Time-restricted eating (TRE) has gained popularity as a dietary intervention that limits daily food consumption to a 4-to-12-hour window. Most short-term randomized controlled trials reported that TRE improved cardiometabolic risk profiles. However, whether TRE is associated with long-term hard endpoints remains a mystery.

      Participants aged at least 20 years who completed two valid 24-hour dietary recalls and reported usual intake in both recalls were included from the National Health and Nutrition Examination Survey in 2003-2018. Mortality status as of December 2019 was obtained through linkage to the National Death Index. An eating occasion required consuming more than 5 kcal of foods or beverages. Eating duration between the last and first eating occasion was calculated for each day. The average duration of two recall days defined typical eating duration which was then categorized as <8, 8 - <10, 10 - <12, 12-16 (reference group; mean duration in US adults), and >16 hours. Multivariable Cox proportional hazards models were employed to estimate the association of eating duration with all-cause and cause-specific mortality in the overall sample and among adults with cardiovascular disease or cancer.

      The results revealed that during a median follow-up of 8.0 years, 2797 all-cause deaths occurred, including 840 cardiovascular deaths and 643 cancer deaths. Compared with eating duration of 12-16 hours, eating duration <8 hours were significantly associated with an increased risk of cardiovascular mortality (HR, 1.96 [95% CI, 1.23 - 3.13]); this association was also observed in adults with cardiovascular disease (HR, 2.06 [95% CI, 1.12 - 3.81]) and adults with cancer (HR, 2.72 [95% CI, 1.28-5.80]). Other eating durations were not associated with cardiovascular mortality, except for eating duration of 8 - <10 hours in people with cardiovascular disease (HR, 1.64 [95% CI, 1.02-2.63]). No significant associations were found between eating duration and all-cause or cancer mortality in the overall sample and diseased subsamples, except that eating duration >16 hours was associated with a lower risk of cancer mortality in people with cancer.

      The study concluded that TRE with eating duration <8 hours was significantly associated with a higher risk of cardiovascular mortality in the general population as well as in people with cardiovascular disease or cancer.

      This study was presented at 'The American Heart Assocation EPI 2024'.