Late Eating Is Associated with Obesity, Inflammatory Markers and Circadian-Related Disturbances in School-Aged Children

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.

Chrononutrition and metabolic health in children and adolescents: a systematic review and meta-analysis

CONTEXT

Obesity has emerged as a global health issue for the pediatric population, increasing the need to investigate physiopathological aspects to prevent the appearance of its cardiometabolic complications. Chrononutrition is a field of research in nutritional sciences that investigates the health impact of 3 different dimensions of feeding behavior: regularity of meals, frequency, and timing of food intake.

OBJECTIVE

We carried out a systematic review and meta-analysis to investigate the association between chrononutrition in children and adolescents and the risk of overweight/obesity or a cluster of metabolic abnormalities related to glucose and lipid metabolism, blood pressure, and cardiovascular disease risk.

DATA EXTRACTION

A literature search was performed using PubMed, EMBASE, and The Cochrane Library for relevant articles published before August 2022.

DATA ANALYSIS

A total of 64 articles were included in the narrative synthesis (47 cross-sectional and 17 cohort studies), while 16 studies were included in the meta-analysis. Meta-analysis showed that non-daily breakfast consumers (≤6 d/wk) had a higher risk of overweight/obesity (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.08-1.82] compared with daily breakfast eaters (7 d/wk). Similarly, irregular breakfast consumption (only 0-to-3 times/wk) increased the risk of abdominal obesity (waist-to-height ratio ≥ 0.5) compared with regular consumption (5-to-7 times/wk) (OR, 1.38; 95% CI, 1.26-1.49). There was evidence to suggest that a regular frequency of meal consumption (≥4 times/d) is preventive against overweight/obesity development compared with fewer meals (≤3 times/d) (OR, 0.83; 95% CI, 0.70-0.97). In the narrative synthesis, snacking habits showed controversial results, while food timing was the most understudied dimension.

CONCLUSION

Overall, our data indicate a potential implication of chrononutrition in affecting pediatric metabolic health; however, the evidence of this association is limited and heterogeneous. Further prospective and intervention studies with a consistent approach to categorize the exposure are needed to elucidate the importance of chrononutrition for pediatric metabolic health.

Later eating rhythm measured in children at 7 years of age in the ALSPAC cohort

Later eating rhythm (LER) refers to later timing, greater energy intake (EI), and higher frequency of eating occasions (meal/snack) in the evening. The significance of LER in child health is becoming increasingly recognised. However, the lack of consensus regarding definitions of LER make it challenging to fully comprehend its role. This data note describes LER variables derived in the Avon Longitudinal Study of Parents and Children (ALSPAC), an ongoing birth cohort which enrolled 14,541 pregnant women living in Avon, UK, with an expected date of delivery between April 1991 - December 1992. When children were 7 years, parents completed a structured 3-day food diary, recording all foods/drinks consumed over 3 days (preferably 1 weekend day and 2 weekdays). Data was available for 7,285 children (50.1% response rate). A subsample of 4,869 children had exact time of eating occasions added to the existing database, which only included broad indications of eating timing based on 2-7 hour long meal slots. 13 LER variables were derived for the entire week and weekdays/weekend days separately. These comprise: 1) eating around individual bedtime (number days); 2) eating around average bedtime (number days); 3) time of evening main meal (hrs:mins); 4) time of last eating occasion (hrs:mins); 5) EI in the evening (percentage of total daily energy intake, %TDEI); 6) EI within 2hrs before bedtime (%TDEI); 7) EI for evening main meal (%TDEI); 8) EI for evening snacks (%TDEI); 9) Night eating1 (NE1): eating over 30% of total daily energy intake after 18:00 (number days); 10) NE2: eating over 25% of total daily energy intake within 2hrs before bedtime (number days); 11) eating frequency after 17:00 (number of eating occasions); 12) regularity of dinner (number of days); 13) frequency of evening snacks (number days). We describe the derivation, prevalence and inter-corelations between LER variables.

The Effect of Prebedtime Behaviors on Sleep Duration and Quality in Children: Protocol for a Randomized Crossover Trial

BACKGROUND

It is recommended that children should avoid eating dinner, being physically active, or using screens in the hour before bed to ensure good sleep health. However, the evidence base behind these guidelines is weak and limited to cross-sectional studies using questionnaires.

OBJECTIVE

The aim of this randomized crossover trial was to use objective measures to experimentally determine whether recommendations to improve sleep by banning electronic media, physical activity, or food intake in the hour before bed, impact sleep quantity and quality in the youth.

METHODS

After a baseline week to assess usual behavior, 72 children (10-14.9 years old) will be randomized to four conditions, which are (1) avoid all 3 behaviors, (2) use screens for at least 30 minutes, (3) be physically active for at least 30 minutes, and (4) eat a large meal, during the hour before bed on days 5 to 7 of weeks 2 to 5. Families can choose which days of the week they undertake the intervention, but they must be the same days for each intervention week. Guidance on how to undertake each intervention will be provided. Interventions will only be undertaken during the school term to avoid known changes in sleep during school holidays. Intervention adherence and shuteye latency (time from getting into bed until attempting sleep) will be measured by wearable and stationary PatrolEyes video cameras (StuntCams). Sleep (total sleep time, sleep onset, and wake after sleep onset) will be measured using actigraphy (baseline, days 5 to 7 of each intervention week). Mixed effects regression models with a random effect for participants will be used to estimate mean differences (95% CI) for conditions 2 to 4 compared with condition 1.

RESULTS

Recruitment started in March 2024, and is anticipated to finish in April 2025. Following data analysis, we expect that results will be available later in 2026.

CONCLUSIONS

Using objective measures, we will be able to establish if causal relationships exist between prebedtime behaviors and sleep in children. Such information is critical to ensure appropriate and achievable sleep guidelines.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12624000206527; https://tinyurl.com/3kcjmfnj.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/63692.

Children with obesity have poorer circadian health as assessed by a global circadian health score

BACKGROUND

Circadian health refers to individuals' well-being and balance in terms of their circadian rhythm. It is influenced by external cues. In adults, a close relationship between circadian-related alterations and obesity has been described. However, studies in children are scarce, and circadian health and its association with obesity have not been evaluated globally. We aimed to assess whether circadian health differed between children with and without obesity as determined by a global circadian score (GCS) in a school-age population.

