Limited Eating Times Could Be a New Way to Fight Obesity and Diabetes
A time-restricted eating plan provides a new way to fight obesity and metabolic diseases that affect millions of people worldwide. RossHelen / iStock / Getty Images Plus
By Satchin Panda and Pam Taub
People with obesity, high blood sugar, high blood pressure or high cholesterol are often advised to eat less and move more, but our new research suggests there is now another simple tool to fight off these diseases: restricting your eating time to a daily 10-hour window.
We are scientists — a cell biologist and a cardiologist — and are exploring the effects of the timing of nutrition on health. Results from flies and mice led us and others to test the idea of time-restricted eating in healthy people. Studies lasting more than a year showed that TRE was safe among healthy individuals. Next, we tested time-restricted eating in patients with conditions known collectively as metabolic syndrome. We were curious to see if this approach, which had a profound impact on obese and diabetic lab rats, can help millions of patients who suffer from early signs of diabetes, high blood pressure and unhealthy blood cholesterol.
A Leap From Prevention to Treatment
It's not easy to count calories or figure out how much fat, carbohydrates and protein are in every meal. That's why using TRE provides a new strategy for fighting obesity and metabolic diseases that affect millions of people worldwide. Several studies had suggested that TRE is a lifestyle choice that healthy people can adopt and that can reduce their risk for future metabolic diseases.
However, TRE is rarely tested on people already diagnosed with metabolic diseases. Furthermore, the vast majority of patients with metabolic diseases are often on medication, and it was not clear whether it was safe for these patients to go through daily fasting of more than 12 hours – as many experiments require – or whether TRE will offer any benefits in addition to those from their medications.
In a unique collaboration between our basic science and clinical science laboratories, we tested whether restricting eating to a 10-hour window improved the health of people with metabolic syndrome who were also taking medications that lower blood pressure and cholesterol to manage their disease.
We recruited patients from UC San Diego clinics who met at least three out of five criteria for metabolic syndrome: obesity, high blood sugar, high blood pressure, high level of bad cholesterol and low level of good cholesterol. The patients used a research app called myCircadianClock, developed in our lab, to log every calorie they consumed for two weeks. This helped us to find patients who were more likely to spread their eating out over the span of 14 hours or more and might benefit from 10-hour TRE.
We monitored their physical activity and sleep using a watch worn on the wrist. As some patients with bad blood glucose control may experience low blood glucose at night, we also placed a continuous glucose monitor on their arm to measure blood glucose every few minutes for two weeks.
Nineteen patients qualified for the study. Most of them had already tried standard lifestyle interventions of reducing calories and doing more physical activity. As part of this study, the only change they had to follow was to self-select a window of 10 hours that best suited their work-family life to eat and drink all of their calories, say from 9 a.m. to 7 p.m. Drinking water and taking medications outside this window were allowed. For the next 12 weeks they used the myCircadianClock app, and for the last two weeks of the study they also had the continuous glucose monitor and activity monitor.
Timing Is the Medicine
After 12 weeks, the volunteers returned to the clinic for a thorough medical examination and blood tests. We compared their final results with those from their initial visit. The results, which we published in Cell Metabolism, were pleasantly surprising. We found most of them lost a modest amount of body weight, particularly fat from their abdominal region. Those who had high blood glucose levels when fasting also reduced these blood sugar levels. Similarly, most patients further reduced their blood pressure and LDL cholesterol. All of these benefits happened without any change in physical activity.
Reducing the time window of eating also had several inadvertent benefits. On average, patients reduced their daily caloric intake by a modest 8%. However, statistical analyses did not find strong association between calorie reduction and health improvement. Similar benefits of TRE on blood pressure and blood glucose control were also found among healthy adults who did not change caloric intake.
Nearly two-thirds of patients also reported restful sleep at night and less hunger at bedtime – similar to what was reported in other TRE studies on relatively healthier cohorts. While restricting all eating to just a six-hour window was hard for participants and caused several adverse effects, patients reported they could easily adapt to eating within a 10-hour span. Although it was not necessary after completion of the study, nearly 70% of our patients continued with the TRE for at least a year. As their health improved, many of them reported having reduced their medication or stopped some medication.
