Population Project

The impact of timing of eating on weight: A Multi-site Cohort Study using The Metabolic Compass Mobile Application

Obesity affects more than one third of the US population and is associated with multiple cardiovascular risk factors and heart disease, including congestive heart failure and coronary artery disease. Most research studies and clinical programs have focused on the balance of calories consumed and expended to explain the obesity epidemic and as interventions to induce weight loss. However, long-term studies, such as Look AHEAD, have had disappointing results on cardiovascular disease (CVD) endpoints. Emerging data suggest that the timing of calories consumed, not just caloric balance, can have significant effects on body weight and metabolism. Studies in animals and small studies in humans have shown that feeding mistiming results in weight gain, increased body and ectopic fat, impaired glucose homeostasis and dyslipidemia. Furthermore, early studies suggest that actively synchronizing food intake with the circadian rhythm can enhance weight loss and improve glucose and lipids. We have assembled a talented, multidisciplinary team of early career and senior investigators that are committed to seeking new solutions to the obesity epidemic. We have thus developed this proposal to conduct synergistic basic, clinical and population studies around the overarching hypothesis that the mistiming of caloric intake relative to normal circadian rhythm contributes to obesity and adverse cardiometabolic outcomes.

Project summary:

Overweight and obesity are established risk factors for cardiovascular disease. Successful weight loss strategies have focused on modifying the composition of peoples’ diet (e.g. low calorie, low fat) but few studies have assessed the role of circadian rhythms, particularly the timing of eating, with weight loss. Time restricted feeding influences metabolic outcomes and weight. However, no population-based studies have developed real-time measurement tools to assess the timing of eating, or examined the effect of intervals between meals on weight change and cardiometabolic outcomes. Our objectives are to: 1) Adapt the mobile application called The Metabolic Compass to motivate health behavior change and adherence to using the application; and 2) Enroll 1000 overweight/obese participants from the PaTH Clinical Data Research Network in a 6 month longitudinal cohort study to use the Metabolic Compass to assess the impact of time restricting feeding on weight. We will examine patterns of participants timing of eating and other circadian rhythms, use machine learning to characterize eating patterns and test the hypothesis that restricting the time spent eating will be associated with weight loss over 6 months. This population-based study will enable us to advance the field of obesity by linking mobile momentary assessments with 3 electronic medical record databases, thus leveraging the established information technological infrastructure of PaTH, a large established patient-centered research network. Ultimately, the goal is to improve our understanding of the role of the timing of eating on weight and metabolic outcomes, which could lead to the development of behavioral approaches to time restricted eating and obesity prevention and control.

PI: Wendy Bennett, MD, MPH