Meal Timing and Crohn’s Disease: Clinical Implications of Intermittent Fasting, With Andres Hurtado-Lorenzo, PhD

Interest in dietary management of Crohn’s disease has long focused on identifying specific foods that trigger symptoms or promote remission, but a growing body of research is expanding that conversation beyond food composition alone. Increasingly, investigators are examining whether meal timing may influence inflammation, metabolic health, and the gut microbiome in patients with inflammatory bowel disease.

In a recent randomized clinical trial published in Gastroenterology, researchers evaluated time-restricted feeding as a complementary strategy in adults with Crohn’s disease, adding new rigor to a field eager for validated lifestyle interventions.

In discussing the findings, Andres Hurtado-Lorenzo, PhD, VP of IBD Ventures and Translational Research at the Crohn’s & Colitis Foundation, emphasized that traditional dietary strategies in Crohn’s disease have largely focused on what patients should eat. While he says that food quality remains central, emerging science now suggests that when people eat may be equally important.

“Multiple studies in the context of other diseases have shown that meal timing can independently influence circadian regulated immune and metabolic pathways, microbial balance and adipose tissue biology, even without changes in calorie intake or nutrient composition,” Hurtado-Lorenzo explained. “In Crohn's disease, the intersection of chronic immune dysregulation, disturbances in gut microbiota, and high prevalence of overweight and obesity establishes a strong case for examining time based dietary interventions such as intermittent fasting.”

The 12-week randomized controlled trial evaluated the effects of a 16:8 time-restricted feeding protocol, in which participants fasted for 16 hours and consumed all meals within an 8-hour window. Investigators assessed the impact on clinical disease activity, body composition, and systemic inflammation in adults with Crohn’s in clinical remission and overweight or obesity.

Results showed that over 12 weeks, BMI decreased significantly in the time-restricted feeding group compared with controls (Δ –0.9 ± 0.03 kg/m2 vs +0.6 ± 0.3 kg/m2; P <.001). Energy intake and diet quality (Mediterranean Diet Index) did not differ between groups or across time, suggesting BMI reduction occurred independent of caloric restriction and diet quality.

Clinical disease activity as measured by the Harvey–Bradshaw Index also improved significantly in the time-restricted feeding group (Δ –2 ± 4 vs –0.5 ± 2; P = .02), with a 40% decrease in stool frequency and 50% reduction in abdominal discomfort, which was not observed in controls.

Additionally, compared with controls, the time-restricted feeding group exhibited significant reductions in serum adipokines, including leptin, plasminogen activator inhibitor-1, and adipsin (all, P < .05). Further analysis revealed ​​greater BMI loss correlated positively with both anti-inflammatory cytokines (interleukin [IL]1RA, IL4; r = 0.78) and pro-inflammatory cytokines (IL2, IL12p40, IL12p70; r = 0.83–0.90).

Hurtado-Lorenzo pointed to the magnitude and speed of change as being among the most striking findings from the study. From a mechanistic standpoint, he outlined 2 primary processes underlying these effects, metabolic remodeling and autophagy, and further hypothesized that fasting-induced autophagy could play a therapeutic role in Crohn’s due to its potential contribution to disease pathogenesis.

“Importantly, this is the first randomized clinical trial to demonstrate a benefit of intermittent fasting in patients with Crohn's disease, providing rigorous evidence in the field that is hungry for validated lifestyle strategies,” Hurtado-Lorenzo said. “In my opinion, this approach meets a real clinical need of sustaining remission by offering a practical solution in synergy with pharmacological treatment strategies for Crohn's disease.”

References

1. Crohn’s & Colitis Foundation of America. Intermittent fasting cut Crohn’s disease activity by 40% and halved inflammation in randomized clinical trial. February 9, 2026. Accessed February 19, 2026. https://www.eurekalert.org/news-releases/1114988

2. Haskey N, Ye J, Lewis A, Yousuf M, Reimer RA, Raman M. Time-Restricted Feeding Reduces Body Mass Index, Visceral Adiposity, Systemic Inflammation, and Clinical Disease Activity in Adults With Crohn's Disease: A Randomized Controlled Study. Gastroenterology. Published online February 9, 2026. doi:10.1053/j.gastro.2025.11.008