Time-Restricted Eating Improves Quality of Life, Heart Rate, and Mitochondrial Function in Patients with Postural Orthostatic Tachycardia Syndrome.

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 hour 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 hours. 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), improved QOL metrics including POTS symptom severity (p < 0.0001), physical functioning (p = 0.02), and energy/fatigue (p < 0.01), and increased mitochondrial-derived ATP. These findings suggest TRE as a promising lifestyle intervention to improve QOL, heart rate, and mitochondrial function in POTS patients.