Effects of time‐restricted eating on intrahepatic fat and metabolic health among patients with nonalcoholic fatty liver disease

Abstract Objective The study's objective was to explore whether early time‐restricted eating (eTRE) and late time‐restricted eating (lTRE) have different impacts on intrahepatic fat and metabolic health among patients with nonalcoholic fatty liver disease (NAFLD). Methods This is an 8‐week, randomized, parallel‐arm, open‐label trial. Forty eligible patients were randomly assigned to eTRE (eating between 8:00 a.m. and 4:00 p.m.) or lTRE (eating between 12:00 p.m. and 8:00 p.m.). The primary outcome was the change of intrahepatic fat measured by magnetic resonance image‐derived proton density fat fraction. Secondary outcomes included changes in weight, body composition, liver function, and cardiometabolic factors. Results Forty participants who underwent randomization completed the trial (mean age: 38.25 years). The eTRE group had a −3.24% absolute reduction of intrahepatic fat (95% CI: −4.55% to −1.92%) and there was a −3.51% absolute reduction for the lTRE group (95% CI: −5.10% to −1.92%). Changes in intrahepatic fat were not statistically different between the two groups. Both the eTRE and lTRE groups had similar and significant reductions in weight, visceral fat, subcutaneous fat, liver enzymes, and glucose regulatory indicators. Conclusions Among patients with NAFLD, both eTRE and lTRE induced significant reductions in intrahepatic fat and improvements in body composition, liver function, and metabolic health with similar magnitude. These findings suggest that eTRE and lTRE are comparable and feasible strategies for NAFLD management.