Eating Occasions, Obesity and Related Behaviors in Working Adults: Does it Matter When You Snack?

Prevalence and determinants of healthy and balanced diet among office workers in a sedentary working environment: evidence from Southern Sri Lanka

BACKGROUND

An unhealthy diet is a key risk factor for non-communicable diseases (NCD), which account for a significant number of premature deaths and disability-adjusted life years worldwide. Office workers are reported to have unhealthy and unbalanced diets, while being sedentary due to the nature of their work, placing them at a greater risk of NCD. This study aimed to determine dietary intake and associated factors among sedentary office workers in Southern Sri Lanka.

METHODS

A cross-sectional study was conducted among 518 sedentary workers in 20 offices in the Galle district. Socio-demographic, health and work-related factors and dietary practices were assessed using a self-administered questionnaire. Twenty-four-hour dietary recall was used to assess dietary intake, which was converted into the number of servings from each food group. Healthy dietary intake was defined as 'adherence to the numbers of servings recommended in Food Based Dietary Guidelines for Sri Lankans for more than three food groups including cereal and cereal-based foods, fruits, and vegetables, with the consumption of one or no unhealthy food per day'.

RESULTS

Only 4.6% (n = 24) of the participants consumed a healthy diet, while a considerable proportion had the recommended intake of cereal-based foods, vegetables and fish, meat and pulses (65.3%, 65.8% and 50.8%, respectively). Intake of fruits, dairy products, nuts and seeds was low among the participants. Meal skipping and group eating were significantly associated with an overall unhealthy diet. Stratified analysis showed sex as an effect modifier for the association between group eating and unhealthy diet. In multivariate analysis, none of the factors showed a significant association with healthy dietary intake.

CONCLUSIONS

The dietary intake of sedentary office workers was not up to the recommendations. Meal skipping and group eating were associated with unhealthy dietary intake. This study recommends introducing interventions to improve the intake of fruits, dairy products, nuts, and seeds for sedentary office workers.

The Effect of Meal Frequency on Body Composition, Biochemical Parameters and Diet Quality in Overweight/Obese Individuals

OBJECTIVES

There is no consensus on the ideal frequency of meals for the prevention and treatment of obesity. While some studies have reported that increasing meal frequency might be beneficial in the treatment of obesity due to its positive effects on glycemic regulation, appetite and diet quality, other studies have reported negative effects. In this study, it was aimed to examine the effect of meal frequency on body composition, anthropometric measurements, some of the biochemical parameters and diet quality in overweight/obese adults.

METHODS

A total of 91 individuals, all overweight/obese, between the ages of 18-64, including 46 consuming 2 main meals (2MMG) and 45 consuming 3 main meals (3MMG) participated in the study. General characteristics and dietary habits of the individuals were obtained with a questionnaire. A 3-day food consumption record was taken to determine their daily energy and nutrient intake and to evaluate their diet quality with the "Healthy Eating Index 2015". Anthropometric measurements of the individuals were performed, body compositions were analyzed and some blood parameters were evaluated.

RESULTS

The median values of body weight, lean body mass (kg), total body water, basal metabolic rate and hip circumference of men in the 3MMG were found to be higher than men in the 2MMG (p < 0.05). The anthropometric measurements and body composition components of women were similar between the two groups (p > 0.05). The renal urea nitrogen and total cholesterol values of women in 2MMG were higher than those of women in the 3MMG. In the regression analysis, a 1-unit increase in the number of main meals was determined to lead to a 9.3 points increase in the total score of HEI 2015.

CONCLUSIONS

Regular consumption of main meals may have positive effects on diet quality, some of the biochemical parameters, basal metabolic rate and body composition in overweight/obese adults. In this group, which is known to have incorrect food preferences in general, it is important to plan the number of meals and the content of these meals correctly.

Exploring factors influencing late evening eating and barriers and enablers to changing to earlier eating patterns in adults with overweight and obesity

Late evening eating is a potential risk factor for overconsumption and weight gain. However, there is limited qualitative research investigating the complex factors that influence late evening eating in adults living with obesity. Identifying the factors that influence late evening eating can inform interventions to reduce late evening eating and associated health risks. Therefore, this study aimed to: i) explore factors that contribute to eating late, and ii) apply the Capability, Opportunity, and Motivation Behaviour (COM-B) model to understand the barriers and enablers to changing to earlier food intake timings in UK adults who report eating late. Semi-structured interviews with seventeen participants [32.47 ± 6.65 years; 34.68 ± 7.10 kg/m2; 71% female (n = 12); 41% White (n = 7)] investigated reasons for late evening eating and the potential barriers and enablers to changing to earlier eating patterns. Thematic analysis identified four main contributors to late evening eating: 1) internal signals (e.g., feeling hungry in the evening); 2) external and situational factors (e.g., work schedules and the food-rich environment); 3) social factors (e.g., interactions with family) and 4) behavioural and emotional factors (e.g., personal preferences and negative feelings in the evening). Time constraints and work schedules were identified as main barriers to changing to earlier eating patterns. Whereas, having high motivation (e.g., contentment with eating earlier in the evening) and interpersonal support were identified as main enablers to eating earlier. This study provides in-depth insights into the psychological, social, and environmental factors contributing to late evening eating. The findings highlight potential targets for future interventions to facilitate earlier eating times in individuals at risk of overweight and obesity.

Associations of menopausal status and eating behaviour with subjective measures of sleep

Eating and sleeping behaviour are known to interact with each other, yet research is limited in the context of menopausal women. The aim of this study was to examine whether menopausal status is associated with perceived problems in sleeping. Furthermore, we studied different aspects of eating behaviour as potential risk factors for poor sleep in menopausal women. The present study is exploratory in nature, thus the results should be interpreted as hypothesis-generating. We analysed the sleeping and eating behaviour of 1098 women aged 47-55 years and represented different menopausal statuses with regression analyses. Over 20% of them reported fairly poor or poor perceived sleep quality. A higher number of postmenopausal women reported experiencing at least fairly poor sleep quality compared with the other menopausal groups. However, in regression models controlled for several confounding factors menopausal status was not associated with measures of sleep. Women who reported more snacking-type eating behaviour were more likely to report shorter sleep duration, and more daytime tiredness. Externally cued eating was associated with shorter sleep duration and emotional eating was associated with experiencing daytime tiredness. However, after adjusting for multiple testing, it appears that eating behaviour is associated only with daytime tiredness. Menopausal women with sleeping problems may benefit from nutritional interventions targeting eating behaviour.

Time-restricted eating affects human adipose tissue fat mobilization

OBJECTIVE

Time-restricted eating (TRE), a dietary approach that confines food intake to specific time windows, has shown metabolic benefits. However, its impact on body weight loss remains inconclusive. The objective of this study was to investigate the influence of early TRE (eTRE) and delayed TRE (dTRE) on fat mobilization using human adipose tissue (AT) cultures.

METHODS

Subcutaneous AT was collected from 21 participants with severe obesity. We assessed fat mobilization by measuring glycerol release in AT culture across four treatment conditions: control, eTRE, dTRE, and 24-h fasting.

RESULTS

TRE had a significant impact on lipolysis (glycerol release [mean (SD)] in micromoles per hour per gram: control, 0.05 [0.003]; eTRE, 0.10 [0.006]; dTRE, 0.08 [0.005]; and fasting, 0.17 [0.008]; p < 0.0001). Both eTRE and dTRE increased lipolysis compared with the control group, with eTRE showing higher glycerol mobilization than dTRE during the overall 24-h time window, especially at the nighttime/habitual sleep episode (p < 0.0001). Further analysis of TRE based on fasting duration revealed that, independently of the time window, glycerol release increased with fasting duration (in micromoles per hour per gram: 8 h = 0.08 [0.001]; 12 h = 0.09 [0.008]; and 16 h of fasting = 0.12 [0.011]; p < 0.0001).

CONCLUSIONS

This study provides insights into the potential benefits of TRE on fat mobilization and may guide the design of future dietary strategies for weight management and metabolic health.

