Impact of Achieved Weight Loss by Intermittent Fasting Plus Early Time-Restricted Eating and Calorie Restriction on Systemic and Adipose Tissue Markers of Inflammation in Adults at Risk of Type 2 Diabetes: An Exploratory Sub-Study

BACKGROUND: Intermittent fasting (IF) and calorie restriction (CR) may reduce inflammation, though it is unclear which is more effective in adults at risk of type 2 diabetes. OBJECTIVE: This exploratory sub-study compared the effects of achieved weight loss by IF plus early time-restricted eating (iTRE) or CR versus standard care (SC) on systemic and adipose tissue markers of inflammation. METHODS: Adults (N = 209, 34.8 ± 4.7 kg/m²) were randomised into three groups (2:2:1): iTRE (30% energy requirements between 0800 and 1200 on 3 days/week); CR (30% energy restriction); or SC for 6 months. Body weight and plasma C-reactive protein (CRP), tumour necrosis factor α (TNF-α), interleukin-6 (IL-6) and interferon-ɣ (IFNɣ) were measured at baseline and month 6 in a subset with weight loss above (CR: N = 32, iTRE: N = 35) or below median (SC: N = 18). The expression of inflammatory genes in adipose tissue was measured using qPCR. RESULTS: Weight loss was greater in iTRE and CR versus SC. While TNF-α and CRP levels decreased at month 6 (CRP: -1.36 ± 0.47 mg/dL, p < 0.001; TNF-α: -0.082 ± 0.03 pg/mL, p = 0.025), there were no between group effects. In adipose tissue, no differences in inflammatory genes were detected. CONCLUSIONS: The mode of weight loss intervention did not differentially impact inflammatory markers in participants with weight loss above median.