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Original Article

Calorie Restriction with or without Time-Restricted Eating in Weight Loss

List of authors.
  • Deying Liu, M.D.,
  • Yan Huang, M.S.,
  • Chensihan Huang, M.D.,
  • Shunyu Yang, M.D.,
  • Xueyun Wei, M.D.,
  • Peizhen Zhang, M.D.,
  • Dan Guo, M.D.,
  • Jiayang Lin, M.D.,
  • Bingyan Xu, M.D.,
  • Changwei Li, Ph.D.,
  • Hua He, Ph.D.,
  • Jiang He, M.D., Ph.D.,
  • Shiqun Liu, M.D.,
  • Linna Shi, M.D.,
  • Yaoming Xue, M.D.,
  • and Huijie Zhang, M.D., Ph.D.

Abstract

Background

The long-term efficacy and safety of time-restricted eating for weight loss are not clear.

Methods

Download a PDF of the Research Summary.

We randomly assigned 139 patients with obesity to time-restricted eating (eating only between 8:00 a.m. and 4:00 p.m.) with calorie restriction or daily calorie restriction alone. For 12 months, all the participants were instructed to follow a calorie-restricted diet that consisted of 1500 to 1800 kcal per day for men and 1200 to 1500 kcal per day for women. The primary outcome was the difference between the two groups in the change from baseline in body weight; secondary outcomes included changes in waist circumference, body-mass index (BMI), amount of body fat, and measures of metabolic risk factors.

Results

Of the total 139 participants who underwent randomization, 118 (84.9%) completed the 12-month follow-up visit. The mean weight loss from baseline at 12 months was −8.0 kg (95% confidence interval [CI], −9.6 to −6.4) in the time-restriction group and −6.3 kg (95% CI, −7.8 to −4.7) in the daily-calorie-restriction group. Changes in weight were not significantly different in the two groups at the 12-month assessment (net difference, −1.8 kg; 95% CI, −4.0 to 0.4; P=0.11). Results of analyses of waist circumferences, BMI, body fat, body lean mass, blood pressure, and metabolic risk factors were consistent with the results of the primary outcome. In addition, there were no substantial differences between the groups in the numbers of adverse events.

Conclusions

Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily calorie restriction. (Funded by the National Key Research and Development Project [No. 2018YFA0800404] and others; ClinicalTrials.gov number, NCT03745612.)

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Time-Restricted Eating for Weight Loss
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Funding and Disclosures

Supported by a grant (2018YFA0800404) from the National Key Research and Development Project; a grant (2017J005) from the Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University; a grant (LC2019ZD010) from the Key-Area Clinical Research Program of Southern Medical University; a grant (2019B020227004) from the Key-Area Research and Development Program of Guangdong Province; and a grant (81970736) from the National Natural Science Foundation of China.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

Dr. Liu, Ms. Huang, and Drs. Huang, Yang, and H. Zhang contributed equally to this article.

A data sharing statement provided by the authors is available with the full text of this article at NEJM.org.

We thank all trial staff and the trial participants, as well as nutritionists Haibin Dai, Yatong Lie, and Xinmiao Wu at Zhejiang Nutriease.

Author Affiliations

From the Department of Endocrinology and Metabolism (D.L., Y.H., C.H., X.W., P.Z., D.G., J.L., B.X., S.L., Y.X., H.Z.) and the Department of Nutrition (S.Y., L.S.), Nanfang Hospital, Southern Medical University, Guangzhou, China; and the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans (C.L., H.H., J.H.).

Dr. Zhang can be contacted at or at the Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangdong Provincial Key Laboratory of Shock and Microcirculation, State Key Laboratory of Organ Failure Research, 1838 North Guangzhou Ave., Guangzhou 510515, China.

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