CoChat
Sign Up
Cited by 597Dietary Effects on HealthDiet and metabolism studiesNutritional Studies and Diet

Effects of 4- and 6-h Time-Restricted Feeding on Weight and Cardiometabolic Health: A Randomized Controlled Trial in Adults with Obesity

Open access
Cienfuegos, Sofia, Gabel, Kelsey, Kalam, Faiza, Ezpeleta, Mark, Wiseman, Eric, Pavlou, Vasiliki, Lin, Shuhao, Oliveira, Manoela Lima +1 more·2020·Cell Metabolism
DOI 10.1016/j.cmet.2020.06.018PMC PMC9407646
Open this paper in CoChat — free accountOpen PDF

Abstract

Time-restricted feeding (TRF) regimens have grown in popularity; however, very few studies have examined their weight-loss efficacy. We conducted the first human trial (Clinicaltrials.gov NCT03867773) to compare the effects of two popular forms of TRF (4 and 6 h) on body weight and cardiometabolic risk factors. Adults with obesity were randomized to 4-h TRF (eating only between 3 and 7 p.m.), 6-h TRF (eating only between 1 and 7 p.m.), or a control group (no meal timing restrictions). After 8 weeks, 4- and 6-h TRF produced comparable reductions in body weight (∼3%), insulin resistance, and oxidative stress, versus controls. Energy intake was reduced by ∼550 kcal/day in both TRF groups, without calorie counting. These findings suggest that 4- and 6-h TRF induce mild reductions in body weight over 8 weeks and show promise as interventions for weight loss. These diets may also improve some aspects of cardiometabolic health.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.cmet.2020.06.018

Cites

11 of 11 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Recent human trials on TRE have highlighted numerous beneficial metabolic effects of TRE, e.g., improved mean daily glucose levels, fasting glucose levels, insulin resistance or insulin sensitivity, triglyceride levels, total cholesterol, and LDL cholesterol levels.

    “Recent human trials on TRE have highlighted numerous beneficial metabolic effects of TRE, e.g., improved mean daily glucose levels (107, 108), fasting glucose levels (108–110), insulin resistance (108, 110, 111) or insulin sensitivity (112, 113), triglyceride levels (107, 109, 114, 115), total cholesterol (115, 116), and LDL cholesterol levels (116).”

    From Meal timing and its role in obesity and associated diseases (2024) · cites this paper as [111]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 46

