Time-restricted eating may lower BP in paediatric population

Time-restricted eating (TRE) with a 12-hr window, particularly with the last meal completed before 8:00 pm, significantly lowers blood pressure (BP) in children and adolescents with elevated BP compared with a usual eating pattern, according to a recent study.

The prevalence of elevated BP in children is on the rise worldwide. In this population, lifestyle-based interventions, specifically dietary modifications, have emerged as the primary approach to managing hypertension. [Pediatrics 2017;140:e20171904; Eur J Intern Med 2022;97:18–25]

Among interventions, TRE has gained attention as a dietary pattern. It is characterized by limiting daily caloric intake to a defined eating window (eg, 12 hr) without prescribing caloric restriction. [Endocr Rev 2022;43:405–436; Nutrients 2020;12:3396]

In the current study, the researchers analysed 192 children (aged 6–15 years) with elevated BP who were randomized into two TRE groups following a 12-hr eating window, the TREa group with the last meal before 8:00 pm and the TREb group without a specific last mealtime, or a control group (usual eating patterns). [Clin Exp Hypertens 2026;48:2635384]

Over a 12-month intervention period, the prevalence of elevated BP was greatly reduced in the TREa group at 58.7 percent, followed by those in the TREb group at 48.4 percent and the control group at 38.1 percent.

From baseline to 12 months, systolic BP was significantly decreased by 7.03 mm Hg (p<0.001) in the TREa group and by 5.29 mm Hg (p=0.013) in the TREb group, while no significant change was observed in the control group (0.38 mm Hg; p=0.841).

Diastolic BP was also significantly reduced in the TREa group (-4.09 mm Hg; p=0.004) relative to the control group (1.44 mm Hg; p=0.302). However, no significant differences were observed between the TREb group (-2.05 mm Hg; p=0.202) and the control group.

Accordingly, the TRE group demonstrated the most substantial improvements, suggesting that completing the last meal before 8:00 pm may enhance the efficacy of TRE in lowering BP.

“Our finding that the earlier last-meal strategy (TREa; last meal completed before 8:00 pm) tended to yield larger BP improvements than a 12-hr window without a fixed last-meal time (TREb) suggests that when eating ends may be as important as eating window duration,” said the researchers.

“This pattern is consistent with the hypothesis that late eating and prolonged eating windows are linked to elevated BP and adverse cardiometabolic profiles through circadian and metabolic pathways rather than through adiposity change alone,” they added.

Overall, the findings revealed that “both 12-hr TRE strategies may lead to lower BP over 12 months compared with usual eating patterns, with the largest improvement observed when the last meal was completed before 8:00 pm,” said the researchers.

“These findings suggest that a pragmatic 12-hr eating window, with an earlier last meal, may be a feasible adjunct approach for paediatric BP management,” they added.