Cardiometabolic effects of time-restricted eating (tentative)

Time-restricted eating (TRE) confines daily caloric intake to 4-10 hours, thereby inducing recurrent fasting intervals of 14-20 hours. TRE alters meal timing without the need for calorie counting and has been proposed as a simple and sustainable dietary intervention with potential metabolic benefits mediated through circadian alignment and increased amount of time spent in the postabsorptive/fasted state. This mini-review summarizes evidence from randomized controlled trials and meta-analysis on cardiometabolic effects of TRE. Studies indicate a modest weight loss compared to ad libitum eating, but with no consistent benefit when compared to caloric restriction. Effects on glycemic control, insulin sensitivity, and lipid profiles are generally small, variable and context dependent. The most consistent finding is a lowering of blood pressure by about 4/2 mmHg. The effects of TRE on cardiac function and perfusion are still mostly unexplored, but a 3-week intervention with alternate-day fasting (~36 hours of fasting) improves myocardial flow reserve and reduces oxygen consumption. In summary, TRE appears to be a feasible dietary intervention, but robust evidence of beneficial effects remains limited. Larger and longer-term studies with clinically relevant cardiometabolic endpoints are needed to determine the clinical efficacy of TRE.