Early, midday, and late time-restricted eating impact on anthropometry and cardiometabolic health: a network meta-analysis of RCTs.
Level 1 - systematic review of randomized trials
Systematic review and network meta-analysis of randomized controlled trials
PubMed 42625842 · doi:10.3389/fnut.2026.1887087
What was done
A Bayesian network meta-analysis of 39 randomized controlled trials with 3,236 adults with cardiometabolic risk factors evaluated the effects of early time-restricted eating (eTRE), midday TRE (mTRE), and late TRE (lTRE), with or without exercise (EX) and calorie restriction (CR), compared with control on anthropometric and metabolic outcomes. Treatment effects were measured as mean differences (MD) with 95% credible intervals (CrI), and interventions were ranked using the surface under the cumulative ranking curve (SUCRA).
What was found
Most interventions reduced anthropometric measures compared with control, except mTRE + EX. eTRE reduced fasting blood glucose (MD -3.64 mg/dL, 95% CrI -5.93 to -1.36) and HOMA-IR (MD -0.42, 95% CrI -0.83 to -0.03) compared with control. eTRE + EX reduced HOMA-IR (MD -1.33, 95% CrI -2.58 to -0.08). eTRE + EX and eTRE ranked highest across SUCRA curves, while clear differences between TRE patterns and CR were limited.
Why it matters
This network meta-analysis indicates that shifting the eating window earlier in the day, particularly when combined with exercise, may optimize glycemic and insulin sensitivity outcomes in adults with cardiometabolic risk.
Limits
Certainty of evidence evaluated by GRADE ranged from very low to moderate for most outcomes. SUCRA rankings relied on a limited number of trials for specific combinations, and the abstract omitted specific quantitative values for anthropometric changes, trial durations, and long-term adherence.