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The Influence of Time-Restricted Eating in Patients With Metabolic Syndrome (TIMET)

Primary Purpose

Metabolic Syndrome, Pre-Diabetes

Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Time Restricted Eating + Standard of Care
Standard of Care
Sponsored by
University of California, San Diego
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metabolic Syndrome focused on measuring Time Restricted Eating, Circadian Rhythm, Glucose Homeostasis, Mitochondrial Function, Fasting

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 18-75 years
  2. 41 ≥ BMI ≥ 25 AND
  3. Metabolic syndrome, as defined as presence of 3 or more of the following criteria:

    Elevated fasting plasma glucose ≥ 100 mg/dL and/or HbA1c ≥ 5.7% < 7.1% Elevated waist circumference: In Asians: ≥ 90 cm in men, ≥ 80 cm in women, all other races: ≥ 102 cm in men, ≥ 88 cm in women Fasting plasma triglycerides ≥ 150 mg/dL, or on drug treatment for elevated triglycerides Reduced High-density lipoprotein (HDL)-cholesterol < 40 mg/dL in males or < 50 mg/dL in females, or drug treatment for reduced HDL-cholesterol Elevated blood pressure, Systolic blood pressure ≥ 135 mm Hg and/or diastolic blood pressure ≥ 85 mm Hg or drug treatment for hypertension

  4. Own a smartphone (Apple iOS or Android OS)
  5. Baseline eating period ≥ 12 hour window
  6. If patients are on cardiovascular medications (HMG CoA reductase inhibitors (statins), other lipid modifying drugs (including over the counter drugs such as red yeast rice and fish oil), anti-hypertensive, anti-diabetes drugs), no dose adjustments will be allowed during the study period.

Exclusion Criteria:

  1. Taking insulin within the last 6 months.
  2. Manifest diabetes, defined as HbA1c > 7.0% given a 0.3% margin of error in lab readings, or diagnosis of diabetes.
  3. Known inflammatory and/or rheumatologic disease.
  4. Active tobacco abuse or illicit drug use or history of treatment for alcohol abuse.
  5. Pregnant or breast-feeding women.
  6. Shift workers with variable (e.g. nocturnal) hours.
  7. Caregivers for dependent requiring frequent nocturnal care/sleep interruptions.
  8. Planned travel to a time zone with greater than a 3-hour difference during study period.
  9. History of major adverse cardiovascular event within the past 1 year (acute coronary syndrome (ACS), percutaneous coronary intervention, coronary artery bypass graft surgery, hospitalization for congestive heart failure, stroke/transient ischemic attack (TIA)).
  10. Uncontrolled arrhythmia (i.e. rate-controlled atrial fibrillation/atrial flutter are not exclusion criteria).
  11. History of thyroid disease requiring dose titration of thyroid replacement medication(s) within the past 3 months (i.e. hypothyroidism on a stable dose of thyroid replacement therapy is not an exclusion).
  12. History of adrenal disease.
  13. History of malignancy undergoing active treatment, except non-melanoma skin cancer.
  14. Known history of type I diabetes.
  15. History of eating disorder(s).
  16. History of cirrhosis.
  17. History of stage 4 or 5 chronic kidney disease or requiring dialysis.
  18. History of HIV/AIDS.
  19. Currently enrolled in a weight-loss or weight-management program.
  20. On a special or prescribed diet for other reasons (e.g. Celiac disease).
  21. Currently taking any medication that is meant for, or has known effect on, appetite.
  22. Any history of surgical intervention for weight management.
  23. Uncontrolled psychiatric disorder (including history of hospitalization for psychiatric illness).
  24. A score of >16 on the Epworth Sleepiness Scale (ESS).
  25. Depression determined by the Beck Depression Inventory (BDI) (unless previously diagnosed and well-controlled).
  26. Failure to use the smartphone app for documentation (defined as <2 meals/day for ≥3 days during baseline).

Sites / Locations

  • Altman Clinical and Translational Research Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

SOC (Standard of Care)

TRE + SOC

Arm Description

Everyone in this arm will receive standard of care nutritional behavioral counseling and will be required to log their caloric intake through the use of a smartphone app.

Everyone in this arm will receive standard of care nutritional behavioral counseling and will implement a daily 8-10-hour window within which they must consume their calories. They will also be required to log their caloric intake through the use of a smartphone app.

Outcomes

Primary Outcome Measures

Change in glucose levels assessed via HbA1c
HbA1c (%)
Change in glycemic parameters
Glycemic parameters assessed via fasting glucose (mg/dL), HOMA-IR, Insulin (mIU/L), and continuous glucose monitors (CGM).

