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Raji OE, Kyeremah EB, Sears DD, St-Onge MP, Makarem N. Chrononutrition and Cardiometabolic Health: An Overview of Epidemiological Evidence and Key Future Research Directions. Nutrients 2024; 16:2332. [PMID: 39064774 PMCID: PMC11280377 DOI: 10.3390/nu16142332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Chrononutrition is a rapidly evolving field of nutritional epidemiology that addresses the complex relationship between temporal eating patterns, circadian rhythms, and metabolic health, but most prior research has focused on the cardiometabolic consequences of time-restricted feeding and intermittent fasting. The purpose of this topical review is to summarize epidemiological evidence from observational and intervention studies regarding the role of chrononutrition metrics related to eating timing and regularity in cardiometabolic health preservation and cardiovascular disease prevention. Observational studies are limited due to the lack of time-stamped diet data in most population-based studies. Findings from cohort studies generally indicate that breakfast skipping or the later timing of the first eating occasion, a later lunch and dinner, and a greater proportion of caloric intake consumed in the evening are associated with adverse cardiometabolic outcomes, including higher risk for coronary heart disease, hypertension, type 2 diabetes, obesity, dyslipidemia, and systemic inflammation. Randomized controlled trials are also limited, as most in the field of chrononutrition focus on the cardiometabolic consequences of time-restricted feeding. Overall, interventions that shift eating timing patterns to earlier in the day and that restrict evening caloric intake tend to have protective effects on cardiometabolic health, but small sample sizes and short follow-up are notable limitations. Innovation in dietary assessment approaches, to develop low-cost validated tools with acceptable participant burden that reliably capture chrononutrition metrics, is needed for advancing observational evidence. Culturally responsive pragmatic intervention studies with sufficiently large and representative samples are needed to understand the impact of fixed and earlier eating timing schedules on cardiometabolic health. Additional research is warranted to understand the modifiable determinants of temporal eating patterns, to investigate the role of chrononutrition in the context of other dimensions of diet (quantity, quality, and food and nutrition security) in achieving cardiometabolic health equity, and to elucidate underlying physiological mechanisms.
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Affiliation(s)
- Oluwatimilehin E. Raji
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA; (O.E.R.); (E.B.K.)
| | - Esther B. Kyeremah
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA; (O.E.R.); (E.B.K.)
| | - Dorothy D. Sears
- College of Health Solutions, Arizona State University, Tempe, AZ 85287, USA;
- Department of Medicine, University of California San Diego School of Medicine, La Jolla, CA 92093, USA
- Department of Family Medicine, University of California San Diego School of Medicine, La Jolla, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA
| | - Marie-Pierre St-Onge
- Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA;
- Sleep Center of Excellence, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA; (O.E.R.); (E.B.K.)
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Phoi YY, Bonham MP, Rogers M, Dorrian J, Coates AM. Construct validity and test-retest reliability of a chrononutrition questionnaire for shift work and non-shift work populations. Chronobiol Int 2024; 41:669-683. [PMID: 38666461 DOI: 10.1080/07420528.2024.2342937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/09/2024] [Indexed: 05/22/2024]
Abstract
The irregular eating patterns of both shift workers and evening chronotypes adversely affect cardiometabolic health. A tool that conveniently captures temporal patterns of eating alongside an indicator of circadian rhythm such as chronotype will enable researchers to explore relationships with diverse health outcome measures. We aimed to investigate the test-retest reliability and convergent validity of a Chrononutrition Questionnaire (CNQ) that captures temporal patterns of eating and chronotype in the general population (non-shift workers, university students, retirees, unemployed individuals) and shift work population. Participants attended two face-to-face/virtual sessions and completed the CNQ and food/sleep/work diaries. Outcomes included subjective chronotype, wake/sleep/mid-sleep time, sleep duration, meal/snack regularity, meal/snack/total frequency, times of first/last/largest eating occasions (EO), main meal (MM) 1/2/3, and duration of eating window (DEW). 116 participants enrolled (44.5 ± 16.5 years, BMI: 27.3 ± 5.8 kg/m2, 73% female, 52% general population); 105 completed the study. Reliability was acceptable for chronotype, sleep, and all temporal eating patterns except on night shifts. Convergent validity was good for chronotype and sleep except for certain shift/shift-free days. Generally, meal/snack regularity and frequency, and times of first/last EO showed good validity for the general population but not shift workers. Validity was good for DEW (except work-free days and afternoon shifts) and times of MM 1/2/3 (except afternoon and night shifts), while time of largest EO had poor validity. The CNQ has good test-retest reliability and acceptable convergent validity for the general and shift work population, although it will benefit from further validation, especially regarding regularity, frequency, and times of first and last eating occasions across more days amongst a larger sample size of shift workers. Use of the CNQ by researchers will expand our current understanding of chrononutrition as relationships between timing of food intake and the multitude of health outcomes are examined.