Dietary and Lifestyle Strategies for Obesity

The prevalence of obesity globally has tripled over the last half century, and currently affects around 650 million adults and 340 million children and adolescents (ages 5-19 years). Obesity contributes towards >50 co-morbidities and premature mortality. Obesity is a highly stigmatised condition that is associated with much mental and emotional distress and dysfunction. Thus, obesity is a major contributor to healthcare expenditure globally. Traditionally, the management of obesity stratifies into three major groups that include metabolic (bariatric) surgery, pharmacotherapies, and lifestyle (primarily dietary) strategies. Although listed as a separate category, dietary strategies for obesity remain a central component of any management plan, and often complement other surgical and pharmacotherapeutic options. Indeed, the effectiveness of any management approach for obesity relies upon successful behavioural changes, particularly relating to eating behaviours. In this concise review, we explore the foundational pillars of dietary strategies for obesity: sleep, listening, routine, de-stressing and optimisation of social conditions. We then discuss the importance of balancing dietary macronutrients (including dietary fibre, carbohydrates, protein and ultra-processed foods [UPFs]) as a key dietary strategy for obesity. Although we focus on general principles, we should provide bespoke dietary strategies for our patients, tailored to their individual needs. Rather than judging the utility of a diet based simply on its associated magnitude of weight loss, we should adopt a more holistic perspective in which a dietary strategy is valued for its overall health benefits, including the nurturing of our gut microbiota, to enable them to nurture and protect us.

The association between diet quality and chrononutritional patterns in young adults

PURPOSE

Young adults eat erratically and later in the day which may impact weight and cardiometabolic health. This cross-sectional study examined relationships between chrononutritional patterns and diet quality in two young adult populations: a university and community sample.

METHODS

Three days of dietary data were collected including food images captured using wearable cameras. Chrononutritional variables were extracted: time of first and last eating occasions, caloric midpoint (time at which 50% of daily energy was consumed), number of eating occasions per day, eating window, day-to-day variability of the above metrics, and evening eating (≥20:00h). The Healthy Eating Index for Australian Adults scored diet quality. Statistical analyses controlled for gender, body mass index, and socio-economic status.

RESULTS

No significant associations between chrononutritional patterns and diet quality were found for all participants (n = 95). However, differences in diet quality were found between university (n = 54) and community (n = 41) samples with average diet quality scores of 59.1 (SD 9.7) and 47.3 (SD 14.4), respectively. Of those who extended eating ≥20:00 h, university participants had better diet quality (62.9±SE 2.5 vs. 44.3±SE 2.3, p < 0.001) and discretionary scores (7.9±SE 0.9 vs. 1.6±SE 0.6, p < 0.001) than community participants. University participants consumed predominately healthful dinners and fruit ≥20:00h whereas community participants consumed predominately discretionary foods.

CONCLUSION

For the general young adult population, meal timing needs to be considered. Food choices made by this cohort may be poorer during evenings when the desire for energy-dense nutrient-poor foods is stronger. However, meal timing may be less relevant for young adults who already engage in healthy dietary patterns.

Conceptualization and Assessment of 24-H Timing of Eating and Energy Intake: A Methodological Systematic Review of the Chronic Disease Literature

Timing of eating (TOE) and energy intake (TOEI) has important implications for chronic disease risk beyond diet quality. The 2020 Dietary Guidelines Advisory Committee recommended developing consistent terminology to address the lack of TOE/TOEI standardization. The primary objective of this methodological systematic review was to characterize the conceptualization and assessment of TOE/TOEI within the chronic disease literature (International Prospective Register of Systematic Reviews registration number: CRD42021236621). Literature searches in Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, Embase, PubMed, and Scopus were limited to English language publications from 2000 to August 2022. Eligible studies reported the association between TOE/TOEI and obesity, cardiovascular disease, type 2 diabetes mellitus, cancer, or a related clinical risk factor among adults (≥19 y) in observational and intervention studies. A qualitative synthesis described and compared TOE/TOEI conceptualization, definitions, and assessment methods across studies. Of the 7579 unique publications identified, 259 studies (observational [51.4 %], intervention [47.5 %], or both [1.2 %]) were eligible for inclusion. Key findings indicated that most studies (49.6 %) were conducted in the context of obesity and body weight. TOE/TOEI variables or assigned conditions conceptualized interrelated aspects of time and eating or energy intake in varying ways. Common TOE/TOEI conceptualizations included the following: 1) timepoint (specific time to represent when intake occurs, such as time of breakfast [74.8 %]); 2) duration (length of time or interval when intake does/does not occur, such as "eating window" [56.5 %]); 3) distribution (proportion of daily intake at a given time interval, such as "percentage of energy before noon" [29.8 %]); and 4) cluster (grouping individuals based on temporal ingestive characteristics [5.0 %]). Assessment, definition, and operationalization of 24-h TOE/TOEI variables varied widely across studies. Observational studies most often used surveys or questionnaires (28.9 %), whereas interventions used virtual or in-person meetings (23.8 %) to assess TOE/TOEI adherence. Overall, the diversity of terminology and methods solidifies the need for standardization to guide future research in chrononutrition and to facilitate inter-study comparisons.

How many meals and snacks do Brazilians eat a day? Findings from the 2017-2018 Brazilian National Dietary Survey

The habit of eating specific meals has been addressed in several studies, but the evaluation of meal patterns has received less attention. This study aimed to describe the meal patterns of the Brazilian population. A complex sampling design was used to select the 46,164 ≥ 10-year-old individuals examined in the Brazilian National Dietary Survey. Food consumption was assessed by two non-consecutive 24-hour recalls applied throughout a one-week period. The exploratory data analysis approach was used to determine the meal patterns, i.e., how individuals combined the main meals (breakfast, lunch, dinner) and snacks (morning, afternoon, evening/night) throughout the day. The most common meal patterns were three main meals + one snack, reported by 25.1% of the individuals, and three main meals + two snacks (24.6%). Other meal patterns identified were: three main meals + three snacks (18.5%); three main meals and no snacks (10.9%); one or two main meals + two snacks (7.4%); one or two main meals + one snack (6.9%); one or two main meals + three snacks (4.2%); and one or two main meals and no snacks (2.3%). Meal patterns varied according to gender and age group, and on typical versus atypical food consumption days. We found that eight patterns characterized the daily meal consumption in Brazil. Furthermore, around 80% of the population had three main meals every day and about 13% did not report having any snacks. The characterization of meal habits is important for tailoring and targeting health promotion actions.

A systematic review of associations between day-to-day variability in meal pattern and body weight, components of the metabolic syndrome and cognitive function

BACKGROUND

Meal pattern is a potential health determinant. Previously, mean values for properties of meal pattern, such as daily meal frequency, have been considered. Means, however, obscure variability between-day (irregular or chaotic eating). This systematic review aimed to identify and critique published methods used to characterise between-day variability in meal pattern, and to explore relationships between this and obesity, as well as associated health outcomes.

METHODS

Using relevant databases, a systematic search was undertaken for studies with adults and children in which between-day variability in meal pattern was measured, and related to body weight, metabolic syndrome components and cognitive function.

RESULTS

In 34 papers identified (28 observational and six intervention studies), between-day variability in meal pattern was characterised by a variety of methods. These ranged from single questions about intake regularity to more complex methods quantifying the degree of variability. Assumptions were made, such as there being three main meals, resulting in dissociation from the "clock time" of eating. In 24 of the papers, between-day variability in meal pattern was associated with negative weight and health outcomes including higher weight, reduced thermogenic response to meals and poorer academic achievement.

CONCLUSIONS

Between-day variability in meal pattern is a promising research area that might inform low-cost public health interventions. However, current methods of characterising between-day variability tend to make assumptions and be inconsistent in the meal pattern properties considered. Well controlled dietary intervention studies are required to confirm causation.

Snack consumption frequency of children and adults in the Vaal region of Gauteng, South Africa

Background

Energy-dense, nutrient-poor snacks are associated with an increased risk of non-communicable diseases (NCDs) and the double burden of malnutrition, especially among poor communities.

Aim

To determine and compare the snacking preferences and consumption frequency of children and adults from a low SES community in South Africa.

Setting

A preschool, primary school, and an elderly centre in Gauteng.

Methods

A cross-sectional study with a convenience sample of 90 children (3-8 years) and 100 adults (≥ 18 years) to assess snack consumption frequency and preferences of children and adults by means of a snack survey. Mann-Whitney U test was used to determine the differences in preferences and snack consumption frequency of children and adults.