  1. Antoni R, Johnston KL, Collins AL, and Robertson MD (2018). Intermittent v. continuous energy restriction: differential effects on postprandial glucose and lipid metabolism following matched weight loss in overweight/obese participants. Br J Nutr 119, 507– 516. 29508693
  2. Bhutani S, Klempel MC, Kroeger CM, Trepanowski JF, and Varady KA (2013). Alternate day fasting and endurance exercise combine to reduce body weight and favorably alter plasma lipids in obese humans. Obesity (Silver Spring) 21, 1370– 1379. 23408502
  3. Bowen J, Brindal E, James-Martin G, and Noakes M (2018). Randomized Trial of a High Protein, Partial Meal Replacement Program with or without Alternate Day Fasting: Similar Effects on Weight Loss, Retention Status, Nutritional, Metabolic, and Behavioral Outcomes. Nutrients 10. PMC6165084 30142886
  4. Carlson O, Martin B, Stote KS, Golden E, Maudsley S, Najjar SS, Ferrucci L, Ingram DK, Longo DL, Rumpler WV, (2007). Impact of reduced meal frequency without caloric restriction on glucose regulation in healthy, normal-weight middle- aged men and women. Metabolism 56, 1729– 1734. 17998028 PMC2121099
  5. Catenacci VA, Pan Z, Ostendorf D, Brannon S, Gozansky WS, Mattson MP, Martin B, MacLean PS, Melanson EL, and Troy Donahoo W (2016). A randomized pilot study comparing zero-calorie alternate-day fasting to daily caloric restriction in adults with obesity. Obesity (Silver Spring) 24, 1874– 1883. 27569118 PMC5042570
  6. Chowdhury EA, Richardson JD, Gonzalez JT, Tsintzas K, Thompson D, and Betts JA (2019). Six Weeks of Morning Fasting Causes Little Adaptation of Metabolic or Appetite Responses to Feeding in Adults with Obesity. Obesity (Silver Spring) 27, 813– 821. 30925197 PMC6519370
  7. Dansinger ML, Gleason JA, Griffith JL, Selker HP, and Schaefer EJ (2005). Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 293, 43– 53. 15632335
  8. Dhurandhar EJ, Dawson J, Alcorn A, Larsen LH, Thomas EA, Cardel M, Bourland C, Astrup A, St-Onge MP, Hill JO, (2014). The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial. Am J Clin Nutr 100, 507– 513. 24898236 PMC4095657
  9. Eshghinia S, and Mohammadzadeh F (2013). The effects of modified alternate-day fasting diet on weight loss and CAD risk factors in overweight and obese women. J Diabetes Metab Disord 12, 4. 23497604 PMC3598220
  10. Gabel K, Hoddy KK, Burgess HJ, and Varady KA (2019a). Effect of 8-h time-restricted feeding on sleep quality and duration in adults with obesity. Appl Physiol Nutr Metab 44, 903– 906. 30802152
  11. Gabel K, Hoddy KK, Haggerty N, Song J, Kroeger CM, Trepanowski JF, Panda S, and Varady KA (2018). Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: A pilot study. Nutr Healthy Aging 4, 345– 353. 29951594 PMC6004924
  12. Gabel K, Hoddy KK, and Varady KA (2019b). Safety of 8-h time restricted feeding in adults with obesity. Appl Physiol Nutr Metab 44, 107– 109. 30216730
  13. Gabel K, Kroeger CM, Trepanowski JF, Hoddy KK, Cienfuegos S, Kalam F, and Varady KA (2019c). Differential Effects of Alternate-Day Fasting Versus Daily Calorie Restriction on Insulin Resistance. Obesity (Silver Spring) 27, 1443– 1450. 31328895 PMC7138754
  14. Gayoso-Diz P, Otero-Gonzalez A, Rodriguez-Alvarez MX, Gude F, Garcia F, De Francisco A, and Quintela AG (2013). Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study. BMC Endocr Disord 13, 47. 24131857 PMC4016563
  15. Geliebter A, Astbury NM, Aviram-Friedman R, Yahav E, and Hashim S (2014). Skipping breakfast leads to weight loss but also elevated cholesterol compared with consuming daily breakfasts of oat porridge or frosted cornflakes in overweight individuals: a randomised controlled trial. J Nutr Sci 3, e56. 26101624 PMC4473164
  16. Goris AH, Westerterp-Plantenga MS, and Westerterp KR (2000). Undereating and underrecording of habitual food intake in obese men: selective underreporting of fat intake. Am J Clin Nutr 71, 130– 134. 10617957
