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.
After decades on the political periphery, the climate movement is entering the mainstream in 2020, with young leaders at the fore. The Sunrise Movement now includes more than 400 local groups educating and advocating for political action on climate change. Countless students around the world have clearly communicated what's at stake for their futures, notably Swedish activist Greta Thunberg, who just finished her yearlong school strike for climate. Youth activists have been praised for their flexible, big-picture thinking and ability to harness social media to deliver political wins, as Sunrise recently did for U.S. Sen. Ed Markey's primary campaign. They necessarily challenge the status quo.
A Convergence of Issues<p>The unequal impacts of a changing climate have become extremely clear in 2020, so equity has come to the fore of climate conversations in every corner of the country. A global deadly pandemic continues to rage out of control in the U.S., heat waves are setting new temperature records, wildfires are scorching American Western states, and the hurricane season has already made it to the end of the alphabet for naming storms. In all cases, low-income, Black, Latinx, and Indigenous communities are bearing a disproportionate amount of the impacts.</p><p>"Today, the scab is off, the ugly reality of injustice is hitting us up close and personal, made more realistic by this COVID pandemic," Bullard says.</p><p>This year the decidedly youthful focus on intersectionality is a big part of what defines the transformation of the climate movement. Climate is not just an environmental issue, according to youth activists. It's also a racial justice issue, an economic issue, and an access-to-health care issue.</p><p>"Environmental justice is really seeing the intersection of these issues," says Alex Rodriguez, a community organizer with the Connecticut League of Conservation Voters, which aims to make environmental issues a priority for the state's elected leaders. The group is now focusing their efforts on the coming election and recently succeeded in persuading the state to allow absentee voting in November. "We want people to be safe when casting their vote," says Rodriguez, 26, whose fellow grassroots committee members range from age 16 to 60.</p><p>Rodriguez, who also serves on the equity and environmental justice working group for the Governor's Council on Climate Change, says, "We see our programmatic work as a way to help lawmakers see what they can do to improve the dignity of those suffering from environmental racism, systematic racism, and economic oppression."</p><p>Seeing the overlap and bringing these issues together is a strength that Bullard says was missing from the civil rights organizing he was involved with in the 1960s. He says 2020 is unique in many ways.</p><p>"The number of marchers is unprecedented, from different economic, ethnic, and racial groups—an awakening unlike any that I've seen on this Earth in over 70 years," Bullard says. "Today, the different movements are converging, and I think that convergence makes for greater potential for success."</p>
Young and Old<p>But young people are one essential demographic among many when it comes to climate action. With all that's on the line for climate in the coming elections, up and down the ballot, collaboration becomes key. Bullard says previous generations of climate activists can now play the critical role of mentoring, assisting, and supporting. Standing with, not in front of, youth.</p><p>"Youth are leading us and taking on frontline activity," says Jayce Chiblow, the community engagement lead for Indigenous Climate Action, a Canadian organization that works for Indigenous-led climate justice solutions. But in doing so, she says many young Indigenous activists are experiencing the trauma of violence, getting arrested, and being taken away from their land. "All of our older people are supporting those youth: Elders, mentors, people trained in nonviolent action," Chiblow says. "The youth aren't alone."</p><p>That support can go a long way. "There's a lot of anger and a lot of fear, and that's understandable," says Wazer of Sunrise Connecticut. "I definitely feel those things, too, just considering the ways that our future has been threatened and kind of trashed by older generations."</p><p>Under the Trump administration, the number of environmental rollbacks alone can be disheartening, not to mention new <a href="https://www.yesmagazine.org/video/arctic-national-wildlife-refuge/" target="_blank">drilling permits in the Alaska National Wildlife Refuge going up for auction</a>.</p><p>Wazer is frank about the risks of burnout, depression, and anxiety from the stress of it all, but draws inspiration from the example of the late U.S. representative and lifelong civil rights activist John Lewis. "That forgiveness and that ability to keep fighting and stay motivated … I think that that is something really powerful to learn from older generations."</p><p>An intergenerational approach can leverage the individual strengths of youth and older people in all their diversity.</p><p>"The elders hold our stories," says Chiblow, who is Anishinaabe from Garden River First Nation, Ontario. Those stories include lived experiences, culture, history, and generations of adapting to changes in climate. Such collective experience continues to inform Indigenous knowledge and connections to the land, as well as how people manage and govern themselves in relation to it. This knowledge is passed on through relationship-building and storytelling.</p><p>"Every time you hear that story, you're at a different point in your life, and you'll pick up something else … something new," Chiblow says.</p><p>Changes in perspectives that come with time and experience are among the reasons why intergenerational learning and coalitions are critical to the climate movement. To combine that living and learning is to expand the reach and meaning of the message exponentially. As part of her research for her master's degree, Chiblow brought together youth, community leaders, and knowledge keepers in her community to workshop climate action. "Those relationships are vital to keep that movement going," Chiblow says.</p>
