
Ten-Hour Time-Restricted Eating Benefits Patients with Metabolic Syndrome - pseudolus
https://www.npr.org/sections/thesalt/2019/12/08/785142534/eat-for-10-hours-fast-for-14-this-daily-habit-prompts-weight-loss-study-finds
======
dang
[https://news.ycombinator.com/item?id=21718456](https://news.ycombinator.com/item?id=21718456)

------
jt2190
> The study was small, just 19 people. All the participants were overweight
> and had a cluster of risk factors (elevated blood sugar, elevated
> cholesterol levels and high blood pressure) that put them at higher risk for
> Type 2 diabetes and heart disease. A larger study, funded by the National
> Institutes of Health, is underway to examine daily fasting in people with
> metabolic syndrome.

~~~
Lagogarda
19 people "study" looks like a fake news?

~~~
judofyr
No. This is a preliminary study of a new fasting method. There is no-one who
is deliberately spreading this on social media to advance their own political
situation.

~~~
mikorym
> political

And financial!

------
matwood
I wasn't overweight, but started doing IF as part of a larger life shift as a
way to improve general health. I ended up losing weight because of the
lowering of calories through skipping a meal, but I kept most of my muscle.

The biggest adjustment is that I work out most mornings, and felt I needed
food prior. After a few days it became no factor. After doing IF for the past
year+, I'm almost never hungry in the morning.

The biggest positive change for me though, was my morning mental sharpness.
The hours between my workout and lunch time have become the best hours of the
day for anything requiring mental acuity.

------
nickjj
This is a weird title. Isn't this basically just trying to eat regularly with
a reminder to avoid really bad habits such as eating right before going to
bed?

For example, eat dinner at 6-7pm and that's your last food intake for the day
and then eat breakfast around 7-9am. That's roughly a 10/14 set up. In my mind
this isn't "fasting". It's just living life normally based on your sleep
schedule.

~~~
SteveNuts
Is eating right before bed actually a bad habit? I don't see why it would
matter much what time you eat (barring indigestion possibly).

~~~
blaser-waffle
If you're in the first world then chances are you've already 2000+ calories
today and don't really need more. You're hungry before bed because your blood
sugar is falling, and all those extra calories will do is push you over the
limit for the day, aka extra calories lead to fat.

~~~
Liquid_Fire
I think you are making the assumption that eating before bed implies an extra
snack, but it could just be that you have dinner shortly before going to bed.

------
xphilter
Isn’t it just as likely that the 8% reduction in calories gave all the
benefits? I briefly read the study and it didn’t seem like they had a reduced
calorie group without time restrictions. Thoughts anyone?

~~~
biggerfisch
If this strategy works to encourage people to accidentally consume fewer
calories, isn't that good enough? I don't think this was about the _mechanism_
about the weight loss, but merely that the behavior pattern ended up
encouraging it.

~~~
AnIdiotOnTheNet
> If this strategy works to encourage people to accidentally consume fewer
> calories, isn't that good enough?

Depends. I'm sure for some people it does work. I don't understand those
people, because I, like many people who put on a whole lot of weight, am a
food addict. Give me only an hour in which to eat, with no other restrictions,
and I will find a way to shove as much food into my maw as I can. I know this
from experience.

It makes much more sense to just track calories directly and stop lying to
yourself.

~~~
notacoward
"lying to yourself" seems unduly insulting. Maybe other people _are_ tracking
calories, and TRF is how they stay within a budget. Even if they are tricking
themselves, what's wrong with that? We all hack our own reward-response
mechanisms all the time to achieve all sorts of goals. If it works, it works,
and what's the harm? Why condemn that as less "honest" than whatever you do to
work around your own limitations and achieve your own goals?

Making people feel bad about the methods they choose is real-world harmful.
Maybe "advice" like yours won't actually kill anyone, but people who become
discouraged by that drumbeat of negativity could experience some ill effects.
Be glad that what works for you _works for you_ , but please stop pissing on
everyone else.

~~~
AnIdiotOnTheNet
If you count calories, then any additional strategies are fine, but I know
from experience that not counting calories and relying on other strategies as
an abstraction leaves too much room for self delusion about your intake.

------
solids
Right now I'm doing 16/8, with 3 full meals a day, and I also spend one day a
week in full fasting.