  17. Heilbronn LK, Civitarese AE, Bogacka I, Smith SR, Hulver M, and Ravussin E (2005). Glucose tolerance and skeletal muscle gene expression in response to alternate day fasting. Obes Res 13, 574– 581. 15833943
  18. Hoddy KK, Bhutani S, Phillips SA, and Varady KA (2016). Effects of different degrees of insulin resistance on endothelial function in obese adults undergoing alternate day fasting. Nutr Healthy Aging 4, 63– 71. 28035343 PMC5166513
  19. Hoddy KK, Kroeger CM, Trepanowski JF, Barnosky A, Bhutani S, and Varady KA (2014). Meal timing during alternate day fasting: Impact on body weight and cardiovascular disease risk in obese adults. Obesity (Silver Spring) 22, 2524– 2531. 25251676
  20. Hutchison AT, Liu B, Wood RE, Vincent AD, Thompson CH, O’Callaghan NJ, Wittert GA, and Heilbronn LK (2019). Effects of Intermittent Versus Continuous Energy Intakes on Insulin Sensitivity and Metabolic Risk in Women with Overweight. Obesity (Silver Spring) 27, 50– 58. 30569640
  21. Jimenez Jaime T, Leiva Balich L, Barrera Acevedo G, de la Maza Cave MP, Hirsch Birn S, Henriquez Parada S, Rodriguez Silva J, and Bunout Barnett D (2015). Effect of calorie restriction on energy expenditure in overweight and obese adult women. Nutr Hosp 31, 2428– 2436. 26040348
  22. Johnson JB, Summer W, Cutler RG, Martin B, Hyun DH, Dixit VD, Pearson M, Nassar M, Telljohann R, Maudsley S, (2007). Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma. Free Radic Biol Med 42, 665– 674. 17291990 PMC1859864
  23. Kalam F, Gabel K, Cienfuegos S, Wiseman E, Ezpeleta M, Steward M, Pavlou V, and Varady KA (2019). Alternate day fasting combined with a low-carbohydrate diet for weight loss, weight maintenance, and metabolic disease risk reduction. Obes Sci Pract 5, 531– 539. 31890243 PMC6934424
  24. Klempel MC, Kroeger CM, and Varady KA (2013). Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet. Metabolism 62, 137– 143. 22889512
  25. Kretsch MJ, Fong AK, and Green MW (1999). Behavioral and body size correlates of energy intake underreporting by obese and normal-weight women. J Am Diet Assoc 99, 300– 306; quiz 307–308. 10076581
  26. Levitsky DA, and Pacanowski CR (2013). Effect of skipping breakfast on subsequent energy intake. Physiol Behav 119, 9– 16. 23672851
  27. Morris CJ, Yang JN, Garcia JI, Myers S, Bozzi I, Wang W, Buxton OM, Shea SA, and Scheer FA (2015b). Endogenous circadian system and circadian misalignment impact glucose tolerance via separate mechanisms in humans. Proc Natl Acad Sci U S A 112, E2225– 2234. 25870289 PMC4418873
  28. Nas A, Mirza N, Hagele F, Kahlhofer J, Keller J, Rising R, Kufer TA, and Bosy-Westphal A (2017). Impact of breakfast skipping compared with dinner skipping on regulation of energy balance and metabolic risk. Am J Clin Nutr 105, 1351– 1361. 28490511
  29. Patterson RE, and Sears DD (2017). Metabolic Effects of Intermittent Fasting. Annu Rev Nutr 37, 371– 393. 28715993 PMC13170603
  30. Poggiogalle E, Jamshed H, and Peterson CM (2018). Circadian regulation of glucose, lipid, and energy metabolism in humans. Metabolism 84, 11– 27. 29195759 PMC5995632
  31. Powell ES, Smith-Taillie LP, and Popkin BM (2016). Added Sugars Intake Across the Distribution of US Children and Adult Consumers: 1977–2012. J Acad Nutr Diet 116, 1543– 1550 e1541. 27492320 PMC5039079
  32. Rains JL, and Jain SK (2011). Oxidative stress, insulin signaling, and diabetes. Free Radic Biol Med 50, 567– 575. 21163346 PMC3557825
  33. Ravussin E, Redman LM, Rochon J, Das SK, Fontana L, Kraus WE, Romashkan S, Williamson DA, Meydani SN, Villareal DT, (2015). A 2-Year Randomized Controlled Trial of Human Caloric Restriction: Feasibility and Effects on Predictors of Health Span and Longevity. J Gerontol A Biol Sci Med Sci 70, 1097– 1104. 26187233 PMC4841173
