A new study (stay with me!) published in Gastroenterology adds to a growing body of evidence that it’s not just what or how someone eats, but also when they eat, that may influence symptoms and underlying inflammation in Crohn’s disease.
This study looked at time-restricted feeding (TRF) in participants with Crohn’s disease who were overweight or obese—a reminder that Crohn’s disease affects people of all body sizes.
Time-restricted feeding, a form of intermittent fasting, has been shown in other populations to positively influence inflammation, insulin resistance, the gut microbiome, and intestinal permeability—which was the rationale for studying it in Crohn’s disease.
In this study, 20 participants were randomized to a TRF group, where they ate all of their calories within an 8-hour eating window and fasted for the remaining 16 consecutive hours, while otherwise following their usual diet.
They did this 6 days per week for 12 weeks.
Here’s what they found:
- BMI decreased significantly in the TRF group compared with controls, even though total energy intake and overall diet quality did not differ between groups.
- Clinical outcomes improved, including about a 40% reduction in stool frequency and a 50% decrease in abdominal discomfort in the TRF group.
- There were also changes suggesting positive effects on the gut microbiome and markers of inflammation.
This study caught my attention because I helped design a small study at the IBD Center at Weill Cornell that looked at 4 weeks of time-restricted feeding in patients with mild-to-moderately active Crohn’s disease, regardless of body weight.
While lab data did not change significantly, symptoms improved for most participants.
So what do we make of all this?
Time-restricted feeding may be another tool we can consider—particularly for those who are overweight or obese, since visceral adiposity (belly fat around the organs) can negatively influence inflammation, metabolic health, and quality of life in IBD.
That said, a few important nuances to keep in mind, especially since it’s not appropriate for everyone:
- I would not recommend this approach for people at risk for bowel obstruction, since prolonged fasting followed by larger meals could increase risk.
- For individuals with a history of eating disorders or significant anxiety around food, this approach could do more harm than good.
- For some people, time-restricted feeding can worsen morning symptoms, especially if late-night eating was already contributing to overnight or early-morning issues. In those cases, starting the eating window earlier in the day may be more appropriate.
- Anecdotally, I’ve seen people do well with this approach—but I’ve also seen others find it difficult or unhelpful.
There isn’t enough evidence yet to recommend time-restricted feeding broadly for Crohn’s disease.
But for the right person, in the right context, it may be worth considering.
