Time-restricted eating and exercise training improve HbA1c and body composition in women with overweight/obesity: A randomized controlled trial

Diet modification and exercise training are primary lifestyle strategies for obesity management, but poor adherence rates limit their effectiveness. Time-restricted eating (TRE) and high-intensity interval training (HIIT) improve cardiometabolic health in at-risk individuals, but whether these two interventions combined induce superior improvements in glycemic control than each individual intervention is not known. In this four-armed randomized controlled trial (ClinicalTrials.gov NCT04019860), we determined the isolated and combined effects of seven weeks of TRE (≤ 10-h ad libitum eating window every day) and HIIT (three exercise sessions per week), compared with a non-intervention control group, on glycemic control and secondary cardiometabolic outcomes in women with overweight/obesity. There were no statistically significant effects after isolated TRE, HIIT, or a combination (TREHIIT) on glucose area under the curve during an oral glucose tolerance test (the primary outcome) compared with the control group; TRE: -26.3 mmol/L, 95% confidence interval (CI): -82.3, 29.7 (p = .36), HIIT: -53.8 mmol/L, 95% CI: -109.2, 1.6 (p = .057), TREHIIT: -41.3 mmol/L, 95% CI: -96.4, 13.8 (p = .14). However, TREHIIT improved HbA1c and induced superior reductions in total and visceral fat mass compared with TRE and HIIT alone. High participant adherence rates suggest that TRE, HIIT, and a combination thereof, may be realistic diet-exercise strategies for improving markers of metabolic health in women at risk of cardiometabolic disease.

饮食调整与运动训练是肥胖管理的首要生活方式策略，然而，由于依从率较低，其效果受到限制。限食时间（TRE）与高强度间歇训练（HIIT）能够改善高危个体的心代谢健康，但两者结合是否比单独干预能更优越地改善血糖控制尚无定论。在本项四臂随机对照试验（ClinicalTrials.gov NCT04019860）中，我们评估了为期七周的TRE（每日自由进食窗口≤10小时）与HIIT（每周三次锻炼）的单独及联合效果，与未干预对照组相比，对肥胖/超重女性血糖控制和次要心代谢指标的影响。与对照组相比，单独的TRE、HIIT或联合干预（TREHIIT）在口服葡萄糖耐量测试（主要结局）的血糖曲线下面积方面均无统计学上的显著影响；TRE：-26.3 mmol/L，95%置信区间（CI）：-82.3，29.7（p = .36），HIIT：-53.8 mmol/L，95% CI：-109.2，1.6（p = .057），TREHIIT：-41.3 mmol/L，95% CI：-96.4，13.8（p = .14）。然而，与单独的TRE和HIIT相比，TREHIIT改善了HbA1c水平，并显著降低了总脂肪和内脏脂肪量。高依从率提示，TRE、HIIT及其联合应用可能是改善心血管代谢疾病风险女性代谢健康标记的现实可行的饮食运动策略。