  34. Rehm CD, Penalvo JL, Afshin A, and Mozaffarian D (2016). Dietary Intake Among US Adults, 1999–2012. JAMA 315, 2542– 2553. 27327801 PMC6287627
  35. Scheer FA, Hilton MF, Mantzoros CS, and Shea SA (2009). Adverse metabolic and cardiovascular consequences of circadian misalignment. Proc Natl Acad Sci U S A 106, 4453– 4458. 19255424 PMC2657421
  36. Schubel R, Nattenmuller J, Sookthai D, Nonnenmacher T, Graf ME, Riedl L, Schlett L, von Stackelberg O, Johnson T, Nabers D, (2018). Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial. Am J Clin Nutr 108, 933– 945. 30475957 PMC6915821
  37. Sievert K, Hussain SM, Page MJ, Wang Y, Hughes HJ, Malek M, and Cicuttini FM (2019). Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. BMJ 364, l42. 30700403 PMC6352874
  38. Stote KS, Baer DJ, Spears K, Paul DR, Harris GK, Rumpler WV, Strycula P, Najjar SS, Ferrucci L, Ingram DK, (2007). A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults. Am J Clin Nutr 85, 981– 988. 17413096 PMC2645638
  39. Sundfor TM, Svendsen M, and Tonstad S (2018). Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial. Nutr Metab Cardiovasc Dis 28, 698– 706. 29778565
  40. Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, and Peterson CM (2018). Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell Metab 27, 1212– 1221 e1213. 29754952 PMC5990470
  41. Tinsley GM, Moore ML, Graybeal AJ, Paoli A, Kim Y, Gonzales JU, Harry JR, VanDusseldorp TA, Kennedy DN, and Cruz MR (2019). Time-restricted feeding plus resistance training in active females: a randomized trial. Am J Clin Nutr 110, 628– 640. 31268131 PMC6735806
  42. Trepanowski JF, Kroeger CM, Barnosky A, Klempel M, Bhutani S, Hoddy KK, Rood J, Ravussin E, and Varady KA (2018). Effects of alternate-day fasting or daily calorie restriction on body composition, fat distribution, and circulating adipokines: Secondary analysis of a randomized controlled trial. Clin Nutr 37, 1871– 1878. 29258678 PMC5988907
  43. Varady KA, Bhutani S, Church EC, and Klempel MC (2009). Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults. Am J Clin Nutr 90, 1138– 1143. 19793855
  44. Varady KA, Bhutani S, Klempel MC, Kroeger CM, Trepanowski JF, Haus JM, Hoddy KK, and Calvo Y (2013). Alternate day fasting for weight loss in normal weight and overweight subjects: a randomized controlled trial. Nutr J 12, 146. 24215592 PMC3833266
  45. Williamson DA, Bray GA, and Ryan DH (2015). Is 5% weight loss a satisfactory criterion to define clinically significant weight loss? Obesity (Silver Spring) 23, 2319– 2320. 26523739
  46. Zaulkffali AS, Md Razip NN, Syed Alwi SS, Abd Jalil A, Abd Mutalib MS, Gopalsamy B, Chang SK, Zainal Z, Ibrahim NN, Zakaria ZA, (2019). Vitamins D and E Stimulate the PI3K-AKT Signalling Pathway in Insulin-Resistant SK-N-SH Neuronal Cells. Nutrients 11. PMC6836113 31635074

Cited by

Sorted by citations

Authors
Cienfuegos, S., Gabel, K., Kalam, F., Ezpeleta, M., Wiseman, E., Pavlou, V., Lin, S., Oliveira, M. L., & Varady, K. A.
Affiliations
University of Illinois Chicago (US)
Corresponding author
Varady, Krista A.
ORCID
Venue
Cell Metabolism
Publisher
Elsevier BV
Published
2020-09
Volume
32
Issue
3
Pages
366-378.e3
ISSN
1550-4131 (ISSN-L)
DOI
10.1016/j.cmet.2020.06.018
PMC
PMC9407646
OpenAlex
W3043503484
Cited by
597
References
11
Citations by year
2026: 78 · 2025: 109 · 2024: 114 · 2023: 106 · 2022: 90 · 2021: 81 · 2020: 18
FWCI
44.37
Type
journal article
Language
en
Open access
Licence
Locations
  • Cell Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health
Topics
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
time-restricted feeding, obesity, weight loss, cardiometabolic health, insulin resistance, oxidative stress, energy intake, meal timing
MeSH terms
Adolescent, Adult, Aged, Body Weight, Cardiovascular Diseases, Fasting, Female, Humans, Middle Aged, Obesity, Risk Factors, Weight Loss, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review