METHODS

Four hundred and thirty-two children (7-12 years) were recruited in Spain. Non-invasive tools were used to calculate the GCS: (1) 7-day rhythm of wrist temperature (T), activity (A), position (P), an integrative variable that combines T, A, and P (TAP); (2) cortisol; and (3) 7-day food and sleep records. Body mass index, body fat percentage, waist circumference (WC), melatonin concentration, and cardiometabolic marker levels were determined.

RESULTS

Circadian health, as assessed by the GCS, differed among children with obesity, overweight, and normal weight, with poorer circadian health among children with obesity. Children with obesity and abdominal obesity had 3.54 and 2.39 greater odds of having poor circadian health, respectively, than did those with normal weight or low WC. The percentage of rhythmicity, a marker of the robustness of the TAP rhythm, and the amplitude, both components of the GCS, decreased with increasing obesity. Different lifestyle behaviors were involved in the association between circadian health and obesity, particularly protein intake (P = 0.024), physical activity level (P = 0.076) and chronotype (P = 0.029).

CONCLUSIONS

The GCS can capture the relationship between circadian health and obesity in school-age children. Protein intake, physical activity level, and chronotype were involved in this association. Early intervention based on improving circadian health may help to prevent childhood obesity.

Chrono-nutrition and sleep: lessons from the temporal feature of eating patterns in human studies - A systematic scoping review

An emerging field of research has revealed a bidirectional relationship between sleep and diet, highlighting the potential role of a healthy diet in improving sleep. However, the impact of chrono-nutrition on sleep remains less explored. Here we conducted a systematic scoping review, considering the multiple dimensions of chrono-nutrition, to describe the extent, range, and nature of the existing literature in this area (PROSPERO: CRD42021274637). There has been a significant increase in the literature exploring this topic over the past six years (almost 67 % of the evolving literature). A breakdown of the included studies was performed according to three major chrono-nutritional dimensions: meal timing [n = 35], irregular eating patterns [n = 84], and frequency of eating occasions [n = 3]. Meal timing included three sub-dimensions: breakfast skipping [n = 13], late eating [n = 16], and earlier vs later meals schedules [n = 6]. Irregular meal patterns included three sub-dimensions: diurnal fasting [n = 65], intermittent fasting [n = 16], and daily meal patterns [n = 3]. Frequency was the least studied dimension (n = 3). We provided a synthetic and illustrative framework underlining important preliminary evidence linking the temporal characteristics of eating patterns to various facets of sleep health. Nonetheless, much work remains to be done to provide chrono-nutrition guidelines to improve sleep health in the general population.

Late bedtime combined with more screen time before bed increases the risk of obesity and lowers diet quality in Spanish children

This cross-sectional study aimed to investigate whether the combination of bedtime and screen time (ST) before bed were associated with obesity and diet quality in toddlers and school-aged children. Parents reported children's bedtimes and ST before bed (0 min, 1-30 min, >30 min). We then defined bed + screen time behavior using bedtime median cut-offs (early [EB] or late [LB]) and ST responses, resulting in four groups: EB-0'ST, EB ≤ 30'ST/LB-0'ST, EB > 30'ST/LB ≤ 30'ST, and LB > 30'ST. For all participants (n = 1133; 5.4 ± 2.7 years, 49.7% girls, 51.9% school-aged) we evaluated body mass index (BMI), diet quality, sleep-related variables, physical activity, and health-related quality of life (HRQoL). Outcome variables were compared across bed + screen time behavior groups, stratified by age group (toddlers and school-aged children) using general linear models for continuous variables, as well as chi-squared tests or logistic regressions for categorical variables. Additionally, we calculated linear p-trends. Analyses were adjusted for sociodemographic variables, BMI, and physical activity (unless the variable was tested). The results showed that toddlers and school-aged children in the LB ≥ 30'ST group were more likely to have overweight/obesity (OR: 3.42 [95%CI:1.41,8.26] and OR: 2.53 [95%CI:1.10,5.03], respectively) than those in the EB-0'ST group. Additionally, toddlers and school-aged children in the EB > 30'ST/LB ≤ 30'ST and LB > 30'ST groups showed significantly lower adherence to the Mediterranean diet compared to the other groups (p < 0.001). Regarding sleep-related outcomes, we observed that the combination of LB and more ST was associated with poorer sleep quality and shorter sleep duration in toddlers and school-aged children (p < 0.001). These findings emphasize the importance of promoting earlier bedtimes and limiting ST before bed as part of obesity prevention strategies for children. Furthermore, such intervention could benefit the quality of children's diet and overall lifestyle.

Early Dinner Improves the Glycemic Profile in Habitual Late Eaters With Uncontrolled Type 2 Diabetes Mellitus in the Short Term

Background Late dinner (LD) can worsen the glucose profile in type 2 diabetes (T2D). We assessed the short-term effect of early dinner (ED) on glycemic control in habitual late eaters with uncontrolled T2D. Methodology This interventional, single-arm, within-group trial recruited 10 habitual late eaters with uncontrolled T2D (glycosylated hemoglobin: 7-9% and either fasting plasma glucose (FPG): ≥140 mg/dl or post-prandial plasma glucose: ≥200 mg/dl). They had their usual LD (beyond 22:00 hours) on Days 0-3 and ED (before 20:00 hours) on Days 4-10. Continuous glucose monitoring system (CGMS) parameters, two-hour post-dinner, and fasting (10-hour post-dinner) investigations were analyzed. Bedtime hunger was assessed using a Labeled Magnitude Satiety Scale. Results The mean dinner time was reduced from 22:28 hours to 19:29 hours. CGMS revealed that ED lowered the 10-hour post-dinner incremental area under the curve (22,587.9 ± 5,168.3 mg/dl×mins vs. 15,886.3 ± 4,288.7 mg/dl×mins, P < 0.002), 10-hour post-dinner average blood glucose (ABG) (137.5 ± 9.3 mg/dl vs. 125 ± 7.9 mg/dl, P < 0.002), 24-hour ABG (132.2 ± 7.5 mg/dl vs. 124.8 ± 5.4 mg/dl, P = 0.037), and night mean amplitude of glucose excursion (83.7 ± 5.8 mg/dl vs. 69.3 ± 7.5 mg/dl, P = 0.027). ED also reduced FPG (119.8 ± 7.3 mg/dl vs. 105.2 ± 5.7 mg/dl, P = 0.015), fasting insulin (15.0 ± 4.3 µIU/ml vs. 9.7 ± 2.7 µIU/ml, P < 0.002), and HOMA-IR (4.36 ± 1.2 vs. 2.56 ± 0.79, P < 0.002). Post-dinner glucose, insulin, and inflammatory markers were unchanged. Bedtime hunger increased significantly on Days 4 and 5 but returned to baseline by Day 10. Conclusions A simple modification of dinner time in habitual late eaters with uncontrolled T2D improves FPG, glycemic control, and insulin resistance in the short term.

