Open Access
Time-restricted eating and sleep, mood, and quality of life in adults with overweight or obesity: a secondary analysis of a randomized clinical trial
(American Medical Association, 2025-06-25) Clavero-Jimeno, Antonio; Dote-Montero, Manuel; Migueles, Jairo H.; Camacho-Cardenosa, Alba; Medrano Echeverría, María; Alfaro-Magallanes, Víctor Manuel; Osés Recalde, Maddi; Carneiro-Barrera, Almudena; Cabo, Rafael de; Muñoz Torres, Manuel; Labayen Goñi, Idoia; Ruiz, Jonatan R.; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Gobierno de Navarra / Nafarroako Gobernua
Importance It remains largely unknown whether the timing of the eating window during time-restricted eating (TRE) affects sleep, mood, and quality of life differently. Objective To investigate whether 3 TRE schedules—an 8-hour eating window in the early part of the day, the late part of the day, or selected by the participant—combined with usual care (UC; a Mediterranean diet education program) were associated with changes in sleep, mood, and quality of life compared with UC alone in adults with overweight or obesity over a 12-week intervention. Design, Setting, and Participants This was a prespecified secondary analysis of a parallel-group randomized clinical trial conducted from April 11, 2022, to March 6, 2023, in Granada (southern Spain) and Pamplona (northern Spain). Eligible participants were men and women aged 30 to 60 years with overweight or obesity. Data analyses for the current study were performed between March 14, 2024, and December 5, 2024. Intervention Participants in the UC group maintained their usual eating window (≥12 hours daily) and received an educational program based on the Mediterranean diet. Participants in the early TRE group had an 8-hour eating window starting before 10 am and the late TRE group, after 1 pm; self-selected TRE participants chose their own 8-hour window. All TRE participants also received the UC educational program. Group allocation was 1:1:1:1. Main Outcomes and Measures Changes in sleep were objectively assessed using accelerometry for 2 weeks before the intervention and during the final 2 weeks of the intervention. Changes in mood dimensions—depression, anxiety, and stress—and quality of life were assessed before and after the 12-week intervention using self-administered questionnaires. Results A total of 197 participants (98 women [49.7%]; mean [SD] age, 46.1 [8.4] years; mean [SD] body mass index, 32.8 [3.2], calculated as weight in kilograms divided by height in meters squared) were randomized to UC (n = 49), early TRE (n = 49), late TRE (n = 52), and self-selected TRE (n = 47). No significant differences were observed between the early TRE and UC groups for sleep (eg, mean difference in total sleep time, 0.2 [95% CI, –0.2 to 0.6] hours), mood (eg, mean difference in Beck Depression Inventory Fast Screen score, 0.2 [95% CI, –1.0 to 1.3] points; mean difference in state anxiety score on the State-Trait Anxiety Inventory, –1.2 [95% CI, –6.4 to 4.1] points; mean difference in Perceived Stress Scale score, 2.1 [95% CI, –1.8 to 5.9] points), and quality of life (eg, mean difference in general health score on the Rand 36-Item Short Form Health Survey, 3.3 [95% CI, –4.4 to 10.9] points). Results were also nonsignificant for the late TRE and self-selected TRE groups compared with the UC group as well as between the TRE groups. Conclusions and Relevance In this secondary analysis of a randomized clinical trial of 3 different TRE schedules, incorporating TRE into a UC intervention, regardless of the eating window timing, was not associated with significant changes in sleep, mood, or quality of life compared with UC alone in adults with overweight or obesity. The findings suggest TRE may be a viable nutritional weight management strategy without adverse effects on sleep, mood, or quality of life.
Open Access
Effects of exercise on bone marrow adipose tissue in children with overweight/obesity: role of liver fat
(Oxford University Press, 2024-08-07) Labayen Goñi, Idoia; Cadenas-Sánchez, Cristina; Idoate, Fernando; Gracia-Marco, Luis; Medrano Echeverría, María; Alfaro-Magallanes, Víctor Manuel; Alcántara Alcántara, Juan Manuel; Rodríguez Vigil, Beatriz; Osés Recalde, Maddi; Ortega, Francisco B.; Ruiz, Jonatan R.; Cabeza Laguna, Rafael; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio Ingeniaritza; Agronomía, Biotecnología y Alimentación; Agronomia, Bioteknologia eta Elikadura; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Gobierno de Navarra / Nafarroako Gobernua
Context: Exercise reduces adiposity, but its influence on bone marrow fat fraction (BMFF) is unknown; nor is it known whether a reduction in liver fat content mediates this reduction. Objectives: This work aimed to determine whether incorporating exercise into a lifestyle program reduces the lumbar spine (LS) BMFF and to investigate whether changes in liver fat mediate any such effect.Methods Ancillary analysis of a 2-arm, parallel, nonrandomized clinical trial was conducted at primary care centers in Vitoria-Gasteiz, Spain. A total of 116 children with overweight/obesity were assigned to a 22-week family-based lifestyle program (control group [n = 57]) or the same program plus an exercise intervention (exercise group [n = 59]). The compared interventions consisted of a family-based lifestyle program (two 90-minute sessions/month) and the same program plus supervised exercise (three 90-minute sessions/week). The primary outcome examined was the change in LS-BMFF between baseline and 22 weeks, as estimated by magnetic resonance imaging. The effect of changes in hepatic fat on LS-BMFF were also recorded.Results Mean weight loss difference between groups was 1.4 +/- 0.5 kg in favor of the exercise group. Only the children in the exercise group experienced a reduction in LS-BMFF (effect size [Cohen d] -0.42; CI, -0.86 to -0.01). Importantly, 40.9% of the reductions in LS-BMFF were mediated by changes in percentage hepatic fat (indirect effect: beta=-0.104; 95% CI, -0.213 to -0.019). The effect of changes in hepatic fat on LS-BMFF was independent of weight loss.Conclusion The addition of exercise to a family-based lifestyle program designed to reduce cardiometabolic risk improves bone health by reducing LS-BMFF in children with overweight or obesity. This beneficial effect on bone marrow appears to be mediated by reductions in liver fat.
