Friday, June 16, 2023

Eating meals earlier improves metabolic health


Meeting Announcement

NYU LANGONE HEALTH / NYU GROSSMAN SCHOOL OF MEDICINE

Dietary Interventions 

IMAGE: EARLY TIME-RESTRICTED FEEDING (ETRF) IMPROVES GLYCEMIA AND INFLAMMATORY MARKERS EVEN IN THE ABSENCE OF WEIGHT LOSS. view more 

CREDIT: NYU LANGONE HEALTH




Eating more of one’s daily calories earlier in the day may counter weight gain, improve blood sugar fluctuations, and reduce the time that blood sugar is above normal levels, a new study suggests.

“This type of feeding, through its effect on blood sugar, may prevent those with prediabetes or obesity from progressing to type 2 diabetes,” said study lead author Joanne H. Bruno, MD, PhD, an endocrinology fellow at NYU Langone Health.

Presented at the Endocrine Society’s annual meeting on June 15, the new report evaluated early time-restricted feeding (eTRF), which involves restricting calories to the first eight hours of the day. Previous studies have found this form of intermittent fasting may improve cardiometabolic health and blood sugar levels. However, the team wanted to determine whether these improvements are related to weight loss or the fasting strategy.

Led by researchers at NYU Grossman School of Medicine, the work is the first to evaluate the effects of early time-restricted feeding on glycemia and inflammation independent of weight loss.

For their study, the researchers compared eTRF (80 percent of calories consumed before 1PM) to a usual feeding pattern (50 percent of calories consumed after 4PM) among ten participants with prediabetes and obesity.

The patients were randomized to eTRF or usual feeding patterns for the first seven days and were changed over to the alternative arm for the next 7 days. Food was provided to meet the patients’ caloric needs for weight maintenance to determine the weight-independent effects of this strategy. Patients wore continuous glucose (blood sugar) monitors throughout the study.

“We decreased the time these individuals were having high blood sugar levels with just one week of eTRF feeding,” said study senior author Jose O. Aleman, MD, PhD, assistant professor in the Department of MedicineDivision of Endocrinology, Diabetes, & Metabolism at NYU Grossman School of Medicine. “The findings show that eating a majority of one’s calories earlier in the day reduces the time that the blood sugar is elevated, thereby improving metabolic health.”  

Dr. Aleman and colleagues discovered the participants’ weights were stable throughout the study. Early time-restricted feeding led to a decreased mean amplitude of glycemic excursion and decreased time above range (blood glucose > 140mg/dL) compared to the usual eating pattern group. The time in range was similar between the eTRF and usual feeding pattern group.

“Based on this data, eTRF may be a helpful dietary strategy for diabetes prevention,” concluded Dr. Bruno. “Further studies are needed to understand the true overall benefit of these intervention strategies.”

Funding for the study was provided by the National Heart, Lung and Blood Institute Institutional training grant T32HL098129 and National Institutes of Health grant K08 DK117064. Further funding was provided by Rockefeller University’s Shapiro Silverberg Fund for the Advancement of Translational Research.

In addition to Dr. Bruno and Dr. Aleman, other NYU Langone researchers involved in the study were Shabnam Nasserifer, MD; Sally Vanegas, PhD; and Collin Popp, PhD.

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Fewer meals may prevent Type 2 diabetes, obesity


Reducing meals, cutting out midnight snacks may optimize gut health

Peer-Reviewed Publication

UNIVERSITY OF GEORGIA




When intermittent fasting became all the rage among Hollywood celebrities, skeptics balked at the idea of skipping meals. But new research from the University of Georgia suggests the celebs might not have been that far off.

The review found that a specific type of restricted eating may reduce the chances of developing Type 2 diabetes and improve your overall health. Known as time-restricted eating, this type of fasting means having regular but fewer meals, cutting out late-night snacks and not eating for 12 to 14 hours (often overnight).

After a comprehensive review of published, peer-reviewed studies, the researchers found a connection between number of meals and obesity and Type 2 diabetes.

“What we’ve been taught for many decades is that we should eat three meals a day plus snacking in between,” said Krzysztof Czaja, an associate professor of biomedical sciences in UGA’s College of Veterinary Medicine. “Unfortunately, this appears to be one of the causes of obesity.”

The three meals and snacks style of eating prevents insulin levels from going down during the day, and, with the amount of calories and sugars Americans consume on average, that can overload the body’s insulin receptors. That leads to insulin resistance and often Type 2 diabetes.

“That’s why it’s so hard to lose body fat,” Czaja said. “We are not giving our bodies a chance to use it. Having fewer meals a day will allow these fat deposits to be used as an energy source rather than the sugar we keep consuming.”

Modern eating approach disrupts body’s biological clock

The researchers found that time-restricted eating allows the body to relax and lower insulin and glucose levels, which in turn can improve insulin resistance, brain health and glycemic control. It can also reduce calorie intake by around 550 calories per day without the stress of calorie counting.

Previous studies have shown disruptions to sleep and meal schedules can change both the type and amount of bacteria and other microorganisms in the digestive tract. But fasting may positively alter the gut microbiome, potentially staving off inflammation and a variety of metabolic disorders.

Additionally, the review suggests time-restricted eating can help regulate hormones responsible for appetite regulation and energy levels.

Regular meal schedules, eating breakfast and decreasing meals and snacks can help guard against obesity and Type 2 diabetes, according to the publication. And not all breakfasts aren’t created equal. Aim for healthy fats and protein, like eggs, and avoid the sugar-filled breakfast cereals and pastries.

Although time-restricted eating appeared to improve health, the researchers found that other types of restricted eating, such as fasting for days on end, provided few benefits.

Regular but fewer meals can stave off obesity and metabolic disorders

More than four in 10 Americans are clinically obese, meaning their weight is higher than what is considered a healthy range for their height. Almost 10% are severely obese, according to the Centers for Disease Control and Prevention.

Obesity may lead to a variety of health conditions, including Type 2 diabetes, heart disease and even some cancers.

“Obesity is an epidemic right now, especially in the United States,” Czaja said. “It is a preventable disease. When we started looking at the research, we found that ancient humans didn’t eat every day. That means our body evolved not needing food every day.”

The modern approach of three meals plus snacks became popular decades ago, and it’s a hard pattern to break.

“But our gut-brain signaling is not designed for this type of eating,” Czaja said.

The researchers caution that eating is not a one size fits all situation. Smaller, less active people need fewer calories on average than taller athletes, for example. So for some, one meal of nutrient-rich food might be another while others may need more.

But one thing was very clear from the literature they reviewed: Fewer meals of high-quality food is a good guideline for individuals at risk of developing Type 2 diabetes and obesity.

“Also definitely avoid late-night eating,” Czaja said. “Our midnight snacks spike insulin, so instead of us going into a resting state when we sleep, our GI is working on digestion. That’s why we wake up in the morning tired—because we don’t get enough resting sleep.”

Published in Nutrientsthe study was co-authored by Carlee Harris, an undergraduate biology major in UGA’s Franklin College of Arts and Sciences.


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