"Evening chronotype associates with increased triglyceride levels in young adults in two independent populations"

Examining the evidence between screen time and night eating behaviour with dietary intake related to metabolic syndrome: A narrative review

Screen time (ST) on digital devices has increased in recent decades due to digital development. Furthermore, constant engagement with digital devices alters sleep patterns, leading to nocturnal eating behaviour among users. These phenomena are therefore of great concern, as digital device addiction and night eating are associated with unhealthy food intake, increasing the metabolic syndrome (MetS) risks. The purpose of this review was to examine the evidence of the influence of ST and night eating behaviour (NEB) on dietary intake and its association with MetS based on previous literature. Prolonged ST and NEB have an association with excessive intake of energy from overconsumption of high-sugar and high-fat foods. However, the relationship between digital content and its influence on food intake is inconsistent. A higher MetS risk was found in individuals with longer ST due to a sedentary lifestyle, while positive energy balance and a shift in circadian rhythm contributed to night eaters. ST and NEB presented with a significant influence on food intake in adults. Additionally, unhealthy food intake due to excessive consumption of empty-calorie foods such as sweet and fatty foods due to addiction to electronic devices and eating at night has a detrimental effect on metabolic function. Therefore, improving food intake by reducing ST and night binges is essential to reduce the risk of MetS.

Association of diet, lifestyle, and chronotype with metabolic health in Ukrainian adults: a cross-sectional study

Morning chronotypes are associated with healthier metabolic profiles and lifestyles compared to evening chronotypes. However, limited research examined the relationship between chronotype, dietary intake, and metabolic health using accurate measures such as food records. This cross-sectional study aimed to investigate the association between chronotype, dietary intake, and metabolic health markers in a cohort of Ukrainian individuals. Chronotypes were determined using the Morningness-Eveningness Questionnaire (MEQ) in 110 healthy to obese individuals (30-75 years) without type 2 diabetes. Dietary intake was derived from weighed seven days food diaries, anthropometrics and blood markers of glucose and lipid metabolism were measured. Morning chronotypes were significantly older and exhibited distinct dietary patterns, including lower intake of fat and animal protein and higher intake of carbohydrates when compared to evening chronotypes (p < 0.01). Higher MEQ scores, reflecting a tendency toward a morning chronotype, were associated with lower BMI, waist circumference, fasting triglycerides, and glucose (p < 0.05). Further, being of morning chronotype predicted better overall metabolic health. These associations remained significant after adjusting for confounders. The findings suggest that morning chronotypes have a different dietary pattern characterized by a more balanced diet and favorable metabolic profile. Synchronizing daily routines with morning preferences could positively influence metabolic health.

Rise and shine for eating right: the link between healthy nutrition and chronotype among young adults

Aim

Many studies have examined the relationship between chronotype and general health. Because healthy eating is the basis of health aim of this study is to evaluate the relationship between healthy nutrition attitudes and chronotype in young adults. Methods: This cross-sectional study was conducted with 1,400 young adults (936 females and 464 males). Chronotype was assessed by the Turkish version of the Morningness-Eveningness Questionnaire (MEQ) and the Attitude Scale for Healthy Nutrition (ASHN) was applied by face-to-face interview. Furthermore, 24-h dietary recall was collected. The scores of nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR) were calculated. The anthropometric measurements including body weight and height were taken.

Results

The chronotype distribution of participants according to the MEQ score and MAR score were not significantly different between females and males (p > 0.05). The percentage of participants with high healthy eating attitude was lowest in the evening chronotype and highest in the morning chronotype (49.7, 37.7 and 25.4% in morning-, intermediate-, evening-types, respectively; p = 0.000 for all groups according to the reciprocal comparisons). There was a positive correlation of the MEQ scores with the scores of ASHN (r = 0.282, p < 0.01). ASHN score was shown to be a predictor for MEQ score (β = 0.280, p = 0.000). Moreover, the score of "poor eating habits" was shown to be highest in the evening chronotype and lowest in the morning chronotype (14.9 ± 3.0 and 13.1 ± 3.0, respectively; p < 0.01).

Conclusion

The results of this study indicate that individuals with the evening chronotype are more deficient in terms of healthy nutrition attitudes. Further studies with larger populations will potentially guide the development of health promotion strategies to prevent and treat chronic diseases based on an individual's chronotype.