Results

The most preferred and consumed snacks included fruits, potato chips, corn chips, sweets, and cookies. Children frequently ate more potato chips (p < 0.001), corn chips (p < 0.001), cheese curls (p < 0.001), and muffins (p = 0.024) than adults. In contrast, adults frequently consumed more peanuts or nuts (p = 0.024), savoury biscuits (p = 0.048) and biltong (p < 0.001) than children.

Conclusion

Apart from fruits, the most preferred and frequently consumed snacks by the sample were highly processed snacks, which are low in fibre and high in added sugars, saturated fat, and sodium.

Contributions

Findings from this study highlight current snack trends and can guide future nutrition education interventions on healthy snacking and in developing nutritious snacks for the South African community.

Changes in eating patterns in response to chronic insufficient sleep and their associations with diet quality: a randomized trial

STUDY OBJECTIVES

Insufficient sleep leads to overconsumption, but the factors contributing to this effect are poorly understood. Therefore, we assessed the influence of prolonged curtailment of sleep on free-living eating patterns linked with overconsumption and explored associations of these eating patterns with diet quality under different sleep conditions.

METHODS

Sixty-five adults (47 females) participated in outpatient randomized crossover studies with two 6-week conditions: adequate sleep (7-9 h/night) and sleep restriction (-1.5 h/night relative to screening). Food records were collected over 3 nonconsecutive days, from which we ascertained data on eating frequency, midpoint, and window and intakes of energy and nutrients. Linear mixed models were used to assess the impact of sleep condition on change in eating pattern (sleep × week interaction) and the relation between eating patterns and dietary intakes (sleep × eating pattern interaction).

RESULTS

Sleep condition impacted the change in eating frequency across weeks, with eating frequency increasing in sleep restriction relative to adequate sleep (β = 0.3 ± 0.1; P = .046). Across conditions, eating more frequently tended to relate to higher energy intakes (β = 60.5 ± 34.6; P = .082). Sleep also influenced the relation of variability in eating midpoint with intakes of saturated fat (β = 6.0 ± 2.1; P = .005), polyunsaturated fat (β = -3.9 ± 2.0; P = .051), and added sugar (β = 17.3 ± 6.2; P = .006), with greater midpoint variability associated with more adverse changes in these diet quality components in sleep restriction vs adequate sleep.

CONCLUSIONS

Chronic short sleep increases eating frequency and adversely influences associations of variability in meal timing with components of diet quality. These findings help to explain how short sleep leads to overconsumption and obesity.

CLINICAL TRIAL REGISTRATION

Registry: ClinicalTrials.gov; Name: Impact of Sleep Restriction in Women; URL: https://clinicaltrials.gov/ct2/show/NCT02835261; Identifier: NCT02835261 and Name: Impact of Sleep Restriction on Performance in Adults; URL: https://clinicaltrials.gov/ct2/show/NCT02960776; Identifier: NCT02960776.

CITATION

Barragán R, Zuraikat FM, Tam V, RoyChoudhury A, St-Onge M-P. Changes in eating patterns in response to chronic insufficient sleep and their associations with diet quality: a randomized trial. J Clin Sleep Med. 2023;19(11):1867-1875.

Circadian misalignment in obesity: The role for time-restricted feeding

BACKGROUND AND AIMS

The epidemic of obesity is associated with a substantial, complex and escalating burden of disease. Dietary and lifestyle interventions provide the mainstay of management; however, obesity is multifactorial and challenging to address clinically. Disrupted circadian behaviours, including late eating, are associated with obesity. Time-restricted feeding (TRF), the confinement of calorie intake to a temporal 'eating window', has received growing interest as a weight-loss intervention. Benefits are purported to arise from the fasting period and strengthened circadian metabolism. However, the current evidence-base for TRF is small-scale, limited, and there has been little evaluation of circadian schedule. This research aims to enable evidence-based conclusions regarding circadian-aligned TRF as a weight-loss intervention in obesity.

METHODS

A systematic three-tranche search strategy was conducted within PubMed. Included studies were critically evaluated. Search tranches scoped: interventional evidence for TRF; evidence linking meal timing, obesity and metabolic function; and evidence linking circadian function, obesity, and dysmetabolism. Results were summarised in a narrative analysis.

RESULTS

A total of 30 studies were included. From small-scale and short-term evidence, TRF was consistently associated with improved weight, glycaemic and anthropometric outcomes versus baseline or control. Good adherence and safety, and consistency of results between studies, were notable. Earlier ('circadian-aligned') eating was associated with greater diet-induced thermogenesis, and improved weight loss and glycaemic outcomes. Limited evidence suggested meaningful correlations between circadian clock function and obesity/metabolic risk.

CONCLUSIONS

Circadian-aligned TRF may present a promising intervention for weight loss and metabolic benefits in obese/overweight individuals.

Snacking behavior is associated with snack quality, overall diet quality, and body weight among US college students

Snacking behavior may affect snack quality, overall diet quality, and body weight; however, the associations between these variables have not been studied among college students. The objective of this study was to associate snacking behaviors with snack quality, diet quality, and weight status among college students with overweight and obesity. We hypothesized that a higher snacking frequency, accessibility and availability of unhealthy snacks, and lack of knowledge would be associated with lower snack and diet quality, and higher weight. Participants (n = 140) completed a snack behavior questionnaire, three 24-hour dietary recalls to assess diet quality using Healthy Eating Index 2015 (HEI-2015), and snack score using an algorithm based on the US DA Smart Snack guidelines and reported weight and height to calculate body mass index (BMI). Analysis of variance and Pearson correlation was used in the analyses. After adjusting for confounders, snack frequency was not associated with snack score, HEI-2015 score, or BMI, but evening snacks had a significantly lower snack score compared with late afternoon snacks (P = .017). Also, those with more accessibility and availability of unhealthy snacks had a lower snack score (P = .001), lower HEI-2015 score (P = .006), and higher BMI (P = .019). Snacking for pleasure was significantly associated with a lower snack score (P = .037). Snack score was positively correlated with HEI-2015 score but not with BMI. In conclusion, late snacking, unhealthy snack environment, and snacking for pleasure were associated with lower snack and diet quality. These findings could be used in future intervention strategies to improve snacking behaviors and the food environment.

Eating Behaviours of Polish and Portuguese Adults-Cross-Sectional Surveys

Eating behaviours affect energy intake through the types and amounts of foods chosen and decisions about the beginning and ending of the eating process. This study aims to determine and compare the eating behaviours of Polish and Portuguese adults and, in addition, to establish the correlations between daily behaviours, food-approaches and food-avoidance behaviours, and BMI in both populations. The study was conducted between January 2023 and March 2023. Participants from Poland and Portugal responded to the AEBQ questionnaire and questions on eating habits and body-image self-perception. The research tool was a website-based survey questionnaire with single-choice questions. No significant differences related to BMI levels were found between the Polish and Portuguese adults in terms of their eating behaviours. Both groups were characterised by the increased intensity of their food-approach behaviours, which was directly correlated with increases in BMI. Greater snacking intensity and binge drinking were associated with higher BMI. The study revealed an increased prevalence of binge drinking in the Polish sample. The study also confirmed a higher frequency of food-approach behaviours in overweight and/or obese individuals and uncontrolled calorie intake in participants imposing dietary restrictions for weight loss. Nutrition education is needed to improve eating habits and food choices, as well as to prevent overweight and obesity in adults.

Snacking Consumption among Adults in the United States: A Scoping Review

Snacks are a staple of the American diet, contributing to approximately 20% of energy intake. Most U.S. adults consume one to three snacks/day, yet few reviews have focused on snacking among this population. This scoping review was conducted to characterize snacks and snacking occasions among U.S. adults to further inform healthy eating practices. The protocol was prepared following the PRISMA-Extension for Scoping Reviews. Three web databases were used to identify articles using snacking or eating occasions as primary or secondary outcomes among U.S. adults. A search strategy was developed using subject headings, truncation, and phrase searching in the title and abstract of articles published between 2010 and 2022. A two-stage, multi-step screening process identified 31 of 4795 publications as meeting the inclusion criteria. Findings included identification of snacking themes, e.g., cues and motivations; diet composition; and weight management. Food quality, time of consumption, and convenience emerged as characteristics of snacking; time of day was found to influence food choice. Snacks contribute to or detract from a healthy diet. Strategic selection of healthy snack options can improve diet quality. Applied to nutrition education, this information can help strengthen programs or policies, ultimately contributing to health and wellbeing.

