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Early Time-Restricted Eating for Cardiovascular Health (ALIGN)
Aligning Clocks: Time-Restricted Eating to Improve Cardiovascular Health in Hypertensive Older Adults Who Skip Breakfast
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
Aging is a major risk factor for cardiovascular disease, largely due to elevated blood pressure (BP) and endothelial dysfunction. These conditions are common in older adults and often coexist, and breakfast skipping has emerged as an additional contributor. Delaying the first meal creates misalignment between central and peripheral circadian rhythms that regulate vascular and metabolic processes. This misalignment alters cortisol patterns and impairs glucose and insulin responses, increasing inflammation and oxidative stress. These disturbances weaken endothelial function and disrupt vascular tone and diurnal BP rhythms, contributing to hypertension and underscoring the need for interventions that restore vascular health in older adults who skip or delay breakfast.
Early time-restricted eating (eTRE) is a promising strategy that aligns food intake with hormonal rhythms by shifting meals earlier in the day. eTRE may strengthen circadian rhythms, reduce oxidative stress, and improve cardiovascular function, yet its effects in older adults with hypertension remain understudied. This project will address this gap by implementing a 12-week eTRE to evaluate effects on vascular health and circadian rhythms and to explore participants' experiences with adopting eTRE.
Thirty-six adults aged 60 and older with breakfast-skipping behavior and hypertension (average daytime systolic BP ≥130 mmHg per AHA criteria) will be randomized to eTRE or control, with equal numbers of morning and evening chronotypes based on the Morningness-Eveningness Questionnaire. Cardiovascular outcomes will be assessed with 24-hour ambulatory BP monitoring and flow-mediated dilation. Fasting blood samples will be collected to measure circadian clock gene expression and redox biomarkers. To understand behavioral and perceptual factors, ten eTRE participants will join two focus groups (n=5 per group) to discuss changes in energy, sleep timing, and daily routines.
The central hypothesis is that eTRE will improve BP regulation and endothelial function, regardless of chronotype, by enhancing circadian alignment, restoring redox balance, and promoting greater daily structure. Findings from this pilot study will provide preliminary evidence for a future trial and guide strategies to improve cardiovascular health in older adults.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Yi Lin, PhD
- Número de telefone: 205.996.5876
- E-mail: yilin@uabmc.edu
Locais de estudo
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Alabama
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Birmingham, Alabama, Estados Unidos, 35205
- University of Alabama at Birmingham
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Contato:
- Yi Lin, PhD
- Número de telefone: 205.996.5876
- E-mail: yilin@uabmc.edu
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Men and women ≥ 60 years old
- Average office systolic BP ≥130 mmHg5
- Self-reported skipping breakfast for at least 3 days in the past 7 days
- Identified as having a morning or evening chronotype according to the Morningness-Eveningness Questionnaire68
- Stable health history over the past 2 months
- Stable medication history over the past 2 months, as recommended by the primary provider
- Willing and able to provide informed consent.
Exclusion Criteria:
- Fasting >13 hours per day
- Actively trying to lose weight by participating in formal weight loss program or significantly restricting calorie intake
- Resting heart rate of >120 beats/minute, systolic BP >180 and/or diastolic BP >100 mmHg
- Have lost ≥ 10 pounds in last 3 months
- Self-reported exercise over 90 min/week
- Unable to wake up at a regular time between 6-9 am
- Perform overnight shift work more than 1day/week on average
- Have been diagnosed with diabetes
- On insulin or diabetes medication
- Unstable angina, heart attack or stroke in the past 3 months
- Continuous use of supplemental oxygen to manage a chronic pulmonary condition or heart failure
- Pregnant or breastfeeding
- Rheumatoid arthritis, Parkinson's disease or currently on dialysis
- Current diagnosis of a major psychiatric condition that would impair study participation
- Severe gastrointestinal disease, major gastrointestinal surgery, or active gallstone disease
- Active treatment for cancer in the past year
- Taking medications that preclude fasting for 16 hours (e.g. must be taken with food at least 12 hours apart)
- Diagnosed cognitive impairment
- Unable to fast for 16 hours.
- Any condition that in the opinion of the investigator would impair ability to participate in the trial
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
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Experimental: Early time-restricted eating (eTRE) group
Participants in the eTRE group will be asked to fast for a target of 16 hours per day (eat ad libitum within the 8-hour eating window, starting between 6:30-9:30 am), 6 days/week for 12 weeks.
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Participants in the eTRE group will be asked to fast for a target of 16 hours per day (eat ad libitum within the 8-hour eating window, starting between 6:30-9:30 am), 6 days/week for 12 weeks.
Participants will be allowed to consume calorie-free beverages, sugar-free gum, and will be encouraged to drink plenty of water throughout the entire intervention period.
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Sem intervenção: Control group
Participants in the control group will be instructed to maintain habitual eating patterns.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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24-Hour Systolic Blood Pressure
Prazo: Baseline (Week 0), Week 6, and Week 12 of the intervention
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Change in mean 24-hour systolic blood pressure measured using ambulatory blood pressure monitoring (ABPM).
Blood pressure will be recorded over a 24-hour period to assess the effects of early time-restricted eating on blood pressure regulation.
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Baseline (Week 0), Week 6, and Week 12 of the intervention
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Flow-Mediated Dilation
Prazo: Baseline (Week 0), Week 6, and Week 12 of the intervention
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Change in endothelial function assessed by brachial artery flow-mediated dilation (FMD) using ultrasound.
FMD will be expressed as the change in brachial artery diameter following reactive hyperemia.
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Baseline (Week 0), Week 6, and Week 12 of the intervention
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Colaboradores e Investigadores
Patrocinador
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
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Conclusão do estudo (Estimado)
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Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
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Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- IRB-300016105
- 26CDA1600914 (Número de outro subsídio/financiamento: American Heart Association)
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Descrição do plano IPD
Prazo de Compartilhamento de IPD
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