Time-Restricted Mediterranean Diet Shows Promise for MASLD

Edited By: Archita Rai

TOPLINE:

A 12-week Mediterranean diet protocol, with or without time-restricted feeding, showed improvements in cardiometabolic risk factors, like body weight and blood pressure, in patients with metabolic dysfunction–associated steatotic liver disease (MASLD) and overweight or obesity. When combined with early time-restricted feeding, the diet also reduced A1c levels and insulin resistance.

METHODOLOGY:

• Increasing interest in the health benefits of time-restricted feeding prompted researchers to test its effectiveness in combination with the Mediterranean diet, widely considered as the optimal dietary approach for patients with MASLD.
• The randomized controlled trial, conducted in Athens from 2022-2024, involved 59 patients with MASLD and overweight or obesity (mean age, 52.9 years; 45.8% men; mean body mass index, 32.1).
• Patients were randomly assigned to the control (n = 19), early time-restricted feeding (n = 20), and late time-restricted feeding (n = 20) groups.
• All participants followed the hypocaloric, Mediterranean-type diet (500 kcal/d below resting energy expenditure), with the early time-restricted group eating within a 10-hour window from 8 AM to 6 PM, the late group eating from 12 PM to 10 PM, and the control group following no time restrictions.
• Various health metrics were collected at baseline and at regular intervals during the 12-week intervention, and most also were measured at 8 weeks post-intervention. These parameters included metabolic health and liver steatosis status, anthropometric measures, body composition, blood pressure, glycemic control, and subjective appetite.

TAKEAWAY:

• All three groups showed similar body weight loss (7.6%-8.3%; P < .001 for all) and fat mass loss (14.8%-16.7%; P < .001 for all), along with significant reductions in blood pressure (systolic, 7%-12%; diastolic, 5%-12%; P < .05 for all) at week 12, when compared with the baseline values.
• The Mediterranean diet with early time-restricted feeding demonstrated significant improvements in A1c levels (P = .001) and insulin resistance markers (P < .05) at week 12.
• Liver steatosis decreased by 6.5%-9.5% across all groups at week 12 compared with baseline (P < .05 for all), but liver stiffness improved only in the early time-restricted feeding group (P = .03).
• No significant differences in subjective appetite or adherence to the interventions were noted among the three groups.

IN PRACTICE:

“Our findings suggest that a 14:10 TRF [time-restricted feeding] protocol with a Mediterranean hypocaloric diet may be an effective, accepted and well-tolerated alternative nutritional treatment for MASLD individuals,” the authors write.

SOURCE:

This study, led by Sofia Tsitsou, Agricultural University of Athens, Athens, Greece, was published online in Alimentary Pharmacology & Therapeutics.

LIMITATIONS: 

Despite all participants being diagnosed with MASLD, indicating liver steatosis and at least one cardiometabolic risk factor, significant variability in these factors was observed among the participants. Additionally, circadian clock genes were not measured to evaluate changes in metabolic parameters considering circadian rhythms. 

DISCLOSURES:

The authors received no specific funding for this study and reported no relevant financial relationships.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.