Intended isocaloric time-restricted eating shifts circadian clocks but does not improve cardiometabolic health in women with overweight

Time-restricted eating (TRE) is a promising strategy to improve metabolic outcomes. However, it remains unclear whether TRE has cardiometabolic benefits in an isocaloric setting and whether its effects depend on the eating timing. We conducted a randomized crossover trial in 31 women with overweight or obesity to directly compare the effects of a 2-week early TRE (eTRE; eating from 8:00 to 16:00) and a 2-week late TRE (lTRE; eating from 13:00 to 21:00) on insulin sensitivity, cardiometabolic risk factors, and the internal circadian phase. During the restricted 8-hour eating period, participants were asked to consume their habitual food quality and quantity. Insulin sensitivity did not differ between (−0.07; 95% CI, −0.77 to 0.62; P = 0.60) or within (eTRE: 0.31; 95% CI, −0.14 to 0.76; P = 0.11; lTRE: 0.19; 95% CI, −0.22 to 0.60; P = 0.25) interventions. Twenty-four–hour glucose, lipid, inflammatory, and oxidative stress markers showed no clinically meaningful between- or within-intervention differences. Participants demonstrated high timely adherence (eTRE, 96.5%; lTRE, 97.7%), unchanged dietary composition and physical activity, minor daily calorie deficit (eTRE, −167 kilocalories/day), and weight loss (eTRE, −1.08 kilograms; lTRE, −0.44 kilograms). In lTRE, the circadian phase in blood monocytes (24 minutes; 95% CI, −5 to 54 minutes; P = 0.10) and sleep midpoint (15 minutes; 95% CI, 7 to 23 minutes; P < 0.001) occurred later compared with eTRE. Overall, in an intended isocaloric setting, neither eTRE nor lTRE improves insulin sensitivity or other cardiometabolic traits, despite a shift of internal circadian clocks.