Steno Diabetes Center Copenhagen
Gentofte Municipality, DK-2810, Denmark
NCT Number: NCT03854656
The aim of the present study is to investigate effects of 12 weeks time-restricted eating on behaviour and metabolism in individuals with overweight or obesity at high risk of type 2 diabetes.
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Notify Me30 year–70 year
All sexes
Interventional
Not applicable
Gentofte Municipality, DK-2810, Denmark
Overweight and obese individuals with pre-diabetes or with a family history of diabetes or cardiovascular disease (CVD) are at high risk for developing type 2 diabetes (T2D) and CVD. Current prevention and treatment of obesity and T2D include energy restricted diets and increased levels of physical activity; however, adequate adherence to such strategies is difficult, and maintenance is challenging for most individuals, which stresses the need for feasible and sustainable interventions.
Circadian rhythms of behaviour and metabolism are closely related to the daily light/dark cycle and sleep-wake patterns and timing of food intake and fasting periods may affect the circadian rhythms of metabolic organs. In an evolutionary perspective, the pattern of food consumption has been characterised by periods of caloric intake when food was available and subsequent periods of fasting 9. This cyclic pattern leads to cycles of absorption and storage of energy and utilisation of the energy for e.g. tissue repair, stress resistance and vitality where expression of metabolic regulators coordinates with cellular processes, leading to efficient metabolism 10. Factors including the 24-hour availability of energy-dense foods, busy time schedules, different eating and sleep patterns during weekdays and weekends (i.e. 'social jetlag') challenge the feeding-fasting paradigm. Recent data suggest that an erratic diurnal eating pattern characterised by food intake largely spread throughout hours awake (≥15 h) and a concomitant short fasting period is highly prevalent in humans and animal suggest that circadian misalignment of food intake is associated with adverse metabolic effects. A number of animal studies and a few small studies in humans have reported promising effects of time-restricted eating (TRE), without concomitant dietary restrictions, on body weight and other cardiometabolic risk factors. There is a lack of randomized controlled trials investigating effect of TRE in individuals at high risk of type 2 diabetes and cardiovascular diseases.
The aim of the present study is to investigate effects of 12 weeks TRE on behaviour and metabolism in individuals with overweight or obesity at high risk of type 2 diabetes. Maintenance will be assessed at a follow-up visit 13 weeks after completion of the trial (26 weeks). Testing will be conducted at baseline and after 6, 12, and 26 weeks. Participants are instructed to follow randomization during one week assessment periods after testing at 6 and 12 weeks. Therefore, the total duration of the intervention is 13 weeks.
Healthy volunteers accepted: Yes
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
Specific exclusion criteria for participants receiving SmartPillTM (n=60)
Participants will be instructed to eat within a self-selected 10-hour timeframe between 6AM and 8PM every day. All food/beverages except water must be consumed within the time-interval. Staff will help participants select a time-interval that fits into their daily life and optimally fulfil the following guiding principles:
Diet is ad libitum and with no further dietary restrictions. Participants will receive advice about a healthy lifestyle according to the national dietary recommendations from the Danish Health Authority.