Secondary Outcome Measures

Change in LDL particle number
LDL particle number (nmol/L) via NMR lipoprofile
Change in LDL cholesterol
LDL cholesterol (mg/dl)
Change in HDL cholesterol
HDL cholesterol (mg/dl)
Change in Triglycerides
Triglycerides (mg/dl)
Change in body composition by DXA
Lower abdominal fat mass as assessed by dual-energy X-ray absorptiometry (DXA).
Change in hs-CRP
High sensitivity C-reactive protein (mg/L)

Full Information

First Posted
April 2, 2019
Last Updated
April 3, 2023
Sponsor
University of California, San Diego
Collaborators
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Salk Institute for Biological Studies
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1. Study Identification

Unique Protocol Identification Number
NCT04057339
Brief Title
The Influence of Time-Restricted Eating in Patients With Metabolic Syndrome
Acronym
TIMET
Official Title
Influence of Time-restricted Eating (TRE) on Circadian Regulation of Glucose Homeostasis and Mitochondrial Function - The TIMET Study
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 8, 2019 (Actual)
Primary Completion Date
June 2023 (Anticipated)
Study Completion Date
June 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of California, San Diego
Collaborators
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Salk Institute for Biological Studies

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
In a randomized controlled trial, the investigators intend to measure the health impact of TRE in patients with metabolic syndrome (with three or more of the following criteria: increased waist circumference, abnormal cholesterol levels, elevated blood pressure, or elevated blood sugar), who habitually eat for more than 14 hours every day. Patients will be randomly assigned to a control group of behavioral nutrition counseling (standard of care) or the intervention group of behavioral nutrition counseling with the addition of adopting a 8-10 hour eating window for 12 weeks (TRE).
Detailed Description
Circadian rhythms optimize nutrient homeostasis by orchestrating catabolic and anabolic metabolism to appropriate times of the 24 hour day. Chronic circadian rhythm disruption predisposes individuals to metabolic diseases including obesity and type 2 diabetes. Conversely, maintaining a daily rhythm of feeding and fasting cycles sustains a robust circadian rhythm which improves cellular bioenergetics and results in improved metabolism. Time-restricted eating (TRE) is a specific feeding-fasting pattern in which feeding is restricted to 8-12 hours a day. At the beginning and end of the study (which will be three months in duration), the following parameters will be measured: height, weight, body mass index, percent body fat, waist/hip circumference and blood pressure. Blood sugar levels will be monitored continuously for 2 weeks at a time at the beginning and end of the study using a continuous glucose monitor. Additionally, a dual energy X-ray absorptiometry (DXA) scan will be used to collect information about body composition. Information will be collected about the mitochondria with a muscle biopsy. Participants will use a smartphone application (called myCircadianClock (mCC), developed by the Salk Institute) to keep track of food/beverage intake and will wear a wrist-worn actigraphy device to monitor physical activity levels and sleep.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metabolic Syndrome, Pre-Diabetes
Keywords
Time Restricted Eating, Circadian Rhythm, Glucose Homeostasis, Mitochondrial Function, Fasting