Despite the success of this study, time-restricted eating is not currently a standard recommendation from doctors to their patients who have metabolic syndrome. This study was a small feasibility study; more rigorous randomized control trials and multiple location trials are necessary next steps. Toward that goal, we have started a larger study on metabolic syndrome patients.
Although we did not see any of our patients go through dangerously low levels of glucose during overnight fasting, it is important that time-restricted eating be practiced under medical supervision. As TRE can improve metabolic regulation, it is also necessary that a physician pays close attention to the health of the patient and adjusts medications accordingly.
We are cautiously hopeful that time-restricted eating can be a simple, yet powerful approach to treating people with metabolic diseases.
Satchin Panda is a professor of regulatory biology at the Salk Institute for Biological Studies, and an adjunct professor of cell and developmental biology at UCSD, University of California San Diego.
Pam Taub is an associate professor of Medicine at the University of California San Diego
Disclosure statement: Satchin Panda receives funding from the National Institute of Health, Department of Defense, Federal Emergency Management Agency, Helmsley Charitable trust, Robertwood Johnson Foundation, and Glenn Foundation for Medical Research. He is the author of the book "The Circadian Code" for which he receives author royalty. Satchin Panda is a founding member of the Center for Circadian Biology at UC San Diego.
Pam Taub receives funding from NIDDK, American Heart Association, Department of Defense.
Reposted with permission from The Conversation.
By Karen L. Smith-Janssen
Colette Pichon Battle gave a December 2019 TEDWomen Talk on the stark realities of climate change displacement, and people took notice. The video racked up a million views in about two weeks. The attorney, founder, and executive director of the Gulf Coast Center for Law & Policy (GCCLP) advocates for climate justice in communities of color. Confronted with evidence showing how her own South Louisiana coastal home of Bayou Liberty will be lost to flooding in coming years, the 2019 Obama Fellow dedicates herself to helping others still reeling from the impacts of Katrina face the heavy toll that climate change has taken—and will take—on their lives and homelands. Her work focuses on strengthening multiracial coalitions, advocating for federal, state, and local disaster mitigation measures, and redirecting resources toward Black communities across the Gulf South.
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"These are not just wildfires, they are climate fires," Jay Inslee, Governor of Washington State, said as he stood amid the charred remains of the town of Malden west of Seattle earlier this month. "This is not an act of God," he added. "This has happened because we have changed the climate of the state of Washington in dramatic ways."
'These Aren't Wildfires'<p>Sam Ricketts, who led climate policy and strategy for Governor Jay Inslee's 2020 presidential campaign, tweeted on September 11 that "These aren't wildfires. These are #climatefires, driven by fossil fuel pollution."</p><p>"The rate and the strength and the devastation wrought by these disasters are fueled by climate change," Ricketts told DW of fires that have burnt well over 5 million acres across California, Oregon, Washington State, and into neighboring Idaho. </p><p>In a two-day period in early September, Ricketts notes that more of Washington State burned than in almost any entire fire season until now, apart from 2015. </p><p>California, meanwhile, was a tinderbox after its hottest summer on record, with temperatures in Death Valley reaching nearly 130 degrees Fahrenheit, according to the U.S. National Weather Service. It has been reported as the hottest temperature ever measured on Earth.</p>
<div id="29ad9" class="rm-shortcode" data-rm-shortcode-id="8346fe7350e1371d400097cd48bf45a2"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1306969603180879872" data-partner="rebelmouse"><div style="margin:1em 0">Drought-parched wetlands in South America have been burning for weeks. https://t.co/pjAKdFcKPg #Pantanal https://t.co/ImN2C5vwcp</div> — NASA Earth (@NASA Earth)<a href="https://twitter.com/NASAEarth/statuses/1306969603180879872">1600440810.0</a></blockquote></div><p>As evidenced by Australia's apocalyptic Black Summer of 2019-2020, fires are burning bigger and for longer, with new records set year-on-year. Right now, Brazil's vast and highly biodiverse Pantanal wetlands are suffering from catastrophic fires.</p>