Time frame: Change from baseline to the end of the intervention (after 12 weeks)
Measured in fasted state on a digital scale
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks)
Measured on a digital scale
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks)
Calculated from body weight (kg) and height (m)
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks)
Measured by Dual-energy X-ray Absorptiometry
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks)
Measured by Dual-energy X-ray Absorptiometry
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks)
Measured by Dual-energy X-ray Absorptiometry
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks)
Measured using tape measure
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks)
Measured using tape measure
Time frame: Changes from baseline. All four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from blood samples at all visits
Time frame: Changes from baseline. Measured at all four visits (Baseline and after 6, 12, and 26 weeks)
Measured under resting and fasting conditions
Time frame: Changes from baseline. Measured at all four visits (Baseline and after 6, 12, and 26 weeks)
Measured under resting and fasting conditions
Time frame: Changes from baseline. Measured at all four visits (Baseline and after 6, 12, and 26 weeks)
Measured under resting and fasting conditions during measurements of blood pressure and in the supine position by a handheld ECG measuring device (Vagus™)
Time frame: Changes from baseline. Measured at visits at baseline and after 12 weeks
Measured by indirect calorimetry under resting and fasting conditions
Time frame: Changes from baseline. Measured at visits at baseline and after 12 weeks
Measured by indirect calorimetry under resting and fasting conditions
Time frame: Changes from baseline. Measured in the blood in the fasted state at all four visits (Baseline and after 6, 12, and 26 weeks) and during a mixed meal test (4 hours) at baseline and end of the intervention (after 12 weeks)
Fasting and postprandial (after a standard mixed breakfast meal) concentrations of metabolites including but not limited to: glucose, lipids, cholesterol, free-fatty acids, and amino acids
Time frame: Changes from baseline. Measured in the blood in the fasted state at all four visits (Baseline and after 6, 12, and 26 weeks) and during a mixed meal test (4 hours) at baseline and end of the intervention (after 12 weeks)
Fasting and postprandial (after a standard mixed breakfast meal) concentrations of hormones related to regulation of appetite, glucose and lipid metabolism (including but not limited to: insulin, glucagon, ghrelin, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and peptide YY (PYY), leptin, fibroblast growth factor 19 (FGF-19), fibroblast growth factor 21 (FGF-21), growth differentiation factor 15 (GDF-15)).
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks)
Fasting levels of circulating proteins that associate with low-grade inflammation and lipid metabolism. Such proteins are captured by mass-spectrometry driven analyses of the plasma proteome i.e. proteins circulating in the blood
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks) and during a mixed meal test at baseline and end of the intervention (after 12 weeks)
Measured using the Seahorse method, which measures mitochondrial respiration
Time frame: Changes from baseline. Measured at visits at baseline and end of the intervention (after 12 weeks)
Measured by a handheld ECG measuring device (Vagus™).
Time frame: Changes from baseline. Measured at visits at baseline and end of the intervention (after 12 weeks)
Measured by a handheld ECG measuring device (Vagus™).
Time frame: Changes from baseline. Measured at visits at baseline and end of the intervention (after 12 weeks)
Measured by a handheld ECG measuring device (Vagus™).
Time frame: Changes from baseline. Time after consumption of the standard mixed meal at baseline and end of the intervention (after 12 weeks).
Measured using the SmartPill™ technique. The SmartPill™ is ingested together with a standard mixed breakfast meal
Time frame: Changes from baseline. Time after consumption of the standard mixed meal at baseline and end of the intervention (after 12 weeks).
Measured using the SmartPill™ technique. The SmartPill™ is ingested together with a standard mixed breakfast meal
Time frame: Changes from baseline. Time after consumption of the standard mixed meal at baseline and end of the intervention (after 12 weeks).
Measured using the SmartPill™ technique. The SmartPill™ is ingested together with a standard mixed breakfast meal
Time frame: Changes from baseline. Time after consumption of the standard mixed meal at baseline and end of the intervention (after 12 weeks).
Measured using the SmartPill™ technique. The SmartPill™ is ingested together with a standard mixed breakfast meal
Time frame: Changes from baseline. Time after consumption of the standard mixed meal at baseline and end of the intervention (after 12 weeks).
