The effects of time-restricted eating and weight loss on bone metabolism and health: a 6-month randomized controlled trial.

Maria Papageorgiou, Emmanuel Biver, Julie Mareschal, Nicholas Edward Phillips, Alexandra Hemmer, Emma Biolley, Nathalie Schwab, Emily N C Manoogian, Elena Gonzalez Rodriguez, Daniel Aeberli, Didier Hans, Caroline Pot, Satchidananda Panda, Nicolas Rodondi, Serge L Ferrari, Tinh-Hai Collet

Journal: Obesity (Silver Spring, Md.) 2023;31 Suppl 1(Suppl 1):85-95

PMID: 36239695

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Plain Language Summary

Intermittent fasting (IF) involves an alternation of abstinence and consumption of food and caloric beverages over a cycle of hours to days. Time-restricted feeding (in animals) or eating (TRE in humans) is a form of IF that entails restricting eating within a window of 4 to 12 hours per 24-hour cycle and prolonging the time spent in the fasted state to realign eating-fasting patterns with circadian rhythms. The aim of this study was to explore the impact of a 6-month randomised controlled trial of TRE versus standard dietary advice (SDA, active control arm) on bone metabolism and health in a population with at least one component of the metabolic syndrome. This study is a secondary analysis of an open-label 6-month randomised controlled trial in which participants who ate within a time interval > 14 hours per 24-hour cycle (n=54) were randomised to TRE or SDA (active control) with a 1:1 allocation ratio. A total of 42 participants (76% women) with available bone turnover markers and/or bone mass measurements were included in this study. Results show that there weren’t any detrimental effects on bone health outcomes i.e. bone metabolism or bone loss after 6 months of TRE. Additionally, weight loss following a period of TRE might be associated with small bone-sparing effects compared with SDA. Authors conclude that future studies of longer duration (>6 months) assessing multiple bone phenotypes are required in order to confirm the study’s findings and explore the effects of various TRE regimens particularly among individuals at risk for bone fragility such as postmenopausal women and the elderly.

Abstract

OBJECTIVE

This study explored the impact of time-restricted eating (TRE) versus standard dietary advice (SDA) on bone health.

METHODS

Adults with ≥1 component of metabolic syndrome were randomized to TRE (ad libitum eating within 12 hours) or SDA (food pyramid brochure). Bone turnover markers and bone mineral content/density by dual energy x-ray absorptiometry were assessed at baseline and 6-month follow-up. Statistical analyses were performed in the total population and by weight loss response.

RESULTS

In the total population (n = 42, 76% women, median age 47 years [IQR: 31-52]), there were no between-group differences (TRE vs. SDA) in any bone parameter. Among weight loss responders (≥0.6 kg weight loss), the bone resorption marker β-carboxyterminal telopeptide of type I collagen tended to decrease after TRE but increase after SDA (between-group differences p = 0.041), whereas changes in the bone formation marker procollagen type I N-propeptide did not differ between groups. Total body bone mineral content decreased after SDA (p = 0.028) but remained unchanged after TRE (p = 0.31) in weight loss responders (between-group differences p = 0.028). Among nonresponders (<0.6 kg weight loss), there were no between-group differences in bone outcomes.

CONCLUSIONS

TRE had no detrimental impact on bone health, whereas, when weight loss occurred, it was associated with some bone-sparing effects compared with SDA.

Address: Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.; Nutrition Unit, Service of Endocrinology, Diabetes, Nutrition and Therapeutic Education, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.; Institute of Bioengineering, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.; Department of General Internal Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.; Institute of Primary Health Care, University of Bern, Bern, Switzerland.; Salk Institute for Biological Sciences, La Jolla, California, USA.; Interdisciplinary Center for Bone Diseases, Service of Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.; Department of Rheumatology and Immunology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.; Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.; Diabetes Centre, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

DOI: 10.1002/oby.23577