Influence of Time-restricted Meal Intake on Blood Pressure Variables
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Abstract
Time-restricted Eating (TRE) has garnered attention for its potential metabolic benefits by aligning meal timing with circadian rhythms and facilitating extended fasting periods. This narrative review explores the mechanistic underpinnings of blood pressure regulation within the context of diurnal rhythms and the potential implications of TRE on blood pressure outcomes. While research on TRE's direct impact on blood pressure remains limited, existing studies suggest associations between narrower eating windows and reductions in blood pressure levels, independent of weight loss. Mechanistically, TRE may influence blood pressure through various pathways, including alterations in sympathetic activity, hormonal regulation, and sodium retention. Animal studies and preliminary human trials support the hypothesis that aligning meal timing with circadian rhythms may promote cardiovascular health by modulating blood pressure rhythms. However, conflicting findings and methodological variations across studies underscore the need for further research, particularly larger clinical trials with diverse populations and comprehensive methodologies such as ambulatory blood pressure monitoring. Integrating TRE into broader lifestyle interventions may offer a holistic approach to optimize cardiovascular health through circadian alignment and metabolic regulation.
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References
Duan, Daisy, et al. “Time-Restricted Eating in Metabolic Syndrome–Focus on Blood Pressure Outcomes.” Current Hypertension Reports, vol. 24, no. 11, 6 Sept. 2022, pp. 485–497, https://doi.org/10.1007/s11906-022-01219-z. Accessed 23 Nov. 2022
Chaix A, Zarrinpar A, Miu P, Panda S. Time-restricted feeding is a preventative and therapeutic intervention against diverse nutritional challenges. Cell Metab. 2014;20:991–1005.
Hatori M, Vollmers C, Zarrinpar A, et al. Time-restricted feed- ing without reducing caloric intake prevents metabolic diseases in mice fed a high-fat diet. Cell Metab. 2012;15:848–60.
Ohkubo T, Imai Y, Tsuji I, et al. Relation between nocturnal decline in blood pressure and mortality: The Ohasama study. Am J Hypertens. 1997;10(11):1201–7. https://doi.org/10.1016/ S0895-7061(97)00274-4/2/AJH.1201.F3.JPEG.
Fagard RH, Thijs L, Staessen JA, Clement DL, De Buyzere ML, De Bacquer DA. Night–day blood pressure ratio and dipping pattern as predictors of death and cardiovascular events in hypertension. J Human Hyperten. 2009;23(10):645– 653. https://doi.org/10.1038/jhh.2009.9.
Taylor KS, Heneghan CJ, Stevens RJ, Adams EC, Nunan D, Ward A. Heterogeneity of prognostic studies of 24-hour blood pressure variability: systematic review and meta-analysis. PLoS ONE. 2015;10(5): e0126375. https://doi.org/10.1371/ JOURNAL.PONE.0126375.
Weber MA, Drayer JIM, Nakamura DK, Wyle FA. The circa- dian blood pressure pattern in ambulatory normal subjects. Am J Cardiol. 1984;54(1):115–9. https://doi.org/10.1016/ 0002-9149(84)90314-X.
Degaute JP, Van De Borne P, Linkowski P, Van Cauter E. Quantitative analysis of the 24-hour blood pressure and heart rate patterns in young men. Hypertension. 1991;18(2):199– 210. https://doi.org/10.1161/01.HYP.18.2.199.
Shea SA, Hilton MF, Hu K, Scheer FAJL. Existence of an endogenous circadian blood pressure rhythm in humans that peaks in the evening. Circ Res. 2011;108(8):980–4. https:// doi.org/10.1161/CIRCRESAHA.110.233668.
17. Scheer FAJL, Hu K, Evoniuk H, et al. Impact of the human cir- cadian system, exercise, and their interaction on cardiovascular function. Proc Natl Acad Sci USA. 2010;107(47):20541–6. https:// doi.org/10.1073/PNAS.1006749107/-/DCSUPPLEMENTAL.
Mills JN, Stanbury SW. Persistent 24-hour renal excretory rhythm on a 12-hour cycle of activity. J Physiol. 1952;117(1):22– 37. https://doi.org/10.1113/JPHYSIOL.1952.SP004730.
Moore-Ede MC, Kass DA, Herd JA. Transient circadian internal desynchronization after light-dark phase shift in monkeys. Am J Physiol. 1977;232(1):R31–7.
