{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T12:49:12Z","timestamp":1775652552238,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Purpose: The aims of this study were to evaluate the feasibility of time-restricted eating (TRE) in patients with Cushing\u2019s disease (CD) and assess its effects on body weight and metabolic parameters. Methods: Twelve CD patients in remission with obesity were enrolled in a TRE program restricting food intake to 10:00\u201318:00. Anthropometric data, glycemic and lipid profiles, and circadian cortisol secretion were assessed at baseline and post-intervention. Serum cortisol levels were measured at multiple time points to evaluate diurnal patterns. Results: Nine patients completed the study. Over the 12-week period, participants showed a significant reduction in body weight, with median values decreasing from 93.8 kg [83.1\u2013106.5] to 82.6 kg [76.9\u2013100.3] (p = 0.011). Body mass index (BMI) also declined from 37.6 kg\/m2 [34.2\u201339.7] to 34.4 kg\/m2 [32.6\u201338.3] (p = 0.012). No statistically significant changes were observed in fasting glucose, HbA1c, or lipid parameters. Notably, 24 h urinary free cortisol levels significantly decreased (p = 0.01), and serum cortisol showed a downward trend at all measured time points, with the most pronounced reductions during mid-day and evening hours. No clinical or biochemical evidence of CD relapse was observed during the 12-month follow-up. Conclusions: Time-restricted eating is a feasible and well-tolerated dietary approach for patients with CD in remission, promoting weight loss and modest improvements in metabolic markers and cortisol rhythmicity.<\/jats:p>","DOI":"10.3390\/nu18081175","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T11:41:18Z","timestamp":1775648478000},"page":"1175","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Time-Restricted Eating on Circadian Cortisol Secretion and Obesity-Related Metabolic Markers in Cushing\u2019s Disease: A Pilot Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4420-4721","authenticated-orcid":false,"given":"Lala","family":"Soltanova","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No. 53, Istanbul 34098, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7070-0895","authenticated-orcid":false,"given":"Ceren","family":"Iseri","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetic, Faculty of Health Sciences, Istanbul Kent University, Istanbul 34413, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-5418","authenticated-orcid":false,"given":"Serdar","family":"Sahin","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No. 53, Istanbul 34098, T\u00fcrkiye"},{"name":"Pituitary Center, Istanbul University-Cerrahpasa, Istanbul 34320, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihriban","family":"Kara","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34320, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzan Aydin","family":"Guclu","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine Nursing Service, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34320, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Busra","family":"Yesilova","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine Nursing Service, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34320, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1906-0535","authenticated-orcid":false,"given":"Ilkin","family":"Muradov","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No. 53, Istanbul 34098, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9281-1771","authenticated-orcid":false,"given":"Banu Betul","family":"Kocaman","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No. 53, Istanbul 34098, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8329-140X","authenticated-orcid":false,"given":"Pinar","family":"Kadioglu","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No. 53, Istanbul 34098, T\u00fcrkiye"},{"name":"Pituitary Center, Istanbul University-Cerrahpasa, Istanbul 34320, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1007\/s11102-015-0645-6","article-title":"Comorbidities in Cushing\u2019s disease","volume":"18","author":"Sharma","year":"2015","journal-title":"Pituitary"},{"key":"ref_2","unstructured":"Juszczak, A., Morris, D., and Grossman, A. (2024). Cushing\u2019s syndrome. Endotext, MDText.com, Inc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1530\/EJE-11-1095","article-title":"Management of Endocrine Disease: The burden of Cushing\u2019s disease: Clinical and health-related quality of life aspects","volume":"167","author":"Feelders","year":"2012","journal-title":"Eur. J. Endocrinol."