Meal timing and its role in obesity and associated diseases

Meal timing emerges as a crucial factor influencing metabolic health that can be explained by the tight interaction between the endogenous circadian clock and metabolic homeostasis. Mistimed food intake, such as delayed or nighttime consumption, leads to desynchronization of the internal circadian clock and is associated with an increased risk for obesity and associated metabolic disturbances such as type 2 diabetes and cardiovascular diseases. Conversely, meal timing aligned with cellular rhythms can optimize the performance of tissues and organs. In this review, we provide an overview of the metabolic effects of meal timing and discuss the underlying mechanisms. Additionally, we explore factors influencing meal timing, including internal determinants such as chronotype and genetics, as well as external influences like social factors, cultural aspects, and work schedules. This review could contribute to defining meal-timing-based recommendations for public health initiatives and developing guidelines for effective lifestyle modifications targeting the prevention and treatment of obesity and associated metabolic diseases. Furthermore, it sheds light on crucial factors that must be considered in the design of future food timing intervention trials.

Kairos study protocol: a multidisciplinary approach to the study of school timing and its effects on health, well-being and students' performance

Recent evidence from chronobiology, chssronomedicine and chronopsychology shows that the organisation of social time (e.g., school schedules) generally does not respect biological time. This raises concerns about the impact of the constant mismatch between students' social and internal body clocks on their health, well-being and academic performance. The present paper describes a protocol used to investigate the problem of (de) synchronisation of biological times (chronotypes) in childhood and youth in relation to school times. It studies the effects of student chronotype vs. school schedule matches/mismatches on health behaviours (e.g., how many hours students sleep, when they sleep, eat, do physical activity, spend time outdoors in daylight) and learning (verbal expression, spatial structuring, operations) and whether alert-fatigue levels mediate this effect alignments/misalignments on learning (verbal expression, spatial structuring, operations) and their mediation by alert-fatigue levels. The novelty of our protocol lies in its multidisciplinary and mixed methodology approach to a relevant and complex issue. It draws on up-to-date knowledge from the areas of biology, medicine, psychology, pedagogy and sociology. The methods employed include a varied repertoire of techniques from hormonal analysis (cortisol and melatonin), continuous activity and light monitoring, self-registration of food intake, sleep timings, exercise and exposure to screens, alongside with systematic application of cognitive performance tests (e.g., memory, reasoning, calculation, attention) and self-reported well-being. This comprehensive and interdisciplinary protocol should support evidence-based education policy measures related to school time organisation. Appropriate and healthier school timetables will contribute to social change, healthier students and with more efficient learning. The results of studies using a similar methodology in other countries would ensure replication and comparability of results and contribute to knowledge to support policy making.

Night eating in timing, frequency, and food quality and risks of all-cause, cancer, and diabetes mortality: findings from national health and nutrition examination survey

OBJECTIVE

To investigate the association of timing, frequency, and food quality of night eating with all-cause, cancer, and diabetes mortality.

METHODS

This study included 41,744 participants from the US National Health and Nutrition Examination Survey (2002-2018). Night eating information was collected by 24-h dietary recall and the exposures were timing, frequency, and food quality of night eating. Food quality was assessed by latent class analysis. The outcomes were all-cause, cancer, and diabetes mortality, which were identified by the National Death Index and the International Classification of Diseases 10th Revision. Adjusted hazard ratios [aHR] with 95% confidence intervals [CI] were computed by Cox regression.

RESULTS

During a median follow-up of 8.7 years, 6066 deaths were documented, including 1381 from cancer and 206 from diabetes. Compared with no night eating (eating before 22:00), the later timing of night eating was associated with higher risk of all-cause and diabetes mortality (each P-trend <0.05) rather than cancer mortality, with the highest risk of eating being 00:00-1:00 (aHR 1.38, 95% CI 1.02-1.88) and being 23:00-00:00 (aHR 2.31, 95% CI 1.21-4.40), respectively. However, the increased risks were not observed for 22:00-23:00. Likewise, one time or over frequency of night eating was associated with higher all-cause and diabetes mortality (each P < 0.05). That risks were further observed in high-dietary-energy-density group of night eating (all-cause mortality: aHR 1.21 [95% CI 1.06-1.38]; diabetes mortality: aHR 1.97 [95% CI 1.13-3.45]), but not in low-dietary-energy-density group. Finally, correlation analysis found positive associations of night eating with glycohemoglobin, fasting glucose, and OGTT.

CONCLUSIONS

Night eating was associated with increased all-cause, cancer and diabetes mortality; however, reduction of excess mortality risk was observed when eating before 23:00 or low-dietary-energy-density foods.

Alignment between timing of 'highest caloric intake' and chronotype in relation to body composition during adolescence: the DONALD Study

PURPOSE

Our aim was to assess alignment in timing of 'highest caloric intake' with individual chronotype and its association with body composition in adolescents.

METHODS

We used repeatedly collected data from n = 196 adolescents (age 9-16 years, providing N = 401 yearly questionnaires) of the DONALD open cohort study. Chronotype was assessed by the Munich Chronotype Questionnaire from which midpoint of sleep (MSFsc) was derived. A sex- and age-specific diet-chrono-alignment score (DCAS) was calculated as the difference in hours between the chronotype-specific median timing of highest caloric intake of the studied population and the individual timing of 'highest caloric intake' or vice versa. Repeated-measures regression models were applied to study cross-sectional and longitudinal associations between the DCAS and body composition, e.g., Fat Mass Index (FMI) or Fat Free Mass Index (FFMI).

RESULTS

DCAS ranged from -6:42 h to + 8:01 h and was not associated with body composition. Among adolescents with a later chronotype (N = 201) a 1 h increase in DCAS (later consumption of 'highest caloric intake' in comparison to the median intake of that group), increased FFMI by 1.92 kg/m2 (95% CI: 0.15, 3.69, p value = 0.04) over a median follow-up of 0.94 year.

CONCLUSION

Alignment of energy intake with individual chronotype appears beneficial for FFMI among those with a late chronotype.

Prevalence of malnutrition and its associated factors among 18,503 Chinese children aged 3-14 years

Background

Child malnutrition places a major burden on global public health. We aimed to estimate the prevalence of child malnutrition and identify its potential factors among children aged 3-14 years from Beijing and Tangshan.