Kamperis K, Hagstroem S, Radvanska E, Rittig S, Djurhuus JC. Excess diuresis and natriuresis during acute sleep deprivation in healthy adults. Am Physiol Renal Physiol. 2010;299(2):F404– 11. https://doi.org/10.1152/ajprenal.00126.2010.
Richards J, Cheng KY, All S, et al. A role for the circadian clock protein Per1 in the regulation of aldosterone levels and renal Na+ retention. Am Physiol Renal Physiol. 2013;305(12):1697– 704. https://doi.org/10.1152/AJPRENAL.00472.2013/ASSET/ IMAGES/LARGE/ZH20011471490008.JPEG.
Nikolaeva S, Pradervand S, Centeno G, et al. The circadian clock modulates renal sodium handling. J Am Soc Nephrol. 2012;23(6):1019–26. https://doi.org/10.1681/ASN.2011080842.
Zubera AM, Centenoa G, Pradervandb S, et al. Molecular clock is involved in predictive circadian adjustment of renal function. Proc Natl Acad Sci USA. 2009;106(38):16523–8. https://doi.org/ 10.1073/PNAS.0904890106.
Gumz ML, Stow LR, Lynch IJ, et al. The circadian clock pro- tein Period 1 regulates expression of the renal epithelial sodium channel in mice. J Clin Investig. 2009;119(8):2423–34. https:// doi.org/10.1172/JCI36908.
Doi M, Takahashi Y, Komatsu R, et al. Salt-sensitive hyperten- sion in circadian clock-deficient Cry-null mice involves dysregu- lated adrenal Hsd3b6. Nat Med. 2010;16(1):67–74. https://doi. org/10.1038/NM.2061
Chalmers JA, Martino TA, Tata N, Ralph MR, Sole MJ, Belsham DD. Vascular circadian rhythms in a mouse vascular smooth muscle cell line (Movas-1). Am J Physiol Renal Physiol. 2008;295(5):1529–38. https://doi.org/10.1152/AJPREGU. 90572.2008/SUPPL_FILE/FIGS3.PDF.
Xie Z, Su W, Liu S, et al. Smooth-muscle BMAL1 participates in blood pressure circadian rhythm regulation. J Clin Investig. 2015;125(1):324–36. https://doi.org/10.1172/JCI76881.
Talan MI, Engel BT, Kawate R. Overnight increases in haema- tocrit: additional evidence for a nocturnal fall in plasma vol- ume. Acta Physiol Scand. 1992;144(4):473–6. https://doi.org/ 10.1111/J.1748-1716.1992.TB09323.X.
Van Someren EJW. More than a marker: Interaction between the circadian regulation of temperature and sleep, age- related changes, and treatment possibilities. Chronobiol Int. 2000;17(3):313–54. https://doi.org/10.1081/CBI-100101050.
Sindrup JH, Kastrup J, Christensen H, Jorgensen B. Nocturnal variations in peripheral blood flow, systemic blood pressure, and heart rate in humans. Am J Physiol. 1991;261(4 30–4). https:// doi.org/10.1152/AJPHEART.1991.261.4.H982.
Coccagna G, Mantovani M, Brignani F, Manzini A, Lugaresi E. Arterial pressure changes during spontaneous sleep in man. Electroencephalogr Clin Neurophysiol. 1971;31(3):277–81. https://doi.org/10.1016/0013-4694(71)90098-8.
Andersson B, Wallin G, Hedner T, Ahlberg AC, Andersson OK. Acute Effects of Short-term Fasting on Blood Pressure, Circu- lating Noradrenaline and Efferent Sympathetic Nerve Activity. Acta Med Scand. 1988;223(6):485–90. https://doi.org/10.1111/J. 0954-6820.1988.TB17685.X.
Grundler F, Mesnage R, Michalsen A, de Toledo FW. Blood pressure changes in 1610 subjects with and without antihyper- tensive medication during long-term fasting. J Am Heart Assoc. 2020;9(23):18649. https://doi.org/10.1161/JAHA.120.018649.
Schloeder FX, Stinebaugh BJ. Renal tubular sites of natriuresis of fasting and glucose-induced sodium conservation. Metabo- lism. 1970;19(12).
