Time‐Restricted Eating Promotes Weight Loss and Favorable Changes in Adipose in Obesity: The TREAD Randomized Control Trial

Objective Examine time‐restricted eating (TRE) as a strategy to promote weight loss and cardiometabolic health in adults with obesity. Methods TRE in obesity and ADipose Tissue (TREAD) was a single‐center 12‐week RCT, involving 1:1 randomization to 10‐h TRE versus standard of care (SOC) in adults with obesity (BMI 30–50 kg/m 2 ) without diabetes and baseline eating window ≥ 14 h/day. The primary endpoint was change in weight (kg). Exploratory RNA‐seq in subcutaneous abdominal adipose tissue was performed in a subgroup of participants. Results A total of 61 participants were randomized, and 52 (26 TRE, 26 SOC) completed the study. Mean ± SD age was 55 ± 12.1 years, n = 35 were (58%) women, n = 35 were non‐Hispanic White (58%), and BMI was 35.5 ± 4.8 kg/m 2 . With TRE, the mean total reduction in weight from baseline to end of study was −4.59 kg (95% CI −5.51, −3.67) (−4.6%) versus −1.68 kg (95% CI −2.59, −0.77) (−1.7%) with SOC (between‐group difference −2.91 kg [−4.21, −1.60]) ( p < 0.001), primarily through loss of body fat. Downregulation of proinflammatory genes was observed in adipose tissue during TRE. Conclusions In adults with obesity, compared with SOC dietary counseling alone, TRE promotes weight loss, healthier body composition, and, in exploratory analyses, reduction in adipose tissue proinflammatory gene expression. Trial Registration ClinicalTrials.gov identifier: NCT04916730