Invited Talk ESA-SRB-ANZBMS 2024 in conjunction with ENSA

Meal timing as an intervention to combat obesity and associated metabolic disorders. (#143)

Leonie Heilbronn 1
  1. The University of Adelaide, Adelaide, SA, Australia

Circadian rhythms are internal processes that synchronize metabolism with daily cycles of activity and rest, optimizing energy use and physiological function. Disruptions in circadian rhythms increase the risk of chronic diseases like type 2 diabetes. In nightshift workers, we recently showed that meal timing during simulated shift work had a critical effect upon glucose metabolism and that glucose tolerance was readily amendable to improvement through meal re-timing interventions. In concert, an increasing number of studies are showing that aberrant meal timing alone can induce circadian desynchrony. Intermittent fasting and time restricted eating (TRE) dietary approaches have recently emerged as therapeutic alternatives to caloric restriction (CR) that improve cardiometabolic health in people with obesity. However, many questions remain around the optimal length to fast, as well as the optimal time-of-day to eat. Few trials have also applied meal timing considerations during intermittent fasting. We recently developed an intermittent fasting plus early time-restricted eating (iTRE) approach whereby 209 adults (58±10 years, 34.8±4.7 kg/m2) at increased risk of developing type 2 diabetes were randomised (2:2:1) to iTRE, CR or control. The iTRE diet led to greater improvements in glucose tolerance, non-esterified fatty acids, triglycerides and B-hexosaminidase versus CR, despite equivalent weight losses. Assessment of eating behaviours, diet satisfaction and postprandial feelings of appetite and gastro-intestinal hormones has also provided valuable insight into how these dietary approaches may influence body weight longer term. To gain deeper understanding of the approaches in more real-world environments, we have recently completed a trial comparing TRE to current best practice in dietetics, utilizing available management support practices, and preliminary findings will be discussed.