IMHO, the current status of nutrition is very divergent, almost every habit is
backed up and discouraged at the same time by more than one study. There seems
to be some agreements (about sugar, for instance) but the rest is not clear at
all. And on top of it, you have to take into account how your own body reacts
to a particular habit. Seems that trial/error is the best option for now.

~~~
wyldfire
> IMHO, the current status of nutrition is very divergent, almost every habit
> is backed up and discouraged at the same time by more than one study

Are there any that say fasting is bad?

~~~
pmilb
No expert here, but I think fasting can sometimes trigger disordered eating in
some people. Binge eating, etc. People are just so varied and so is nutrition.

------
dforrestwilson
I have been skipping breakfast for the past year. This works for me when
nothing else has.

I started a new job which is highly unpredictable and involves a lot of last
minute travel. Due to the stress, lack of sleep, etc I had gone from 165 ->
180 pounds in 8 months. All fat.

After 3-4 months of morning fasting I am down to 165 pounds again. No change
in workout routine. I generally stop eating around 8pm local time, and have my
first meal around 11 or 12pm.

The best part is I can eat whatever I want still - burgers, pizza, etc. No
restrictions.

I am wondering if female metabolism is fundamentally different. My wife tried
the same diet and it just hasn’t worked for her. She gets too hangry whereas I
find myself in a flow-state by mid morning.

Dr Peter Attia has done some great podcasts and YouTube presentations on the
science behind fasting for the curious.

~~~
matwood
> Dr Peter Attia has done some great podcasts and YouTube presentations on the
> science behind fasting for the curious.

As someone who wasn't overweight, it was Dr. Attia with his guest Rhonda
Patrick who finally got me to try IF for general health. I highly recommend
listening to his podcasts.

------
Moto7451
This has worked pretty well for me and my own weight loss (and maintenance)
journey. When I eat outside of my own 9-10 hour window it usually ends up as a
meal that I overindulge in and subsequently regret.

As more anecdata, I find myself voracious between 8 and 9 AM, again between 11
and noon, and then between 4 and 5. After that I’ll throw back a decaf coffee
or two but don’t normally crave food. When I ate whenever I was hungry I was
all over the place and simply ate too large of a portion of anything and
everything except breakfast.

------
WA
I have another one, which I followed now for a while. My intention was less
about weight loss, but I'd argue it still helps:

Eat breakfast, lunch and dinner like you'd normally do. But in between meals,
follow a strict zero-calory intake. This way, you have 4-5 hours of zero
calories between meals. Thus:

\- only water is allowed

\- if you want to drink coffee, drink it right with/after a meal

\- if you want to eat chocolate or snacks, they have to come after a meal

I noticed that this has several effects:

1\. For me, it's easier to do than intermittent fasting, because my family
eats three meals.

2\. Most people gain weight because they snack all the time or drink stuff
with sugar (or coffee with milk).

3\. I actually became hungry after 4-5 hours. A feeling I haven't had in a
while.

4\. I can't eat lots of snacks or chocolate, because I'm full from a meal.

~~~
nottorp
If you drink your coffee black, you don't need to do it right after a meal :)

~~~
yebyen
You're saying this based on what exactly? I've heard that coffee/caffeine is
most effective at boosting sharpness when your stomach is not empty. (I'm
under the impression now that there is more than one reason why coffee after a
meal is the recommended way to take it, and not understanding how whether you
take it with milk plays into it... could you elaborate?)

~~~
WA
Not the parent poster, but I understood this as "black coffee has almost zero
calories". This was the only restriction I explained in my post. This is not
about boosting the effectiveness of coffee, but simply cutting out all
calories between meals (except possibly for neglectible amounts as in tea or
coffee).

~~~
yebyen
Ah, thanks for the clarification. My understanding about the effects of
caffeine is not based on anything other than hear-say from people who seemed
to have done their research better than I have, but from what I did hear,
caffeine on an empty stomach may have opposite the intended effects, making
you actually more confused instead of boosting focus.

Anecdotally after hearing this myself, I have tried to make it a point to take
coffee less often when on an empty stomach, and it does seem to help with
focus-depletion.

------
alanwil2
Dr. Jason Fung (he is on youtube) found that his patients who fasted during
Ramadan had improvements to their metabolic health. After Ramadan, he would
have to adjust their meds. This evolved in to him advocating fasting for his
diabetic patients and has reversed people's diabetes. Bottom line is that it
really works and gets results...and it is easy for people to follow.

------
eemil
> Typically, people would go for an 8 a.m. to 6 p.m. eating window

This is something I don't get. After sleeping 8h, you're in a fasted state,
having done the "hard part" that is not eating for several hours. So
breakfast/lunch should be the easiest meals to skip.