The Unique Value Proposition of Elders<p>Older activists bring unique strengths to the table, according to gerontologist Mick Smyer, who designs strategies to move people from anxiety to action on climate. He calls himself "the aging whisperer to climate groups" and "the climate whisperer to aging groups." He is quick to point out that the learning can go in both directions.</p><p>"I think older adults are untapped resources," Smyer says. "Older adults bring several resources, one of which is their circles of influence. Just by virtue of having lived longer, older adults are going to have denser and richer networks," Smyer says. "The second is, when it comes to voting and civic engagement, older adults, as an age group, outperform all other age groups."</p><p>He uses the 2016 presidential election to illustrate his point: "The older age groups, 70% of them voted. Nobody [else] came close." He is cautious about making sweeping statements about older people broadly, but he says that ageism is alive and well. And that can deter the kind of collaboration that would beget necessary progress on climate action.</p><p>As the twin global patterns of an aging population and a changing climate continue arm in arm, Smyer says a good place for starting this work is within one's family.</p><p>"We each have that power to use in our circles of influence, particularly in our families, and we don't realize it," Smyer says. Whether it's via Zoom or FaceTime or a phone call or a chat in the living room, Smyer says, family members have a superpower: They will listen to each other, and they'll at least start the conversation.</p><p> "Intergenerational collaboration around climate issues, particularly in this election season, starts at home, and then goes to the polling booth," he says.</p>
Speaking the Same Language<p>As an individual's network of family, friends, and connections becomes wider and more diverse, the more work will need to be done to have them all working toward the same goals. That is equally true for the climate movement at large.</p><p>In bridging the gaps among baby boomers, Gen Xers, and millennials, Bullard says, "Each generation will have some idiosyncrasy and uniqueness about it that another generation will not understand or comprehend."</p><p>If everybody in a group or institution is similar, then there's no need to explain a lot, Bullard says. There's usually a fair amount of shared knowledge and values. But the more diverse that group gets, in age, race, gender, or culture, he says, the greater the potential for making mistakes, stepping on people's culture, and causing pain. But the potential for learning also increases exponentially.</p><p>Chiblow says successful collaboration comes down to being able to speak in shared concepts. The term "justice," for example, is an English word that's hard to translate into the Anishinaabe language. Chiblow says that because her community sees itself as belonging to the land, and being part of the land, the Anishinaabe worldview, and therefore their understanding of justice, is necessarily more holistic than the mainstream.</p><p>"Indigenous people have been feeling [the effects of climate change] for so long," Chiblow says. Today, as wildfires rage across the West, the mantra of "I can't breathe" is being driven home on a grand scale. For better and worse, climate justice is finally a front-page story.</p><p>"It's affecting the broader society," Chiblow says. "We're finally at the turning point where we could start to make real change because … people are really starting to feel that urgency."</p><p>The urgency will be tantamount in the coming election. A lot is at stake, says Chiblow: "Incentives, funding, all-around agreement, and also the way we're able to manage our lands and ourselves as people."</p><p>Bullard, too, is insistent on urgency. "This election is one of the most important elections of a generation, because there's so many things at stake," he says. "We can't wait another 40 years on climate. We don't have that much time. We don't have 40 years to get justice."</p><p>Issues of climate justice will be on the ballot in state and local elections this fall, such as Nevada's proposed renewable energy standards and Louisiana's proposed disaster funding. And the topic has finally made it onto the national stage. Joe Biden called Trump a "climate arsonist" for not acting on or even admitting that the wildfires in California are clearly climate-related. The frequency and intensity of such disasters is indisputable.</p><p>"Hurricanes don't swerve to avoid red states or blue states. Wildfires don't skip towns that voted a certain way," Biden <a href="https://abcnews.go.com/Politics/biden-address-west-coast-fires-confront-growing-threat/story?id=73000218" target="_blank">said in a speech on Sept. 14</a>. "The impacts of climate change don't pick and choose. That's because it's not a partisan phenomenon."</p><p>In many ways, the results of the upcoming elections will reflect the ways youth activists and older activists are able come to a common understanding of what climate justice means and what they want the future world to look like. </p><p>"There's a lot of knowledge built up in experience, and there's a lot of energy that's stored in young people," Bullard says. "When you put those two together, you have … an excellent recipe for potential success."</p>
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By Simon Montlake
For more than a decade, Susan Jane Brown has been battling to stop a natural gas pipeline and export terminal from being built in the backcountry of Oregon. As an attorney at the nonprofit Western Environmental Law Center, she has repeatedly argued that the project's environmental, social, and health costs are too high.