Self-Reported Eating-Occasion Frequency and Timing are Reproducible and Relatively Valid in the American Cancer Society Cancer Prevention Study-3 Diet Assessment Substudy

BACKGROUND

Accurate assessment of eating-occasion behaviors, such as timing, frequency, and consumption intervals, is important for evaluating associations with obesity and other chronic diseases.

OBJECTIVES

The main objective of this study was to assess the relative validity of a 24-hour grid approach to assess eating-occasion timing and frequency in comparison to data derived from repeated 24-hour dietary recalls (DRs). A second objective was to assess the 1-year test-retest reproducibility of the 24-hour grid.

METHODS

Between 2015 and 2016, 626 participants in the Cancer Prevention Study-3 (CPS-3) Diet Assessment Substudy (mean age, 52 years; age range, 31-70 years; 64% female; 64% non-Hispanic white, 22% non-Hispanic black, 14% Hispanic) completed 2 grids and up to 6 unannounced, telephone, interviewer-administered DRs over 1 year. Spearman correlations (ρ; 95% CIs) were calculated to assess reproducibility between the repeated eating-occasion grid-derived variables (e.g., numbers of snacks and meals per day, timing of eating occasions) and to assess relative validity by comparing the meal grid and DR-derived summary data separately for weekdays and weekend days.

RESULTS

Reproducibility correlations for eating-occasion variables derived from the eating-occasion grids completed 1 year apart were ≥0.5 for the majority of variables analyzed for both weekdays and weekend days, including numbers of snacks and meals per day and timing of the first and last eating occasions of the day. Relative validity was highest among weekday variables and was ≥0.5 for the majority of variables, with correlations ranging from ρ values of 0.32 (number of meals per day) to 0.68 (hour of the first eating occasion).

CONCLUSIONS

These findings suggest the eating-occasion grid used in CPS-3 has good reproducibility over 1 year and yields estimates comparable to those from a more detailed method of assessment of eating timing and frequency.

Understanding the link between frequency of eating and cardiometabolic health outcomes in Americans who "snack"

On average, Americans ages 2 yr and older eat 5 or more times per day and consume nearly a quarter of their daily energy outside of breakfast, lunch, and dinner. Frequency of eating (FOE) has been identified by both the 2020 Dietary Guidelines for Americans Scientific Advisory Committee and the American Heart Association as an important area of study to improve the dietary patterns and overall health of the American public. However, the current evidence on FOE is conflicting; it does not indicate whether eating more frequently is a healthful behavior or not. Clinical and prospective studies have shown that FOE has an inverse relationship with some cardiometabolic health markers, including total cholesterol and low-density lipoprotein cholesterol concentrations, but the relationship between FOE and other health markers such as high-density lipoprotein cholesterol concentrations, blood pressure, obesity, and coronary heart disease incidence remains unclear. Several factors may affect the relationship between FOE and cardiometabolic health including the types of foods consumed, time of day, motivation to eat, cultural background, age, sex, and food security status. Another factor affecting both the relationship between FOE and health as well as the research on FOE and health is how eating occasions are labeled. Many definitions have been proposed and used in research to delineate between meals and snacks, but a consistent definition is not currently used for "snacks," even in official dietary guidance. With the current limitations in the body of research, conclusions about the healthfulness of frequent eating cannot be drawn. In addition, conclusions cannot be drawn on the healthfulness of eating snacks (as an eating occasion) or more than 3 meals per day. More directed research is required to understand the relationships between the labels used for an eating occasion and cardiometabolic health outcomes as well as the health impacts of frequent food and beverage consumption and how and why they may vary among different population groups.

Time-Related Eating Patterns Are Associated with the Total Daily Intake of Calories and Macronutrients in Day and Night Shift Workers

The aim of the study was to investigate whether time-related eating patterns are associated with the daily intake of calories and macronutrients in Brazilian male military police officers (n = 81; 29-day and 52-night workers; mean age: 36.4 ± 0.9 and 38.5 ± 0.7 years, respectively). Energy and macronutrient intake were determined by a non-consecutive 3-day food recall. Time-related eating patterns, such as the time of the first and the last meals, eating duration, and caloric midpoint, were evaluated. Individuals were classified as “early” or “late” eaters according to the median caloric midpoint. Night shift workers showed a later eating time for the last meal (p < 0.001), longer eating duration (p < 0.001), and later caloric midpoint (p = 0.037) than day workers. Late eaters from both workgroups consumed more 24 h energy (p = 0.028), fat in calories (p = 0.006) and protein (calories: p < 0.001; percentage of total calories: p = 0.042), and less carbohydrates in calories (p = 0.010) intake than early eaters. The time of the first meal was negatively correlated with 24 h energy (p = 0.024) and carbohydrate (p = 0.031) intake only in day workers. The time of the last meal was positively correlated with 24 h energy (day workers: β = 0.352; p = 0.044; night workers: β = 0.424; p = 0.002) and protein (day workers: β = 0.451; p = 0.013; night workers: β = 0.536; p < 0.001) intake for both shift workers, and with carbohydrate (β = 0.346; p = 0.016) and fat (β = 0.286; p = 0.042) intake only in night workers. Eating duration was positively correlated with energy (day workers: β = 0.473; p = 0.004; night workers: β = 0.320; p = 0.023) and carbohydrate (day workers: β = 0.418; p = 0.011; night workers: β = 0.364; p = 0.010) intake in both groups. Thus, time-related eating patterns indicative of intake later at night are associated with increased daily energy and macronutrient intake.

Dietary habits, shopping behavior and weight gain during COVID-19 pandemic lockdown among students in a private university in Selangor, Malaysia

Background

Due to the global surge in COVID-19 cases, numerous countries have enforced lockdowns of varying stringency. Social isolation and stay-at-home orders have detrimental effects on one's lifestyle and dietary habits. This study aimed to assess the dietary patterns, food preferences, shopping behavior and weight gain during the lockdown among students in a private university in Malaysia.

Design and Methods

We conducted a cross-sectional study among 426 students using convenience sampling method one-month after initiating the Conditional Movement Control Order (November 15-30, 2020), using a validated self-administered web-based survey. Chi-square test with post-hoc and planned comparison procedures were performed.

Results

Of the 426 participants, more than half were females (55.9%). Over half of the surveyed students reported increased eating (51.2%), snacking (55.2%) and online food ordering (71.1%) during the lockdown. Meat products and sweet drinks (both >90%) were the most consumed food among individuals with higher BMI. 45.5% of the participants reported weight gain (mean 3.36, SD 1.61kg) one month after the lockdown. Female, youth (aged 19-24), working remotely, increased eating, snacking, cooking, and online food ordering were positively associated with weight gain.

Conclusions

Findings suggested that unintended consequences of lockdown have negative impacts on dietary habits and food preferences among university students. Advocacy and public health measures for nutritional support amidst the pandemic are crucial, especially for at-risk groups such as overweight and obese individuals.

Food obesogens as emerging metabolic disruptors; A toxicological insight

Human food is composed of loads of chemicals derived naturally as well as unintentionally through environmental sources. Food additives added purposefully, play an important role in the palatability of foods. Most additives are synthetic whose essentiality in food processing is well-known however their health risks are not overlooked. The palatability of food should not only stimulate our eating desire alone but, also assure sufficient quality and safety. Application of food additives varies from region to region due to cultural or ethnic differences and the local food availability. There are about more than ten thousand chemicals allowed in food whereas due to weak enforcement, it becomes onerous for regulatory bodies identifying chemicals that are inadequately or not tested at all for safety. The hiking population and urbanization in many industrialized and developing countries resulted in life-style changes including culinary and eating choices. Particularly, the modern way of this globalised life demands ready-to-cook or ready-made foods, snacks, sweets, soft drinks, desserts, confectionery and so on. These sorts of food would be most uninteresting unless processed with additives. This puts food industries under demand to robustly supply foods that are either partially, fully or ultra-processed using plenty of additives. Recent research warns consuming food additives may result in serious health risks, not only for children but also for adults. Growing body of studies on food additives in various experimental animals, cell cultures, and human population suggest elevation of number of obesity and diabetes risk factors i.e. adiposity, dyslipidemia, weight gain, hyperglycaemia, insulin resistance, glucose intolerance, energy imbalance, hormonal intervention etc. Hence, it is important to identify and explore food obesogens or obesogenic food additives posing potential impact. Based on the recent toxicological findings, the review aspires to establish the association between exposure of food obesogen and metabolic disruption which may help filling knowledge gaps and distributing more knowledge, awareness and effective measures to implement treatment and preventive strategies for metabolic syndrome.

