Effects of Time-Restricted Eating Combined with Exercise on Body Composition and Cardiometabolic Health in Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis.

CONTEXT: The global prevalence of overweight and obesity continues to rise, imposing substantial health and economic burdens. Time-restricted eating (TRE) and exercise each improve body composition and cardiometabolic health, although both carry limitations when applied in isolation. However, evidence specifically examining their combined effects in adults with overweight or obesity remains limited.

OBJECTIVE

To synthesize evidence from randomized controlled trials (RCTs) to evaluate the effects of TRE combined with exercise (TRE + EX) compared with a control diet (CD) plus exercise (CD + EX) on body composition and cardiometabolic health in adults with overweight or obesity.

DATA SOURCES: The PubMed, Web of Science, Embase, and the Cochrane Library databases were searched from inception through April 2026, with reference lists additionally screened.

DATA EXTRACTION: Two reviewers independently extracted study characteristics, participant demographics, intervention protocols, and outcome data.

DATA ANALYSIS: Eleven RCTs enrolling 602 participants were included. Compared with CD + EX, TRE + EX produced modest reductions in body weight (WMD = -1.64 kg; 95% CI, -2.49 to -0.79), fat mass (WMD = -1.30 kg; 95% CI, -1.72 to -0.89), and waist circumference (WMD = -1.53 cm; 95% CI, -2.61 to -0.44), and significant improvements in body mass index (WMD = -0.83 kg m-2; 95% CI, -1.34 to -0.33) and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) (WMD = -0.44; 95% CI, -0.82 to -0.06), without significantly affecting fat-free mass. No significant between-group differences were observed for fasting glucose, fasting insulin, hemoglobin A1c, lipid profiles, or blood pressure. Subgroup analyses indicated that interventions longer than 8 weeks produced significantly greater reductions in fasting glucose, fasting insulin, and HOMA-IR values.

CONCLUSIONS

Compared with CD + EX, TRE + EX improved body composition and HOMA-IR in adults with overweight or obesity, whereas no significant differences were observed in lipid profiles or blood pressure. Furthermore, longer intervention durations may contribute to greater improvements in glycemic markers. Large-scale RCTs with longer follow-up are needed to confirm these findings and identify optimal TRE + EX combinations.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. CRD420261298734.