Association between sleep duration and quality with food intake, chrononutrition patterns, and weight gain during pregnancy

To analyse the association between sleep duration and quality with food intake, chrononutrition patterns, and weight gain during pregnancy. A prospective cohort study was conducted with 100 pregnant women. Data collection occurred once during each gestational trimester. The assessment of sleep quality and duration was performed using the Pittsburgh Sleep Quality Index. Food intake was assessed using three 24-h recalls in each trimester. Body weight was measured during the three trimesters, and height was measured only once to calculate the BMI. Linear regression analyses were performed to associate sleep duration and quality with food consumption and weight gain variables. Longer sleep duration was associated with a later dinner in the first trimester (β = 0·228, P = 0·025) and earlier in the third trimester (β = -0·223, P = 0·026), in addition to a later morning snack in the second trimester (β = 0·315, P = 0·026). Worse sleep quality was associated with higher total energy intake (β = 0·243, P = 0·044), total fat (β = 0·291, P = 0·015) and the chrononutrition variables such as a higher number of meals (β = 0·252, P = 0·037), higher energetic midpoint (β = 0·243, P = 0·044) and shorter fasting time (β = -0·255, P = 0·034) in the third trimester. Sleep quality was also associated with a higher BMI in the first trimester of pregnancy (β = 0·420, P = < 0·001). Most of the associations found in the present study show that poor sleep is associated with higher energy and fat intake and higher BMI. Longer sleep duration was associated with a later dinner in early pregnancy and an earlier dinner in late pregnancy, as well as with a later morning snack in the second trimester of pregnancy.

Is the Caloric Midpoint Associated with Food Cravings and Food Intake in Pregnant Women?

Objective: The field of chrononutrition suggests that mealtime can influence food intake. Previous studies have linked the caloric midpoint - defined as the time at which 50% of the daily energy is consumed - with different aspects of food consumption. However, its relationship with food craving remains unexplored. This cross-sectional study aimed to investigate the association between caloric midpoint, food craving, and food consumption in pregnant women.Methods: The study comprised 233 pregnant women classified as early eaters (caloric midpoint ≤ 1:00pm) and late eaters (caloric midpoint >1:00pm). Food craving were assessed using Food Craving Trait and State Questionnaires. Energy and nutrient intake, as well as mealtimes, were assessed using a 24-h food recall.Results: No association between caloric midpoint and food craving was found. However, late eaters consumed more calories (2039.47 kcal vs 1843.44 kcal; p < 0.001), carbohydrates (255.06 g vs 211.12 g; p = 0.002), total fat (73.1 g vs 64.8 g; p = 0.003), monounsaturated fat (21.33 mg vs 18.59 mg; p = 0.002) and saturated fat (24.37 mg vs 22.21 mh; p = 0.01) and had higher consumption of calories and macronutrients in the first (calories: 275.63 vs 213.41, p = 0.007; carbohydrate: 170.42 vs 142.54, p = 0.01; total fat: 56.49 vs 50.17, p = 0.04) and second (calories: 213.21 vs 151.59, p = 0.04; carbohydrate: 130.44 vs 96.6, p = 0.04; protein: 15.17 vs 13.71, p = 0.03) afternoon snack, dinner (calories: 576.89 vs 412.4, p < 0.001; carbohydrate: 230.76 vs 169.45, p < 0.001; protein: 80.48 vs 68.9, p = 0.02; total fat: 212.77 vs 147.12, p < 0.001) and late-night snack (calories: 135.75 vs 68.3, p = 0.04; total fat: 13.23 vs 22.45, p = 0.04) than early eaters.Conclusion: Pregnant women who concentrate their meals at later times consumed more calories, macro and micronutrients throughout the day and in the night meals when compared to early eaters.

Is chronotype associated with dietary intake and weight gain during pregnancy? A prospective and longitudinal study

OBJECTIVES

The effects of chronotype on dietary intake and weight gain during pregnancy have not been addressed in the literature. The aim of this study was to analyze the effect of chronotype on eating patterns, energy, and macronutrient intake and distribution, as well as weight gain during pregnancy.