~~~
nathancahill
Most people I know do IF by waiting to eat until 2-3pm.

~~~
robochat42
It seems like this would be the easiest approach but the second part of the
article talks about the importance of syncing body clocks with daylight hours.
If that argument has merit then we shouldn't be skipping breakfast but missing
dinner.

~~~
vidarh
The problem with missing dinner is that it makes compliance at lot harder if
you mess with social schedules.

~~~
skohan
Also, willpower is strongest in the morning and decreases over the course of
the day.

------
srik
Once one adopts a routine like this, it's becomes so much easier to
efficiently condense that 10 hr eating window into a 2-1 hr one for more of
those "gains". Combine that with a low carb lifestyle and you essentially get
yet another free multiplier.

------
skocznymroczny
I've recently started doing 23h fasts. It's the easiest diet so far. As soon
as I come back from work, which is around 5pm, I eat whatever I want. Then no
eating until I come back from work next day. It's also nice not to think about
food all day.

~~~
dingaling
That is incredible, and I'm a little jealous.

I need to eat every two hours, maximum, whilst awake. If I miss one period
then I'm basically unable to function normally.

~~~
Dirlewanger
That's not a good thing, btw. It shows you're addicted to constant blood sugar
hits. Getting through a day or two of agony and fasting would probably help
you out in the long run.

~~~
0xcde4c3db
I've forgotten the details, but I believe the described pattern is
characteristic of some metabolic disorders. Considering that, I'd recommend
talking to a doctor before going straight to fasting.

------
xboxnolifes
Honestly, this is a habit that a lot of people (that I know) do without even
realizing it. All you need to do is skip breakfast (maybe replace with a black
coffee since they wont skip caffeine) and you almost certainly fall into a
10/14 TRE regimen.

------
carbocation
The main risk in a study like this is that (1) with inclusion criteria but (2)
without controls, you’re susceptible to reversion to the mean.

Imagine that your weight fluctuates by about 3% every few days. The risk is
that by imposing a cutoff for inclusion, you are more likely to identify
people at the top of their usual range. So, the natural decline as they
oscillate around their normal weight will look like a treatment effect.

Adding controls without intervention would be helpful to identify (and control
for) this problem.

Unrelated, but also, I note that 6 people were excluded because they already
eat for fewer than 10h/day.

------
rubinelli
I wonder if there is something like a Hawthorne effect for diets that would
explain why almost any dietary change leads to some weight loss. Simply
changing when they eat seems to make people ingest fewer calories.

~~~
0xcde4c3db
I'm not aware of a formal name for it, but there's certainly a hypothesis
floating around that weight loss diets mostly work by altering the way that
people pay attention to food. That is, the behavioral effects of being "on a
diet" explain most of the weight loss while the particular rules and theory of
any given diet explain little of the weight loss. It's sort of like the dodo
bird verdict [1] for diets. It would be interesting to know if any studies
have compared "real" and "placebo" diets to estimate this effect; searches
mostly come up with references to a book called "The Placebo Diet" which seems
related but I'm not sure it directly addresses the empirical question.

[1]
[https://en.wikipedia.org/wiki/Dodo_bird_verdict](https://en.wikipedia.org/wiki/Dodo_bird_verdict)

------
hamadj
The sample of people is really small (n = 19), so I would definitely take this
with a grain of salt. I’ve personally found fasting to be an incredibly
effective method of weight reduction, however I was fasting for upwards of 20
hours a day. If you view the world from a basic calories in vs. Calories out
lens, what is the best way to reduce calories in... just don’t eat. I find it
a lot easier to not have the option to eat than to have the option to eat but
having to eat less. I would be interested to see how the rest of the HN
community sees fasting

~~~
Uberphallus
It's also easier not to eat than burning off the excess. With my complexion,
it takes about 5K to burn through 1 Snickers bar. I do run and I find easier
not to eat that bar than to burn it, so for people who don't exercise
themselves it should be a no brainer.

------
isoos
I wish it was easier to monitor what goes on inside our body. E.g. digesting
works differently if you have some kind of intolerance, allergy, diabetes,
whether you have enough muscle mass or not... We treat it as a black box, give
blanket statements with a self-selected sample size, and hope that it works
for everybody, which it rarely does.