Calculated based on amplitudes and number of contractions measured using the SmartPill™ technique. The SmartPill™ is ingested together with a standard mixed breakfast meal
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks) and during a mixed meal test at baseline and end of the intervention (after 12 weeks)
Eye tracking metrics including gaze duration bias, gaze direction bias, fixations, saccades, pupil size/dilation, distance to screen, ocular vergence and blinks to measure attention in response to looking at food pictures during the computerized Leeds Food Preference Questionnaire
Time frame: Changes from baseline. Fasted state at all four visits (baseline and after 6, 12, and 26 weeks) and during a mixed meal test at baseline and end of the intervention (after 12 weeks)
Facial expression analyses using computer-vision algorithms (AFFDEX) to measure emotions in response to looking at food pictures during the computerized Leeds Food Preference Questionnaire
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks) and during a mixed meal test at baseline and end of the intervention (after 12 weeks)
Changes in conductivity of the skin (galvanic skin response) in response to looking at food pictures during the computerized Leeds Food Preference Questionnaire
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks) and during a mixed meal test at baseline and end of the intervention (after 12 weeks)
Food choice of food items from four combined food categories (high-fat savoury, high-fat sweet, low-fat savoury and low-fat sweet foods) examined from the computerized Leeds Food Preference Questionnaire. Food choice is determined based on frequency of selection made within each food category. The scores range from 0-48 i.e. 0 = foods within a specific food category have not been selected at all to 48 = foods within a specific food category have been selected 48 times
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks) and during a mixed meal test at baseline and end of the intervention (after 12 weeks)
Implicit wanting of food items from four combined food categories (high-fat savoury, high-fat sweet, low-fat savoury and low-fat sweet foods) examined from the computerized Leeds Food Preference Questionnaire. Implicit wanting is assessed based on food choice and response time for selected and non-selected food items as well as mean response time.
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks) and during a mixed meal test at baseline and end of the intervention (after 12 weeks)
Explicit liking of 16 food items from four combined food categories (high-fat savoury, high-fat sweet, low-fat savoury and low-fat sweet foods) examined from the computerized Leeds Food Preference Questionnaire. Explicit liking is rated using visual analogue scales and the range is 0-100. Each end represents the extremes e.g. Question: "how pleasant would it be to taste this food right now?" Answer: "not at all" (rated 0 on the 0-100 scale) to "extremely" (rated 100 on the 0-100 scale)
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks) and during a mixed meal test at baseline and end of the intervention (after 12 weeks)
Explicit wanting of 16 food items from four combined food categories (high-fat savoury, high-fat sweet, low-fat savoury and low-fat sweet foods) examined from the computerized Leeds Food Preference Questionnaire. Explicit wanting is rated using visual analogue scales and the range is 0-100. Each end represents the extremes e.g. Question: "how much do you want some of this food now?" Answer: "not at all" (rated 0 on the 0-100 scale) to "extremely" (rated 100 on the 0-100 scale).
Time frame: At all four visits (Baseline and after 6, 12, and 26 weeks)
Including but not limited to the Matsuda index
Time frame: At all four visits (Baseline and after 6, 12, and 26 weeks)
Including but not limited to Homeostaic Model Assessment for Insulin Resistance (HOMA-IR)
Time frame: Changes from baseline. Fasted state at all four visits (Baseline and after 6, 12, and 26 weeks) and during a mixed meal test at baseline and end of the intervention (after 12 weeks)
Rated using visual analogue scales and includes sensations of: Hunger, fullness, satiety, prospective food consumption, wellbeing, nausea, thirst, desire to eat meat, salty, and sweet. The scale range is 0-100 and each end represent the extremes e.g. hunger rating: "I am not hungry at all" to "I have nerver been this hungry before".
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Measured using continous glucose monitoring
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Measured using continous glucose monitoring
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Measured using continous glucose monitoring.
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Measured using continous glucose monitoring.
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Measured using continous glucose monitoring.
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Measured using continous glucose monitoring.