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Affiliation(s)
- Yan Yin Phoi
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, University of South Australia, Adelaide, Australia
| | - Maxine P Bonham
- Nutrition, Dietetics & Food, Be Active Sleep Eat (BASE) Facility, Monash University, Melbourne, Australia
| | - Michelle Rogers
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, University of South Australia, Adelaide, Australia
| | - Jillian Dorrian
- Justice and Society, Behaviour-Brain-Body Research Centre, University of South Australia, Adelaide, Australia
| | - Alison M Coates
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, University of South Australia, Adelaide, Australia
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Santos-Cebrián M, Morales-Moya MÁ, De-Pablos-Heredero C, Pacheco-Olivares MDR. How Much Dialogic Coordination Practices Matter to Healthcare Professionals-A Delphi Approach towards a Tool for Identification and Measurement. Healthcare (Basel) 2023; 11:2961. [PMID: 37998453 PMCID: PMC10671251 DOI: 10.3390/healthcare11222961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
The study of coordination practices in health policy is a central aspect. The need for further research has been recently highlighted because of COVID-19. In this sense, dialogic practices (DP) have been identified but not validated yet. The purpose of this study is to develop and validate a DP questionnaire for healthcare teams. Items were identified based on a literature review, and the content validation was carried out by means of a Delphi study. A total of 10 experts assessed the clarity and appropriateness of the items and their corresponding measurement scales. After two rounds, a high level of consensus was reached, with agreement of 90% or higher on all items, and a high degree of stability and concordance in the results. This study resulted in a questionnaire consisting of four items, one for each identified DP initially proposed to the experts, as no other practices were revealed. From a practical perspective, the validation of these items constitutes a methodological innovation that responds to the call in the literature to open new avenues for comparative studies, and the possibility of generalising the findings and bringing together different approaches to the problem of coordination, which is key in health policy where unforeseen situations emerge.
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Affiliation(s)
- Mónica Santos-Cebrián
- Financial Economy and Accounting Department, Rey Juan Carlos University, 28032 Madrid, Spain; (M.S.-C.);
| | - Miguel-Ángel Morales-Moya
- Financial Economy and Accounting Department, Rey Juan Carlos University, 28032 Madrid, Spain; (M.S.-C.);
| | - Carmen De-Pablos-Heredero
- Department of Business Economics (Administration, Management, and Organization), Applied Economics II and Fundamentals of Economic Analysis, Rey Juan Carlos University, 28032 Madrid, Spain;
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Chong GY, Kaur S, Abd. Talib R, Loy SL, Siah WY, Tan HY, Harjit Singh SS, Binti Abdullah R, Binti Mahmud H, Lee YH, Koo HC. Translation, validation, and reliability of the Malay version chrononutrition profile-questionnaire (CPQ-M) in Malaysian adult populations. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2105536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Guey Yong Chong
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - Satvinder Kaur
- Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Ruzita Abd. Talib
- Nutritional Sciences Program, Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - See Ling Loy
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Woan Yie Siah
- Community Clinic Batu Berendam, Malacca Central District Health Office, Malacca, Malaysia
| | - Hui Yin Tan
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | | | - Rosmiza Binti Abdullah
- Community Clinic Batu Berendam, Malacca Central District Health Office, Malacca, Malaysia
| | - Hanisah Binti Mahmud
- Community Clinic Batu Berendam, Malacca Central District Health Office, Malacca, Malaysia
| | | | - Hui Chin Koo
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