E.g. there are conditions which require you to eat small meals throughout the
day, which obviously is in conflict with fasting...

------
mlforlife123
I have been intrigued with IF for a few years now. While i think in theory I
think it sounds great I also find it difficult to believe that you can
strictly stick to a 9-9 diet every day. While on my own I can stick to such,
but I will often be asked out to eat later in the evening or for drinks on the
weekend which takes place outside of my fasting times. Does anyone have any
suggestions for this?

~~~
tvanantwerp
I can usually plan for events that would normally be outside my eating window
and adjust timing accordingly. But ultimately, I don't beat myself up about it
if, say, one day a week I can't get things perfect due to social constraints.

~~~
mlforlife123
yes agreed!

------
AnIdiotOnTheNet
As someone who has worked hard to lose and keep off about half my bodyweight,
I believe I've got a pretty good idea of what works and what doesn't and,
frankly, it really irks me that people advise these kinds of tactics. Time
restriction alone is not sufficient. I can easily (very, very easily) down 10k
Calories in under an hour. By some delusional people's metric, that's a 23
hour fasting period and should work great. I can assure you from experience
that it does not result in weight loss.

This sort of advice is, at best, a highly abstracted trick for just plain
eating fewer calories. You're better off just tracking the calories directly,
_especially_ if you're a food addict.

Edit: To everyone disagreeing, find me a single study that shows anyone
gaining weight on a long term caloric deficit. For comparison, here's a
nutrition professor losing 27lbs eating Twinkies at a caloric deficit:
[http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/...](http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/index.html)

~~~
notacoward
> I can easily (very, very easily) down 10k Calories in under an hour.

But would you _want_ to? Maybe you would, but most wouldn't because appetite
doesn't just increase linearly over time. The idea with TRF is that even if
people eat 500 extra calories at dinner that still has less effect than 1000
calories' worth of breakfast, lunch, and/or snacks, both in terms of raw
calories and in terms of varying metabolic effects. Even if it were just a
highly abstracted trick for just eating fewer calories (it's not), people
might find it easier to stick to than having every meal but eating less at
each. Motivation matters.

You're right that time restriction alone is not sufficient. Neither is
calories counting alone. How much you eat, what you eat, when you eat _all_
matter. Any diet that focuses on only one - any one - won't work for some
people, or at all. Let's not try to counter bad advice with more sample-of-one
bad advice.

~~~
AnIdiotOnTheNet
> Neither is calories counting alone.

I've got 160lbs of missing mass that disagrees. Not to mention numerous
studies and basic physics.

~~~
notacoward
Again, sample of one. Great that it worked for you. Doesn't mean it will work
for everyone, even if they can stick to it. Science is not made of anecdotes.

Edit (responding to your ninja-edit): there might not be any examples of
people gaining weight _if they stuck to_ a long-term caloric-deficit plan, but
there are millions who gained weight when they couldn't stick to one. And be
careful about criticizing them for lacking willpower or whatever, or someone
might wonder about the willpower aspect of being unable to keep from eating
10K calories in a single sitting. People are different, with individual
strengths and weaknesses. That's why statistical evidence outweighs anecdotes.

------
PretzelFisch
It's interesting that they pick 14/10 when most of the "people" hyping IM push
for 16/8 or 18/6, It would be nice to see studies that show any benefit of the
longner fast window. I have a feeling the longer time has some kind of
competition component to it.

~~~
jerrytsai
Perhaps there is a little competition component, but the idea is to stay
longer in the ketosis state. If you're doing 18/6, then your body will be in a
fasting state for a longer time, and the belief is that the longer your body
is in that state, the more benefit you will reap.

------
smartbit
Seems similar to Ramadan :-) _if_ following the timetable of Mecca
[https://en.wikipedia.org/wiki/Ramadan](https://en.wikipedia.org/wiki/Ramadan)

------
jimnotgym
Great, I leave on my commute at 06.45, get home about 18:30 to 19:00.

Do I not eat before my morning commute, or eat my evening meal at my desk?

~~~
blaser-waffle
Eat a protein bar at 1400.

Most of the fasting schedules are 16/8, or 16 hours no-eating, 8 hours eating.

Assuming you start at 2pm, you can eat from 1400-2200. Grab a small snack at
2, and then plan on a big meal at home.

~~~
jimnotgym
Hardly a balanced diet. I don't think a lot of schedules that fly in the face
of healthy eating.

