Table 1.
Recent clinical trials (2017–to date) exploring the effects of IF regimens on outcomes of bone health
| Study | Study population | Duration | Intervention description | Weight changes | Main bone findings |
|---|---|---|---|---|---|
| ADF (n 3) | |||||
| Barnosky et al., 2017(60) | Overweight/obese adults aged 18–65 years, 3 groups (ADF, CER, control) ADF: n 21, mean ± sem age: 44 ± 2 years, BMI: 34 ± 1 kg/m2, 19 W/2 M CER: n 24, age: 44 ± 2 years, BMI: 34 ± 1 kg/m2, 20 W/4 M Control: n 17, age: 40 ± 3 years, BMI: 32 ± 1 kg/m2, 15W/2M |
6 months | ADF: 25 % DEI fast day, alternated with 125 % DEI feast day | –7·8 ± 1·2 % | Total body BMC and BMD remained unchanged in all groups. OC, BAP and CTX did not change in any group. No differences between premenopausal or postmenopausal women for any marker |
| CER: 75 % DEI every day | –8·8 ± 1·5 % | ||||
| Control: habitual intake | NS | ||||
| Stekovic et al., 2019(57) | Non-obese adults aged 35–65 years, 2 groups (ADF, control) ADF: n 29, median age (IQR): 48 (43–55) years, mean BMI (±sd): 25·5 ± 1·8 kg/m2, 17 W/12 M Control: n 28, age 51 (45–57) years, BMI: 25·4 ± 2·2 kg/m2, 17 W/11 M | 4 weeks | ADF: ad libitum eating every second-day, no kcal on the fast days | –3·5 ± 1·5 kg | BMD at the lumbar spine region (derived from total body scans) ↓ after ADF but not after control. Comparing Comparison of ΔBMDs of both groups did not yield significant differences. No within or between group differences were seen for total body BMC |
| Control: habitual diet | NS:–0·2 ± 1·1 kg | ||||
| Templeman et al., 2021(30) | Lean healthy adults aged 18–65 years, 3 groups (CER 75:75, ADF 0:150, ADF 0:200) CER 75:75: n 12, mean ± sd age: 45 ± 6 years, BMI: 24·0 ± 1·9 kg/m2, 7W/5M ADF 0:150: n 12, age: 42 ± 11 years, BMI: 23·9 ± 2·4 kg/m2, 5W/7M ADF 0:200: n 12, age: 41 ± 14 years, BMI: 23·6 ± 2·1 kg/m2, 9 W/3 M | 3 weeks | CER: 75 % DEI (75:75) | –1·9 ± 1·0 kg | No differences in plasma CTX pre- and post-intervention. No group differences in BMC or BMD |
| ADF with ER: 24-h fasting with 150 % DEI on alternate days (0:150) | –1·6 ± 1·1 kg | ||||
| ADF without ER: 24-h fasting 200 % DEI on alternate days (0:200) | NS: −0·5 ± 1·1 kg | ||||
| TRE (n 5) | |||||
| Martens et al., 2019(63 | Apparently healthy, non-obese adults, 2 crossed-over interventions (TRE, control) n 22, mean ± sem age: 67 ± 1 years, BMI: 24·7 ± 0·6 kg/m2, 12 W/10 M |
6 weeks | TRF: ad libitum 8-h eating window | NS | Total and regional BMD were not different between conditions |
| Control: habitual diet | NS | ||||
| Lowe et al., 2020(61) | Overweight and obese adults (in-person cohort), two groups (TRE, consistent meal timing (CMT)) TRE: n 25, mean ± sd age: 43 ± 12 years, BMI: 31·5 ± 4·5 kg/m2, 12 W/13 M CMT: n 25, age:44 ± 11 years, BMI: 31·3 ± 3·5 kg/m2, 10 W/15 M | 12 weeks | TRE: ad libitum 8-h eating window between 12.00 and 20.00 hours | –1·7 kg | A trend towards a ↑ in BMC in the TRE group (P = 0·09) but not in the CMT group. BMC changes did not differ between groups |
| CMT: Habitual diet consumed in 3 structured meals per day |