Methods

We cross-sectionally recruited 18,503 children aged 3-14 years from September 2020 to January 2022, according to a stratified cluster random sampling strategy. Child malnutrition was defined according to the World Health Organization criteria. Data were analyzed by STATA software and R language.

Results

The prevalence of malnutrition among 18,503 children was 10.93%. After multivariable adjustment, seven factors significantly associated with child malnutrition were parental education (adjusted odds ratio, 95% confidence interval, p: 1.52, 1.40 to 1.67, <0.001), family income (1.23, 1.16 to 1.30, <0.001), fast food intake frequency (1.14, 1.06 to 1.21, <0.001), night meals intake frequency (1.09, 1.04 to 1.15, <0.001), eating speed (1.01, 1.01 to 1.02, <0.001), maternal obesity (0.97, 0.95 to 0.99, <0.001), and paternal obesity (0.97, 0.96 to 0.98, <0.001). The seven significant factors had better prediction performance (area under the receiver operating characteristic, 0.956) for child malnutrition.

Conclusion

Approximately 10% of Chinese children aged 3-14 years were in malnutrition status, and seven factors were found to be significant predictors for child malnutrition.

Afternoon school shift is associated with increased risk of overweight/obesity in 11-14-year-old females with early and intermediate chronotype

OBJECTIVE

The purpose of this study was to compare the anthropometric and sleep-wake rhythm characteristics of schoolchildren that attend school in morning and afternoon school shifts.

METHODS

We recruited 18 481 individuals (females: 56.4%) aged 11 to 18 years old with an average age of 14.4 ± 1.7 years old. In total, 812 (4.2%) questionnaires were incomplete. The self-reported height and weight were used to assess the sex- and age-corrected body mass index of the participants. The Munich ChronoType Questionnaire was used to assess the chronotype, social jetlag, and sleep duration of the participants.

RESULTS

In total, 12.6% of the participants were affected by overweight or obesity. The overweight and obesity incidence rate was higher among the students studying in the afternoon (odd ratio [95%CI]: 1.33 [1.16-1.52]). The afternoon school shift had a negative impact on the anthropometric indicators only in the 11-14-year-olds (1.29 [1.11-1.50]) and girls (1.26 [1.04-1.54]) with an early (1.27 [1.03-1.56]) and intermediate (1.30 [1.07-1.58]) chronotype.

CONCLUSION

The data obtained indicated that the afternoon school shift is not ideal, especially for female children and adolescents under 15 years old with an early and intermediate chronotype.

Meal-specific dietary patterns and biomarkers of insulin resistance in a sample of Iranian adults: a cross-sectional study

Current research emphasizes the habitual dietary pattern without differentiating eating occasions. We aimed to assess meal-specific dietary patterns and insulin resistance indicators. This cross-sectional study was conducted on 825 Iranian adults. Dietary data were recorded by three 24-h dietary recalls. Dietary patterns were identified using principal component analysis (PCA) on main meals and an afternoon snack. Anthropometric measurements, blood pressure, and laboratory investigation, fasting plasma glucose (FPG), triglyceride, insulin, c-reactive protein (CRP) were done. Homeostatic model assessment for insulin resistance and sensitivity (HOMA-IR and HOMA-IS), Triglycerides and glucose (TyG-index), and Lipid accommodation product index were calculated. We used multivariate analysis of variance (MANOVA) analysis. Two major dietary patterns at the main meals and the afternoon were identified. Higher adherence to "Bread, vegetable, and cheese" dietary pattern at breakfast was related to lower FPG, and "Oil, egg, and cereals" showed a direct association with body mass index, FPG, and TyG-index at breakfast. The "Western" pattern in lunch and dinner directly related to waist circumference (WC) and body mass index, however, it was inversely related to HOMA-IS. This pattern at dinner was related to higher CRP. Higher adherence to "bread, cereals, and oil" pattern at afternoon snack was associated with a lower WC. These results indicated that unhealthy meal-specific dietary patterns are associated with a greater chance of obesity and insulin resistance risk. However, "Bread, vegetable, and cheese" dietary pattern at breakfast was related to lower FPG, and "bread, cereals, and oil" pattern in the afternoon was associated with lower WC.

Association between Late-Eating Pattern and Higher Consumption of Ultra-Processed Food among Italian Adults: Findings from the INHES Study

Late eating is reportedly associated with adverse metabolic health, possibly through poor diet quality. We tested the hypothesis that meal timing could also be linked to food processing, an independent predictor of health outcomes. We analysed data on 8688 Italians (aged > 19years) from the Italian Nutrition & HEalth Survey (INHES) established in 2010-2013 throughout Italy. Dietary data were collected through a single 24 h dietary recall, and the NOVA classification was used to categorize foods according to increasing levels of processing: (1) minimally processed foods (e.g., fruits); (2) culinary ingredients (e.g., butter); (3) processed foods (e.g., canned fish); (4) ultra-processed foods (UPFs; e.g., carbonated drinks, processed meat). We then calculated the proportion (%) of each NOVA group on the total weight of food eaten (g/d) by creating a weight ratio. Subjects were classified as early or late eaters based on the population's median timing for breakfast, lunch and dinner. In multivariable-adjusted regression models, late eaters reported a lower intake of minimally processed food (β = -1.23; 95% CI -1.75 to -0.71), a higher intake of UPF (β = 0.93; 0.60 to 1.25) and reduced adherence to a Mediterranean Diet (β = -0.07; -0.12 to -0.03) as compared to early eaters. Future studies are warranted to examine whether increased UPF consumption may underpin the associations of late eating with adverse metabolic health reported in prior cohorts.

Sleep variability and regularity as contributors to obesity and cardiometabolic health in adolescence

OBJECTIVE

Adolescence is a developmental stage of critical changes in sleep and its circadian timing when the contribution of abnormal sleep variability (amount) and sleep regularity (timing) to obesity and its associated adverse cardiometabolic health outcomes appears to increase. The aim of this study was to summarize findings from studies conducted in adolescents examining both sleep variability and regularity in relation to obesity and cardiometabolic health. Gaps in research and potential causal pathways that future studies should examine are highlighted.

RESULTS

Nightly deviations in sleep duration and sleep midpoint appear to contribute to the development of obesity and associated adverse cardiometabolic outcomes in youth. Studies show that increased sleep variability and irregularity are associated with obesity, decreased physical activity, dysregulated eating and inadequate diet, metabolic dysfunction, impaired cardiac autonomic balance, and elevated blood pressure in adolescents.