------
yodsanklai
> We saw a 3% reduction in their weight

> participants consumed about 8.6% fewer calories

I would say the interesting fact is that people consumed less food. It was
basically forced diet.

They should do a different study to see how 14-hours fasting compares with a
-8.6% calories intake diet.

~~~
mcv
Anything that reduces how much calories you take in without reducing the
calories you burn, is going to make you lose weight.

The whole trick in helping people lose weight is finding a way people can
easily keep doing that without any expenditure in willpower. That's the big
problem with every single diet: it requires discipline and willpower. The less
of those it requires, the easier it becomes to stick to the diet.

~~~
mumblemumble
I'd go a step further: That seems to be the problem with the very idea of a
diet. The connotations are all wrong. The idea that it's going to be an
expenditure of discipline and willpower is intimately wrapped up in the
concept, and it's downright depressing to contemplate doing that indefinitely.

I would guess that it's a lot easier to achieve success if you try to play a
different mental game, where the goal is to change your habits in a way that
makes a different way of eating the default state instead of something that
requires a constant effort. Maybe decide that certain kinds of foods are only
for when you're eating out? Maybe buy a rice cooker so that whole grains are
more convenient to prepare? Maybe find other motivations entirely? Chip bags
and the like aren't recyclable, so my home consumption of junk calories
dropped off precipitously after I decided to make a concerted effort to limit
the amount of plastic packaging I'm sending to the landfill.

~~~
mcv
Exactly. Don't follow a diet, but structurally change your eating pattern.
Long ago, after a year of eating mostly pizza, I switched to eating mostly
stir-fry vegetables. My food still wasn't very varied, but that meant it
required little effort and willpower. And it was still a lot healthier than
pizza. Lost 5 kg in 5 weeks.

Then I met my wife and she didn't want to eat just stir-fry vegetables, so now
I'm heavier than ever.

------
thrownaway954
intermittent fasting works wonders for the body. Most people I know do 16/8,
16 hour fast with 8 hour eating. the ones who lost the most weight do 20/4\.
Now... you still have to control what you're eating. it does no good to fast
and then eat 5000 calories.

------
BelleOfTheBall
The weight loss is cool and all but it seems like a bad idea to just start
doing this method until there's a long-term study about the effects this has
on your body. What if you stick to it for a few years and ruin your body? 12
weeks is not nearly enough for conclusive results.

~~~
vidarh
People have been going on intermittent fasting schedules for centuries.

Ramadan being a good example.

This is also by no means the first study into intermittent fasting.

While we certainly don't know every detail about what the optimal pattern is,
the idea that you might "ruin your body" by limiting your eating to a 10 your
window seems far fetched.

~~~
BelleOfTheBall
Ramadan isn't a constant diet, though, it's only for a month in a year. I'm
talking about doing intermittent fasting as a regular daily diet. But, yeah,
maybe I worded it a bit too severely.

------
pizza234
Both the article and the study are extremely suspicious.

In addition to the mentioned points:

> When you're constantly giving the body calories, you're constantly making
> your cells work

This is a nonsensical statement.

> We saw a 3% reduction in their weight and a 4% reduction in abdominal
> visceral fat

Taken out of context, this is poor journalism. There's fat all over the body;
abdominal fat is only a part of it.

I've checked the research:

> We observed significant reductions (p < 0.05) in body weight (mean ± SD, 3.3
> ± 3.20 kg [3%]) [...] percent body fat (1.0% ± 0.91% [3%])

If I understand this correctly, they lost, in average, 3.3 kgs of body weight
(on an 85 kgs person, that's 3.9%), and 1% of body fat.

This is a catastrophe. It means that a lot of non-fatty tissues (muscles) have
been lost, which is the effect of poor diets.

------
mikorym
I'm sorry but these kind of studies tell you nothing.

I've done the "San/Khoikhoi" approach to eat and fast. I've done the "eat
small amounts" frequently. All of these have their virtues and under any such
(whilst being sensible) you'll probably live to an averaged healthy 80. Edit:
If you have a disease that puts you way below average, then you probably
already have personal recommendations via the scientific literature (or no
recommendations).

What these studies _do_ do is make you panic about your current habits. The
oldest woman a while ago was an Italian woman who ate two eggs every morning
until she died some time in her 110s. I don't know if that means you should
eat eggs.

Stress about your diet at this point is more likely to be an issue that the
actual diet. That is now if you don't have Kwashiorkor.

