Time-restricted eating offers no additional benefits in adults with obesity, NAFLD

Time-restricted eating (TRE) does not appear to be more effective than daily calorie restriction (DCR) in terms of improving intrahepatic triglyceride content, body fat, and metabolic risk factors for adults with obesity and nonalcoholic fatty liver disease (NAFLD), according to a study.

A total of 88 participants with obesity and NAFLD (mean age 32.0 years, 56 percent male, mean body mass index 32.2 kg/m²) were randomly assigned to undergo TRE (eating only between 8:00 am and 4:00 pm; n=45) or DCR (habitual meal timing; n=43) for 12 months. At the same time, all of the participants were instructed to maintain a diet of 1,500–1,800 kcal/d for men and 1,200–1,500 kcal/d for women for 12 months.

The main endpoint was change in intrahepatic triglyceride content, measured using magnetic resonance imaging. Secondary endpoints included changes in body weight, waist circumference, body fat, and metabolic risk factors.

Intention-to-treat analysis showed that the intrahepatic triglyceride content decreased by 8.3 percent (95 percent confidence interval [CI], −10.0 to −6.6) in the TRE group and by 8.1 percent (95 percent CI, −9.8 to −6.4) in the DCR group at the 6-month assessment, and then by 6.9 percent  (95 percent CI, −8.8 to −5.1) and 7.9 percent (95 percent CI, −9.7 to −6.2), respectively, at the 12-month assessment.

The differences in intrahepatic triglyceride content between the TRE and DCR groups were not statistically significant at both 6 months (percentage point difference: −0.2, 95 percent CI, −2.7 to 2.2; p=0.86) and 12 months (percentage point difference: 1.0, 95 percent CI, −1.6 to 3.5; p=0.45).

Moreover, the reductions in liver stiffness, body weight, and metabolic risk factors were significant and comparable in the two groups.