CONCLUSIONS

A stable circadian timing of sleep is essential to the overall physical well-being of youth. Emerging evidence supports that sleep variability and circadian misalignment, including sleep irregularity, contribute to adverse obesity-related health outcomes early on in adolescence. Future studies should focus on the underlying behavioral and biological mechanisms in the causal pathway between day-to-day deviations in the amount and timing of sleep and obesity.

Research gaps and opportunities in precision nutrition: an NIH workshop report

Precision nutrition is an emerging concept that aims to develop nutrition recommendations tailored to different people's circumstances and biological characteristics. Responses to dietary change and the resulting health outcomes from consuming different diets may vary significantly between people based on interactions between their genetic backgrounds, physiology, microbiome, underlying health status, behaviors, social influences, and environmental exposures. On 11-12 January 2021, the National Institutes of Health convened a workshop entitled "Precision Nutrition: Research Gaps and Opportunities" to bring together experts to discuss the issues involved in better understanding and addressing precision nutrition. The workshop proceeded in 3 parts: part I covered many aspects of genetics and physiology that mediate the links between nutrient intake and health conditions such as cardiovascular disease, Alzheimer disease, and cancer; part II reviewed potential contributors to interindividual variability in dietary exposures and responses such as baseline nutritional status, circadian rhythm/sleep, environmental exposures, sensory properties of food, stress, inflammation, and the social determinants of health; part III presented the need for systems approaches, with new methods and technologies that can facilitate the study and implementation of precision nutrition, and workforce development needed to create a new generation of researchers. The workshop concluded that much research will be needed before more precise nutrition recommendations can be achieved. This includes better understanding and accounting for variables such as age, sex, ethnicity, medical history, genetics, and social and environmental factors. The advent of new methods and technologies and the availability of considerably more data bring tremendous opportunity. However, the field must proceed with appropriate levels of caution and make sure the factors listed above are all considered, and systems approaches and methods are incorporated. It will be important to develop and train an expanded workforce with the goal of reducing health disparities and improving precision nutritional advice for all Americans.

Sex differences in the association between dinner-bedtime interval and abdominal obesity: a large-scale cross-sectional study

PURPOSE

Dinner-bedtime interval was reported to be associated with general obesity. However, the association between dinner-bedtime interval and abdominal obesity is still unclear. This study was conducted to investigate the association of dinner-bedtime interval and abdominal obesity.

METHODS

A total of 7600 participants from Henan rural cohort study were included in this study. A standard questionnaire was used to obtain the time of dinner and sleep by the way of face-to-face interview. Sleep quality of each participant was evaluated by Pittsburgh Sleep Quality Index. Logistic regression and restricted cubic spline were used to assess the association between dinner-bedtime interval and abdominal obesity. Line regression was used to estimate the association between dinner-bedtime interval and lipid metabolism indexes. The mediation effect of sleep quality on the relationship between dinner-bedtime interval and abdominal obesity was evaluated.

RESULTS

In male, increased dinner-bedtime interval was associated with abdominal obesity risk (Adjusted OR: 1.084, 95% CI 1.009-1.164). Compared with participants with dinner-bedtime interval ≤ 2 h, those dinner-bedtime interval > 2 h had an elevated risk of abdominal obesity (Adjusted OR: 1.199, 95% CI 1.009-1.425). In addition, a positive linear dose-response relationship was detected between dinner-bedtime interval and abdominal obesity. Moreover, total cholesterol concentration increased by 0.047 mmol/L for each 1-h increase in dinner-bedtime interval (P = 0.019). In addition, sleep quality mediated 11.45% of the relationship between dinner-bedtime interval and abdominal obesity (adjusted mediation effect: - 0.010, 95% CI - 0.019 to - 0.003). But in female, these associations were not significant.

CONCLUSION

It is suggested that increased dinner-bedtime interval was related to a higher risk of abdominal obesity in rural China and this association was differed by sex.

LEVEL OF EVIDENCE

Level V: cross-sectional descriptive study.

The Role of Nutrition on Meta-inflammation: Insights and Potential Targets in Communicable and Chronic Disease Management

PURPOSE OF REVIEW

Chronic low-grade inflammation may contribute to the onset and progression of communicable and chronic diseases. This review examined the effects and eventual mediation roles of different nutritional factors on inflammation.

RECENT FINDINGS

Potential nutritional compounds influencing inflammation processes include macro and micronutrients, bioactive molecules (polyphenols), specific food components, and culinary ingredients as well as standardized dietary patterns, eating habits, and chrononutrition features. Therefore, research in this field is still required, taking into account critical aspects of heterogeneity including type of population, minimum and maximum intakes and adverse effects, cooking methods, physiopathological status, and times of intervention. Moreover, the integrative analysis of traditional variables (age, sex, metabolic profile, clinical history, body phenotype, habitual dietary intake, physical activity levels, and lifestyle) together with individualized issues (genetic background, epigenetic signatures, microbiota composition, gene expression profiles, and metabolomic fingerprints) may contribute to the knowledge and prescription of more personalized treatments aimed to improving the precision medical management of inflammation as well as the design of anti-inflammatory diets in chronic and communicable diseases.

Chrononutrition-When We Eat Is of the Essence in Tackling Obesity

Obesity is a chronic and relapsing public health problem with an extensive list of associated comorbidities. The worldwide prevalence of obesity has nearly tripled over the last five decades and continues to pose a serious threat to wider society and the wellbeing of future generations. The pathogenesis of obesity is complex but diet plays a key role in the onset and progression of the disease. The human diet has changed drastically across the globe, with an estimate that approximately 72% of the calories consumed today come from foods that were not part of our ancestral diets and are not compatible with our metabolism. Additionally, multiple nutrient-independent factors, e.g., cost, accessibility, behaviours, culture, education, work commitments, knowledge and societal set-up, influence our food choices and eating patterns. Much research has been focused on 'what to eat' or 'how much to eat' to reduce the obesity burden, but increasingly evidence indicates that 'when to eat' is fundamental to human metabolism. Aligning feeding patterns to the 24-h circadian clock that regulates a wide range of physiological and behavioural processes has multiple health-promoting effects with anti-obesity being a major part. This article explores the current understanding of the interactions between the body clocks, bioactive dietary components and the less appreciated role of meal timings in energy homeostasis and obesity.

