Time-restricted eating, liver health, and fecal microbiota in adults with overweight or obesity: A randomized controlled trial.
Manuel Dote-Montero, Antonio Clavero-Jimeno, Adrián Cortés-Martín et al.
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In 30 seconds
This 12-week multicenter randomized trial compared Mediterranean diet-based usual care (UC) alone with UC plus early, late, or self-selected 8-hour time-restricted eating (TRE) in adults with overweight or obesity. Hepatic fat fraction (HFF) decreased within each TRE group, but no TRE group differed significantly from UC or from the other TRE groups in HFF, liver health markers, or fecal microbiota. A higher proportion of participants receiving TRE achieved ≥5% weight loss than with UC (41-44% vs. 16%, p = 0.001).
Key findings
- HFF fell within all three TRE groups (all p ≤0.02), but between-group comparisons with UC were not significant.
- Participants with baseline MASLD had greater HFF reductions than those without it (MD -2.7%, p <0.001).
- Those achieving ≥5% weight loss had greater HFF reductions than those who did not (MD -2.6%, p <0.001).
- A higher proportion of TRE participants achieved ≥5% weight loss than UC participants (41-44% vs. 16%, p = 0.001).
Why it matters
The trial found no evidence that choosing an early, late, or self-selected 8-hour eating window improves liver fat, other liver markers, or fecal microbiota beyond Mediterranean diet-based usual care over 12 weeks. The greater HFF reductions associated with baseline MASLD and achieving ≥5% weight loss highlight the relevance of weight change when interpreting liver-fat outcomes, while the study does not establish that TRE timing drives those changes.
What to keep in mind
The trial was not powered for secondary outcomes, as the authors note, and follow-up was limited to 12 weeks.