Open Access
Effects of time-restricted eating and resistance training on skeletal muscle tissue quantity, quality and function in postmenopausal women with overweight or obesity: a study protocol
(Elsevier, 2024-12-30) Alfaro-Magallanes, Víctor Manuel; Medrano Echeverría, María; Echarte Medina, Jon; Osés Recalde, Maddi; Izquierdo Rodríguez, Claudia; Concepción Álvarez, Mara de la Caridad; Galbete Jiménez, Arkaitz; Idoate, Fernando; Zugasti Murillo, Ana; Petrina Jáuregui, María Estrella; Goñi Gironés, María Elena; Ribelles, María Jesús; Amasene, María; Arenaza Etxeberría, Lide; Tejada Garrido, Clara Isabel; Elejalde, E.; Azcárate Jiménez, Unai Xabier; Ruiz Sarrias, Oskitz; Sayar-Beristain, Onintza; García-Ramos, Amador; Martínez Labari, Cristina; Armendáriz Brugos, Cristina; Villanueva Larre, Arantxa; Ruiz, Jonatan R.; Cabeza Laguna, Rafael; Labayen Goñi, Idoia; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio Ingeniaritza; Estadística, Informática y Matemáticas; Estatistika, Informatika eta Matematika; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Background & aims: time-restricted eating (TRE) shows promise for weight loss and improving menopauserelated body composition and cardiometabolic health, but its effects on skeletal muscle tissue (SMT) in postmenopausal women are unknown. This study investigates the effects of three weight loss interventions over 12 weeks on SMT quantity, quality, function, and cardiometabolic health in postmenopausal women with overweight/obesity, with effects persistence evaluated at a 12-month follow-up. Methods and results: in this randomized controlled trial, 78 postmenopausal women (50–65 years; BMI 25–40 kg/m2; sedentary lifestyle; eating window ≥12 h/day; no severe metabolic impairments) will be recruited. Participants will be randomly assigned to one of three groups for 12 weeks: TRE, TRE + resistance training, or CR + resistance training. The TRE groups will reduce their eating window to 8 h and receive nutritional advice to adhere to a Mediterranean diet. The CR group will follow a personalized hypocaloric diet (− 500 kcal/day). Resistance training groups will perform supervised resistance training 3 times/week. Primary Outcome: Change in SMT quantity measured by MRI at baseline and after 12 weeks. Secondary Outcomes: intermuscular adipose tissue (IMAT), strength, power, body weight and composition, and cardiometabolic risk factors. Conclusion: this study will illustrate the effects of TRE and TRE combined with resistance exercise compared with the currently recommended obesity-lifestyle treatment on SMT quantity, quality, function, and cardiometabolic markers. The results will offer insights into dietary strategies to combat obesity and metabolic diseases without increasing sarcopenia risk in postmenopausal women, a sparsely studied and particularly affected population.