Extended Inter-Meal Interval Negatively Impacted the Glycemic and Insulinemic Responses after Both Lunch and Dinner in Healthy Subjects

This study aimed to investigate the glycemic and insulinemic effects of lunch timing based on a fixed feeding window, and the effects of apple preload on postprandial glucose and insulin responses after nutrient-balanced lunch and the subsequent high-fat dinner in healthy participants. Twenty-six participants completed four randomized, crossover experimental trials: (1) early standardized lunch at 12:00 (12S); (2) apple preload to 12S (12A+S); (3) late standardized lunch at 14:00 (14S); and (4) apple preload to 14S (14A+S); wherein twenty participants’ blood samples were collected for insulin analysis following the lunch trails. In each experimental trial, each participant equipped with a continuous glucose monitor (CGM) was provided with a standardized breakfast and a high-fat dinner to be consumed at 8:00 and 18:00, respectively. The late lunch (14S) resulted in significantly elevated glucose peak, delayed insulin peak time, decreased insulin sensitivity, and increased insulin resistance following the lunch; also decreased glycemic response following the subsequent dinner and larger blood glucose fluctuation over the 24-h period compared with the 12S. The 14A+S significantly reduced the glucose peak, the insulin peak time and the glycemic variability following the lunch, also the 24-h glycemic variability compared with the 14S. The insulin sensitivity was significantly improved in the 12A+S, compared with that of the 12S. In conclusion, the present study found that an extra 2-h inter-meal fasting before and after lunch resulted in elevated glycemic response in both macronutrient-balanced meal and high-fat meal in healthy subjects. The negative impact of a late lunch could be partly reversed by the apple preload, without a trade-off of insulin secretion.

A Preliminary Study on Acute Otitis Media in Spanish Children with Late Dinner Habits

The timing of caloric intake plays an important role in the long-term process that leads to communicable diseases. The primary objective of this study was to analyse whether children who ate dinner early were at lower risks of acute respiratory infections than children who ate dinner late during the COVID-19 pandemic.

METHODS

This cross-sectional study was conducted from July to December 2020 on children attending Majorcan emergency services. Our survey on dinner time habits was carried out by using self-administered questionnaires.

RESULTS

A total of 669 children were included in this study. The median dinner time was 8:30 pm. Late dinner eaters accounted for a higher proportion of acute otitis media (7% vs. 3%; p = 0.028) than early dinner eaters. Other infectious diseases were not associated with dinner time habits.

CONCLUSIONS

We make a preliminary estimate of the link between late dinner habits and acute otitis media in children. However, no conclusions about causality can be established due to the observational design of the study, and further research is needed in order to confirm the different issues raised by our initial exploration of an emerging research area.

Skipping breakfast and excess weight among young people: the moderator role of moderate-to-vigorous physical activity

The present study aimed to test whether the daily minutes of moderate-to-vigorous physical activity (MVPA) engaged moderate the relationship between breakfast status and excess weight (i.e., overweight and/or obesity) in a Spanish sample of young people. A cross-sectional study involving a total sample of 2890 Spanish schoolchildren (46% girls) aged 6-17 years (M = 12.3 ± 2.6) was conducted. To determine the habit of having breakfast, a dichotomous item about breakfast status (yes/no) from the Mediterranean Diet Quality Index for children and teenagers (KIDMED) was used. Physical Activity Questionnaire for Older Children and the Physical Activity Questionnaire for Adolescents were fulfilled to offer an estimation of the minutes of MVPA that individuals had in the last seven days. Body mass index (BMI) was converted into z-scores and, therefore, excess weight status (i.e., overweight and/or obesity) was established according to World Health Organization criteria for sex and age. Skipping breakfast was positively related with BMI (z-score) and excess weight. Moderation analyses suggested that daily MVPA minutes moderated the association between skipping breakfast and BMI (boys: β =  - 0.175; girls: β =  - 0.073) or the excess weight (boys: OR = 1.10; CI 95%, 1.02 to 1.07; girls: OR = 1.14; CI 95%, 1.04 to 1.24), meaning that physical activity of sufficient intensity seems to reduce the effect of skipping breakfast on the body weight status of young people.

CONCLUSION

Our results indicate that promotion of having breakfast should be accompanied by daily MVPA, as young participants who have breakfast and with higher daily MVPA seem to be more likely to have no excess weight.

WHAT IS KNOWN

• Some of the well-studied factors associated with childhood obesity have been skipping breakfast and insufficient physical activity. • Some studies have pointed out the association between having breakfast and both body mass index and physical activity level, in isolation.

WHAT IS NEW

• Daily minutes of moderate-to-vigorous physical activity moderate the association between skipping breakfast and excess weight. • Breakfast promotion as a healthy eating habit should be accompanied by increases in moderate-to-vigorous physical activity, since participants who have breakfast and with higher moderate-to-vigorous physical activity seem to be more likely to have no excess weight.

The roles of sleep and executive function in adolescent nighttime eating

Nighttime eating has been associated with obesity, inflammation, and poor nutritional intake, yet correlates of this behavior are understudied in pediatric populations and among adolescents in particular. The current study examines modifiable factors related to nighttime eating, including sleep parameters and regulatory abilities-as well as the interplay between these constructs-in adolescents. A total of 223 adolescents (Mage = 15.32 years, 52.9 % female, 15.7 % classified as overweight, 21.1 % had obesity) wore ActiGraph devices to measure sleep and were instructed to complete three 24-h dietary recall measures over a two-week period. Participants also completed self-report measures of executive function. Greater variability in sleep duration was consistently associated with higher average calorie, sugar, and fat consumption after 8, 9, and 10 PM. The main effect of global executive function on all nighttime eating measures was nonsignificant, and executive function did not moderate relationships between sleep parameters and nighttime eating measures. Since adolescents' eating habits may set the stage for lifelong dietary practices, efforts to ensure consistent sleep duration may reduce risk for nighttime eating in this nutritionally vulnerable population.

Environmental light exposure and mealtime regularity: Implications for human health

Light exposure and mealtime act as cues to the human circadian rhythm, which subsequently regulates various physiological functions in the body. However, modernization alters lifestyles, with changes to social and work-related activities independent of the natural light-dark cycle. This review summarizes the role of light exposure and regular mealtime on bodily processes and, ultimately, metabolic health. Various aspects of light are reviewed, including the type of light (natural/artificial), intensity (lux), spectral composition, time of exposure (night/day), and exposure duration. Further, the possible relationship between light exposure and mealtime irregularity is discussed as a function affecting metabolic health. In essence, research evidence suggests that mealtime regularity and light exposure habits based on the natural occurring light-dark cycle are essential for metabolic health in relation to an aligned circadian rhythm.

The Role of Diet and Gut Microbiota in Regulating Gastrointestinal and Inflammatory Disease

Diet is an important lifestyle factor that is known to contribute in the development of human disease. It is well established that poor diet plays an active role in exacerbating metabolic diseases, such as obesity, diabetes and hypertension. Our understanding of how the immune system drives chronic inflammation and disease pathogenesis has evolved in recent years. However, the contribution of dietary factors to inflammatory conditions such as inflammatory bowel disease, multiple sclerosis and arthritis remain poorly defined. A western diet has been associated as pro-inflammatory, in contrast to traditional dietary patterns that are associated as being anti-inflammatory. This may be due to direct effects of nutrients on immune cell function. Diet may also affect the composition and function of gut microbiota, which consequently affects immunity. In animal models of inflammatory disease, diet may modulate inflammation in the gastrointestinal tract and in other peripheral sites. Despite limitations of animal models, there is now emerging evidence to show that anti-inflammatory effects of diet may translate to human gastrointestinal and inflammatory diseases. However, appropriately designed, larger clinical studies must be conducted to confirm the therapeutic benefit of dietary therapy.

The Role of Morning Plasma Cortisol in Obesity: A Bidirectional Mendelian Randomization Study

CONTEXT

Cortisol, an important hormone regulated by the hypothalamic-pituitary-adrenal axis, is associated with obesity. However, it is unclear whether the relationship between cortisol and obesity is causal or could be explained by reverse causality.

OBJECTIVE

This work aims to assess the role of morning plasma cortisol in clinical classes of obesity.

METHODS

In this bidirectional, 2-sample mendelian randomization (MR) study, cortisol-associated genetic variants were obtained from the CORtisol NETwork consortium (n = 12 597). The primary outcomes were obesity class I (body mass index [BMI] ≥ 30), class II (BMI ≥ 35), and class III (BMI ≥ 40). The inverse variance weighting method was used as the main analysis, with weighted median, MR-Egger, and MR pleiotropy residual sum and outlier (MR-PRESSO) as sensitivity analyses. Conversely, genetic variants predicting clinical classes of obesity were applied to the cortisol genome-wide association study.

RESULTS

Genetically predicted cortisol was associated with reduced risk of obesity class I (OR = 0.905; 95% CI, 0.865-0.946; P < .001). Evidence from bidirectional MR showed that obesity class II and class III were associated with lower cortisol levels ([class II-cortisol OR = 0.953; 95% CI, 0.923-0.983; P = .002]; [class III-cortisol OR = 0.955; 95% CI, 0.942-0.967; P < .001]), indicating reverse causality between cortisol and obesity.

CONCLUSION

This study demonstrates that cortisol is negatively associated with obesity and vice versa. Together, these findings suggest that blunted morning plasma cortisol secretion may be responsible for severe obesity. Regulating morning plasma cortisol secretion might be a prevention measure for obese people.

The Eating Healthy and Daily Life Activities (EHDLA) Study

BACKGROUND

Childhood obesity is one of the greatest public health concerns facing advanced societies, Spain being one of the countries with the highest incidence. In this sense, the Region of Murcia has been pointed out as the Spanish autonomous community with the highest prevalence of excess weight among young people. More specifically, the Valle de Ricote has shown an even greater proportion of excess weight among young people. Several sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors are related to excess weight. Based on the lack of information, this research project will try to provide relevant information to design intervention programs, as well as to implement effective public policies to try and reverse this alarming situation. Therefore, this research project aims (1) to obtain cross-sectional and longitudinal data on the excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among adolescents from the Valle de Ricote (Region of Murcia, Spain) (aged 12-17 years), and (2) to examine the association between excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among this population.

METHODS

A cross-sectional study and follow-up study will be performed. This research project will involve adolescents using a simple random sampling technique. A total of three secondary schools from the Valle de Ricote (Region of Murcia, Spain) will be included in this project. The minimum sample size will be 1138, establishing a 95% confidence interval, a 40% prevalence of excess weight, a 3% margin of error, and a non-response rate of 10%. Primary outcome measures will be: (1) anthropometric measurements, (2) sociodemographic factors, (3) environmental factors, (4) lifestyle factors, (5) health-related factors, (6) cognitive factors, and (7) psychological factors.

CONCLUSION

This research project will aim to determine the prevalence of excess weight and interrelate their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated. The obtained results will help to manage and propose possible multidisciplinary interventions and strategies in order to prevent and reduce the excess weight in adolescents from the Valle de Ricote. Furthermore, orientations will be given to transfer the obtained results to the public sector to evaluate or change the adopted policies.

Multi-Modal Regulation of Circadian Physiology by Interactive Features of Biological Clocks

The circadian clock is a fundamental biological timing mechanism that generates nearly 24 h rhythms of physiology and behaviors, including sleep/wake cycles, hormone secretion, and metabolism. Evolutionarily, the endogenous clock is thought to confer living organisms, including humans, with survival benefits by adapting internal rhythms to the day and night cycles of the local environment. Mirroring the evolutionary fitness bestowed by the circadian clock, daily mismatches between the internal body clock and environmental cycles, such as irregular work (e.g., night shift work) and life schedules (e.g., jet lag, mistimed eating), have been recognized to increase the risk of cardiac, metabolic, and neurological diseases. Moreover, increasing numbers of studies with cellular and animal models have detected the presence of functional circadian oscillators at multiple levels, ranging from individual neurons and fibroblasts to brain and peripheral organs. These oscillators are tightly coupled to timely modulate cellular and bodily responses to physiological and metabolic cues. In this review, we will discuss the roles of central and peripheral clocks in physiology and diseases, highlighting the dynamic regulatory interactions between circadian timing systems and multiple metabolic factors.

