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In the Time-Restricted Eating: Microbiome and Bone (TREMBO) study, the primary goal is to determine the effect of time-restricted eating with caloric restriction compared to caloric restriction alone on bone health, as well as body weight and the gut microbiota in older women who are overweight or obese.
Time-restricted eating (TRE) has gained increased attention due to the possibility to induce weight loss and improve cardiometabolic health as a result of the purported alignment of circadian rhythm. However, since TRE is often reported to cause a spontaneous reduction of calories, it is not well understood if these health benefits are due to weight loss, circadian rhythm alignment, or a combination of the two. Furthermore, while weight loss can improve cardiometabolic health, it can also induce bone loss, which is problematic in older women who are at a higher risk of fracture. Interestingly, both bone turnover and the gut microbiota are responsive to diurnal variations, such as meal timing, and alterations in the gut microbiota have been associated with differences in bone health. In rodent models, caloric restriction can alter the gut microbiota composition with further alterations shown due to time-restricted eating. This suggests that time-restricted eating could affect bone health, which may be partially mediated by changes in the gut microbiota. Also, lifestyle patterns affects both the microbiota and bone. This randomized controlled trial will use behavior modification to examine TRE plus caloric restriction (CR) to achieve an evening energy deficit compared to CR alone on bone health, as well as body weight and the gut microbiota in older women who have overweight or obese.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Time restricted eating and calorie restriction | Experimental | Subjects will be asked to adhere to a calorie-restricted diet and will be counseled by a dietitian for diet and lifestyle behavior education. In addition, they will be asked to only consume calories during a 9-hour window (15:9). |
|
| Calorie restriction alone | Active Comparator | Subjects will be asked to adhere to a calorie-restricted diet and will be counseled by a dietitian for diet and lifestyle behavior education. They will be advised to continue to consume foods throughout the day and into the evening. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Time Restricted Eating (TRE) | Behavioral | 9-hour eating window |
|
| Measure | Description | Time Frame |
|---|---|---|
| Bone mineral density (BMD - hip) | dual energy x-ray absorptiometry | change from baseline to an average 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Areal BMD (radius, lumbar spine) | dual energy x-ray absorptiometry | change from baseline to an average 6 months |
| Gut Microbiota | stool |
| Measure | Description | Time Frame |
|---|---|---|
| Fasting osteocalcin | serum bone formation and energy marker | change from baseline to an average 6 months |
| Fasting procollagen type 1 N-terminal propeptide (PINP) | serum bone formation marker |
Inclusion Criteria:
Exclusion Criteria:
Women
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rutgers University - NJ Inst Food Nutrition & Health | New Brunswick | New Jersey | 08901 | United States |
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| ID | Term |
|---|---|
| D015431 | Weight Loss |
| D000093763 | Intermittent Fasting |
| D001851 | Bone Diseases, Metabolic |
| D009765 | Obesity |
| D050177 | Overweight |
| ID | Term |
|---|---|
| D001836 | Body Weight Changes |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D031204 | Caloric Restriction |
| ID | Term |
|---|---|
| D004035 | Diet Therapy |
| D044623 | Nutrition Therapy |
| D013812 | Therapeutics |
| D002149 | Energy Intake |
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Randomized Controlled Trial
Enroll ~48 to achieve sample size of 40
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| Calorie Restriction | Behavioral | daily calorie restriction |
|
| change from baseline to an average 6 months |
| Weight loss | Body weight in kg | change from baseline to an average 6 months |
| Soft tissues | dual energy x-ray absorptiometry (lean, fat mass, visceral adipose tissue) | change from baseline to an average 6 months |
| Trabecular bone | peripheral quantitative computed tomography (volumetric BMD, bone volume / total volume, and separation) | Change from baseline to an average 6 months |
| Cortical (Ct) bone | peripheral quantitative computed tomography (Ct volumetric BMD, Ct thickness and porosity, and total BMD) | change from baseline to an average 6 months |
| Glucose - response to oral glucose tolerance test | fasting and response to glucose solution | change from baseline to an average 6 months |
| Insulin - response to oral glucose tolerance test | fasting and response to glucose solution | change from baseline to an average 6 months |
| change from baseline to an average 6 months |
| Fasting C-telopeptide of type I collagen (CTX) | serum bone resorption marker | change from baseline to an average 6 months |
| Circumferences | tape measure (waist, hip and thigh) | change from baseline to an average 6 months |
| Short physical performance battery (SPPB) | Total score of SPPB (0-12; higher score is better) | change from baseline to an average 6 months |
| 6 minute walk test | total distance | change from baseline to an average 6 months |
| Timed up and go | total time | change from baseline to an average 6 months |
| Hand Grip | dynanometer (isometric grip force) | change from baseline to an average 6 months |
| Total body bone | dual energy x-ray absorptiometry (BMD and BMC) | Change from baseline to an average 6 months |
| Blood pressure (BP) | sphygmomanometer (systolic and diastolic BP) | change from baseline to an average 6 months |
| 25-hydroxyvitamin D (25OHD) | serum | change from baseline to an average 6 months |
| Parathyroid hormone (PTH) | serum | change from baseline to an average 6 months |
| estradiol | serum | change from baseline to an average 6 months |
| melatonin | serum | change from baseline to an average 6 months |
| cortisol | serum | change from baseline to an average 6 months |
| Cognitive function | Cambridge Neuropsychological Test Automated Battery (SOC, PAL, RTI, MTT) | change from baseline to an average 6 months |
| Quality of sleep | Pittsburgh sleep quality index (0-21; higher score is worse) | change from baseline to an average 6 months |
| Biomarkers of brain health | Serum amyloid-beta (42,40) and tau markers (217, 181), BDNF, NfL | change from baseline to 6 months |
| Diet quality score | nutrient analysis software (Healthy Eating Index 0-100; higher score is better) | change from baseline to an average 6 months |
| Eating self-efficacy | Weight lifestyle efficacy questionnaire short-form (0-80; higher score is better) | change from baseline to an average 6 months |
| D005215 | Fasting |
| D005247 | Feeding Behavior |
| D001519 | Behavior |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D004032 |
| Diet |
| D009747 | Nutritional Physiological Phenomena |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |