes between groups in total lean mass or total bone mineral content, which Taub said indicates that intermittent fasting is a safe intervention for decreasing weight and A1c levels.
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