METHODS

This was a prospective cohort study carried out with 100 pregnant women in the first, second, and third gestational trimesters. Dietary intake was assessed by three 24-h dietary recalls in each trimester, totaling nine recalls. Energy and macronutrient intake and distribution were evaluated at meals throughout the day. Chronotype was derived from midsleep time on free days, and the scores obtained were categorized into tertiles. Recommendations from the Institute of Medicine were used to assess the adequacy of weight gain. Generalized estimating equation models were used to determine the effects of chronotype and gestational trimester on eating patterns, daily energy, macronutrient distribution, and weight gain.

RESULTS

Pregnant women with values for midsleep time on free days indicative of eveningness have breakfast later and also have higher energy and carbohydrate intake at dinner than "morning" women. Pregnant "morning" women showed better diet quality in terms of milk and dairy and saturated fat. Also, despite the tendency for all tertiles to gain excess weight during pregnancy, we found that pregnant women with a tendency to eveningness had worse adequacy of gestational weight gain in the third trimester than "morning" women (2.24 ± 0.25 versus 1.22 ± 0.14, P < 0.001).

CONCLUSION

Pregnant women with a tendency to eveningness consume breakfast later in the day and exhibit greater consumption of energy and carbohydrates in the evening, as well as a worse standard of gestational weight gain in the third trimester. Our results emphasize the importance of considering chrononutrition variables in prenatal nutritional guidelines to promote maternal and fetal health.

Circadian misalignment measured by social jetlag from early to late pregnancy and its association with nutritional status: a longitudinal study

A mismatch between circadian and social clocks leads to a circadian misalignment, which has been widely measured by social jetlag (SJL). There are several studies measuring SJL, but it has not been studied in pregnant women. Therefore, this study aimed to identify the occurrence of SJL throughout pregnancy and to verify whether there is an effect of pre-pregnancy body mass index (BMI) on SJL throughout pregnancy. The baseline of the present study was conducted with 205 1st trimester pregnant women of whom 100 were followed in their 2nd and 3rd trimester. SJL was calculated based on the absolute difference between mid-sleep time on workdays versus work-free days. The pre-pregnancy BMI and current BMI (kg/m²) were calculated. Linear regression and Generalised Estimating Equation (GEE) adjusted for confounders were used to determine the association between SJL and the gestational trimesters (time), and anthropometric variables. Most of the pregnant women (54.5%) presented SJL > 1 h in the first gestational trimester. We also found an isolated effect of the gestation trimester on the SJL mean. In this sense, pregnant women had a decrease in SJL from the second to the third trimester (1.33 ± 0.08 versus 1.12 ± 0.07, respectively; p = 0.012). GEE analyzes showed that pregnant women of a normal weight showed a decrease in SJL from the second to the third trimester (1.29 ± 0.11 and 0.93 ± 0.08, respectively, p = 0.032), but this was not found in the other groups of nutritional status (underweight, overweight and obesity). In addition, a positive association between SJL and pre-gestational BMI in the third trimester (β = 0.200, p = 0.046) was found. SJL is quite prevalent during the gestational period and excessive BMI both before and during pregnancy is associated with an increased risk of having SJL > 1 h in the third and second trimesters, respectively. In addition, pregnant women of normal weight—but not underweight or overweight—had decreased SJL from the second to the third trimester.

Oral Nutritional Supplementation Affects the Dietary Intake and Body Weight of Head and Neck Cancer Patients during (Chemo) Radiotherapy

Considering the symptoms of (chemo) radiotherapy and the reduction in food intake in head and neck cancer (HNC) patients, this study aimed to investigate the association between treatment time points and oral nutritional supplementation (ONS) on dietary intake to estimate the frequency of energy and nutrient inadequacy, and also to evaluate body weight changes (BWC). Dietary intake data of 65 patients were obtained from 24-h dietary recalls and prevalence of inadequacy was calculated before or at the beginning (T0), in the middle (T1), and at the end of treatment (T2). BWC were calculated as the weight difference considering the previous weight reported and/or measured. Energy and macronutrient intake decreased in T1 and then improved in T2 (p < 0.001 for both). Micronutrient intake increased during treatment due to ONS use, but still presented a high probability of inadequate intake. In particular, calcium, magnesium, and vitamin B6 showed almost 100% of probability of inadequacy for those who did not use ONS. Finally, overweight patients suffered a higher weight accumulated deficit with a delta of −15 kg compared to other BMI (body mass index) categories. Therefore, we strongly recommend initiating nutritional counseling in conjunction with prophylactic ONS prescription from diagnosis to adjust nutrient intake and minimize weight loss.