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Investigator
Allocation
Randomized
Enrollment
122 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SOC (Standard of Care)
Arm Type
Placebo Comparator
Arm Description
Everyone in this arm will receive standard of care nutritional behavioral counseling and will be required to log their caloric intake through the use of a smartphone app.
Arm Title
TRE + SOC
Arm Type
Experimental
Arm Description
Everyone in this arm will receive standard of care nutritional behavioral counseling and will implement a daily 8-10-hour window within which they must consume their calories. They will also be required to log their caloric intake through the use of a smartphone app.
Intervention Type
Behavioral
Intervention Name(s)
Time Restricted Eating + Standard of Care
Other Intervention Name(s)
Time Restricted Eating
Intervention Description
Participants in this arm will adhere to a daily, consistent 8-10-hr eating window for the course of the study as well as receive nutritional counseling from the study dietitian.
Intervention Type
Behavioral
Intervention Name(s)
Standard of Care
Intervention Description
Participants in this arm will receive nutritional counseling from the study dietician, but will not be required to adopt a 8-10-hr eating window.
Primary Outcome Measure Information:
Title
Change in glucose levels assessed via HbA1c
Description
HbA1c (%)
Time Frame
Baseline and 14 weeks
Title
Change in glycemic parameters
Description
Glycemic parameters assessed via fasting glucose (mg/dL), HOMA-IR, Insulin (mIU/L), and continuous glucose monitors (CGM).
Time Frame
Baseline and 14 weeks
Secondary Outcome Measure Information:
Title
Change in LDL particle number
Description
LDL particle number (nmol/L) via NMR lipoprofile
Time Frame
Baseline and 14 weeks
Title
Change in LDL cholesterol
Description
LDL cholesterol (mg/dl)
Time Frame
Baseline and 14 weeks
Title
Change in HDL cholesterol
Description
HDL cholesterol (mg/dl)
Time Frame
Baseline and 14 weeks
Title
Change in Triglycerides
Description
Triglycerides (mg/dl)
Time Frame
Baseline and 14 weeks
Title
Change in body composition by DXA
Description
Lower abdominal fat mass as assessed by dual-energy X-ray absorptiometry (DXA).
Time Frame
Baseline and 14 weeks
Title
Change in hs-CRP
Description
High sensitivity C-reactive protein (mg/L)
Time Frame
Baseline and 14 weeks
Other Pre-specified Outcome Measures:
Title
Change in mitochondrial structure and gene expression in skeletal muscle
Description
Mitochondrial structure and gene expression in skeletal muscle as assessed by skeletal muscle biopsies.
Time Frame
Baseline and 14 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18-75 years 41 ≥ BMI ≥ 25 AND Metabolic syndrome, as defined as presence of 3 or more of the following criteria: Elevated fasting plasma glucose ≥ 100 mg/dL and/or HbA1c ≥ 5.7% < 7.1% Elevated waist circumference: In Asians: ≥ 90 cm in men, ≥ 80 cm in women, all other races: ≥ 102 cm in men, ≥ 88 cm in women Fasting plasma triglycerides ≥ 150 mg/dL, or on drug treatment for elevated triglycerides Reduced High-density lipoprotein (HDL)-cholesterol < 40 mg/dL in males or < 50 mg/dL in females, or drug treatment for reduced HDL-cholesterol Elevated blood pressure, Systolic blood pressure ≥ 135 mm Hg and/or diastolic blood pressure ≥ 85 mm Hg or drug treatment for hypertension Own a smartphone (Apple iOS or Android OS) Baseline eating period ≥ 12 hour window If patients are on cardiovascular medications (HMG CoA reductase inhibitors (statins), other lipid modifying drugs (including over the counter drugs such as red yeast rice and fish oil), anti-hypertensive, anti-diabetes drugs), no dose adjustments will be allowed during the study period. Exclusion Criteria: Taking insulin within the last 6 months. Manifest diabetes, defined as HbA1c > 7.0% given a 0.3% margin of error in lab readings, or diagnosis of diabetes. Known inflammatory and/or rheumatologic disease. Active tobacco abuse or illicit drug use or history of treatment for alcohol abuse. Pregnant or breast-feeding women. Shift workers with variable (e.g. nocturnal) hours. Caregivers for dependent requiring frequent nocturnal care/sleep interruptions. Planned travel to a time zone with greater than a 3-hour difference during study period. History of major adverse cardiovascular event within the past 1 year (acute coronary syndrome (ACS), percutaneous coronary intervention, coronary artery bypass graft surgery, hospitalization for congestive heart failure, stroke/transient ischemic attack (TIA)). Uncontrolled arrhythmia (i.e. rate-controlled atrial fibrillation/atrial flutter are not exclusion criteria). History of thyroid disease requiring dose titration of thyroid replacement medication(s) within the past 3 months (i.e. hypothyroidism on a stable dose of thyroid replacement therapy is not an exclusion). History of adrenal disease. History of malignancy undergoing active treatment, except non-melanoma skin cancer. Known history of type I diabetes. History of eating disorder(s). History of cirrhosis. History of stage 4 or 5 chronic kidney disease or requiring dialysis. History of HIV/AIDS. Currently enrolled in a weight-loss or weight-management program. On a special or prescribed diet for other reasons (e.g. Celiac disease). Currently taking any medication that is meant for, or has known effect on, appetite. Any history of surgical intervention for weight management. Uncontrolled psychiatric disorder (including history of hospitalization for psychiatric illness). A score of >16 on the Epworth Sleepiness Scale (ESS). Depression determined by the Beck Depression Inventory (BDI) (unless previously diagnosed and well-controlled). Failure to use the smartphone app for documentation (defined as <2 meals/day for ≥3 days during baseline).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pam Taub, MD
Organizational Affiliation
Associate Professor of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Altman Clinical and Translational Research Institute
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
35732151
Citation
Taub PR, Panda S. Time for better time-restricted eating trials to lessen the burden of metabolic diseases. Cell Rep Med. 2022 Jun 21;3(6):100665. doi: 10.1016/j.xcrm.2022.100665.
Results Reference
derived

Learn more about this trial

The Influence of Time-Restricted Eating in Patients With Metabolic Syndrome

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