},{"key":"ref_4","first-page":"2664","article-title":"Persistence of increased cardiovascular risk in patients with Cushing\u2019s disease after five years of successful cure","volume":"84","author":"Colao","year":"1999","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_5","first-page":"439","article-title":"Effect of hypercortisolism control on high blood pressure in Cushing\u2019s syndrome","volume":"67","author":"Albiger","year":"2007","journal-title":"Medicina"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3365","DOI":"10.1210\/jc.2009-0766","article-title":"Persistent body fat mass and inflammatory marker increases after long-term cure of Cushing\u2019s syndrome","volume":"94","author":"Barahona","year":"2009","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1016\/S0140-6736(06)68699-6","article-title":"Cushing\u2019s syndrome","volume":"367","author":"Bertagna","year":"2006","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1210\/jc.2010-1942","article-title":"Mortality and morbidity in Cushing\u2019s disease over 50 years in Stoke-on-Trent, UK: Audit and meta-analysis of literature","volume":"96","author":"Clayton","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1530\/EJE-13-0555","article-title":"Surgical remission of Cushing\u2019s syndrome reduces cardiovascular risk","volume":"171","author":"Terzolo","year":"2014","journal-title":"Eur. J. Endocrinol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1590\/S1807-59322010000100003","article-title":"Screening for Cushing\u2019s syndrome in obese patients","volume":"65","author":"Tiryakioglu","year":"2010","journal-title":"Clinics"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2169\/internalmedicine.48.1234","article-title":"Comparison of 1 mg and 2 mg overnight dexamethasone suppression tests for the screening of Cushing\u2019s syndrome in obese patients","volume":"48","author":"Sahin","year":"2009","journal-title":"Intern. Med."},{"key":"ref_12","first-page":"1217","article-title":"Overnight Dexamethasone Suppression Test: A Reliable Screen for Cushing\u2019s Syndrome in the Obese","volume":"10","author":"Nabriski","year":"2003","journal-title":"Obes. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s11695-011-0545-4","article-title":"Prevalence of endocrine disorders in morbidly obese patients and the effects of bariatric surgery on endocrine and metabolic parameters","volume":"22","author":"Wolf","year":"2012","journal-title":"Obes. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Moreno-Moreno, P., Rebollo-Rom\u00e1n, \u00c1., Ibanez-Costa, A., Alhambra Exp\u00f3sito, M.R., Munoz-Jimenez, C., and Galvez-Moreno, M. (2016). Persistence of obesity and overweight in patients with Cushing disease in remission. Endocrine Abstracts, Bioscientifica Ltd.","DOI":"10.1530\/endoabs.41.EP757"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"252","DOI":"10.4158\/EP12247.OR","article-title":"Persistence of Cushing\u2019s disease symptoms and comorbidities after surgical cure: A long-term, integral evaluation","volume":"19","author":"Sosa","year":"2013","journal-title":"Endocr. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1530\/EJE-13-0569","article-title":"Mortality in Cushing\u2019s syndrome: Systematic analysis of a large series with prolonged follow-up","volume":"169","author":"Ntali","year":"2013","journal-title":"Eur. J. Endocrinol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"109000","DOI":"10.1016\/j.isci.2024.109000","article-title":"Time-restricted eating improves health because of energy deficit and circadian rhythm: A systematic review and meta-analysis","volume":"27","author":"Chang","year":"2024","journal-title":"iScience"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2830545","DOI":"10.1155\/2022\/2830545","article-title":"The Effect of Time-Restricted Eating on Insulin Levels and Insulin Sensitivity in Patients with Polycystic Ovarian Syndrome: A Systematic Review","volume":"2022","author":"Floyd","year":"2022","journal-title":"Int. J. Endocrinol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.cmet.2023.12.004","article-title":"Time-restricted eating: Watching the clock to treat obesity","volume":"36","author":"Ezpeleta","year":"2024","journal-title":"Cell Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.tcm.2023.10.002","article-title":"The optimal time restricted eating interventions for blood pressure, weight, fat mass, glucose, and lipids: A meta-analysis and systematic review","volume":"34","author":"Liang","year":"2024","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/S2213-8587(21)00235-7","article-title":"Consensus on diagnosis and management of Cushing\u2019s disease: A guideline update","volume":"9","author":"Fleseriu","year":"2021","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/S0140-6736(14)61375-1","article-title":"Cushing\u2019s syndrome","volume":"386","author":"Lacroix","year":"2015","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101485","DOI":"10.1016\/j.beem.2021.101485","article-title":"The definition of remission and recurrence of Cushing\u2019s disease","volume":"35","year":"2021","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.4158\/EP161512.DSCR","article-title":"American Association of Clinical Endocrinologists and American College of Endocrinology Disease State Clinical Review: Diagnosis of Recurrence in Cushing Disease","volume":"22","author":"Fleseriu","year":"2016","journal-title":"Endocr. Pract."