#climatefires Started in Australia<p>Governor Inslee this month invoked the phrase climate fires for arguably the first time in the U.S., according to Ricketts.</p><p>But the term was also used as fires burnt out of control in Australia in late 2019. In the face of a 2000km (more than 1,200 miles) fire front, and government officials and media who <a href="https://www.dw.com/en/trump-climate-change-denial-emissions-environment-germany-fake-heartland-seibt/a-52688933" target="_blank">played down the link to climate change</a>, Greens Party Senator Sarah Hanson-Young and a friend decided that reference to bushfires was inadequate. </p><p>"We both just said, we've got to start calling them climate fires, that's what they are," the Australian Senator told DW.</p><p>Hanson-Young says scientists have been warning for decades that these would be the effects of global heating. "We've been told these kinds of extreme weather events and destruction is what climate change would look like, and it's right here on our doorstep," she said from her home state of South Australia — where by early September fire warnings had already been issued.</p><p>"Calling them climate fires was making it absolutely crystal clear. It is essential that there's no ambiguity," she said </p><p>Having deliberately invoked the term, Hanson-Young soon started to push it on social media via a #climatefires hashtag. </p>
How to Talk About the Urgency of Global Heating<p>The need to use more explicit language when talking about extreme weather events linked to climate change is part of a broader push to express the urgency of global heating. In 2019, activist Greta Thunberg tweeted that the term "climate change" did not reflect the seriousness of the situation. </p><p>"Can we all now please stop saying 'climate change' and instead call it what it is: climate breakdown, climate crisis, climate emergency, ecological breakdown, ecological crisis and ecological emergency?" she wrote. </p><p>"Climate change has for a long time been talked about as something that is a danger in the future," said Hansen-Young. "But the consequences are already here. When people hear the word crisis, they understand that something has to happen, that action has to be taken."</p><p><span></span>Some terms are now used in public policy, with state and national governments, and indeed the EU Parliament, declaring an official climate emergency in the last year. </p>
Words That Reflect the Science<p>But while the West Coast governors all fervently link the fires to an unfolding climate crisis, U.S. President Donald Trump continues to avoid any reference to climate. In a briefing about the fires, he responded to overtures by Wade Crowfoot, California's Natural Resources Secretary, to work with the states on the climate crisis by stating: "It'll start getting cooler. You just watch." Crowfoot replied by saying that scientists disagreed. Trump rejoined with "I don't think science knows, actually." </p><p>It was reminiscent of the anti-science approach to the coronavirus pandemic within the Trump administration, <a href="https://www.dw.com/en/donald-trump-admits-playing-down-coronavirus-risks/a-54874350" target="_blank" rel="noopener noreferrer">at least publicly</a>. Fossil fuel companies are also benefiting from his disavowal of climate science, with the Trump administration having <a href="https://www.dw.com/en/opinion-trumps-paris-climate-accord-exit-isnt-really-a-problem/a-51124958" target="_blank" rel="noopener noreferrer">pulled out of the Paris Agreement</a> and reopened fossil fuel infrastructure like the Keystone XL pipeline. </p><p>But the science community has responded, with Scientific American magazine endorsing Trump's Democratic presidential challenger Joe Biden, the first presidential endorsement in its 175-year history. </p><p>Hanson-Young says the use of explicit language like climate fires has also been important in Australia due to the climate denialism of politicians and the press, especially in publications owned by Rupert Murdoch. As fires burnt out much of Australia's southeast coast, they were commonly blamed on arson — a tactic also recently used in the U.S.</p>
Climate Rhetoric Could Help Decide Election<p>The language of climate has begun to influence the U.S. presidential election campaign, with Democratic nominee Joe Biden labelling President Trump a "climate arsonist."</p><p>Biden is touting a robust climate plan that includes a 2050 zero emissions target and a return to the Paris Agreement. Though lacking the ambition of The New Green Deal, it has been front and center of his policy platform in recent days, at a time when five hurricanes are battering the U.S. Gulf Coast while smoke blanketing the West Coast spreads all the way to the East. </p><p>People are experiencing the climate crisis in a visceral way and almost universally relate to the language of an emergency, says Ricketts. "They know something is wrong."</p>
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