Effects of late-night eating of easily-or slowly-digestible meals on sleep, hypothalamo-pituitary-adrenal axis, and autonomic nervous system in healthy young males

Aim of the current study was to assess the effects of the digestibility of late-night high calorie meal on sleep and the activities of the hypothalamo-pituitary-adrenal (HPA) and autonomous nervous system (ANS) in healthy young males. For that purpose, effects of an easily digestible meal (starch + sugar-rich meal, SSR, i.e., dessert) or a slowly digestible meal (protein + fat-rich, PFR, i.e. kebab) were investigated in a crossover design in 16 participants (20-26 year old). They did not eat anything after 07:00 PM on Day 0; had an SSR meal on Day 1 and a PFR meal on Day 2 at 10:00 PM. HPA and ANS activities were measured by cortisol awakening response (CAR) and heart rate variability (HRV), respectively. The participants provided salivary samples for CAR; had a 5-min continuous electrocardiogram recording for HRV; and filled in sleep questionnaires. Late-night eating of SSR and PFR diets increased the area under the curve of CAR (p < 0.05) but did not affect HRV parameters (p > 0.05). PFR meal significantly disturbed sleep (p < 0.05). The data suggests that increased activity of HPA, but not ANS, might be involved in pathophysiology of late-night eating and that this might be due to disturbed sleep if slowly-digestible meal is consumed.

Diet-Related Phototoxic Reactions in Psoriatic Patients Undergoing Phototherapy: Results from a Multicenter Prospective Study

Vegans and vegetarians often consume foods containing photosensitizers capable of triggering phytophotodermatitis. The potential effect of vegan and vegetarian diets on the response of psoriatic patients undergoing phototherapy is not well characterized. We assessed clinical outcomes of vegan, vegetarian and omnivore adult psoriatic patients undergoing band ultraviolet B phototherapy (NB-UVB). In this multicenter prospective observational study, we enrolled 119 adult, psoriatic patients, of whom 40 were omnivores, 41 were vegetarians and 38 were vegans, with phototherapy indication. After determining the minimum erythemal dose (MED), we performed NB-UVB sessions for 8 weeks. The first irradiation dosage was 70.00% of the MED, then increased by 20.00% (no erythema) or by 10.00% (presence of erythema) until a maximum single dose of 3 J/cm² was reached and constantly maintained. All the enrolled patients completed the 8 weeks of therapy. Severe erythema was present in 16 (42.11%) vegans, 7 (17.07%) vegetarians and 4 (10.00%) omnivores (p < 0.01). MED was lowest among vegans (21.18 ± 4.85 J/m²), followed by vegetarians (28.90 ± 6.66 J/m²) and omnivores (33.63 ± 4.53 J/m², p < 0.01). Patients with severe erythema were more likely to have a high furocumarin intake (OR 5.67, 95% CI 3.74-8.61, p < 0.01). Vegans consumed the highest amount of furocumarin-rich foods. A model examining erythema, adjusted for gender, age, skin type, MED, phototherapy type, number of phototherapies and furocumarin intake, confirmed that vegans had a lower number of treatments. Vegans had more frequent severe erythema from NB-UVB, even after adjustment of the phototherapy protocol for their lower MED. Assessing diet information and adapting the protocol for vegan patients may be prudent.

Carbohydrate intake and circadian synchronicity in the regulation of glucose homeostasis

PURPOSE OF REVIEW

Glucose metabolism is under circadian regulation, with insulin secretion and sensitivity being highest in the morning as compared to the evening. The present review will discuss the existing evidence for the role of meal and macronutrient timing to improve glucose metabolism and reset circadian clocks, with a focus on the evidence in humans.

RECENT FINDINGS

Shortening the daily eating window (also known as time-restricted eating), or skewing food intake towards breakfast and away from the evening meal both improve glucose control in people with impaired glucose metabolism. Insulin is recently purported to be a zeitgeber and thus an important reset signal for peripheral circadian clocks in vitro and in mice. Although few studies have tested the impact of macronutrient timing in humans, eating a greater proportion of carbohydrates earlier, rather than later, in the day is associated with better glucose control.

SUMMARY

The impact of carbohydrate intake timing on endogenous central and peripheral clocks, and its potential to optimize circadian regulation and improve glycaemic control, are not well understood but are currently under intense exploration.

Circulating inflammatory markers may mediate the relationship between low carbohydrate diet and circadian rhythm in overweight and obese women

Background

Low carbohydrate diet (LCD) can improve inflammation and obesity and also circadian rhythm disorders can lead to increased inflammation in obese individuals. The purpose of this study is to evaluate the association between adherence of LCD and circadian rhythm mediated by inflammatory markers including transforming growth factor-β (TGF-β), interleukin-1β (IL-1β) and Galectin-3 in overweight and obese women.

Methods

304 women affected by overweight and obesity were enrolled. We evaluated LCD scores by Semi-quantitative food frequency questionnaire (FFQ) of 147 items. The morning-evening questionnaire (MEQ) was applied to evaluate the circadian rhythm. Biochemical parameters such as inflammatory markers and anthropometric components were assessed.

Results

There was a negative significant correlation between adherence of LCD and circadian rhythm status. In other words, as the LCD scores increased, the odds of circadian rhythm disturbance in intermediate group and morning type persons decreased compared to evening type. It was showed that, IL-1β and Galectin-3 in intermediate and morning type groups, destroyed the significance of this relationship and may be considered as mediating markers.

Conclusion

Adherence of LCD can improve the circadian rhythm by reducing levels of inflammatory markers and may be considered as a treatment for obesity.

Time Restricted Eating: A Dietary Strategy to Prevent and Treat Metabolic Disturbances

Time-restricted eating (TRE), a dietary approach limiting the daily eating window, has attracted increasing attention in media and research. The eating behavior in our modern society is often characterized by prolonged and erratic daily eating patterns, which might be associated with increased risk of obesity, diabetes, and cardiovascular diseases. In contrast, recent evidence suggests that TRE might support weight loss, improve cardiometabolic health, and overall wellbeing, but the data are controversial. The present work reviews how TRE affects glucose and lipid metabolism based on clinical trials published until June 2021. A range of trials demonstrated that TRE intervention lowered fasting and postprandial glucose levels in response to a standard meal or oral glucose tolerance test, as well as mean 24-h glucose and glycemic excursions assessed using continuous glucose monitoring. In addition, fasting insulin decreases and improvement of insulin sensitivity were demonstrated. These changes were often accompanied by the decrease of blood triglyceride and cholesterol levels. However, a number of studies found that TRE had either adverse or no effects on glycemic and lipid traits, which might be explained by the different study designs (i.e., fasting/eating duration, daytime of eating, changes of calorie intake, duration of intervention) and study subject cohorts (metabolic status, age, gender, chronotype, etc.). To summarize, TRE represents an attractive and easy-to-adapt dietary strategy for the prevention and therapy of glucose and lipid metabolic disturbances. However, carefully controlled future TRE studies are needed to confirm these effects to understand the underlying mechanisms and assess the applicability of personalized interventions.