Eating Behavior (Duration, Content, and Timing) Among Workers Living under Different Levels of Urbanization

From Ampesie to French fries: systematising the characteristics, drivers and impacts of diet change in rapidly urbanising Accra

Sub-Saharan Africa (SSA) is urbanising rapidly. One of the most visible outcomes of this urbanisation process is the change in the diets of urban residents. However, diet change in the context of rapid urbanisation is a complex and multi-dimensional phenomenon that encompasses multiple intersecting historical, environmental, socioeconomic, and political aspects. This study aims to unravel and systematise the characteristics, drivers and impacts of diet changes in Accra, through the interviews of multiple stakeholders and Causal Loop Diagrams. Diet change is characterised by the increased consumption of certain foodstuff such as rice, chicken, fish, vegetable oil, sugar, and ultra-processed food (UPF), and the decreased consumption of traditional foodstuff such as roots, tubers, and some cereals such as millet. These changes are driven by multiple factors, including among others, changes in income, sociocultural practices, energy access, and policy and trade regimes, as well as the proliferation of supermarkets and food vendors. Collectively, these diet changes have a series of environmental, socioeconomic, and health/nutrition-related impacts. Our results highlight the need to understand in a comprehensive manner the complex processes shaping diet change in the context of urbanisation, as a means of identifying effective interventions to promote healthy and sustainable urban diets in SSA. The development of such intervention should embrace a multi-stakeholder perspective, considering that the relevant urban actors have radically different perspectives and interests at this interface of urbanisation and diet change.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11625-022-01195-y.

Development and Evaluation of Integrated Chrono-Nutrition Weight Reduction Program among Overweight/Obese with Morning and Evening Chronotypes

This paper describes the development of an integrated chrono-nutrition weight reduction program and the evaluation of the attendance, retention, satisfaction and compliance towards the chrono-nutrition components among morning and evening chronotypes for overweight/obese non-shift workers. The present study was conducted in two phases: Phase I was composed of needs assessments on the chronotypes’ dietary patterns and chrono-nutrition through a scoping review and integrating the chrono-nutrition components (temporal eating pattern, meal timing and sleeping habits) alongside the existing weight reduction module, SLIMSHAPE™. Phase II consisted of a feasibility study to evaluate the integrated chrono-nutrition weight reduction program (SLIMSHAPE™ Chrono). A total of 91 overweight/obese non-shift workers participated in the 12-week weight reduction program (Age: 39.6 ± 6.3 years; 74.7% women; BMI: 31.2 ± 4.5 kg/m2). Low attrition rate was recorded, with 85 participants (93.4%) completing the pre- and post-intervention assessments. Overall, morning and evening chronotypes had increased their % energy intake in the early eating window (MT: 64.8 vs. 67.2%, ET: 62.7 vs. 65.6%, Mean difference (MD): 2.8, 95%CI: 0.3, 5.1, p = 0.028) and reduced their intake in the late eating window (MT: 35.2 vs. 32.8%, ET: 37.3 vs. 34.4%, MD: −2.8, 95%CI: −5.1, −0.3, p = 0.028) and earlier midpoint of eating (MT: 14:02 vs. 13:49; ET: 14:27 vs. 14:18, 95%CI: −0.4, −0.02, p = 0.029) and had a reduced night eating syndrome score (MT: 10.0 vs. 8.9; ET: 10.7 vs. 8.9, MD: −1.5, 95%CI: −2.5, −0.5, p = 0.004). There was no significant change in the first (MT: 08:12 vs. 08:04, ET: 08:24 vs. 08:22, MD: −0.1, 95%CI: −0.2, 0.03, p = 0.170) and last mealtime (MT: 19:52 vs. 19:33, ET: 20:29 vs. 20:14, MD: −0.3, 95%CI: −0.6, −0.04, p = 0.081), eating duration (MT: 11.7 vs. 11.5 h, ET: 12.1 vs. 11.9 h, MD: −0.2, 95%CI: −0.6, 0.2, p = 0.251) and the elapse time between sleep onset and last meal (MT: 3.1 vs. 3.5 h, ET: 3.5 vs. 3.2 h, MD: 0.1, 95%CI: −0.3, 0.4, p = 0.678). In terms of sleep, evening chronotypes increased their sleep duration (MD: 0.8 h, 95% CI: 0.4, 1.2, p < 0.001) and reduced social jetlag (MD: 19 min, 95% CI: 1.7, 36.3, p = 0.031) post-intervention compared to morning chronotypes. The integrated chrono-nutrition weight reduction program among morning and evening chronotypes improved the temporal pattern of energy intake, meal timing, night eating syndrome and sleep habits post-intervention. The chrono-nutrition practice could be a potentially modifiable behavior as an adjunct strategy in weight management.

Content Validation of a Chrononutrition Questionnaire for the General and Shift Work Populations: A Delphi Study

Unusual meal timing has been associated with a higher prevalence of chronic disease. Those at greater risk include shift workers and evening chronotypes. This study aimed to validate the content of a Chrononutrition Questionnaire for shift and non-shift workers to identify temporal patterns of eating in relation to chronotype. Content validity was determined using a Delphi study of three rounds. Experts rated the relevance of, and provided feedback on, 46 items across seven outcomes: meal regularity, times of first eating occasion, last eating occasion, largest meal, main meals/snacks, wake, and sleep, which were edited in response. Items with greater than 70% consensus of relevance were accepted. Rounds one, two, and three had 28, 26, and 24 experts, respectively. Across three rounds, no outcomes were irrelevant, but seven were merged into three for ease of usage, and two sections were added for experts to rate and comment on. In the final round, all but one of 29 items achieved greater than 70% consensus of relevance with no further changes. The Chrononutrition Questionnaire was deemed relevant to experts in circadian biology and chrononutrition, and could represent a convenient tool to assess temporal patterns of eating in relation to chronotype in future studies.