Effects of healthy low-carbohydrate diet and time-restricted eating on weight and gut microbiome in adults with overweight or obesity: Feeding RCT

The effect of a healthy low-carbohydrate diet (HLCD) and time-restricted eating (TRE), alone or in combination, on body weight and gut microbiome beyond caloric restriction(definition) remains unclear. In this 12-week two-by-two factorial randomized trial with a 28-week follow-up among 96 participants with overweight or obesity, isocaloric-restricted feeding yields significant weight loss, ranging from 2.57 to 4.11 kg across different groups. Beyond caloric restriction, HLCD and TRE lead to additional reduction in body mass index. HLCD results in additional fat mass loss while TRE yields more lean mass loss. Additionally, HLCD leads to decreased fecal branched-chain amino acids, and TRE tends to yield an increased abundance of probiotic species involved in synthesizing short-chain fatty acids. Moreover, the effect of HLCD on reducing fat mass is sustained during the post-intervention follow-up. Overall, HLCD and TRE are effective in weight management and yield profound gut microbiome and metabolome alteration beyond caloric restriction. This study was registered at ChiCTR.org.cn (ChiCTR2200056363). • HLCD and 10-h TRE are effective in weight management beyond caloric restriction (CR) • HLCD leads to greater fat mass loss while TRE yields more lean mass loss beyond CR • The effect of HLCD on reducing fat mass is sustained 28 weeks after intervention • HLCD and TRE lead to profound alterations in the gut microbiome and metabolome Through a 12-week isocaloric-restricted feeding trial with 28-week post-intervention follow-up, Li et al. demonstrate the efficacy of HLCD and TRE in weight management beyond caloric restriction among adults with overweight or obesity. They also identify that both HLCD and TRE yield profound alterations in the gut microbiome and metabolome.