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Gioia SC, Guirette M, Chen A, Tucker C, Gray BE, Vetter C, Garaulet M, Scheer FAJL, Saxena R, Dashti HS. How Accurately Can We Recall the Timing of Food Intake? A Comparison of Food Times from Recall-Based Survey Questions and Daily Food Records. Curr Dev Nutr 2022; 6:nzac002. [PMID: 35198846 PMCID: PMC8856939 DOI: 10.1093/cdn/nzac002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/07/2021] [Accepted: 01/06/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There currently are no standard, low-cost, and validated methods to assess the timing of food intake. OBJECTIVES The aim of this study was to validate simple, recall-based questions that can characterize food timing in free-living populations. METHODS The concordance between recall-based survey questions and food times estimated from multiple daily food records was assessed in 249 generally healthy, free-living adults from the Shift Work, Heredity, Insulin, and Food Timing (SHIFT) Study. At baseline, participants were asked: "At what time do you first start and stop eating on weekdays/workdays and weekends/non-workdays?" and "At what time do you have your main meal on weekdays/workdays and weekends/non-workdays?" Participants were then asked to complete ≤14 d of food records noting the start time of each eating occasion. The timing of the first, last, and main (largest percentage calories) eating occasions were determined from food records. Wilcoxon matched pairs signed rank and Kendall's coefficient of concordance were used to compare differences and determine agreements between the methods for these food timing parameters, as well as for the midpoint between first and last eating occasion. RESULTS Eating occasions on work and free days showed significant agreements between the 2 methods, except for the main eating occasion on free days. Significant agreements were generally modest and ranged from 0.16 (workdays main eating occasion) to 0.45 (workdays first eating occasion). Generally, times based on recall were later than those estimated from food records, and the differences in estimated times were smaller on workdays compared with free days, and smaller for the first compared with the last eating occasion. Main eating occasions from food records often varied between lunch and dinner times, contributing to low concordance with recalled times. CONCLUSIONS Modest agreements were found between food times derived from simple, recall-based survey questions and food times estimated from multiple-day food records. Single administration of these questions can effectively characterize the overall timing of eating occasions within a population for chrononutrition research purposes.
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Affiliation(s)
- Siena C Gioia
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Mélanie Guirette
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Friedman School of Nutrition Science and Policy at Tufts, Tufts University, Boston, MA, USA
| | - Angela Chen
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Chandler Tucker
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Brianna E Gray
- Translational and Clinical Research Centers, Massachusetts General Hospital, Boston, MA, USA
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA
- Broad Institute, Cambridge, MA, USA
| | - Marta Garaulet
- Department of Physiology, University of Murcia, Murcia, Spain
- IMIB-Arrixaca, Murcia, Spain
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Frank A J L Scheer
- Broad Institute, Cambridge, MA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute, Cambridge, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Hassan S Dashti
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute, Cambridge, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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A Time to Rest, a Time to Dine: Sleep, Time-Restricted Eating, and Cardiometabolic Health. Nutrients 2022; 14:nu14030420. [PMID: 35276787 PMCID: PMC8840563 DOI: 10.3390/nu14030420] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/14/2022] [Accepted: 01/16/2022] [Indexed: 02/01/2023] Open
Abstract
Cardiovascular disease (CVD) poses a serious health and economic burden worldwide. Modifiable lifestyle factors are a focus of research into reducing the burden of CVD, with diet as one of the most investigated factors. Specifically, the timing and regularity of food intake is an emerging research area, with approaches such as time-restricted eating (TRE) receiving much attention. TRE involves shortening the time available to eat across the day and is associated with improved CVD outcomes compared with longer eating windows. However, studies that have examined TRE have not considered the impact of sleep on CVD outcomes despite recent evidence showing that sleep duration can influence the timing and amount of food eaten. In this article, we argue that as TRE and sleep influence each other, and influence the same cardiometabolic parameters, experiencing inadequate sleep may attenuate any positive impact TRE has on CVD. We examine the relationship between TRE and CVD, with sleep as a potential mediator in this relationship, and propose a research agenda to investigate this relationship. This will provide necessary evidence to inform future interventions aimed at reducing the burden of CVD.
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