Table 1.

Randomized clinical trials with blood pressure outcomes of time-restricted eating in adults with overweight/obesity and/or metabolic syndrome

Study	Study design	Participants	Intervention	Primary outcome	BP outcomes	Main results	Limitations & notes
Sutton et al. [54••]	Randomized, crossover, isocaloric and eucaloric feeding	Men with prediabetes (N = 8)	TRE: 6 h eating window, begins at habitual breakfast time and dinner before 15:00 Control: 12 h eating window, begins at habitual breakfast time Washout: 7 weeks Duration: 5 weeks	Mean glucose and insulin levels during 3 h OGTT	SBP and DBP ↓ by 11 ± 4 mmHg (p = 0.03) and 10 ± 4 mmHg (p = 0.03)	No changes in fasting glucose or mean glucoses TRE ↓ fasting insulin by 3.4 ± 1.6 mU/L (p = 0.05) and insulin post 60-min and 90-min (p ≤ 0.01) TRE ↑ insulin sensitivity and β-cell responsiveness Weight changes: -1.4 ± 1.3 kg (TRE) vs − 1.0 ± 1.1 kg (control); p = 0.12	Sample population not generalizable Short intervention duration Short eating window Difference in fasting duration prior to outcome measurement testing (18 h fasting for TRE and 12 h fast for control)
Chow et al. [60]	Randomized, parallel arm	Adults with overweight/obesity and baseline eating window ≥ 14 h (N = 20; 3 M, 17F; 11 TRE vs 9 control)	TRE: self-selected 8 h AL eating window (no guidelines for start and end time; generally 10:40–18:40) Control: unrestricted eating Duration: 12 weeks	Weight	No significant within-arm or between-arm changes in SBP or DBP	Weight loss was 3.7% ± 1.8% more with TRE (p = 0.04) Changes in fasting and CGM glucose, fasting insulin, and lipids were not different between TRE vs control	TRE had greater reductions in eating occasions than control though energy intake was not ascertained
Cienfuegos et al. [58]	Randomized, parallel arm	Adults with obesity (4 h TRE: N = 19; 2 M, 17F; 6 h TRE: N = 20; 1 M, 19F; Control: N = 19; 2 M, 12F)	2 TRE groups: 4 h (15:00–19:00) AL TRE vs 6 h AL TRE (13:00–19:00) Control: unrestricted eating, instructed to maintain weight Duration: 8 weeks	Weight	A trend towards lower SBP with both TRE eating windows (− 5.0 ± 2.2 mmHg in 4 h TRE; − 4.4 ± 2.3 mmHg in 6 h TRE; + 3.7 ± 2.8 mmHg in control; p = 0.06)	More weight loss in TRE, weight ↓ by 3.2% ± 0.4% in both 4 h TRE and in 6 h TRE vs 0.1% ± 0.4% in control (p < 0.001) TRE ↓ fasting insulin by − 2.3 ± 1.5 uIU/mL in 4 h TRE vs − 1.9 ± 1.1 uIU/mL in 6 h TRE vs + 3.5 ± 1.4 uIU/mL in controls (p = 0.02) No across-group differences in changes in fasting glucose or lipids	Dropout rate: ~ 16% in 4 h TRE (3/19); ~ 5% in 6 h TRE (1/19); ~ 26% in control (5/19) Both TRE groups had unintentional caloric reduction ~ 550 kcal/day
Lowe et al. [59]	Randomized, parallel arm	Adults with overweight/obesity (N = 141 randomized; N = 116 analyzed; 70 M, 46F; 72 control vs 69 TRE)	TRE: 8 h AL intake 12:00–20:00 Control: 3 meals per day (1st meal at 6:00–10:00, 2nd meal at 11:00–15:00, 3rd meal at 17:00–22:00) Duration: 12 weeks	Weight	No significant difference in SBP in TRE but a significant decrease in control (− 3.86 mmHg, p = 0.04), without between-group difference A significant change in DBP in TRE (− 4.08 mmHg, p = 0.047) but not in control or between-groups	Both groups lost weight without significant between-group difference in weight change (− 0.26 kg; 95% CI, − 1.30 to 0.78 kg) Significant reduction in lean mass in TRE compared to controls (− 0.47 kg; 95% CI − 0.82 to − 0.12 kg) No significant within-group or between-group differences in fasting glucose/insulin or lipid outcomes	Dropout rate of 25.5% (36/141) No data on caloric intake or macronutrient intake
