Exploring the effects of time-restricted eating as a novel intervention in patients with polycystic ovarian syndrome

Abstract

Introduction: Polycystic ovarian syndrome (PCOS) is associated with hyperinsulinemia, insulin resistance and a high lifetime risk of developing type-2 diabetes mellitus. While many dietary interventions have been tested in PCOS to improve insulin resistance, there are minimal data on the effects of time-restricted eating on metabolic profiles in PCOS.

Aim & Methods: The aims of this thesis were to explore the literature to determine the effects of time-restricted eating on insulin levels in PCOS, and to conduct a feasibility study, with a randomised crossover design, to determine if time-restricted eating was a feasible intervention in terms of subject participation, compliance, side effects, and effects on metabolic parameters. Dietary intake was measured measuring using Nutritics and Libro software.

Results: The systematic review identified one study and highlighted a clear research gap. The feasibility study (Registered NCT05126199) found that time-restricted eating was a feasible intervention with near-total compliance in those completing the intervention, with no significant adverse outcomes for those in the TRE group; however, there were considerable difficulties with recruitment. In terms of metabolic outcomes, there was no statistically significant difference in the changes seen with time-restricted eating for the insulin-related parameters. There was a significant reduction in weight, BMI, waist, and hip circumferences in the time-restricted eating group compared to the ab libitum eating group. There was a statistically significant weight gain seen in the ad libitum eating group. Regarding androgen and lipid profile outcomes, those following time-restricted eating had favourable changes in SHBG and Apolipoprotein A1. Those in the time-restricted eating group consumed significantly less energy (calories), carbohydrate, saturated fat, and calcium with no difference in consumption of sugar, protein, fat, or vitamin D.

Conclusion: Time-restricted eating was safe and feasible with high compliance among study participants; however, recruitment was suboptimal. Further studies are required, and a detailed roadmap for a future substantive study was described in order to further investigate the feasibility and clinical efficacy of time-restricted eating in this patient group.