Timing of eating and exercise as a novel strategy to preserve muscle mass and improve glycemic control in obese post-menopausal women with type 2 diabetes – TIMEDIAB

Overweight, obesity, aging and menopause are all independent risk factors in the development of type 2 diabetes mellitus (T2DM). Older women with T2DM are at especially high risk for sarcopenia, i.e. loss of skeletal muscle mass and force, and cardiovascular diseases. The first line of T2DM treatment is based on lifestyle changes including weight loss and physical activity. One major current medical challenge is to find novel lifestyle therapies able to reduce cardiometabolic risk while perserving muscle mass in obese older individuals. As a result, intermittent fasting approaches, including time-restricted feeding/eating (TRF/TRE), have been offered as alternative dietary strategies that may have beneficial effects on weight control and T2DM. We recently observed that long-term TRF improve glucose homeostasis while perserving muscle mass and force in female obese mice. The purpose of TIMEDIAB is to demonstrate that early TRE (eTRE) combined to late (afternoon) exercise will outperform eTRE combined to morning exercise on various components of muscle health as primary endpoint, and blood glucose control, body composition, energy balance, cardiovascular risk, and metabolic health as secondary endpoint. Specfic aims : 1) Investigate the added-value of combining eTRE and late exercise on cardiometabolic health ; 2) Decode at multiple scales the underlying molecular mechanisms. TIMEDIAB is a proof-of-concept study to investigate novel safe interventions that can effectively improve metabolic health in diabetic patients, without increasing the risk of frailty later in life. This study will pave the way to larger scale randomized clinical trials investigating the long term effects/benefits of such intervention and in other target populations.