Is time-restricted eating a robust eating regimen during periods of disruptions in daily life? A qualitative study of perspectives of people with overweight during COVID-19.

BACKGROUND: Time-restricted eating (TRE) has been suggested as a feasible dietary strategy in individuals with overweight. Disruptions in daily life e.g., severe illness can affect engagement in lifestyle interventions to obtain healthier body weight. This study examined if and how the engagement with TRE among people with overweight was affected by the Danish COVID-19 lockdowns as an example of disruptions in daily life. METHODS: Fifteen participants with overweight enrolled in a TRE intervention, i.e. restricting all eating and drinking except water to the same daily ten-hour window, were interviewed about their experiences and engagement with TRE during COVID-19 lockdowns. Interviews were semi-structured and conducted by phone or face-to-face with safe social distancing. Data analysis was grounded in a reflexive thematic analysis approach. RESULTS: Daily life rhythms were disrupted by lockdowns by preventing participants from performing ordinary daily activities such as going to work, socialising, eating out or exercising. For some, this challenged their TRE engagement, while most were able to undertake the TRE eating window but reported increased snacking and consumption of take-away food within their eating window. For all, exercise habits became unhealthier. The negative impact on TRE engagement primarily occurred during daytime, as social distancing made it easier to engage with TRE during evenings. CONCLUSIONS: This study showed that even people highly motivated to obtain healthier lifestyles practices struggled to maintain engagement with healthy behaviours, whereas sticking to the TRE window was manageable during COVID-19. TRE as a weight loss strategy was challenged which calls for more attention to supporting people in daily life to obtain healthier practices, also in case of periods of other disruptions such as divorce, serious illness etc.

Watching, keeping and squeezing time to lose weight: Implications of time-restricted eating in daily life.

Time-restricted eating (TRE) is a novel intervention that allows eating and drinking within a certain time window and has shown positive effects on body weight in few studies. Weight loss strategies that easily can be integrated into daily life are needed, but knowledge about how TRE affects daily life is lacking. This study examined how individuals having overweight or obesity at high risk of type 2 diabetes performed TRE in daily life, with a focus on how the timing of eating changed the organisation and rhythms of daily activities. Semi-structured interviews were conducted with participants enrolled in a randomised controlled trial studying the effect of a 12-week TRE intervention focusing on a self-selected daily 10-h window between 6 AM and 8 PM. Seventeen participants from the intervention group were interviewed at baseline and end of intervention, and data were analysed using a thematic analysis approach. Participants found TRE simple and appealing due to the unrestricted dietary intake. In general, participants did not change their food preferences and continued to eat three main daily meals. However, participants had to increase their awareness of the time of day, reshuffle ordinary daily activities and plan their intake more carefully. Two participants reported fully adherence every day, whereas all other participants reported one to several episodes of intake outside their window during the 12 weeks. Social evening activities and collective rhythms were largest barriers. Our findings suggest that TRE interventions would benefit from a broader perspective on daily life and an expanded view on families and friends as joint units of intervention. TRE interventions should consider individuals' daily rhythms and help them develop practical solutions to integrating new eating practices.