In MedScapes Impact Factor, Dr. F. Perry Wilson from Yale School of Medicine discusses metabolic syndrome, a lifestyle-related condition affecting one-third of American adults, and a study on time-restricted eating as a means of treating it. According to discussion, you have metabolic syndrome if you have three of the following symptoms: elevated waist circumference, elevated fasting triglycerides, elevated blood pressure, low HDL cholesterol, and elevated fasting blood glucose. However, Dr. Perry’s interpretation of a study on time-restricted eating, which yielded underwhelming results, led him to conclude that lifestyle interventions may not be as effective as pharmaceutical treatments in managing metabolic syndrome.

It is essential to recognize that dietary choices play a crucial role in health outcomes. For instance, incorporating a whole-food plant-based diet can lead to significant improvements in health and even reverse lifestyle-induced chronic illnesses. A whole-food plant-based diet abundant in fruits, vegetables, whole grains, legumes, nuts, and seeds is probably the most effective lifestyle intervention, having the potential to bring about significant improvements and even reverse lifestyle-induced chronic illnesses. Dr. Dean Ornish’s Lifestyle Heart Trial, one of the most well-known large-scale studies conducted in the 1980s and 1990s, demonstrated the benefits of a whole-food, plant-based diet in reversing chronic lifestyle diseases. This study managed to not only slow coronary heart disease, which is at the root of metabolic syndrome, but showed a reversal in many patients.

Another study, The Broad Study (British Randomized Controlled Trial of Whole-Food Plant-Based Diet), published in Nutrition & Diabetes in 2017, demonstrated the benefits of a whole-food, plant-based diet on metabolic factors. This study is notable because it was one of the first large-scale trials to highlight the metabolic benefits of a whole-food, plant-based diet, offering significant evidence for its role in improving weight, cholesterol, and glycemic control without the need for calorie restriction.

Exercise, both aerobic and resistance training, works on different pathways to improve metabolic health, namely by improving aerobic capacity and muscle mass. A meta-analysis evaluated 10 randomized controlled trials involving over 1,200 participants. It found that aerobic exercise significantly improved key components of metabolic syndrome, including waist circumference, triglycerides, HDL cholesterol, blood pressure, and fasting glucose. Exercise reduced the incidence of metabolic syndrome by 20-30%. Another meta-analysis worked with a pool of 77,000 patients. Exercise, particularly aerobic exercise, led to improvements in body composition, cardiovascular, and metabolic outcomes in those with metabolic syndrome.

I could have told you that time-restricted eating might lead to minor weight loss because of the tendency to eat fewer calories (like the disappointing time-restricted eating study suggests), but if those calories come from the same foods that gave you metabolic syndrome in the first place (meals loaded with saturated fat like meat and dairy, foods loaded with highly processed oils, and processed carbohydrates like white flour and white sugar), you are simply becoming unhealthy at a slower rate. If you are sitting all day while eating a crappy diet, simply restricting your feeding time a bit is not likely to make a profound change. Selecting an appropriate lifestyle intervention matters.