Kraikitpanitch S, Chrysant SG, Lindeman RD. Natriuresis and car- bohydrate-induced antinatriuresis in fasted, hydrated hypertensives: Proceedings of the Society of Experimental Biology and Medicine. 1975;149:319–24. https://doi.org/10.3181/00379727-149-38798.
DeFronzo RA. The effect of insulin on renal sodium metabolism. Dia- betologia. 1981;21(3):165–71. https://doi.org/10.1007/bf00252649.
Zarrinpar A, Chaix A, Panda S. Daily eating patterns and their impact on health and disease. Trends Endocrinol Metab. 2015;27(2):69–83. https://doi.org/10.1016/j.tem.2015.11.007.
Wang J, Patterson R, Ang A, Emond J, Shetty N, Arab L. Tim- ing of energy intake during the day is associated with the risk of obesity in adults. J Hum Nutr Diet. 2014;27(Suppl 2):255–62.
Zhang D, Colson JC, Jin C, et al. Timing of food intake drives the circadian rhythm of blood pressure. Function. 2020;2(1):1– 15. https://doi.org/10.1093/function/zqaa034.
Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CM. Early time-restricted feeding improves insulin sensitiv- ity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metab. 2018;27:1212-1221. e3.
Wilkinson MJ, Manoogian ENC, Zadourian A, Navlakha S, Panda S, Taub PR. Ten-hour time-restricted eating reduces weight, blood pressure, and atherogenic lipids in patients with metabolic syn- drome. Cell Metab. 2019;31:92–104. Gabel K, Hoddy KK, Haggerty N, et al. Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: a pilot study. Nutr Healthy Aging. 2018;4:345–53.
Prasad M, Fine K, Gee A, et al. A smartphone intervention to promote time restricted eating reduces body weight and blood pressure in adults with overweight and obesity: a pilot study. Nutrients. 2021;13(7).https://doi.org/10.3390/NU13072148.
Liu D, Huang Y, Huang C, et al. Calorie restriction with or without time-restricted eating in weight loss. N Engl J Med. 2022;386(16):1495–504. https://doi.org/10.1056/NEJMOA2114 833.
Cienfuegos S, Gabel K, Kalam F, et al. Effects of 4- and 6-h time-restricted feeding on weight and cardiometabolic health: a randomized controlled trial in adults with obesity. Cell Metab. 2020;32:1–13.
Lowe DA, Wu N, Rohdin-Bibby L, et al. Effects of time- restricted eating on weight loss and other metabolic parameters in women and men with overweight and obesity. JAMA Intern Med. 2020;180:1491–9.
Chow LS, Manoogian ENC, Alvear A, et al. Time-restricted eating effects on body composition and metabolic measures in humans who are overweight: a feasibility study. Obesity. 2020;28:860–9.
Phillips NE, Mareschal J, Schwab N, et al. The effects of time- restricted eating versus standard dietary advice on weight, metabolic health and the consumption of processed food: a prag- matic randomised controlled trial in community-based adults. Nutrients. 2021;13(3). https://doi.org/10.3390/NU13031042.
Pureza IROM, Melo ISV, Macena ML, et al. Acute effects of time-restricted feeding in low-income women with obesity placed on hypoenergetic diets: randomized trial. Nutrition (Bur- bank, Los Angeles County, Calif). 2020;77. https://doi.org/10. 1016/J.NUT.2020.110796.
Anton SD, Lee SA, Donahoo WT, et al. The effects of time restricted feeding on overweight, older adults: a pilot study. Nutrients. 2019;11(7):1–9. https://doi.org/10.3390/nu11071500.
Parr EB, Devlin BL, Lim KHC, et al. Time-restricted eating as a nutrition strategy for individuals with type 2 diabetes: a feasibil- ity study. Nutrients. 2020;12(11):1–22. https://doi.org/10.3390/ NU12113228.
Przulj D, Ladmore D, Smith KM, Phillips-Waller A, Hajek P. Time restricted eating as a weight loss intervention in adults with obesity. PloS one. 2021;16(1). https://doi.org/10.1371/JOURNAL.PONE. 0246186.
Schroder JD, Falqueto H, Mânica A, et al. Effects of time- restricted feeding in weight loss, metabolic syndrome and car- diovascular risk in obese women.J Translat Med. 2021;19(1). https://doi.org/10.1186/S12967-020-02687-0.