Endocrine Abstracts

Objective: Time-restricted eating (TRE) represents a novel intervention that may improve insulinaemia and reduce weight, but is untested in polycystic ovarian syndrome (PCOS). In a randomised interventional study (NCT05126199), we investigated the feasibility of TRE in PCOS. Secondary objectives included effects on insulin and metabolic indices.

Methods: Participants were randomised to 12-week TRE (18h fast/6h eating window) or ‘ab-libitum’ (no time-restriction) and crossed over. Primary outcomes assessed recruitment, compliance, safety, and drop-outs. Secondary outcomes were insulin resistance, androgens, lipids, anthropometrics, and nutritional intake.

Results: We found TRE was a feasible intervention with near-total compliance in those completing the intervention; however, there were considerable difficulties with recruitment. Of n=68 eligible to participate, n=40 declined. Ultimately, n=15 were recruited, with n=9 completing data collection to date (n=4 (27%) drop-outs due to commitment/study duration). There were no serious adverse events in the TRE group. Compliance(%(SD)) with TRE was 94(4.6)%, and n=8 were keen to continue TRE. There was no significant difference with TRE on insulin-related parameters. There was significant decrease in weight (-1.5kg (-2.7, -0.1), P=0.01), BMI (-0.52 (-0.99, -0.04), P=0.02) and hip circumferences (-2cm (-4, -2), P=0.01) in the TRE vs ab-libitum eating group. There was significant weight gain seen in the ad-libitum eating group (2.65kg (0.3, 3.5), P<0.001). Those following TRE had favourable changes in SHBG (2.4nmol/l (0.25, 6.2), P=0.04) and Apolipoprotein A1 (-0.02g/l (-0.06, 0), P=0.01) in androgen and lipid profiles. Those in the TRE group consumed significantly less energy (calories) (P=0.002), carbohydrate (P=0.03), saturated fat (P=0.03), and calcium (P=0.02) with no difference in sugar, protein, fat, or vitamin D consumption.

Conclusion: TRE was a safe and feasible intervention, however there was poor recruitment (13.2% of eligible group). With limited numbers, the TRE group had improvements in metabolic indices and lost more weight than the ‘ad-libitum’ group.