Prospective study of the association between chronotype and cardiometabolic risk among Chinese young adults

BACKGROUND

The association of evening chronotype with cardiometabolic disease has been well established. However, the extent to which circadian rhythm disturbances independently result in risk remains unclear. This study aimed to investigate the cross-sectional and prospective longitudinal associations between chronotype and cardiometabolic risk among Chinese young adults.

METHODS

From April to May 2019, a total of 1 135 young adults were selected to complete the self-administered questionnaire, and 744 fasting blood samples were collected to quantify cardiometabolic parameters. From April to May 2021, 340 fasting blood samples were collected to quantify cardiometabolic parameters. The Morning and Evening Questionnaire 5 (MEQ-5) was used to assess chronotype. The cardiometabolic (CM)-risk score was the sum of standardized Z scores based on gender for the 5 indicators: waist circumference (WC), mean arterial pressure (MAP), triglyceride (TG), homeostasis model assessment for insulin resistance (HOMA-IR), and high-density lipoprotein cholesterol (HDL-C), where the HDL-C is multiplied by-1. The generalized linear model was used to determine the cross-sectional and prospective longitudinal associations between chronotype and each cardiometabolic parameter.

RESULTS

Cross-sectional association analysis showed that lower MEQ-5 scores were correlated with higher fasting insulin (β=-1.420, 95%CI: -2.386~-0.453), higher HOMA-IR (β=-0.301, 95%CI: -0.507~-0.095), and higher CM risk score (β=-0.063, 95%CI: -0.122~-0.003), even after adjustment for covariates. Prospective longitudinal association analysis also showed that lower MEQ-5 scores were associated with 2 years later higher fasting glucose (β=-0.018, 95%CI: -0.034~-0.003), higher fasting insulin (β=-0.384, 95%CI: -0.766~-0.003), higher HOMA-IR (β=-0.089, 95%CI: -0.176~-0.002), and higher CM-risk score (β=-0.109, 95%CI: -0.214~-0.003) after adjustment for covariates.

CONCLUSIONS

Evening chronotype was significantly correlated with higher CM risk among young adults. Our findings suggest that biologically and socially affected sleep timing misalignment is a contributing factor to cardiovascular disease risk.

Optimal cutoffs of sleep timing and sleep duration for cardiovascular risk factors

AIM

We aimed to establish the optimal cutoffs of sleep timing and duration to assess obesity, hypertension (HTN), diabetes mellitus (DM), dyslipidemia (DL), and metabolic syndrome (MetS) using data from the Korea National Health and Nutrition Examination Surveys.

METHODS

In this cross-sectional study, data from 18,677 participants (8,107 men and 10,570 women) aged 19 or over were used. A receiver operating characteristic (ROC) curve adjusted for potential confounding variables was constructed to calculate the cutoff of sleep-related variables (bedtime, mid-sleep on free days corrected for sleep debt on workdays (MSFsc), and sleep duration) for assessing cardiovascular disease (CVD) risk factors according to sex.

RESULTS

Bedtime between 9:00 PM to 0:30 AM for men and 10:00 PM to 11:00 PM for women is appropriate for assessing obesity, HTN, DM, DL, and MetS. The cutoff range was 9:00 PM to 11:00 PM for men ≥65 years and 9:00 PM to 12:00 AM for women ≥65 years, which was slightly earlier than that for participants <65 years. The optimal MSFsc cutoff points were established between 12:00 AM to 3:00 AM and sleep durations around 6 h were associated with the optimal cutoffs for assessing CVD risk factors.

CONCLUSIONS

Bedtime between 10:00 PM to 11:00 PM, early MSFsc, and short sleep durations were appropriate for assessing CVD risk factors.

Effects of exercise timing on metabolic health

The increasing prevalence of metabolic syndrome is associated with major health and socioeconomic consequences. Currently, physical exercise, together with dietary interventions, is the mainstay of the treatment of obesity and related metabolic complications. Although exercise training includes different modalities, with variable intensity, duration, volume, or frequency, which may have a distinct impact on several characteristics related to metabolic syndrome, the potential effects of exercise timing on metabolic health are yet to be fully elucidated. Remarkably, promising results with regard to this topic have been reported in the last few years. Similar to other time-based interventions, including nutritional therapy or drug administration, time-of-day-based exercise may become a useful approach for the management of metabolic disorders. In this article, we review the role of exercise timing in metabolic health and discuss the potential mechanisms that could drive the metabolic-related benefits of physical exercise performed in a time-dependent manner.