All that was before this month's deadly wildfires in Oregon shrouded the skies above her home office in Portland. "It puts a fine point on it. These fossil fuel projects are contributing to global climate change," she says.
Moderates Feeling the Heat<p>If elected, Mr. Biden has vowed to stop new drilling for oil and gas on federal land and in federal waters and to rejoin the 2015 Paris climate accord that President Donald Trump gave notice of quitting. He would reinstate Obama-era regulations of greenhouse gas emissions, including methane, the largest component of natural gas.</p><p>The Biden climate platform also states that all federal infrastructure investments and federal permits would need to be assessed for their climate impacts. Analysts say such a test could impede future LNG plants and pipelines, though not those that already have federal approval. </p><p>Climate change activists who pushed for that language say much depends on who would have oversight of federal agencies that regulate the industry. Some are wary of Biden's reliance on advice from Obama-era officials, including former Energy Secretary Ernest Moniz, who is now on the board of Southern Company, a utility, and a former Obama environmental aide, Heather Zichal, who has served on the board of Cheniere Energy, an LNG exporter. </p>
The Push for U.S. Fuel Exports<p>As vice president, Biden was part of an administration that pushed hard for global climate action while also promoting U.S. oil and gas exports to its allies and trading partners. As fracking boomed, Obama ended a 40-year ban on crude oil exports. In Europe, LNG was touted both as an alternative to coal and as strategic competition with Russian pipelines.</p><p>That much, at least, continued with President Trump. Under Energy Secretary Rick Perry, the agency referred to liquified U.S. hydrocarbons as "<a href="https://www.nytimes.com/2019/05/29/us/freedom-gas-energy-department.html" target="_blank">freedom gas</a>."</p><p>Mr. Trump has also championed the interests of coal, oil, and gas while denigrating the findings of government climate scientists. He rejected the Paris accord as unfair to the U.S. and detrimental to its economy, but has offered no alternative path to emissions cuts. </p><p>Still, Trump's foreign policy has not always served the LNG industry: Tariffs on foreign steel drove up pipeline costs, and a trade war with China stayed the hand of Chinese LNG importers wary of reliance on U.S. suppliers. </p><p>Even his regulatory rollbacks could be a double-edged sword. By relaxing curbs last month on methane leaks, the U.S. has ceded ground to European regulators who are drafting emissions standards that LNG producers are watching closely. "That's a precursor of fights that will be fought in all the rest of the developed world," says Mr. Hutchison. </p><p>Indeed, some oil-and-gas exporters had urged the Trump administration not to abandon the tougher rules, since they undercut their claim to offer a cleaner-burning way of producing heat and electricity. "U.S. LNG is not going to be able to compete in a world that's focused on methane emissions and intensity," says Erin Blanton, a senior research scholar at the Center on Global Energy Policy at Columbia University. </p>
Stepping on the Gas<p>In July, the Department of Energy issued an export license to Jordan Cove's developer, Canada's Pembina Pipeline Corp. In a statement, Energy Secretary Dan Brouillette said the project would provide "reliable, affordable, and cleaner-burning natural gas to our allies around the world."</p><p>As a West Coast terminal, Jordan Cove offers a faster route to Asia where its capacity of 7.8 million tons of LNG a year could serve to heat more than 15 million homes. At its peak, its construction would also create 6,000 jobs, the company says, in a stagnant corner of Oregon.</p><p>But the project still lacks multiple local and state permits, and its biggest asset – a Pacific port – has become its biggest handicap, says Ms. Blanton. "They are putting infrastructure in a state where there's no political support for the pipeline or the terminal, unlike in Louisiana or Texas," she says. </p><p>Ms. Brown, the environmental lawyer, says she wants to see Jordan Cove buried, not just mothballed until natural gas prices recover. But she knows that it's only one among many LNG projects and that others will likely get built, even if Biden is elected in November, despite growing evidence of the harm caused by methane emissions. </p>
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The connection between the pandemic and our dietary habits is undeniable. The stress of isolation coupled with a struggling economy has caused many of us to seek comfort with our old friends: Big Mac, Tom Collins, Ben and Jerry. But overindulging in this kind of food and drink might not just be affecting your waistline, but could potentially put you at greater risk of illness by hindering your immune system.
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