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Sedentary time, light, moderate and vigorous intensity physical activity. Assessed from 24 h/day accelerometry
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Assessed from 24 h/day accelerometry
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Assessed from 24 h/day accelerometry
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Assessed from 24 h/day accelerometry
Time frame: Changes from baseline. Measured 7 days after the test days at baseline and after 6 and 12 weeks
Assessed from activity logs and 24 h/day accelerometry
Time frame: Changes from baseline. Registered 3 days after the test days at baseline and after 6 and 12 weeks
Assessed from diet records
Time frame: Changes from baseline. Registered 3 days after the test days at baseline and after 6 and 12 weeks
Assessed from diet records
Time frame: Changes from baseline. Registered 3 days after the test days at baseline and after 6 and 12 weeks
Assessed from diet records
Time frame: Changes from baseline. Registered and measured for 7 days after the test days at baseline and after 6 and 12 weeks
Including bedtime, sleep onset, wake-up, time out of bed, sleep midpoint. Assessed from sleep logs and 24 h/day accelerometry
Time frame: Changes from baseline. Registered and measured for 7 days after the test days at baseline and after 6 and 12 weeks
Assessed from sleep logs and 24 h/day accelerometry
Time frame: Changes from baseline. Registered and measured for 7 days after the test days at baseline and after 6 and 12 weeks
Variability in bedtime, wake-up, sleep duration and sleep midpoint. Assessed from sleep logs and 24 h/day accelerometry
Time frame: Changes from baseline. Registered and measured for 7 days after the test days at baseline and after 6 and 12 weeks
Assessed from sleep logs and 24 h/day accelerometry
Time frame: Changes from baseline. Measured for 7 days after the test days at baseline and after 6 and 12 weeks
Assessed from 24 h/day accelerometry
Time frame: Changes from baseline. Measured for 7 days after the test days at baseline and after 6 and 12 weeks
Assessed from 24 h/day accelerometry
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from the questionnaires the Gastrointestinal Symptom Rating Scale (GSRS). Rated on 7-point likert scales. Range: 1 = absence of symptoms to 7 = very severe symptoms.
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from the Gastrointestinal Symptom Score (PAGI-SYM). Rated on 6-point likert scales. Range: 1 = absence of symptoms to 6 = very severe symptoms.
Time frame: Changes from baseline. Registered 7 days after the test days at baseline and after 12 weeks
Number of symptoms. Assessed from logs.
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from the questionnaire COMPASS31
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from the questionnaire Control over Eating Questionnaire
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from the questionnaire the Epworth Sleepiness Scale
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from the questionnaire Pittsburgh Sleep Quality Index
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from the Munich Chronotype Questionnaire
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from questionnaire International Physical Activity Questionnaire
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from the questionnaire Self-reported health (SF-36 health survey)
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from The Dutch Eating Behavior Questionnaire
Time frame: Changes from baseline. Assessed at all four visits (Baseline and after 6, 12, and 26 weeks)
Assessed from The Night Eating Questionnaire
Time frame: Registrered every day (13 weeks intervention and 13 weeks follow-up period)
Time of first and last meal/beverage
Time frame: Changes from baseline. Collected before or during test days at visits at baseline and after 12 weeks
Determined from stool samples. Bacterial DNA and RNA will be purified from the stool samples and changes in the microbiome composition and function will be estimated based on sequencing of the microbiomes' DNA and RNA. Includes but is not limited to the Firmicute/Bacteroidete ratio.
Time frame: Visits at baseline and after 12 and 26 weeks. Potential drop-outs will be interviewed at the specific time point.
Themes and aspects related to motivation for participation will be assessed based on interviews with the participants including completers and potential drop-outs.
Time frame: Visits at baseline and after 12 and 26 weeks. Potential drop-outs will be interviewed at the specific time point.
Themes and aspects related to feasibility of the intervention will be assessed based on interviews with the participants including completers and potential drop-outs.
Time frame: Visits at baseline and after 12 and 26 weeks. Potential drop-outs will be interviewed at the specific time point.
Themes and aspects related to satisfaction with the intervention will be assessed based on interviews with the participants including completers and potential drop-outs.
Kristine Færch
Other
Effect of Time-restricted Eating on Behaviour and Metabolism in Overweight Individuals at High Risk of Type 2 Diabetes - the RESET Study
Acronym: RESET
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