Incidence and Associated Factors of Weight Gain During the Covid-19 Pandemic

Introduction and Aims

The behavioral changes that arose from quarantine due to the COVID-19 pandemic may have impacted the weight of people. This study aims to investigate the incidence and predictors of weight gain during the quarantine period.

Methods

An online survey was performed five months after the social distance measures implementation. Participants recorded their current and usual weight before lockdown. A multivariate logistic regression model was performed.

Results

Data on 1334 participants were evaluated (33.6y, 79.8% females), and 58.8% have gained weight (3.0 kg; 0.1 to 30.0 kg). Predictors of weight gain were increased food intake (OR = 5.40); snacking (OR = 2.86); fast food (OR = 1.11); canned products (OR = 1.08); and in physical activity (OR = 0.99) concerning the period before the pandemic; also time spent at work, including household chores (OR = 1.58); evening snack (OR = 1.54); higher frequency of alcoholic beverage intake (OR = 1.59) and dose of alcoholic beverage (OR = 1.11); uncontrolled eating (OR = 1.01), and vegetable intake (OR = 0.92) during the quarantine and physical activity before pandemic period (OR = 0.99).

Conclusion

Most participants have gained weight during the pandemic because of working changes, lifestyle, eating habits changes, and uncontrolled eating behavior. These results can be useful to encourage changes during future quarantine periods to prevent weight gain.

Lifestyle and eating habits before and during COVID-19 quarantine in Brazil

OBJECTIVE

To assess changes in daily habits, food choices and lifestyle of adult Brazilians before and during the COVID-19 pandemic.

DESIGN

This observational study was carried out with Brazilian adults through an online questionnaire 5 months after the social distance measures implementation. The McNemar, McNemar–Bowker and Wilcoxon tests were used to investigate differences before and during the COVID pandemic period, adopting the statistical significance of P < 0·05.

SETTING

Brazil.

PARTICIPANTS

Totally, 1368 volunteers aged 18+ years.

RESULTS

The volunteers reported a lower frequency of breakfast, morning and lunch snacks (P < 0·05) and a higher frequency of evening snacks and other meal categories during the pandemic period (P < 0·05). The results showed an increase in the consumption of bakery products, instant meals and fast food, while the consumption of vegetables and fruits decreased (P < 0·005). There was a significant increase in the frequency of consumption of alcoholic beverages (P < 0·001), but a reduction in the dose (P < 0·001), increased frequency of smoking (P = 0·007), an increase in sleep and screen time in hours and decrease in physical activity (P < 0·001).

CONCLUSIONS

It was possible to observe an increase in screen time, hours of sleep, smoking and drinking frequency. On the other hand, there was a reduction in the dose of alcoholic beverages but also in the practice of physical activity. Eating habits also changed, reducing the performance of daytime meals and increasing the performance of nighttime meals. The frequency of consumption of instant meals and fast food has increased, while consumption of fruits and vegetables has decreased.

Chrono-communication and cardiometabolic health: The intrinsic relationship and therapeutic nutritional promises

Circadian rhythm, an innate 24-h biological clock, regulates several mammalian physiological activities anticipating daily environmental variations and optimizing available energetic resources. The circadian machinery is a complex neuronal and endocrinological network primarily organized into a central clock, suprachiasmatic nucleus (SCN), and peripheral clocks. Several small molecules generate daily circadian fluctuations ensuring inter-organ communication and coordination between external stimuli, i.e., light, food, and exercise, and body metabolism. As an orchestra, this complex network can be out of tone. Circadian disruption is often associated with obesity development and, above all, with diabetes and cardiovascular disease onset. Moreover, accumulating data highlight a bidirectional relationship between circadian misalignment and cardiometabolic disease severity. Food intake abnormalities, especially timing and composition of meal, are crucial cause of circadian disruption, but evidence from preclinical and clinical studies has shown that food could represent a unique therapeutic approach to promote circadian resynchronization. In this review, we briefly summarize the structure of circadian system and discuss the role playing by different molecules [from leptin to ghrelin, incretins, fibroblast growth factor 21 (FGF-21), growth differentiation factor 15 (GDF15)] to guarantee circadian homeostasis. Based on the recent data, we discuss the innovative nutritional interventions aimed at circadian re-synchronization and, consequently, improvement of cardiometabolic health.

Food Sources of Key Nutrients, Meal and Dietary Patterns among Children Aged 4-13 Years in Ibadan, Nigeria: Findings from the 2019 Kids Nutrition and Health Study

This study examined the contribution of food to nutrient intake, meal and dietary patterns among children aged 4–8 and 9–13 years in the city of Ibadan, Nigeria. Multi-pass 24-hour dietary recalls were used to assess intakes. Prudent and traditional Southwestern Nigerian dietary patterns were identified among children. The top foods and beverages were defined by frequency and amount consumed. Meal patterns were described by the eating occasions, while cluster analysis probed dietary patterns. About 88% of children had at least three meals including breakfast (95%), lunch (85%), dinner (92%) and midmorning meals (48%), while about 60% ate snacks at least once daily. Sources of energy and key nutrients were limited (yam, cassava, rice, maize, bread and beans/peas/legumes). The amount consumed per consumer of cassava products (192.2, 256.0 g), yam (169.7, 256.0 g), legumes (115.3, 150.7 g), corn/maize (160.4, 195.2), and rice (138.4, 182.3 g) were high, while beef (15.2, 17.9 g), eggs (50.6, 49.2 g), fish (27.5, 30.6 g), milk (24.2, 27.0 g) and nuts and seeds (18.2, 19.7 g) were low for children ages 4–8 and 9–13 years, respectively. In conclusion, while the frequency of meals suggests a healthy pattern, the top foods could not provide adequate nutrient (especially micronutrient) intake, which is key to the development of the target population.

Snacking behavior differs between evening and morning chronotype individuals but no differences are observed in overall energy intake, diet quality, or food cravings

There is a growing body of literature that links chronotype to certain undesirable eating behaviors. However, the relationship between chronotype and dietary intake is poorly characterized among adults in the United States (U.S.). This cross-sectional study examined the associations among chronotype, snacking habits, dietary intake and quality, and food cravings. One-hundred adults living in the U.S. completed the study. Based on the Horne-Östberg Morningness-Eveningness Questionnaire score, an individual was categorized as having either a morning (M)-type, intermediate (I)-type, or evening (E)-type chronotype. Snack intake was assessed using a previously published specialized food frequency questionnaire. Sugar-sweetened beverage (SSB) intake was assessed using the updated version of the Beverage Intake Questionnaire-15. Alcohol misuse was measured using the Alcohol Use Disorders Identification Test-Consumption. Diet quality was obtained using the Diet History Questionnaire III. The validated General Food Cravings Questionnaire-Trait measured participants' food cravings. E-type individuals reported consuming snacks more often over the course of a week than M-types (p = .002) but not I-types. In terms of timing of snacking, E-type individuals consumed more snacks after dinner than M-types (p < .001). E-type individuals consumed more energy-dense snacks (p = .005), especially candies (p = .005), than M-types. However, there were no significant differences in healthy snack frequency, diet quality, energy and macronutrient intake, SSB consumption, alcohol misuse, or food cravings among chronotypes (p > .05, for all). In conclusion, E-type individuals consumed snacks more frequently and later than M-types; however, chronotype was not associated with an individual's energy intake, diet quality, and food cravings, which suggests that chronotype is negligibly associated with weight gain-related behaviors in this population.

The consumption of energy dense snacks and some contextual factors of snacking may contribute to higher energy intake and body weight in adults

Preventing obesity (OB) among adults is a public health priority. One factor that seems to contribute to OB, due to the extra energy intake it involves, is the greater consumption of snacks. Whether snacking promotes OB in adults is however a source of controversy in the literature at present. The aim of this paper was to evaluate the effects of snacking on body weight status, along with contextual factors such as snacking location, food source, timing, and social context of snacking. To better understand the nature of snacking behavior, seven currently used definitions of snacking were described. Studies published prior to November 2020 were identified by searching the PubMed and Scopus databases, with thirty-three observational studies being identified and included. The consumption of energy-dense snacks may contribute to higher energy intake and weight in adult populations. The context in which adults snacks-such as eating alone, outside home or work, late in the day, in front of a TV or computer-is also important for this behavior. However, the lack of consensus on the definition of snacks in the literature makes these considerations suggestive rather than objective. Better-designed research is needed to determine the prospective association between snacking behavior and weight status in adults. Snacking may be an important behavior that can be modified to prevent obesity on the population level. Social education focused on promoting morning snacks and replacing energy-dense snacks by more nutritious ones, e.g. fruit and vegetables, may thus be beneficial.

Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and Morita therapy (MT); comparison of three established psychotherapies and possible common neural mechanisms of psychotherapies

Psychotherapies aim to relieve patients from mental distress by guiding them toward healthier attitudes and behaviors. Psychotherapies can differ substantially in concepts and approaches. In this review article, we compare the methods and science of three established psychotherapies: Morita Therapy (MT), which is a 100-year-old method established in Japan; Cognitive Behavioral Therapy (CBT), which-worldwide-has become the major psychotherapy; and Acceptance and Commitment Therapy (ACT), which is a relatively young psychotherapy that shares some characteristics with MT. The neuroscience of psychotherapy as a system is only beginning to be understood, but relatively solid scientific information is available about some of its important aspects such as learning, physical health, and social interactions. On average, psychotherapies work best if combined with pharmacotherapies. This synergy may rely on the drugs helping to "kickstart" the use of neural pathways (behaviors) to which a patient otherwise has poor access. Improved behavior, guided by psychotherapy, can then consolidate these pathways by their continued usage throughout a patient's life.

Association of number of bites and eating speed with energy intake: Wearable technology results under free-living conditions

Personalized weight management strategies are gaining interest. However, knowledge is limited regarding eating habits and association with energy intake, and current technologies limit assessment in free-living situations. We assessed associations between eating behavior and time of day with energy intake using a wearable camera under free-living conditions and explored if obesity modifies the associations. Sixteen participants (50% with obesity) recorded free-living eating behaviors using a wearable fish-eye camera for 14 days. Videos were viewed by trained annotators who confirmed number of bites, eating speed, and time of day for each eating episode. Energy intake was determined by a trained dietitian performing 24-h diet recalls. Greater number of bites, reduced eating speed, and increased BMI significantly predicted higher energy intake among all participants (P < 0.05, each). There were no significant interactions between obesity and number of bites, eating speed, or time of day (p > 0.05). Greater number of bites and reduced eating speed were significantly associated with higher energy intake in participants without obesity. Results show that under free-living conditions, more bites and slower eating speed predicted higher energy intake when examining consumption of foods with beverages. Obesity did not modify these associations. Findings highlight how eating behaviors can impact energy balance and can inform weight management interventions using wearable technology.

Late Evening Eating Patterns among US Adults Vary in Their Associations With, and Impact on, Energy Intake and Diet Quality: Evidence from What We Eat in America, National Health and Nutrition Examination Survey 2013-2016

BACKGROUND

Evening eating has been associated with higher energy intake and lower nutrient density. However, these qualities may not characterize all late evening (LE) eating patterns.

OBJECTIVE

We sought to characterize US adults' LE eating patterns on a given day and identify differences, if any, in pattern-specific associations with, and impact on, daily energy intake and total diet quality.

DESIGN

LE eating patterns, energy intakes, and Healthy Eating Index (HEI) scores were identified using Day-1 dietary recall data from the cross-sectional National Health and Nutrition Examination Survey 2013-2016.

PARTICIPANTS/SETTING

The sample included adults aged ≥ 20 years (n = 9,861). LE reporters were respondents who consumed foods/beverages between 20:00 and 23:59 on the intake day.

MAIN OUTCOME MEASURES

Energy intake and HEI-2015 scores by LE status/pattern and the impact of LE consumption on these measures.

STATISTICAL ANALYSES

Cluster analysis assigned individuals to LE eating patterns based on the LE energy contribution of food/beverage groups. Regression models estimated energy intake and HEI-2015 scores; estimates were compared between LE reporters and nonreporters. Similarly, LE's contribution to total energy and the difference in total HEI inclusive vs exclusive of LE consumption were estimated and compared among patterns.

RESULTS

Among US adults, 64.4% were LE reporters. Eleven LE patterns were identified; the six most prevalent patterns (representing 89% of LE reporters) were further analyzed. Daily energy intake in all prevalent patterns except the fruit pattern exceeded that of nonreporters by ≥ 268 kcal (unadjusted; P < 0.001), varying by pattern. Conversely, total HEI score did not differ from that of nonreporters (51.0) in any pattern except the fruit pattern, where it was higher (57.4, unadjusted; P < 0.001). Generally, LE consumption's impact on energy was high and its impact on HEI scores was low.

CONCLUSIONS

Late evening food/beverage consumption is common among US adults, and LE patterns are not monolithic in their associations with, and impact on, total energy intake and dietary quality.

The impact of circadian timing on energy balance: an extension of the energy balance model

A significant proportion of the population is classified as having overweight or obesity. One framework which has attempted to explain biobehavioral mechanisms influencing the development of overweight and obesity is the energy balance model. According to this model, the body continually attempts to balance energy intake with energy expenditure. When energy intake and energy expenditure become imbalanced, there is an increase in homeostatic and allostatic pressure, generally to either increase energy intake or decrease energy expenditure, so as to restore energy homeostasis.Recent research has indicated that circadian aspects of energy intake and energy expenditure may influence energy balance. This paper provides a narrative review of existing evidence of the role of circadian timing on components of energy balance. Research on the timing of food intake, physical activity, and sleep indicates that unhealthy timing is likely to increase risk of weight gain. Public health guidelines focus on how much individuals eat and sleep, what foods are consumed, and the type and frequency of exercise, but the field of circadian science has begun to demonstrate that when these behaviors occur may also influence overweight and obesity prevention and treatment efforts.

The role of an individual's olfactory discriminability in influencing snacking and habitual energy intake

Recent studies have revealed close links between human olfaction, appetite, and food choice. However, it remains unclear whether olfactory sensitivity plays a direct role in determining food and energy intake. The present study addresses this question by assessing relationships between individual olfactory discriminability (at a suprathreshold level), snacking, and habitual energy intake. A total of 92 healthy Caucasian males (mean age = 26.1, SD = 5.8) were tested for their olfactory discriminability (measured by d') to three food-related odorants (O1 - Vanillin, O2 - Methional, and O3 - Maltol/Furaneol mixture) with a 2-AFC method of constant stimuli. These sensory data were then analysed with two separate measures of food consumption - (1) snack energy intake within an ad libitum buffet setting; (2) habitual energy intake using four-day weighed food records. Univariate analyses of variance revealed significant results with regards to O1. Specifically, individuals with higher discriminability consumed significantly less energy from snacking as opposed to their less sensitive counterparts (p = 0.05). However, no significant relationship was found between individual olfactory discriminability and habitual energy intake. While recent years have seen increasing research focus on how external olfactory cues affect food consumption, our study offers particularly novel insights regarding the role of individual olfactory sensitivity in shaping eating behaviour.

Association between frequency of snacking and all-cause mortality among community-dwelling young-old adults: An age-specific prospective cohort study

AIM

We aimed to clarify whether snacking habits decrease the risk of all-cause mortality in an older Japanese population.

METHODS

The study participants were 64- or 65-year-old community-dwelling residents recruited each survey year from 1996 through 2005. Data on the frequency of snacking and other lifestyle factors were obtained during the baseline survey using self-administered questionnaires, and the participants were followed up annually until the end of 2017. In total, 2943 participants (1484 men and 1459 women) were eligible. All-cause mortality was compared among participants grouped by frequency of snacking (no snacking, one to four times/week, or every day).

RESULTS

The number of deaths recorded over the study period of 43 204 person-years was 357 (24.1%) for men and 173 (11.9%) for women. The mean ± standard deviations for the follow-up period were 14.2 ± 4.9 years in men and 15.2 ± 4.5 years in women. Cox proportional hazard regression analyses showed that after adjusting for potential confounding factors, the hazard ratios for women were 0.64 (95% confidence interval [CI], 0.43-0.94) in the group that had a habit of snacking one to four times/week, and 0.93 (95% CI 0.63-1.36) in the group that had a habit of snacking every day compared with those in the no snacking group. These associations were not observed among men.

