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March 19, 2024 | 4 minute read

Time-restricted eating and cancer care

Key Takeaways

  • What you eat is important during cancer treatment.
  • Researchers are also looking into WHEN you eat to see if that affects treatment outcomes too.
  • AICR is funding research on personalized nutrition strategies like intermittent fasting and time-restricted eating to learn more about how they may impact cancer treatment.

Could personalized nutrition enhance outcomes of cancer treatment? Just as treatment plans are now based on individual cancer characteristics, research is exploring personalized nutrition strategies—including intermittent fasting—to improve response to cancer therapy.

THREE TERMS TO KNOW:

  • Personalized nutrition means that the best diet for you may be different than the best diet for someone else. Individualized strategies consider differences in DNA, race, sex, health history, medical treatments, gut microbiome, food intolerances and more.
  • Intermittent fasting is one type of personalized nutrition strategy. It involves specific hours or days with little or no food or drink besides water. Researchers are investigating whether fasting before or after chemotherapy or radiation therapy may reduce side effects or enhance treatment effectiveness.
  • Time-restricted eating (TRE) is one type of intermittent fasting, which extends fasting to 12 to 18 hours a day, typically including overnight hours. Research in rodents shows that it can increase effectiveness and reduce side effects of chemotherapy. Human studies show some benefits for treatment tolerance and quality of life. More clinical trials are currently underway.

Can Meal Timing Improve Treatment Response?

Circadian rhythms are run by a master clock in the brain and other clocks throughout the body. These rhythms help regulate sleep-wake cycles, hormones and metabolic processes. While light and dark are the main cues for the clock in the brain, eating is a major cue for clocks in other body tissues.

Research in rodents suggests that radiation treatment response may vary based on how its timing aligns with circadian rhythms. Human studies suggest that radiation timing may influence side effects and outcomes.

Dr. Nicole Simone, Professor of Integrative Medicine and Nutrition Sciences at Thomas Jefferson University in Philadelphia, explains that once research identifies the circadian phase that’s best for radiation treatment, efforts can focus on how to make a patient’s internal clock match that phase at the time of their radiation treatment.

Although time-restricted eating often focuses on the number of hours in which eating occurs, this strategy would focus on when eating occurs in relationship to cancer treatment. Eating at the right time before radiation treatment might prompt cancer cells to be in a phase at which they are most vulnerable to destruction.

More research is needed before such strategies can become part of cancer treatment protocols. Dr. Simone notes that cancer cells eventually adapt to time-restricted eating, so this strategy might rotate with other nutrition strategies to improve response to radiation treatment.

Questions also remain about whether different types of cancer vary in the circadian timing when they are most responsive to treatment and whether certain foods or nutrients are more powerful than others as cues for body clocks. Research is ongoing.

Personalizing Support for Nutrition Strategies

In an AICR-funded study called Txt4fasting, Dr. Kuang-Yi Wen, PhD, Associate Professor at Thomas Jefferson University, is investigating whether personalized telehealth coaching and interactive text messages help women following a personalized time-restricted eating plan during cancer treatment.

This study is testing TRE to reduce cancer progression and cognitive side effects following radiation treatment of brain metastases from breast cancer. The results of this pilot study will lay groundwork for a larger clinical trial on TRE during cancer treatment.

Dr. Wen and colleagues will also evaluate how well women follow the time-restricted eating strategy when receiving personalized coaching and texts compared to women receiving only general information on healthy eating. Researchers will send participants reminders and tips to help manage challenges like cravings, lapses and plans for circumstances they encounter.

It’s too soon to recommend TRE outside of clinical research settings, but researchers are making strides toward personalizing nutrition protocols during cancer care. To-date, AICR and our affiliates have committed over $280 million to biomedical research into the link between diet, lifestyle and cancer.

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