Time-restricted eating improves quality of life, heart rate, and mitochondrial function in patients with POTS…, 2025, Dzotsi et al.

SNT Gatchaman

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Time-restricted eating improves quality of life, heart rate, and mitochondrial function in patients with postural orthostatic tachycardia syndrome. An open-label pilot study
Dzotsi, Marissa; Strohm, Allyssa; Varshney, Shweta; Zuniga-Hertz, Juan P; Chitteti, Ramamurthy; Manoogian, Emily; Sethi, Anshika; Panda, Satchidananda; Patel, Hemal H; Doherty, Taylor A; Taub, Pam

Postural orthostatic tachycardia syndrome (POTS) is characterized by an abnormal increase in heart rate upon standing, leading to symptoms such as dizziness, fatigue, and rapid heart rate. Time-restricted eating (TRE), which limits caloric intake to an 8–10 h daily window, has been shown to decrease inflammation and improve immune, autonomic, and mitochondrial function, as well as cardiometabolic parameters.

This single arm pilot study evaluated the effects of TRE on quality of life (QOL), heart rate, and mitochondrial function in 20 participants with POTS (≥ 30 bpm increase in upright heart rate) and a baseline dietary window of ≥ 12 h. Following a 2-week baseline monitoring period, participants underwent a 12-week TRE intervention. Pre-and post-intervention assessments included QOL questionnaires, a 10-minute stand test, and plasma mitochondrial analysis.

TRE significantly reduced heart rate increase upon standing (mean decrease: 11 bpm, p < 0.001) and improved QOL metrics, as assessed by the Malmo POTS Symptom Score Survey (MAPS) and the General Health Questionnaire Short Form-36 (SF-36). Notable improvements include POTS symptom severity (p < 0.0001), physical functioning (p = 0.02), and energy/fatigue (p < 0.01). Additionally TRE increased mitochondrial-derived ATP production.

These findings suggest TRE as a promising lifestyle intervention to improve QOL, heart rate, and mitochondrial function in POTS patients.

Web | PDF | Nature Scientific Reports | Open Access
 
Most of the SF-36 scores were a complete bust, except for:
physical functioning change: 9.00 (1.98 to 16.02)
energy/fatigue change: 11.25 (5.09 to 17.41)

There were improvements in more categories for MAPS and they make a big deal out of the average being just below the POTS-cut off at 42 points, but at the same time the participants only started out at 59 out of 120.

They got one significant finding for mitochondrial function, but it’s close to p = 0.05 and I can’t find anything about multiple comparison testing in what they call an «exploratory outcome».

IMG_0391.webp

@jnmaciuch maybe you’re able to make sense of the methodology?

They also say that they tracked their sleep in the app they used (called MyCircadianClock), but I can’t find any data on that anywhere. That makes me a bit suspicious, because their hypothesis was based on improving the circadian rhythm:
We hypothesized that TRE, by optimizing circadian rhythms and improving autonomic/immune function, could address and improve underlying mechanisms contributing to POTS symptoms and ultimately improve QOL for affected individuals. This proof-of-concept pilot study aims to evaluate the potential of TRE as a lifestyle intervention for POTS.
 
@jnmaciuch maybe you’re able to make sense of the methodology?
I’m not sure I understand the rationale here either—ostensibly they’re trying to identify metabolic changes from their invention, but they’re doing that by analyzing the metabolism of cultured mouse muscle cells exposed to patient serum before and after the regimen. Maybe I’m just too unfamiliar with that research niche, but I’m not sure what they expected to see in the first place. At the very least I would need to see a comparison with serum from a healthy control to be able to interpret this at all.
 
TRE's one of those solutions in search of a problem, isn't it. Like cold water immersion. Same sort of underlying philosophy.
 
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