Open Access
Nutrición deportiva
(Eunate, 2024) Medrano Echeverría, María; Cadenas-Sánchez, Cristina; Alfaro-Magallanes, Víctor Manuel; Labayen Goñi, Idoia; Ciencias de la Salud; Osasun Zientziak
La actividad física se define como 'cualquier movimiento corporal producido por los músculos esqueléticos que tiene como resultado un gasto de energía'. Acciones como caminar, subir las escaleras, realizar tareas del hogar, entrenar fuerza, jugar un partido de cualquier deporte o jugar a las palas en la playa son/implican actividad física. El ejercicio físico y el deporte son dos subtipos diferentes de actividad física. La característica distintiva del ejercicio físico es que se realiza de manera estructurada, planificada y repetitiva y con un objetivo determinado. El deporte se caracteriza por tener carácter competitivo, que se rige bajo unas reglas, y en muchas ocasiones se engloba dentro de una estructura federativa o institucionalizada. La realización de ejercicio físico va a influir sobre los requerimientos nutricionales de la persona que la realiza afectando no solo las necesidades energéticas, sino también las de macro y micronutrientes e hidratación. La práctica de ejercicio físico conlleva un aumento del gasto energético que puede suponer un incremento de los requerimientos energéticos que, a su vez, precisan de un aumento de la ingesta energética. La dieta del deportista deberá aportar la energía necesaria, en el momento necesario, aportada mediante una buena planificación también en su composición de macro- y micronutrientes. En ocasiones concretas, la práctica de ejercicio físico puede buscar también superávits o déficits energéticos puntuales o sostenidos, que precisan asimismo de una buena planificación. La planificación dietética de un/una deportista depende de varios factores que tienen que ver con las características morfológicas y de composición corporal del/la deportista, con la disciplina que practica, la cual determinará los sustratos energéticos y rutas metabólicas predominantes de la misma, con los objetivos a corto y largo plazo, y con la fase de la temporada en la que se encuentre. Todos estos aspectos van a determinar la planificación dietética en relación con la ingesta energética, su composición en macronutrientes y su distribución a lo largo del día. El ejercicio físico también va a aumentar los requerimientos de otros nutrientes. Es necesario que haya un correcto aporte de los micronutrientes, vitaminas y minerales (especialmente de los indispensables), que participan en las rutas metabólicas empleadas durante el ejercicio físico para que pueda alcanzarse un buen rendimiento, se produzcan las adaptaciones fisiológicas buscadas con el entrenamiento, y poder preservar la salud del deportista y evitar lesiones. Una correcta hidratación es importante en todas las personas, pero juega un papel determinante en el rendimiento deportivo. Por ello, se deberán diseñar estrategias específicas que permitan al deportista estar correctamente hidratado. Si bien es cierto que no todas las personas que realizan actividad física tienen requerimientos nutricionales especiales y su dieta seguirá los principios nutricionales básicos de una dieta equilibrada. En determinadas ocasiones, puede ser muy difícil cubrir los requerimientos nutricionales del deportista exclusivamente a través de una dieta basada en alimentos, y se recurre a ayudas ergogénicas nutricionales para lograr este objetivo u otros que influyen en el rendimiento deportivo. En general, las personas que realizan menos de una hora de ejercicio físico habitual y estructurado pueden satisfacer sus necesidades nutricionales siguiendo las recomendaciones para una vida activa que se proponen para la población general. En aquellas personas que realizan niveles elevados de ejercicio físico, principalmente deportistas que buscan el máximo rendimiento deportivo, son precisas planificación y recomendaciones dietéticas especiales que se conocen genéricamente como Nutrición Deportiva y cuyas consideraciones y recomendaciones generales se recogen en el este capítulo.
Open Access
Ventilatory thresholds differences according to aerobic fitness level in 1450 males and 241 females on cycle-ergometer: a cross-sectional study
(Wiley, 2025-06-17) Benítez-Muñoz, José Antonio; Alcocer-Ayuga, María; Cupeiro, Rocío; Guisado-Cuadrado, Isabel; Rojo-Tirado, Miguel Ángel; Alfaro-Magallanes, Víctor Manuel; Romero-Parra, Nuria; Aparecida-Castro, Eliane; Ramos Campo, Domingo Jesús; Armero-Sotillo, Alberto; Peinado, Ana Belén; Benito, Pedro J.; Ciencias de la Salud; Osasun Zientziak
The aim of the study was to analyze the influence of an aerobic fitness level on the percentage of maximum oxygen con-sumption, heart rate, and power output (%VO2max, %HRmax, and %Wmax) at which ventilatory thresholds 1 (VT1) and 2 (VT2)occur during a ramp incremental cycle‐ergometer test in males and females considering age. 1450 males and 241 femalesperformed a ramp incremental exercise test until exhaustion to determine VT1, VT2, and VO2max. Combining the oxygenconsumption at VT1, VT2, and VO2max by clustering analysis, males were classified as a low, medium, or high aerobic fitnesslevel and females were classified as a low or high aerobic fitness level. Results showed VO2max was very poorly correlated withthe %VO2max at which VT1 and VT2 occur (r ≤ 0.115), whereas oxygen consumption at VT1 and VT2 showed a stronger positiveassociation with the %VO2max at which VT1 and VT2 occur, respectively (r = 0.357–0.604). Furthermore, the %VO2max at whichVT1 and VT2 occur were greater the higher the aerobic fitness level (all p ≤ 0.002), observing a high heterogeneity in the%VO2max at which VT1 and VT2 occur even stratifying the sample by sex and aerobic fitness levels. In conclusion, the per-centage of maximum at which VT1 and VT2 occur are better related to oxygen consumption at VT1 and VT2, respectively, thanto VO2max. Moreover, the common strategy consisting of establishing exercise intensity as a fixed percentage of maximum mightnot be effective to match intensity across individuals even if sex and aerobic fitness levels is considered.