Does early time-restricted eating reduce body weight and preserve fat-free mass in adults? A systematic review and meta-analysis of randomized controlled trials

Background: This meta-analysis evaluated whether weight loss caused by early time-restricted eating could promote fat mass loss while preserving fat-free mass, thereby leading to improvements in inflammation and metabolic health.

Methods: Relevant randomized controlled trials (RCTs) published up to March 28, 2023, were identified in six databases, including PubMed, Web of Science, and Embase.

Results: We initially screened 1279 articles, thirteen RCTs with 859 patients were ultimately included. Compared with nontime-restricted eating, early time-restricted eating significantly reduced body weight (-1.84 kg [-2.28, -1.41]; I² = 56 %; P < 0.00001), fat mass (-1.10 kg [-1.47, -0.74]; I² = 42 %; P < 0.00001), waist circumstance (-3.21 cm [-3.90, -2.51]; I² = 43 %; P < 0.00001), visceral fat area (-9.76 cm² [-13.76, -5.75]; I² = 2 %; P < 0.00001), and inflammation as measured by tumour necrosis factor-α (-1.36 pg/mL [-2.12, -0.60]; I² = 42 %; P < 0.001). However, early time-restricted eating did not lead to a significant change in fat-free mass (-0.56 kg [-1.16, 0.03]; I² = 59 %; P = 0.06). Subgroup analysis showed that the early time-restricted eating of the 16:08 (fasting-time versus eating-time) strategy had a superior effect on preserving fat-free mass (-0.25 kg [-0.68, 0.18]; I² = 0 %; P = 0.25) while significantly reducing body weight (-1.60 kg [-2.09, -1.11]; I² = 0 %; P < 0.001) and improving metabolic outcomes.

Conclusions: Early time-restricted eating, especially 16:08 strategy, appears to be an effective strategy to decrease body weight, fat mass, abdominal obesity and inflammation, but less likely to decrease fat-free mass.