A Comprehensive Systematic Review of The Association between Time-Restricted Feeding and Metabolic Parameters in Obese Patients
Keywords:
Time-restricted feeding, intermittent fasting, obesity, metabolic parameters, weight loss, glycemic control, calorie restrictionAbstract
Introduction: Time-restricted feeding (TRF) has emerged as a popular dietary strategy for obesity management, yet its metabolic effects beyond caloric restriction remain debated. This systematic review synthesizes evidence from randomized controlled trials examining associations between TRF and metabolic parameters in obese patients.
Methods: We systematically screened studies based on predefined criteria: obese participants (BMI ≥30 kg/m²), TRF interventions (4-12h eating windows), reporting of metabolic parameters, comparison groups, adult participants (≥18 years), intervention duration ≥2 weeks, and peer-reviewed publications. Data extraction encompassed study design, TRF protocols, population characteristics, control comparisons, and metabolic outcomes including weight, glycemic control, lipid profiles, blood pressure, and safety parameters.
Results: Eighty studies with 6,847 participants were included. TRF produced weight loss of 2-8 kg over 8-12 weeks, equivalent to continuous calorie restriction in 12-month trials (between-group differences -1.8 to 0.81 kg, P>0.05). However, TRF was associated with significant lean mass loss (-0.59 kg, 95% CI -1.15 to -0.03), particularly with 4-6h windows. In type 2 diabetes, TRF reduced HbA1c by 0.7-1.54% (P<0.001) and enabled medication reductions. Hepatic steatosis decreased by 6.9-25.8% in NAFLD patients. Isocaloric studies demonstrated no metabolic advantages when calories were controlled. Early versus late TRF showed comparable effects in rigorous trials. Adherence ranged from 81-91%, with shorter windows achieving greater weight loss but poorer lean mass preservation.
Discussion: TRF's metabolic benefits are primarily mediated through spontaneous caloric reduction (300-550 kcal/day) rather than circadian mechanisms. While effective for weight loss and glycemic control in metabolically compromised populations, concerns regarding lean mass loss warrant consideration. TRF should be positioned as a practical alternative to traditional calorie restriction, particularly for individuals preferring simple dietary rules over daily calorie counting.
Conclusion: TRF produces clinically meaningful metabolic improvements equivalent to continuous calorie restriction, with effects driven by reduced energy intake. Optimal protocols should prioritize protein adequacy and resistance training to preserve lean mass. Long-term safety and sustainability require further investigation.
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