Chronotype and lipid metabolism in Arctic Sojourn Workers

This study relates answers to the Munich Chronotype Questionnaire (MCTQ) and Pittsburgh Sleep Quality Index (PSQI) from Arctic Sojourn Workers (ASW) of Yamburg Settlement, 68° Latitude North, 75° Longitude East (n = 180; mean age ± SD; range: 49.2 ± 7.8; 25-66 y; 45% women) to Arctic Sojourn Work Experience (ASWE), age and health status. Chronotype, Mid Sleep on Free Days sleep corrected (MSFsc) and sleep characteristics of ASW were compared to those of age-matched Tyumen Residents (TR, n = 270; mean age ± SD; range: 48.4 ± 8.4; 25-69 y; 48% women), 57° Latitude North, 65° Longitude East. ASW have earlier MSFsc than TR (70 min in men, p < 0.0001, and 45 min in women, p < 0.0001). Unlike TR, their MSFsc was not associated with age (r = 0.037; p = 0.627) and was linked to a larger Social Jet Lag (+21 min in men; p = 0.003, and +18 min in women; p = 0.003). These differences were not due to outdoor light exposure (OLE): OLE on work (OLEw) or free (OLEf) days was not significantly different between ASW and TR in men and was significantly less in ASW than in TR women (OLEw: -31 min; p < 0.001; OLEf: -24 min; p = 0.036). ASWE, but not age, was associated with compromised lipid metabolism in men. After accounting for multiple testing, when corrected for age and sex, higher triglycerides to high-density lipoprotein ratio, TG/HDL correlated with ASWE (r = 0.271, p < 0.05). In men, greater SJL was associated with lower HDL (r = -0.204; p = 0.043). Worse proxies of metabolic health were related to unfavorable components of the Pittsburgh Sleep Quality Index in ASW. Higher OLE on free days was associated with lower systolic (b = -0.210; p < 0.05) and diastolic (b = -0.240; p < 0.05) blood pressure.

Evening types as determined by subjective and objective measures are more emotional eaters

OBJECTIVE

This study aimed to determine the association between being an evening type (ET; defined subjectively by the Morning-Evening Questionnaire or objectively by the dim-light melatonin onset [DLMO] timing) and reporting emotional eating (EE) behaviors.

METHODS

Cross-sectional analyses were conducted in 3964 participants (four international cohorts: ONTIME and ONTIME-MT [both Spain], SHIFT [the US], and DICACEM [Mexico]), in which chronotype (Morning-Evening Questionnaire), EE behaviors (Emotional Eating Questionnaire), and dietary habits (dietary records or food-frequency questionnaire) were assessed. Among 162 participants (ONTIME-MT subsample), additional measures of DLMO (physiological gold standard of circadian phase) were available.

RESULTS

In three populations, ETs presented with a higher EE score than morning types (p < 0.02); and they made up a higher proportion of emotional eaters (p < 0.01). ETs presented with higher scores on disinhibition/overeating as well as food craving factors and experienced these behaviors more frequently than morning types (p < 0.05). Furthermore, a meta-analysis showed that being an ET was associated with a higher EE score by 1.52 points of a total of 30 points (95% CI: 0.89-2.14). The timing of DLMO in the early, intermediate, and late objective chronotypes occurred at 21:02 h, 22:12 h, and 23:37 h, with late types showing a higher EE score (p = 0.043).

CONCLUSIONS

Eveningness associated with EE in populations with different cultural, environmental, and genetic backgrounds. Individuals with late DLMO also showed more EE.

Type 2 Diabetes: Also a “Clock Matter”?

Background: We investigated whether chronotype is associated with glycemic control, antidiabetic treatment, and risk of developing complications in patients with type 2 diabetes (T2DM). Methods: The diabetologists filled out an online questionnaire on the Google Form platform to collect the following parameters of subjects with T2DM: body mass index (BMI), fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), diabetes history, antidiabetic treatment, diabetic complications, and chronotype categories. Results: We enrolled 106 subjects with T2DM (M/F: 58/48; age: 63.3 ± 10.4 years; BMI: 28.8 ± 4.9 kg/m2). Thirty-five point eight% of the subjects showed a morning chronotype (MC), 47.2% an intermediate chronotype (IC), and 17% an evening chronotype (EC). EC subjects reported significantly higher HbA1c (p < 0.001) and FPG (p = 0.004) values, and higher prevalence of cardiovascular complications (CVC) (p = 0.028) and of subjects taking basal (p < 0.001) and rapid insulin (p = 0.01) compared to MC subjects. EC subjects reported significantly higher HbA1c (p < 0.001) and FPG (p = 0.015) than IC subjects. An inverse association was found between chronotype score, HbA1c (r = −0.459; p < 0.001), and FPG (r = −0.269; p = 0.05), remaining significant also after adjustment for BMI, age, and disease duration. Conclusions: EC is associated with higher prevalence of CVC and poorer glycemic control independently of BMI and disease duration in subjects with T2DM.

