A randomized controlled trial found that an eight-hour eating window with a 16-hour overnight fast reduced abdominal pain and stool frequency among Crohn’s patients with overweight or obesity.
By yourNEWS Media Newsroom
A time-restricted eating plan that included a 16-hour overnight fast significantly reduced symptoms in patients with Crohn’s disease who were in remission and had overweight or obesity, according to a randomized controlled trial published in Gastroenterology.
The study found that participants who followed the fasting schedule six days per week had a 50% reduction in abdominal pain and a 40% drop in stool frequency. Researchers said the results suggest that meal timing may play an important role in managing Crohn’s disease symptoms and inflammation.
The trial included 35 patients with Crohn’s disease in remission. Participants were randomly assigned either to continue their usual eating habits or to follow a time-restricted eating pattern that limited food intake to an eight-hour window each day, followed by a 16-hour fast overnight.
Researchers tracked body mass index, collected stool and blood samples, and measured symptoms using the Harvey-Bradshaw Index, a questionnaire commonly used to assess Crohn’s disease activity.
The fasting group lost an average of one BMI point, which researchers considered clinically significant. Participants also showed meaningful reductions in visceral fat and systemic inflammation.
The findings are notable because Crohn’s disease remains difficult to treat for many patients. According to background information in the study, up to 40% of Crohn’s patients do not respond to the most advanced available treatments, and as many as half of those who initially respond eventually stop responding.
Both groups in the trial reported similar calorie and macronutrient intake, suggesting the improvements were not simply the result of eating less.
“So we conclude that the benefits of the weight loss are not entirely related to energy restriction or energy reduction, but more related to circadian rhythms and the timing of when people were eating,” gastroenterologist and senior study author Dr. Maitreyi Raman told the Epoch Times.
Raman, an associate professor of medicine at the University of Calgary in Alberta, Canada, said the benefits appear to be “more related to circadian rhythms and the timing of when people were eating.”
Time-restricted eating may influence the gut microbiome, metabolic function and inflammation by aligning eating patterns more closely with the body’s natural daily rhythms.
Dr. Will Cole, author of Intuitive Fasting, has written that time-restricted feeding can help reset the microbiome’s natural rhythm. His book states: “Fasting can reduce the absorption of specific bacterial endotoxins, which have been linked to an increased risk for obesity and insulin resistance.”
Registered dietitian Matthew Breit, a postdoctoral fellow at the University of Colorado Anschutz Medical Campus who was not involved in the trial, told the Epoch Times that fasting may support insulin sensitivity, metabolic flexibility and immune regulation.
The study also found that participants in the fasting group had lower levels of inflammatory adipokines, including leptin, plasminogen activator inhibitor-1 and adipsin.
Researchers observed favorable changes in the gut microbiome as well. Participants following the fasting schedule had increases in short-chain fatty acid-producing bacteria, which are often reduced in people with inflammatory bowel disease.
Bacteria linked to Crohn’s flares, including Bacteroides ovatus and Escherichia/Shigella, were less abundant among participants who lost more weight.
The findings suggest that reducing visceral fat and improving gut microbial balance may help reduce Crohn’s symptoms and inflammation.
Diet quality may also matter. Prior research has linked high consumption of ultra-processed foods to greater Crohn’s disease risk, suggesting that both what patients eat and when they eat could influence disease activity.
Raman said combining weight management with medication may help some patients achieve more durable remission.
The study’s authors cautioned that more research is needed to determine whether the benefits continue long term and whether the approach works for broader Crohn’s disease populations, including patients without overweight or obesity.
Breit also noted that calorie intake was self-reported, meaning unmeasured changes in food intake may have contributed to some of the results.
Even with those limitations, the trial points to a simple, low-cost dietary strategy that may help improve symptoms for some Crohn’s patients. For patients in remission, an eight-hour eating window paired with a 16-hour overnight fast may offer additional support alongside medical care.
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