Type 2 diabetes affects 1.2 million Australians and accounts for 85–90% of all diabetes cases. As is well known, type 2 diabetes is the cause of many complications, many of which are potentially disabling and life shortening.
Diet is a core intervention alongside exercise and medication and while individualised, professional dietary advice improves blood glucose, it can be complex and isn’t always accessible.
The strategy of time-restricted eating (also known as intermittent fasting) has gained popularity in recent years, with studies over the short term showing improvements in glycaemic control.
A new study has compared time restricted eating to intensive, individualised dietician support on glycaemic control, with promising results.
Researchers compared time-restricted eating directly with advice from an accredited practising dietitian to test results across six months.
They recruited 52 people with type 2 diabetes who were currently managing their diabetes with up to two oral medications. There were 22 women and 30 men, aged between 35 and 65. Participants were randomly divided into two groups: diet and time-restricted eating. In both groups, participants received four consultations across the first four months.
During the next two months they managed diet alone, without consultation, and they continued to measure the impact on blood glucose. In the diet group, consultations focused on changing their diet to control blood glucose, including improving diet quality (for example, eating more vegetables and limiting alcohol). In the time-restricted eating group, advice focused on how to limit eating to a nine-hour window between 10am and 7pm.
Over six months, researchers measured each participant’s blood glucose control every two months using the HbA1c test. Each fortnight, they also asked participants about their experience of making dietary changes (to what or when they ate). Medications were taken as usual.
The research found both time restricted eating and dietitian counselling yielded improvements in glycaemic control and weight, with the most benefit occurring in the first two months of intervention in both groups. Over time, the participants in the time restricted group were more likely to stick to the intervention. Neither group did more exercise during the trial, but both successfully reduced their energy intake.
While improving diet remains an important part of diabetes care, this study showed that restricting the window of eating can play a significant role in reducing energy intake and helping control blood sugar. It can be a useful tool for doctors to provide to their patients, especially if there are barriers to accessing or adhering to dietary advice.
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