NS: 0·6 kg | ||||
| Lobene et al., 2021(62) | Overweight and obese adults, two groups (TRE, non-TRE) TRE: n 11, mean ± sem age: 47 ± 4 years, BMI: 33·8 ± 2·3 kg/m2, 9 W/2 M non-TRE: n 9, age: 44 ± 4 years, BMI:34·4 ± 2·6 kg/m2, 8 W/1 M | 12 weeks | TRE: ad libitum 8-h eating window | –3·7 ± 0·5 % | P1NP ↓ in both groups (time effect) with a trend towards a greater ↓ in the non-TRE group (time × group interaction, P = 0·07). Total body BMC ↑ in the TRE group and ↓ in the non-TRE group (time × group interaction, P = 0·02) |
| Non-TRE: habitual diet | NS | ||||
| Kotarsky et al., 2021(67) | Overweight/obese adults, two groups (TRE + ex, non-TRE + ex) TRE + ex: n 11, age: 45 ± 3 years, BMI: 29·8 ± 0·8 kg/m2, 9 W/2 M non-TRE + ex: n 10, age: 44 ± 2 years, BMI: 29·4 ± 0·8 kg/m2, 9 W/1 M | 8 weeks | TRE + ex : ad libitum 8-h eating window between 12.00 and 20.00 hours + exercise (aerobic + resistance) | 3·3 % | No significant time, group or time × group interaction for total body BMC or BMD |
| Non-TRE + ex: habitual diet + exercise (aerobic + resistance) | NS: 0·2 % | ||||
| Papageorgiou et al., 2022(64) | Individuals with at least one component of the metabolic syndrome, two groups (TRE, SDA) TRE: n 23, median (IQR) age: 47 (32, 57) years, BMI: 27·9 (25·5, 31·4) kg/m2, 18 W/5 M SDA: n 19, age: 45 (27, 50) years, BMI: 26·7 (23·8, 30·6) kg/m2, 14 W/5 M |
6 months | TRE: ad libitum 12-h eating window | –0·6 kg (median) |
Total cohort: no between-group differences (TRE v. SDA) in CTX, P1NP or total body BMC/BMD responses. Analysis by weight loss response: among weight loss responders, CTX tended to ↓ after TRE but ↑ after SDA (between-group differences P = 0·041), P1NP changes did not differ between groups. Total body BMC ↓ after SDA, but remained unchanged after TRE (between-group differences in weight loss responders P = 0·028). Among non-responders (< 0·6 kg weight loss), there were no between-group differences in bone outcomes |
| SDA: 10-min counselling for healthy eating + healthy eating brochure | NS | ||||
↓, indicates a decrease; ↑, indicates an increase; ADF, alternate-day fasting; BAP, bone-specific alkaline phosphatase; BMC, bone mineral content; BMD, bone mineral density; CER, continuous energy expenditure; CMT, consistent meal timing; CTX, β-carboxyterminal telopeptide of type I collagen; Δ, delta; DEI, dietary energy intake; ex, exercise; M, men; NS, non-significant; OC, osteocalcin; P1NP, procollagen type 1 N-terminal propeptide; SDA, standard dietary advice; TRE, time-restricted eating; W, women; IQR, inter-quartile range; .
The primary outcomes of the included studies were changes in body weight (n 3; Barnosky et al. (60); Lowe et al. (61); Kotarsky et al. (67)), changes in body composition (n 1; Templeman et al. (30)), changes in insulin sensitivity (n 1; Stekovic et al. (57)), changes in components of energy balance and post-prandial metabolism (n 1; Templeman et al. (30)), change in the metabolic syndrome components (n 1; Papageorgiou et al. (64)) and changes in endothelium-dependent dilation (n 1; Martens et al. (63)).