Higher energy intake at night effects daily energy distribution and contributes to excessive weight gain during pregnancy

OBJECTIVE

The aim of this study was to analyze the effect of nighttime energy intake on daily energy and macronutrient distribution and weight gain during pregnancy.

METHODS

This was a prospective cohort study carried out with 100 pregnant women and the data collection occurred once per trimester. A dietary intake was assessed by three 24-h dietary recalls in each trimester, totaling nine dietary recalls. The distribution of energy and macronutrient intake was evaluated at meals throughout the day in each trimester and overall pregnancy. Women were classified as having "lower" or "higher" nighttime intake (1900 to 0559) if consumption in this period were below or above the median of the population, respectively, for at least two trimesters. Recommendations from the Institute of Medicine were used to assess the adequacy of weight gain. Generalized estimating equation models were used to determine the effects of nighttime intake and gestational trimesters on daily energy distribution and weight gain.

RESULTS

In overall pregnancy, the higher group consumed a higher percentage of energy and macronutrients in the evening meals, and less energy, proteins, and lipids in morning meals when compared with the lower group. Also, women in the higher group had greater excessive weight gain in the third trimester compared with the lower group.

CONCLUSION

Pregnant women with a higher energy intake at night had a lower percentage of energy, protein, and lipid intake in morning meals and a higher percentage of energy and macronutrient intake in the evening meals during pregnancy. A worse standard of gestational weight gain in the third trimester was also observed in pregnant women with a higher energy intake at night.

CONSUMPTION OF MINIMALLY PROCESSED AND ULTRA-PROCESSED FOODS AMONG STUDENTS FROM PUBLIC AND PRIVATE SCHOOLS

Objective:

To compare and analyze the consumption of minimally processed and ultra-processed foods among students from public and private schools.

Methods:

Study conducted in Uberlândia, MG, with fifth-grade students from three private and six public schools, selected by stratified cluster sampling. We collected data on food consumption using the 24-hour recall. Foods were classified into four groups (G) according to extent and purpose of processing: fresh/minimally processed foods (G1) culinary ingredients (G2), processed foods (G3), and ultra-processed foods (G4). Total energy intake (kcal) of each group, amount of sugar (g), sodium (mg), and fiber (g) were quantified and compared according to administrative affiliation (private or public).

Results:

Percentage of total energy intake was: G1 - 52%; G2 - 12%; G3 - 5%; e G4 - 31%. Energy intake from G1 (53 vs. 47%), G2 (12 vs. 9%), and G3 (6.0 vs. 0.1%), and amount of sodium (3,293 vs. 2,724 mg) and fiber (23 vs. 18 g) were higher among students from public schools. Energy intake from G4 (36 vs. 28%) and amount of sugar (20 vs. 14%) were higher among students from private schools. The consumption of foods from G1 in the school environment was higher among students from public schools (40 vs. 9%).

Conclusions:

Foods from G1 represent the highest percentage of total energy intake, while those from G4 constitute a third of calories consumed. Processed juice, sandwich cookie, processed cake, and breakfast cereals are more frequent among private school students; snacks and juice powder are more common for students from public schools.

Does sleep influence weight gain during pregnancy? A prospective study

Objective

The focus of this study was to evaluate the associations between subjective sleep quality and duration and weight gain during pregnancy.

Methods

A prospective and longitudinal study was conducted with 63 pregnant women. Pregnant women were evaluated at the first, second and third trimester for subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and anthropometric variables for body mass index [BMI] calculation. The sleep quality was grouped per cluster, identifying those individuals who maintained, improved or worsened their sleep quality, based on the PSQI classifications. Generalized estimating equations (GEE) were used to examine the association between sleep and BMI over the pregnancy period.