Pureza et al. [62]	Randomized, parallel arm	Brazilian women with obesity living in social vulnerability (N = 58; 27 control vs 31 TRE)	TRE: 12 h eating window of hypo-energetic diet (individualized based on baseline total energy expenditure with ~ 637 kcal/day deficit) Control: same hypo-energetic diet (~ 650 kcal/day deficit) without TRE Duration: 21 days for all outcomes; 81 days for weight and waist circumference only	Weight	SBP ↓ by − 4.64 mmHg in TRE vs − 6.07 mmHg in control; p = 0.50 DBP ↓ by − 3.22 mmHg in TRE vs − 5.96 mmHg in control; p = 0.18	TRE ↓ %body fat by 0.75% more than control (95% CI − 1.43 to − 0.07) at 21 days No difference in glucose, insulin at 21 days No difference in weight loss between groups at 21 days and at 81 days TRE ↓ WC more at 81 days (− 2.2% vs − 0.49% for TRE vs control)	No adherence data reported No data on actual eating window for TRE arm No assigned or reported eating window for the control group.-No controlled feeding
Phillips et al. [61]	Randomized, parallel arm Pragmatic, community-based trial	Adults with ≥ 1 MS component and baseline eating duration > 14 h (N = 54; 26 control vs 28 TRE)	TRE: self-selected AL eating window of 12 h Control: standard dietary advice Duration: 6 months	Weight	No significant between-group difference in changes in SBP (+ 5.5 mmHg, 95% CI − 1.2 to 12.2) or DBP (+ 3.5 mmHg, 95% CI − 1.7 to 8.6)	TRE lost 1.6% body weight (p = 0.01) while control lost 1.1% (p = 0.19), without significant between-group difference in weight loss (− 0.88%, 95% CI − 3.1 to 1.3) No significant between-group differences in changes in lipids and fasting glucose	Dropout rate ~ 17% (9/54) Weights were self-reported Prevalence of obesity in the Swiss population is lower than the US and the mean eating duration < 14 h Control group received dietary advice and significantly ↑ unprocessed or minimally processed food and significantly ↓ ultra-processed food, compared to TRE group, who did not receive any dietary advice
Liu et al. [10•]	Randomized, parallel arm	Chinese adults with obesity (N = 139; 69 TRE vs 70 caloric restriction)	TRE: 8 h with caloric restriction 8:00–16:00 Control: Caloric restriction (CR) alone without TRE CR involved ~ 25% reduction from baseline caloric intake Duration: 12 months	Weight	At 12 months: TRE↓ SBP by 8.1 mmHg (95% CI − 10.4 to − 5.7) while CR ↓ SBP by 7.7 mmHg (95% CI -10.1 to − 5.4) without significant between-group difference TRE ↓ DBP by 5.1 mmHg (95% CI − 7.1 to − 3.1) and CR ↓ DBP by 3.8 mmHg (95% CI − 5.7 to − 2.0) without significant between-group difference	TRE had 8.0 kg weight loss (95% CI − 9.6 to − 6.4) and CR alone had 6.3 kg weight loss (95% CI − 4.0 to 0.4) with no significant net difference (− 1.8 kg, 95% CI − 4.0 to 0.4) No significant between-group differences in lipids, fasting glucose or insulin, body composition	Baseline daily eating window for all participants were already somewhat restricted at ~ 10 h Sleep and physical activity were not controlled or reported Limited generalizability outside of Chinese study population

TRE time-restricted eating, OGTT oral glucose tolerance test, BP blood pressure, SBP systolic blood pressure, DBP diastolic blood pressure, M male, F female, AL ad libitum, CGM continuous glucose monitor, WC waist circumference, MS metabolic syndrome, CR caloric restriction