Disappointing study on TRE

[elatedsquirrel]

A disappointing study just came out on time-restricted eating. I know a number of you have said that TRE is helpful with CR.

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2771095

One of the authors has an explanatory twitter thread here:

The disappointing bit is not that it conferred no weight loss advantage, but that it seemed to confer a disadvantage in terms of lean mass loss.

Personally, as someone who uses TRE as part of an "appetite control" strategy, I find this disheartening.

[Todd Allen]

It was a small (105 completed) short (12 weeks) study of overweight and obese patients.   The time restricted eating (TRE) group was instructed to eat ad libitum between the hours of 12-8 PM and self reported 83.5% compliance.  The control group was instructed to eat 3 structured meals daily and reported 92.1% compliance.

Both groups lost a little weight and the TRE group lost a tiny bit more.  The reported downside of the TRE group was a loss of lean mass as measured by DEXA.

I think the results are compromised by relying on self reported compliance without any mechanism to guarantee or even evaluate the accuracy of that important piece of data.  They acknowledge the limitation of DEXA scans which report hydration as lean mass.  They attempted to minimize this by instructing participants to fast for 12 hours before their scan but they don't mention any instruction with regards to fluid intake.  I could easily imagine the group regularly eating breakfast drinking more fluids on their fasted morning before scanning as a way to mellow the hunger signaling of a skipped expected meal.  There were no measurements of strength or physical performance.  They also acknowledge other studies show better effects with an earlier time window, ie eat breakfast and skip dinner or at least eat dinner early but they didn't test that because they thought it would be hard...

My takeaway is if you ask unmotivated fat people to do something easy and they tell you their compliance was only fair don't expect miracles.

[elatedsquirrel]

Hope you're right @Todd Allen. I'm not particularly confident in evaluating scientific articles, especially when I know confirmation bias is always a factor.

[Sibiriak]

23 hours ago, elatedsquirrel said:

as someone who uses TRE as part of an "appetite control" strategy

If it works for you,  why would you care if it didn't work for others in a study,   flawed or not.

(TRE works for me.)

Edited October 19, 2020 by Sibiriak

[Todd Allen]

6 hours ago, Sibiriak said:

On 10/18/2020 at 5:41 AM, elatedsquirrel said:

as someone who uses TRE as part of an "appetite control" strategy

If it works for you,  why would you care if it didn't work for others in a study,   flawed or not.

(TRE works for me.)

I agree.  I suggest if this or any study makes one concerned about their dietary and lifestyle practices they should reconsider how they have been evaluating the results of their choices and see if they can improve their process to have more confidence in what they are achieving.

As someone with a supposedly progressive neuromuscular wasting disease I can say there are much better ways to track changes in muscle than taking a couple  DEXA scans 3 months apart.  A glaring mistake these researchers are making that I see over and over again in other studies is an assumption that a couple data points represents a linear change caused by whatever intervention they are testing.  For most any biometric such as body temperature, weight and medical lab results of medical testing each test result is merely a single point of something that is a complex composite wave influenced by a large number of factors.  Without sampling enough to capture the amplitude and frequencies of the underlying waves our confidence in end point determinations should be low.