Morningness/eveningness in gestational diabetes mellitus: clinical characteristics and maternal-neonatal outcomes

Objective

This study aims to evaluate the impact of morning-evening preference in pregnancy outcomes in gestational diabetes mellitus (GDM).

Methods

This is a prospective cohort study of 2nd-3rd trimester GDM outpatient care in Fortaleza, Brazil (2018-2020). Eveningness was defined by the Horne-Östberg Morningness-Eveningness-Questionnaire (MEQ ≤ 41). Furthermore, we obtained a 7-day actigraphic register. Subjective sleep quality, daytime somnolence, insomnia, fatigue and depressive symptoms were also evaluated. Associations with pregnancy outcomes were investigated.

Results

Among 305 patients with GDM, evening preference was found in 21 (6.9%). Patients with evening preference had worse sleep quality (p < 0.01), greater severity of insomnia (p < 0.005), fatigue (p < 0.005) and depressive symptoms (<0.009). Evening chronotype was associated with preeclampsia [p = 0.01; OR = 0.27; CI 0.09-0.79] and a greater need for admission to a neonatal intensive care unit (NICU) [p = 0.02; OR = 0.23; CI .0.06-0.80]. A lower MEQ score confirmed an association with preeclampsia [p = 0.002; OR = 0.94; CI 0.90-0.97] and this was maintained after controlling for age, arterial hypertension, sleep quality, fatigue and depressive symptoms [p < 005; OR = 0.91; CI 0.87-0.95].

Conclusion

In GDM, patients with evening preference had worse sleep quality, more insomnia, fatigue, and depressive symptoms. Furthermore, eveningness was independently associated with preeclampsia. These results indicate the important role of eveningness in adverse pregnancy outcomes.

Associations of chronotype and sleep patterns with metabolic syndrome in the Hispanic community health study/study of Latinos

Sleep duration, sleep efficiency, and sleep timing have been shown to have potential effects on metabolic functions relevant to circadian rhythms. It is not clear if the impact of sleep patterns on metabolic risk factors is through sociocultural and environmental factors or circadian misalignment. We investigated the associations of sleep patterns, chronotype, and social jet lag with metabolic syndrome among non-shift worker Hispanic/Latino adults. We used cross-sectional data from the Sueño Ancillary Study of The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Data from a subsample of 2189 participants aged 18-64 years were used in the analysis. Mean nightly sleep duration, mean sleep onset time, mean sleep offset time, mean sleep midpoint time, sleep efficiency, sleep variability (standard deviation (SD) of sleep duration, and SD of sleep midpoint), and time spent above light exposure threshold (1000 lux) in a day were assessed by wrist actigraphy (Acti-watch Spectrum). Chronotype was determined by the reduced Morningness-Eveningness Questionnaire. Medical conditions including dyslipidemia, hypertension, and diabetes mellitus were determined from a fasting blood specimen and physical exam at the baseline visit. To determine whether sleep patterns, light levels, chronotype, and social jetlag are associated with metabolic syndrome, multivariable logistic regression models were fitted, including variables with P < .15 in the univariate analysis. The results of the multivariable analysis demonstrated that in participants older than 40 years, intermediate chronotype (vs early) was significantly associated with a higher risk of metabolic syndrome (Odds ratio (95%CI): 1.33 (1.04,1.7)), while later chronotype (vs. early) in participants younger than 40 years was significantly associated with a lower risk of metabolic syndrome (Odds ratio (95%CI): 0.37 (0.14, 0.96)). Also, higher sleep efficiency was significantly associated with decreased odds of metabolic syndrome (Odds ratio (95%CI): 0.98 (0.96, 0.99)). Nightly sleep duration was not significantly different between two groups of participants with and without metabolic syndrome in multivariable analyses. There was no significant association between social jet lag and metabolic syndrome in multivariable analysis (p = .286). Moreover, there was no significant association between chronotype and social jet lag in multivariable analysis. The association between metabolic syndrome and chronotype is age-dependent. While early chronotype is associated with metabolic syndrome in younger individuals, it tended to be associated with lower odds for metabolic syndrome in older individuals.

