Distribution of energy intake across the day and weight loss: A systematic review and meta-analysis

Abstract

Consuming a greater proportion of total energy intake earlier in the day rather than in the evening is proposed to positively influence weight loss and health, potentially due to greater synchronization of human body circadian rhythms. This systematic review provides an update on existing evidence regarding earlier distributed eating patterns in weight loss interventions. Using a robust search strategy in five electronic databases, nine randomized controlled trials investigating the impact of energy intake distribution on weight loss were identified. Following critical appraisal, a random-effects meta-analyses found that, in the context of an energy-reduced diet, distributing energy intake with a focus on earlier intake resulted in significantly greater weight loss (-1.23 kg; 95% CI 2.40, -0.06, p = 0.04). Improvements in HOMA-IR, fasting glucose, and LDL cholesterol were also seen. The current study provides a timely update on the evidence linking distribution of total daily energy intake and health, showing that a focus on earlier intakes can result in greater short-term weight loss compared with later intakes. Future studies are needed to elucidate the impact that earlier intakes may have on weight management and metabolic health.

Keywords: chrononutrition; energy distribution; obesity; weight loss.

FIGURE 1

PRISMA flow diagram for study selection

FIGURE 2

(A) Forest plot for meta‐analysis of trials reporting weight loss (kg) for earlier versus later eating patterns. (B) Forest plot for meta‐analysis of trials reporting weight loss (kg) for earlier versus later eating patterns (excluding Madjd et al. [2020] ³⁶ )

FIGURE 3

Forest plot of meta‐analysis for change in fasting serum LDL cholesterol

FIGURE 4

Forest plot of meta‐analysis for change in fasting glucose

FIGURE 5

Forest plot of meta‐analysis for change in HOMA‐IR