Some More Data on Time-Restricted Eating (TRE) as a Means to Manage Food Intake

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The Guide * The Atmasvasth Guide to Living Long, Healthy - 15 Aug 2021 Understanding the Steps and Taking Control Taking Control * Atmagyan, Atmasurakshit, Atmanivaaran and Atmanirbar - the four Atmas to be Atmasvasth - 16 May 2021 * The Healthy 7 is also the Happy 7 - 13 Mar 2022 * Prev…

AtmasvasthBhavin Jankharia

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In May 2021, I touched upon the topic of intermittent fasting (IF), specifically because it was then and is still now, a fad among celebrities and so-called influencers…anything that becomes a fad among such people, who, like lemmings rush to endorse whatever is the fad of the moment (as with superfoods like gojiberries or kale or avocados, most of which are completely useless), should be taken with a huge fistful of salt.

One form of IF is time-restricted eating or TRE, which I then discussed in detail in Apr 2022 because of a New England Journal of Medicine (NEJM) article [1] published a few days prior that had said there was no difference in weight loss between those following TRE with calorie restriction and those following the same amount of calorie restriction, but without TRE. The accompany New York Times article that said that TRE doesn’t work misinterpreted the authors whose conclusion was that TRE was a sustainable practice to achieve calorie loss, if you wanted to do so, for whatever reason.

Weight loss is a negative sum game. It doesn’t work. These days, those who are focussed on weight loss for any reason have another option…the various GLP-1 receptor agonists like semaglutide that produce about 15-20% weight loss while in many instances, also suppressing appetite and improving self-control.

However, if you are physically active, you also have to eat within a reasonable range to maintain your energy requirements. Being fit is more important than your weight and as I have consistently mentioned, those who are so-called overweight and fit, live longer and healthier than those who are so-called normal weight and unfit.

Having said that, in today’s day and age where we have alluring, hard-to-resist food options thrown at us from all sides including shiny, packaged UPFs (ultra-processed foods), often endorsed by cricketers and movie stars, some control over what we eat is always helpful. If you restrict your eating to a specific time period of 6-8 hours a day, it becomes easier not to go overboard with your food intake. I like TRE, because once you become used to eating for just 6-8 hours a day, it becomes much easier to eat well, sensibly and properly without losing control.

New data from a couple of randomized controlled trials (RCTs) strengthens this belief.

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The first is a study by Wei X and colleagues  [2] that looked at calorie restriction, either with TRE or without TRE in patients with non-alcoholic fatty liver disease (NAFLD). Both groups did well on multiple parameters, therefore suggesting that while calorie restriction helps in such patients and it doesn’t matter whether you do it with or without TRE, TRE becomes a more attractive option, because it becomes easier to control food intake, rather than having to exercise control each time you eat, 3-4 times a day. How much can you gorge if your eating window is just 6-8 hours?

As I mentioned in the first article, you can start with a 12:12 (feeding:fasting) pattern for a month, then move to 10:14, then 8:16 and stay there or move to 6:18. Once it becomes part of your lifestyle, it is easy to implement in most instances, except perhaps when you are traveling with friends and/or family.

The second study was performed to show that TRE also works in a racially diverse non-white population. This study from Chicago headed by Lin Shuhao [3] divided people into 3 groups, TRE with calorie restriction, only calorie restriction and a control group with no restriction. Obviously, the first two groups lost more weight than the third group, but with no difference between the first two groups.

What does this mean for you and I? In a world where it is becoming increasingly difficult to exercise good food choices, having a restricted eating period as part of a regular lifestyle, makes it easier to eat sensibly and to exercise some control over what goes into your body. It is not about weight loss, but about maintaining a sensible eating plan. If you are physically active, which you should be  as part of your atmasvasth quest to live long, healthy, you actually need to eat well to maintain your activity levels, but with a modicum of control, which TRE makes easier.

Do remember that if you are able to eat sensibly, easily without stressing yourself out, without any form of IF or TRE, then that’s fine as well…TRE just makes it easier.

Footnotes

1. 1. Liu D et al. N Engl J Med. 2022 Apr 21;386(16):1495-1504.

2. Wei X et al. JAMA Netw Open. 2023 Mar 1;6(3):e233513.

3. Lin S e tal. Ann Intern Med. 2023 Jul;176(7):885-895.