Effect of exercises according to the circadian rhythm in type 2 diabetes: Parallel-group, single-blind, crossover study

BACKGROUND AND AIM

To evaluate the effectiveness of structured exercise appropriate the circadian rhythm in terms of blood sample test (BST), functionality and quality of life (QoL) in individuals with type 2 diabetes.

METHODS AND RESULTS

This was a parallel-group, single-blind, crossover study. Thirty individuals with type 2 diabetes aged 35-65 years were enrolled in the study and allocated into 2 groups as the Morning Chronotype (MC) Group (n = 15) and the Evening Chronotype (EC) Group (n = 15) using Morningness-Eveningness Questionnaire which was used to determine the chronotypes. Participants were evaluated in terms of BST, functionality and QoL at the beginning of the study (T0), at 6 (T1), 12 (T2), and 18 (T3) weeks after the study started. A structured exercise program for 3 days a week over 6 weeks was applied in accordance with the chronotypes (T1-T2) and cross-controlled for the chronotypes (T2-T3). Significant differences were found in favor of the exercise given at the appropriate time for the chronotype in all parameters in both groups within groups (T0-T1-T2-T3) (p < 0.05). In the time∗group interactions, exercise in accordance with the appropriate chronotype in both groups provided the highest statistical improvement in all parameters (p < 0.05).

CONCLUSION

It was concluded that structured exercise performed at the appropriate time for chronotype improves HbA_1c, fasting blood glucose, HDL-LDL cholesterol, triglyceride, total cholesterol, functionality and quality of life in type 2 diabetes. This variation in blood values was observed to reflect the quantitative effects of exercise administered according to the circadian rhythm in individuals with type 2 diabetes.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT04427488). The protocol of the study was registered at ClinicalTrials.gov (NCT04427488).

Chronodisruption and cardiovascular disease

Cardiovascular disease (CVD) is an important challenge for clinicians, researchers and governments to reduce the impact on the global health burden and socioeconomic costs. Moreover, far from diminishing, cardiometabolic risk factors leading to CVD development are on the rise. In order to stop the CVD pandemic, it is not enough to merely attempt to control traditional risk factors. In this regard, chronobiology, the science that studies biological rhythms, has become an important field in research in the last years. Circadian disruption or chronodisruption, defined as a relevant disturbance of the internal temporal order of physiological circadian rhythms significantly increases the risk of CVD. In this article we review some of the evidence that has made chronobiology one of the most emerging scenarios to take into account in routine clinical practice in which a translation of all this evidence should be mandatory.

Association of the Chronotype Score with Circulating Trimethylamine N-Oxide (TMAO) Concentrations

Individual differences in the chronotype, an attitude that best expresses the individual circadian preference in behavioral and biological rhythms, have been associated with cardiometabolic risk and gut dysbiosis. Up to now, there are no studies evaluating the association between chronotypes and circulating TMAO concentrations, a predictor of cardiometabolic risk and a useful marker of gut dysbiosis. In this study population (147 females and 100 males), subjects with the morning chronotype had the lowest BMI and waist circumference (p < 0.001), and a better metabolic profile compared to the other chronotypes. In addition, the morning chronotype had the highest adherence to the Mediterranean diet (p < 0.001) and the lowest circulating TMAO concentrations (p < 0.001). After adjusting for BMI and adherence to the Mediterranean diet, the correlation between circulating TMAO concentrations and chronotype score was still kept (r = -0.627, p < 0.001). Using a linear regression analysis, higher chronotype scores were mostly associated with lower circulating TMAO concentrations (β = -0.479, t = -12.08, and p < 0.001). Using a restricted cubic spline analysis, we found that a chronotype score ≥59 (p < 0.001, R2 = -0.824) demonstrated a more significant inverse linear relationship with circulating TMAO concentrations compared with knots <59 (neither chronotype) and <41 (evening chronotype). The current study reported the first evidence that higher circulating TMAO concentrations were associated with the evening chronotype that, in turn, is usually linked to an unhealthy lifestyle mostly characterized by low adherence to the MD.