ICE 2022: Service evaluation of a real-world, digitally enabled time restricted eating programme for adults in the UK

Service evaluation of a real-world, digitally enabled time restricted eating programme for adults in the UK

Adrian Brown^1,2, Dipesh Patel^1,2,3, Jonathan TC Kwan^2,4, Siri Steinmo^2,5, Danielle Eaton², Laura Falvey^2,6, Ling Chow² and Barbara McGowan^2,7

1. University College London, London, UK
2. Reset Health Ltd, London, UK
3. Royal Free Hospital, London, UK
4. Darent Valley Hospital, Kent, UK
5. UCLH, London, UK
6. Broomfield Hospital, Chelmsford, UK
7. Guys & St Thomas’s Hospital, London, UK

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Introduction

Obesity and type 2 diabetes (T2D) remain major global health challenges. People living with obesity (PLWO) are at increased risk of developing T2D, metabolic syndrome, CVD and cancers¹ with further negative implications for mental health². Continuous energy restriction can help people lose weight, but more recently time-restricted eating (TRE) has gained traction. It involves periods of fasting and eating within each 24-hour period e.g., 16 hours fasting and 8-hours eating. Limited data exists about its effectiveness, particularly in a real-world setting using digital delivery. RESET HEALTH is a technology-enabled clinical programme designed by a multi-disciplinary team for PLWO, T2D and other complications to improve metabolic health and quality of life and reduce the risk of comorbidity. Behaviour change techniques were employed to assist participants in non-pharmacological, lifestyle changes.

Aim

The aim of this service evaluation was to assess the impact of the Reset Health programme on weight, metabolic parameters, and other health-related outcomes at 12 and 24 weeks.

Method

653 eligible adults enrolled (mean age 46.3±10.8yrs, mean BMI 35.2±6.4kg/m2, HbA1c 42.4±12.5mmol/mol; 61% White Ethnicity) with 114 having pre- (n=59; 9.0%) or T2D (n=56; 8.6%). Participants were signed up either via employee health initiative or self referred via a website. Participants were placed on a TRE, low-carbohydrate, moderate protein plan delivered by clinicians in video consultation. They were assigned a mentor for peer-led, social support and provided with dietary guidance, goal setting and regular feedback. Participants were followed up every 4 weeks by a clinician via video consultation. Data was self-reported by the participants and here we present data from the 244 completers, which were reported using mean± standard deviation (SD) and collected over the COVID-19 pandemic.

Results

Members lost a clinically significant amount of weight at both 12 and 24-weeks, 7.7±4.4kg and 9.5±5.9kg respectively (p<0.001). Waist circumference decreased by 11±7.5cm at 24 weeks (p<0.001), with systolic blood pressure (SBP) reducing by 6.6±12.6 mmHg (p<0.001) and diastolic blood pressure (DBP) by 4.2±10.5 mmHg (p=0.002). Glycated Haemoglobin reduced by 4.5±7.4 mmol/mol (p=0.05) in all participants and 8.7±9.2 (p=0.07) in those with T2D. Quality of life improved over 24-weeks with significant reductions in depression (2.2±3.4, p<0.001) and anxiety (1.9±4.0; p<0.001) scores. Eating behaviour improved with binge eating score and emotional eating reduced (5.9±8.1; p<0.001; -0.69±0.83, p<0.001, respectively).

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Conclusions

Evaluation of a novel service using a clinically led, digitally enabled time restricted eating programme within a real-world population shows significant improvements in weight loss, health-related outcomes and eating behaviour. Further data collection and analysis is needed to assess the long term effectiveness beyond 24 weeks.
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References

1. Bray GA, Heisel WE, Afshin A, et al. The Science of Obesity Management: An Endocrine Society Scientific Statement. Endocr Rev. 2018;39(2):79-132. doi:10.1210/er.2017-00253
2. Rand K, Vallis M, Aston M, et al. “It is not the diet; it is the mental part we need help with.” A multilevel analysis of psychological, emotional, and social well-being in obesity. Int J Qual Stud Health Well-being. 2017;12(1):1306421. doi:10.1080/17482631.2017.1306421 Conflicts of interest: AB, DP, JK, SS, BM are on the medical advisory board and are shareholders in Reset Health. DE, LC, LF are employed and are shareholders at Reset Health.

Conflicts of interest: AB, DP, JK, SS, BM are on the medical advisory board and are shareholders in Reset Health. DE, LC, LF are employed and are shareholders at Reset Health.

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