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Hinojosa-Amaya, J.M., Varlamov, E.V., McCartney, S., and Fleseriu, M. (2019). Hypercortisolemia Recurrence in Cushing\u2019s Disease; a Diagnostic Challenge. Front. Endocrinol., 10.","DOI":"10.3389\/fendo.2019.00740"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1210\/jcem-55-4-757","article-title":"Diurnal cortisol peaks and their relationships to meals","volume":"55","author":"Follenius","year":"1982","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1038\/s41430-023-01311-w","article-title":"Time-restricted eating with calorie restriction on weight loss and cardiometabolic risk: A systematic review and meta-analysis","volume":"77","author":"Sun","year":"2023","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"345","DOI":"10.3233\/NHA-170036","article-title":"Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: A pilot study","volume":"4","author":"Gabel","year":"2018","journal-title":"Nutr. Healthy Aging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1113\/JP281101","article-title":"Time restricted eating for the prevention of type 2 diabetes","volume":"600","author":"Cienfuegos","year":"2022","journal-title":"J. Physiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s40292-015-0096-1","article-title":"Middle and Long-Term Impact of a Very Low-Carbohydrate Ketogenic Diet on Cardiometabolic Factors: A Multi-Center, Cross-Sectional, Clinical Study","volume":"22","author":"Cicero","year":"2015","journal-title":"High Blood Press. Cardiovasc. Prev."},{"key":"ref_31","first-page":"2613","article-title":"Very-low-calorie ketogenic diet with aminoacid supplement versus very low restricted-calorie diet for preserving muscle mass during weight loss: A pilot double-blind study","volume":"20","author":"Merra","year":"2016","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Parr, E.B., Devlin, B.L., Radford, B.E., and Hawley, J.A. (2020). A Delayed Morning and Earlier Evening Time-Restricted Feeding Protocol for Improving Glycemic Control and Dietary Adherence in Men with Overweight\/Obesity: A Randomized Controlled Trial. Nutrients, 12.","DOI":"10.3390\/nu12020505"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Guarnotta, V., Amodei, R., Di Gaudio, F., and Giordano, C. (2023). Nutritional Intervention in Cushing\u2019s Disease: The Ketogenic Diet\u2019s Effects on Metabolic Comorbidities and Adrenal Steroids. Nutrients, 15.","DOI":"10.20944\/preprints202310.0431.v1"},{"key":"ref_34","first-page":"692","article-title":"Fasting as a metabolic stress paradigm selectively amplifies cortisol secretory burst mass and delays the time of maximal nyctohemeral cortisol concentrations in healthy men","volume":"81","author":"Bergendahl","year":"1996","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"bvac075","DOI":"10.1210\/jendso\/bvac075","article-title":"Short-Term Fasting Attenuates Overall Steroid Hormone Biosynthesis in Healthy Young Women","volume":"6","author":"Magyar","year":"2022","journal-title":"J. Endocr. Soc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"151","DOI":"10.3109\/10253890.2015.1121984","article-title":"Systematic review and meta-analysis reveals acutely elevated plasma cortisol following fasting but not less severe calorie restriction","volume":"19","author":"Nakamura","year":"2016","journal-title":"Stress"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e1424","DOI":"10.1210\/clinem\/dgae151","article-title":"Epigenetic Mechanisms Modulated by Glucocorticoids with a Focus on Cushing Syndrome","volume":"109","author":"Paes","year":"2024","journal-title":"J. Clin. Endocrinol. Metab."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/8\/1175\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T11:49:14Z","timestamp":1775648954000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/8\/1175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,8]]},"references-count":37,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["nu18081175"],"URL":"https:\/\/doi.org\/10.3390\/nu18081175","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,8]]}}}