Reacción a "Reactions: A preliminary investigation presented at a conference claims that restricting meals to an 8-hour window increases the risk of cardiovascular death by 91%"

This is an interesting study which finds an unexpectedly large increase in risk of cardiovascular disease associated with reporting time restricted eating at baseline.  The strengths of the study are that there was a relatively long follow up period (8 years) and the 20,000 participants were part of national nutritional survey which is representative of the American population.  What is not clear is whether those who reported restricted time eating at baseline continued with this practice throughout the study.  It is also unclear whether the individual reporting time restricted eating made a voluntary choice to adopt this pattern.  It is likely that individuals reporting time restricted eating may be working antisocial hours (e.g. truck drivers, security personnel, health professionals, night workers).  This is important because there is evidence that this type of working practice is associated with increased risk of type 2 diabetes and CVD.  It is not clear whether statistical adjustment have been made for confounding factors (smoking, physical activity, alcohol intake, social class).  It will be necessary to carefully look at the study in more detail when it is published in full.

Although time restricted eating has become popular in the media, there is lack of evidence to show it has any benefit in terms of weight loss or weight maintenance.  Regarding cardiovascular risk factors, we know from previous existing evidence that it is probably better to spread food intake out throughout the day (small but often) rather than consume large meals over a shorter period.  This is because large increases in blood fats and glucose result after big meals.  These postprandial increase in blood fats and glucose can impair endothelial function and increase the level of blood clotting factors particularly factor VII.  Prolonged fasting can contribute to raised blood cholesterol because it promotes the release of fatty acids from adipose tissue that stimulate the synthesis of very low density lipoproteins in the liver that give rise to low density lipoproteins in blood.