By Sumathi Reddy | Update 1 May 17, 2023 10:00 am EST
Some doctors are studying whether the approach could help teens lose weight and improve blood sugar levels, but others have raised questions.
Parents and doctors are looking for new strategies to help teens with obesity. A controversial approach that has attracted the interest of some families is intermittent fasting, which restricts people to eating for only part of the day or week.
Intermittent fasting has gained traction among adults who use it to manage weight and improve health. Doctors have largely avoided dealing with adolescents out of concern that introducing periods of fasting into their schedules when adolescents are rapidly growing and developing could lead to nutritional gaps or eating disorders. Can
Now, some doctors and researchers are evaluating types of intermittent fasting in adolescents, searching for a solution to rising obesity rates and type 2 diabetes. A pediatric endocrinologist in Los Angeles is launching a clinical trial looking at eating within a set time window in obese adolescents. Researchers in Australia are completing a separate trial, the results of which are expected to be published later this year.
According to data from the Centers for Disease Control and Prevention, roughly one-fifth of children in America are considered obese. Pediatricians are so concerned that the American Academy of Pediatrics this month recommended for the first time that physicians offer weight-loss drugs to obese children.
Doctors say that any approach to when and how a teen eats should be handled with care.
Families and doctors need to be very careful with any form of intermittent fasting in youth because it can be a slippery slope with potential risk for eating disorders, says a pediatrician at the University of California, San Francisco. And says eating-disorder expert Jason Nagata. , Doctors have also raised questions about the possible long-term effects of intermittent fasting on developing bodies.
Courtney Peterson, an associate professor of nutritional science at the University of Alabama at Birmingham who studies intermittent fasting in adults, says she would be concerned about teenagers getting enough nutrients. “I think it’s worth testing but testing with caution,” she says.
Their research found that obese adults who ate between 7 a.m. and 3 p.m. lost an average of 5 pounds more than a control group who ate 12 hours or more apart, and those with prediabetes Adults, which start over a period of six hours. The day showed an improvement in blood-sugar levels.
Intermittent fasting is an umbrella term for eating strategies that involve fasting. One such strategy, time-restricted eating, or TRE, limits eating to a set number of hours a day — often eight — with no limit on how much or how much you eat. For the rest of the hours, you refrain from eating or drinking anything except water.
Alaina Widmer, MD, a pediatric endocrinologist and obesity-medicine specialist at Children’s Hospital Los Angeles, is launching a clinical trial to evaluate whether an eight-hour window of eating, from 11 a.m. to 7 p.m. until, results in changes in insulin and glucose response to adolescents. with obesity.
Researchers are also looking at weight loss and body fat mass, as well as blood pressure and cholesterol.
Research has been done in recent years with families of obese patients by Dr. stems from a conversation with Widmer. Some had asked her about time-restricted eating, or had tried it and said they liked it. They tested the concept in obese adolescents in a pilot study published in the journal Nutrients in 2021 to see if it was feasible to schedule an eight-hour window for eating.
“They enjoyed doing it, felt like their whole family could do it, and over time they were losing weight,” Dr. Widmer says about teenagers.
Now, his lab is enrolling 100 youth between the ages of 12 and 21 with type 2 diabetes and obesity in a 12-week trial. Participants are screened and monitored for any negative eating behaviors, she says. So far, she hasn’t found that time-restricted eating “affects eating behavior or worsens disordered eating in any way,” she says.
In Australia, researchers are studying how obese teenagers respond to a different form of fasting called intermittent energy restriction.
In this approach, says Natalie Lister, a researcher and dietitian at the University of Sydney, you eat one-quarter of the calories you normally would for three days a week. On the other four days, you have no calorie limit.
Dr. Lister says she and her colleagues began exploring intermittent fasting in obese adolescents a few years ago when patients began asking about it. They conducted a pilot test with 30 adolescents, published in 2019. Now, researchers are completing a trial whose results they expect to publish later this year.
Doctor. The health team monitors for eating disorders and depression, says Lister, and the study didn’t enroll anyone with a high risk of disordered eating. Dietitians provide guidelines to help ensure participants are meeting nutritional requirements.
In obese adults, the data on TRE is mixed when it comes to weight loss, but two systematic reviews of existing research found a modest weight loss benefit overall, says Dr. Peterson. Studies have also found that adults experience improvements in measures such as insulin resistance, lowering blood-sugar levels, especially when their eating window begins earlier in the day.
Matthew Muros, 15, in Carson, California, is battling his weight and prediabetes. Mathieu participated in Dr. Widmer’s pilot study last year. The first two weeks were challenging, he noted.
“I was really hungry. I just kept drinking water,” he says.
He says it got easier, and when the study ended he decided to stick with the schedule. She’s lost about 30 pounds, and her blood-sugar levels have improved.
He has also changed his diet by cutting down on soda, fast food and carbohydrates. “I’m trying to eat a little more healthfully,” he says.