Changes in Dietary Intake, Macronutrients, Diet Quality, and Hunger Hormones after a 24-Week Diabetes Education Program Featuring Intermittent Energy Restriction or Time-Restricted Eating

Background: The effects of time-restricted eating with energy restriction (TRE+ER) and intermittent energy restriction (IER) on diet intake, quality, and hunger hormones (ghrelin, leptin) have not been compared in a parallel trial. This study examined how ghrelin and leptin relate to diet quality and how IER and TRE+ER affect diet in those with overweight/obesity and type 2 diabetes mellitus (T2DM). Methods: This RCT enrolled 57 adults (mean age of 54. ± 7.16 years, BMI of 34.35 ± 5.66 kg/m², HbA1c of 6.90 ± 1.04%) for a 24-week IER or TRE+ER intervention. TRE+ER used a ≤ 8-hour eating window ≥ 5 days/week with energy restriction in weeks 0-12. IER used 2-3 very low-calorie days/week (as needed during weeks 13-24). Assessments occurred at week 0, 12, and 24 included dietary intake (via Remote Food Photography Method, analyzed with Nutrition Data Systems for Research), Healthy Eating Index (HEI-2020) scores, and fasting ghrelin and leptin. Results: After week 24, both interventions significantly reduced energy intake (IER: -366 kcal [-547, -185]; TRE+ER: -408 kcal [-570, -247]), total fat (IER: -21.0 g fat [-33.4, -8.7]; TRE+ER: -30.9 g fat [-41.7, -20.1]), and total carbohydrate intake (IER: -45.5 g [-61, -30.1]; TRE+ER: -28.4 g [-54.2, -2.7]) relative to baseline. HEI-2020 increased (IER: 15 [10, 20]; TRE+ER: 17 [13, 21]). While hormones were not correlated with diet quality, ghrelin levels significantly changed over time. Conclusions: Both groups significantly reduced energy intake, improved diet quality, and altered macronutrient distribution in individuals with T2DM. Strategies were effective in achieving dietary change recommendations for T2DM. Both interventions affected ghrelin at week 12, but changes were no longer significant at week 24.

Grantor dc:publisher

University of Kansas

Year dc:date.issued

2025

Author dc:creator

• Lackey, Haven Grace

Advisor dc:contributor.advisor

• Steger, Felicia L.

• Nutrition
• appetite hormones
• diet quality
• ghrelin
• intermittent fasting
• leptin

Statement dc:rights

• This item is protected by copyright and unless otherwise specified the copyright of this thesis/dissertation is held by the author.

Language dc:language.iso

en

Dc Identifier Other

https://www.proquest.com/LegacyDocView/DISSNUM/32041210

OAI identifier oai:identifier

oai:kuscholarworks.ku.edu:1808/37879