CONCLUSIONS

A moderate frequency of snacking slightly decreases the risk of all-cause mortality among women. Our findings might be useful for improving the nutrition statuses in older female adults. Geriatr Gerontol Int 2021; 21: 697-704.

Effects of COVID-19 home confinement on eating behavior: A review

Coronavirus disease is a global pandemic that has led to radical changes in lifestyle habits, including dietary habits. Therefore, the objective of the present review is to evaluate the effect of quarantine on dietary habits when enforcing a lockdown. Some databases were used, including Web of Science, Science Direct, Google Scholar, and PubMed. Ten studies conducted between March and May 2020 were included. There is an increase in the number of meals and snacks during home confinement as well as unhealthy food such as fast food, sweets and chocolate, sugar-added drinks, and processed meat, while fruit and vegetable consumption was reduced. Very few studies reported that participants had increased fruit and vegetable intake. In conclusion, collateral effects of this pandemic include an environment that is not favorable to healthy dietary habits, which could have a lasting impact on health. The long-term health effects are unknown and worth investigating.

Eating Behaviors Are Associated With Physical Fitness and Body Composition Among US Army Soldiers

OBJECTIVE

Examine associations between soldiers' eating behaviors, compliance with body composition and fitness standards, and physical performance.

DESIGN

Cross-sectional study.

SETTING

Eight Army installations.

PARTICIPANTS

US Army Soldiers (n = 1,591; 84% male).

MAIN OUTCOME MEASURES

Characteristics, eating behaviors, compliance with body composition and physical fitness standards, and fitness level were assessed via questionnaire.

ANALYSIS

Bivariate and multivariable logistic regression.

RESULTS

Eating mostly at a dining facility was associated with lower odds of body composition failure (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.26-0.73); whereas, eating at a fast rate (OR, 1.51; 95% CI, 1.05-2.17) or often/always ignoring satiety cues (OR, 2.12; 95% CI, 1.06-4.27) was associated with higher odds of body composition failure. Eating mostly fast-food/convenience meals (OR, 1.75; 95% CI, 1.19-2.59) and eating at a fast rate (OR, 1.42; 95% CI, 1.04-1.93) was associated with higher odds of physical fitness failure. Skipping breakfast was associated with lower odds of high physical performance (OR, 0.41; 95% CI, 0.23-0.74); whereas, nutrition education was associated with higher odds of high physical performance (OR, 1.02; 95% CI, 1.01-1.04).

CONCLUSIONS AND IMPLICATIONS

As eating behaviors are modifiable, findings suggest opportunities for improving the specificity of Army health promotion and education programs.

Diet Quality Indices in the SUN Cohort: Observed Changes and Predictors of Changes in Scores Over a 10-Year Period

BACKGROUND

Dietary quality indices (DQI) are widely used in nutritional epidemiology. However, how they might change over time in a Mediterranean population is not well understood.

OBJECTIVE

To evaluate within-participant longitudinal changes in scores for nine a priori-defined DQIs: Fat Quality Index (FQI), Carbohydrate Quality Index (CQI), Pro-vegetarian Dietary Pattern (PVG), Mediterranean Diet Adherence Screener (MEDAS), Mediterranean Diet Score (MDS), Dietary Approaches to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurodegenerative Delay Diet (MIND), Prime Diet Quality Score (PDQS) and Alternate Healthy Eating Index (AHEI-2010) in the "Seguimiento Universidad de Navarra" (SUN) cohort, a well-known Mediterranean cohort of university graduates, and to identify baseline predictors of improvement in MEDAS and AHEI-2010 after 10 years of follow-up.

DESIGN

In this longitudinal cohort study, DQI scores were calculated based on responses from a validated semiquantitative food-frequency questionnaire (FFQ).

PARTICIPANTS/SETTING

Spanish university graduates enrolled in the SUN cohort before March 2008, who completed the 10-year FFQ and reported total dietary intake at baseline and after 10 years of follow-up, included 2,244 men and 3,271 women, whose mean age at baseline was 36.3 years (standard deviation [SD], 10.7).

MAIN OUTCOME MEASURES

Main outcome measures were within-participant longitudinal changes for FQI, CQI, PVG, MEDAS, MDS, DASH, MIND, PDQS, and AHEI-2010.

STATISTICAL ANALYSES PERFORMED

Adjusted logistic regression models were used to evaluate within-participant longitudinal changes and to identify baseline predictors of improvements ≥10% in MEDAS and AHEI-2010 scores after 10 years of follow-up.

RESULTS

The comparison of the nine scores of DQI calculated at baseline and after 10 years of follow-up showed an improvement in all DQI scores except for PDQS. The greatest changes in DQIs were found for MEDAS (from 6.2 to 7.2, +22.9%) and MDS (from 4.3 to 4.4, +15.4%). The strongest predictors at baseline for ≥10% improvements in MEDAS or AHEI-2010 scores varied across indices. Being female, ≥35 years old, and more physically active at baseline were associated with improvement, whereas snacking between meals was associated with <10% improvements in both indices.

CONCLUSIONS

In this cohort, the changes in nine a priori-defined DQI scores suggested modest improvements in diet quality, in which MEDAS and MDS scores showed the largest improvements. Additional longitudinal studies, especially intervention trials with long follow-up, are warranted to establish the most appropriate DQIs to assess long-term changes in diet quality in adult populations.

Beneficial Effects of Early Time-Restricted Feeding on Metabolic Diseases: Importance of Aligning Food Habits with the Circadian Clock

The importance of metabolic health is a major societal concern due to the increasing prevalence of metabolic diseases such as obesity, diabetes, and various cardiovascular diseases. The circadian clock is clearly implicated in the development of these metabolic diseases. Indeed, it regulates physiological processes by hormone modulation, thus helping the body to perform them at the ideal time of day. Since the industrial revolution, the actions and rhythms of everyday life have been modified and are characterized by changes in sleep pattern, work schedules, and eating habits. These modifications have in turn lead to night shift, social jetlag, late-night eating, and meal skipping, a group of customs that causes circadian rhythm disruption and leads to an increase in metabolic risks. Intermittent fasting, especially the time-restricted eating, proposes a solution: restraining the feeding window from 6 to 10 h per day to match it with the circadian clock. This approach seems to improve metabolic health markers and could be a therapeutic solution to fight against metabolic diseases. This review summarizes the importance of matching life habits with circadian rhythms for metabolic health and assesses the advantages and limits of the application of time-restricted fasting with the objective of treating and preventing metabolic diseases.

Consequences of the COVID-19 Syndemic for Nutritional Health: A Systematic Review

Confinement at home, quarantine, and social distancing are some measures adopted worldwide to prevent the spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2), which has been generating an important alteration in the routines and qualities of life of people. The impact on health is still being evaluated, and consequences in the nutritional field are not entirely clear. The study objective was to evaluate the current evidence about the impact that preventive measures of physical contact restriction causes in healthy nutrition. A systematic review was carried out according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" PRISMA Group and Cochrane method for rapid systematic reviews. Searching was performed in six electronic databases and evaluated articles published between 2010 and 2020, including among their participants adult subjects who had been exposed to the preventive measures of physical contact restriction. Seven studies met the selection criteria and reported an overall increase in food consumption, weight, Body Mass Index (BMI), and a change in eating style. Findings suggest that healthy nutrition is affected by preventive measures to restrict physical contact as a result of the COVID-19 syndemic.

Short-term impact of the COVID-19 confinement measures on health behaviours and weight gain among adults in Belgium

BACKGROUND

In Belgium, confinement measures were introduced on the 13th of March 2020 to curb the spread of the coronavirus disease (COVID-19). These measures may affect health behaviours of the population such as eating habits, physical activity and alcohol consumption, which in turn can lead to weight gain resulting in overweight and obesity, increasing the risk of several chronic diseases, but also of severe COVID-19. The purpose of this study is to assess the impact of confinement measures on health behaviours and their associations with weight gain.

METHODS

Data were derived from the second national COVID-19 health survey. Data were collected between the 16th and the 23rd of April 2020. The recruitment of participants was based on snowball sampling via Sciensano's website, invitations via e-mail and social media. The study sample includes participants aged 18 years and over with no missing data on the variables of interest (n = 28,029). The association between self-reported weight gain and health behaviour changes, adjusted for gender, age group and household composition was assessed through OR's (95% CI) calculated with logistic regression models, using post-stratification weights.

RESULTS

Overall, 28.6% reported weight gain after 6 weeks of confinement. Higher odds of weight gain were observed among participants who increased or decreased their consumption of sugar-sweetened beverages (OR = 1.39 (1.15-1.68) and 1.29 (1.04-1.60), respectively), among those who increased their consumption of sweet or salty snacks (OR = 3.65 (3.27-4.07)), among those who became less physically active (OR = 1.91 (1.71-2.13)), and among those who increased their alcohol consumption (OR = 1.86 (1.66-2.08)).

CONCLUSIONS

The most important correlates of weight gain during confinement were an increased consumption of sweet or salty snacks and being less physically active. These findings confirm the impact of diet and exercise on short term weight gain and plead to take more action, in supporting people to achieve healthier behaviours in order to tackle overweight and obesity, especially during the COVID-19 pandemic.

Late-evening food intake is highly prevalent among individuals with type 2 diabetes

Late-evening food intake is associated with cardiometabolic risk. We assessed the prevalence of late-evening and night-time eating in individuals with type 2 diabetes and its association with BMI and HbA_1c. We hypothesized food intake during late evening and night-time to be prevalent among individuals with type 2 diabetes and to be associated with higher BMI and higher HbA_1c. This cross-sectional analysis includes 348 adults with type 2 diabetes from an outpatient diabetes clinic in Denmark. Frequency of late-evening and night-time eating was assessed from a food frequency questionnaire and clinical data were obtained from electronic medical records. Participants were divided into those reporting to eat frequently (≥3 times/week) in the evening after dinner and/or during night-time (late-eaters) and those who did not (reference group) and BMI and HbA_1c levels were compared between groups with and without adjustment for diabetes duration and antidiabetic medication. 42% of the study population reported to eat frequently (≥3 times/week) in the late evening and 8% reported to do so during the night. Most late-eaters reported to eat breakfast regularly, suggesting a long eating window and short fasting period in this group. BMI and HbA_1c did not differ between late-eaters and the reference group. Eating late in the evening or during the night was prevalent among individuals with type 2 diabetes across BMI and HbA_1c levels. Whether restriction of food intake during evening and night-time can induce weight loss and improve glycemic control in individuals with type 2 diabetes needs testing in randomized controlled trials.

Prolonged, Controlled Daytime versus Delayed Eating Impacts Weight and Metabolism

A delayed eating schedule is associated with increased risk of obesity and metabolic dysfunction in humans.^1-9 However, there are no prolonged, highly controlled experimental studies testing the effects of meal timing on weight and metabolism in adults with a body mass index (BMI) of 19-27 kg/m².^10-18 Twelve healthy adults (age: 26.3 ± 3.4 years; BMI: 21.9 ± 1.7 kg/m²; 5 females) participated in a randomized crossover study in free-living conditions. Three meals and two snacks with comparable energy and macronutrient contents were provided during two, 8-week, counterbalanced conditions separated by a 2-week washout period: (1) daytime (intake limited to 0800 h-1900 h) and (2) delayed (intake limited to 1200 h-2300 h). Sleep-wake cycles and exercise levels were held constant. Weight, adiposity, energy expenditure, and circadian profiles of hormones and metabolites were assessed during four inpatient visits occurring before and after each condition. Body weight, insulin resistance (homeostatic model assessment of insulin resistance [HOMA-IR]), trunk-to-leg fat ratio, resting energy expenditure, respiratory quotient, and fasting glucose, insulin, total and high-density lipoprotein (dHDL) cholesterol, and adiponectin decreased on the daytime compared to the delayed schedule. These measures, as well as triglycerides, increased on the delayed compared to the daytime schedule (effect size range: d = 0.397-1.019). Circadian phase and amplitude of melatonin, cortisol, ghrelin, leptin, and glucose were not differentially altered by the eating schedules. Overall, an 8-week daytime eating schedule, compared to a delayed eating schedule, promotes weight loss and improvements in energy metabolism and insulin in adults with BMI 19-27 kg/m², underscoring the efficacy and feasibility of daytime eating as a behavioral modification for real-world conditions.

A latent class analysis of dietary behaviours associated with metabolic syndrome: a retrospective observational cross-sectional study

BACKGROUND

Obesity defined solely by the Body Mass Index (BMI) may not reflect the true heterogeneity of the obese population. This study aimed to classify the dietary behaviours of overweight and obese individuals and to explore the relationship between patterns of dietary behaviour and cardiometabolic risk factors.

METHODS

A total of 259 patients who visited an outpatient weight management clinic at a tertiary hospital and underwent a dietary behaviour assessment between January 2014 and February 2019 were enrolled in the study. Dietary behaviours were assessed in three domains with nine categories, including choice of food (frequently eating out and consumption of instant/fast/takeaway food), eating behaviour (irregular meals; frequent snacking, including eating at night; emotional eating; and overeating/binge eating), and nutrient intake (high-fat/high-calorie foods, salty food, and poorly balanced diet). Latent class analysis (LCA) was used to classify the subjects according to these categories. Associations between latent class and metabolic syndrome were assessed by logistic regression.

RESULTS

The subjects were classified into three LCA-driven classes, including a referent class of healthy but unbalanced eaters (n = 118), a class of emotional eaters (n = 53), and a class of irregular unhealthy eaters (n = 88). Compared with the referent class, emotional eaters had a significantly higher BMI (beta = 3.40, P < 0.001) accompanied by metabolic syndrome (odds ratio 2.88, 95% confidence interval 1.16-7.13).

CONCLUSIONS

Our three LCA-driven obesity phenotypes could be useful for assessment and management of obesity and metabolic syndrome. The association between emotional eaters and higher BMI and metabolic syndrome was stronger than that with other eaters. Thus, emotional regulation strategies might have benefit for emotional eater's diet.

Dietary Choices and Habits during COVID-19 Lockdown: Experience from Poland

The outbreak of coronavirus disease (COVID-19) in late December 2019 in China, which later developed into a pandemic, has forced different countries to implement strict sanitary regimes and social distancing measures. Globally, at least four billion people were under lockdown, working remotely, homeschooling children, and facing challenges coping with quarantine and the stressful events. The present cross-sectional online survey of adult Poles (n = 1097), conducted during a nationwide quarantine, aimed to assess whether nutritional and consumer habits have been affected under these conditions. Over 43.0% and nearly 52% reported eating and snacking more, respectively, and these tendencies were more frequent in overweight and obese individuals. Almost 30% and over 18% experienced weight gain (mean ± SD 3.0 ± 1.6 kg) and loss (−2.9 ± 1.5 kg), respectively. Overweight, obese, and older subjects (aged 36–45 and >45) tended to gain weight more frequently, whereas those with underweight tended to lose it further. Increased BMI was associated with less frequent consumption of vegetables, fruit, and legumes during quarantine, and higher adherence to meat, dairy, and fast-foods. An increase in alcohol consumption was seen in 14.6%, with a higher tendency to drink more found among alcohol addicts. Over 45% of smokers experienced a rise in smoking frequency during the quarantine. The study highlights that lockdown imposed to contain an infectious agent may affect eating behaviors and dietary habits, and advocates for organized nutritional support during future epidemic-related quarantines, particularly for the most vulnerable groups, including overweight and obese subjects.

Epidemiology, Predisposing Factors, Biomarkers, and Prevention Mechanism of Obesity: A Systematic Review

Background. Globally, obesity is becoming a public health problem in the general population. Various determinants were reported by different scholars even though there are inconsistencies. Different biomarkers of obesity were identified for the prediction of obesity. Even though researchers speculate the factors, biomarkers, consequences, and prevention mechanisms, there is a lack of aggregate and purified data in the area of obesity. Summary. In this review, the epidemiology, predisposing factors, biomarkers, consequences, and prevention approaches of obesity were reviewed. Key Messages. The epidemiology of obesity increased in low-, middle-, and high-income countries. Even if the factors vary across regions and socioeconomic levels, sociodemographic, behavioral, and genetic factors were prominent for the development of obesity. There are a lot of biomarkers for obesity, of which microRNA, adipocytes, oxidative stress, blood cell profile, nutrients, and microbiota were promising biomarkers for determination of occurrence of obesity. Since the consequences of obesity are vast and interrelated, multidimensional prevention strategy is mandatory in all nations.