Results

An effect of the interaction between time of pregnancy and clusters of sleep quality was observed on the BMI (p<0.05), which indicates that pregnant women who improved subjective sleep quality during pregnancy gained more weight from the second to third trimester, while those that worsened the subjective sleep quality gained more weight during the first to second trimester. Sleep duration was not associated with weight gain. However, pregnant women who maintained the same BMI category over the pregnancy period increased their sleep duration from the first to third trimester, while those that increased the BMI category slept the same amount of time during this period (median=1.0 [0.0-2.0] and median=0.0 [-2.0-1.0], respectively, p=0.039).

Conclusions

The authors concluded that a worse subjective sleep quality seems to lead to an inadequate weight gain distribution during the period of pregnancy.

Time-related eating patterns and chronotype are associated with diet quality in pregnant women

Animal studies strongly suggest that timed feeding can have beneficial physiological effects, including protection against the obesogenic and metabolic consequences of a high-fat diet. However, the relationship between variables related to the timing of eating and diet quality in pregnancy women, which is considered as a period of nutritional vulnerability, is still poorly described in the literature. Therefore, the aim of the present study was to investigate the associations between time-related eating patterns and chronotype with diet quality of pregnant women. This cross-sectional study was conducted with 100 pregnant women in the first gestational trimester (≤12 weeks of gestation). The information regarding food intake was obtained by three 24-Hour Dietary Recall (24HR). Time-related eating patterns, i.e., the interval between the first and the last meal (eating duration), nightly fasting, time of the first and last meals, and number of meals eating on a day were determined. Chronotype was derived using the mid-sleep time on free days on weekends, with a further correction for calculated sleep debt. Diet quality was evaluated using the Brazilian Healthy Eating Index-Revised (BHEI-R), validated for the Brazilian population. Linear regression modeling analyses adjusted for confounders were used to investigate the association between time-related eating patterns and chronotype with diet quality. The BHEI-R total score was negatively associated with time of the first meal (β =  -0.355; p = 0.002; r² adjusted = 0.141), and positively associated with eating duration (β = 0.262; p = 0.024; r² adjusted = 0.086) and number of meals (β = 0.273; p = 0.019; r² adjusted = 0.091). In addition, the score of total fruit component was negatively associated with chronotype (β = -0.236; p = 0.033; r² adjusted = 0.078), time of the first meal (β = -0.393; p = 0.001; r² adjusted = 0.171), and positively associated with eating duration (β = 0.259; p = 0.022; r² adjusted = 0.087) and number of meals (β = 0.376; p = 0.001; r² adjusted = 0.159). The score for whole fruit component was negatively associated with time of the first meal (β = -0.388; p = 0.001; r² adjusted = 0.152), and positively associated with number of meals (β = 0.403; p = 0.001; r² adjusted = 0.164). A longer eating duration, earlier time of the first meal, higher number of meals and morningness tendency are associated with a better diet quality in the first gestational trimester - higher scores of the total BHEI-R and/or fruit components. We suggest that nutritional guidelines should consider time-related eating patterns and chronotype to ensure good diet quality of pregnant women since the beginning of gestation, contributing on prevention of metabolic-nutritional complications.

Food intake and the nutritional status of women undergoing chemotherapy

The objective behind this study was the analysis of food intake and the nutritional status of women with breast cancer (BC) undergoing chemotherapy (CT). The quantitative dietary evaluation was performed in accordance with Dietary Reference Intakes (DRI), whereas the qualitative evaluation was performed through the Brazilian Healthy Eating Index - Revised (BHEI-R).From among the total number of patients (n = 20), 60% (n = 12) presented waist circumference, equal to or higher than 88cm. It was noted that 75% (n = 15) individuals were overweight. The average intake for calcium, copper, iron, dietary fiber, magnesium, potassium, vitamin A, niacin, vitamin B6 and zinc, were found to be below adequate intake levels, while the intake of vitamin C, phosphorus, manganese, sodium and thiamine were all found to be above DRIs recommendations. As for the analysis of the BHEI-R, 80% (n = 16) of the patients presented a "diet that needs modifications", while 20% (n = 4) presented a "healthy diet". Noted from these observations was the presence of a high overweight rate, a discrepancy in the intake of micronutrients and a diet that needed improvements. In this manner, the establishment and use of a nutritional intervention protocol are very important when it comes to the improvement of the diet in patients with BC and who are undergoing CT.

Impact of Chemotherapy on Diet and Nutritional Status of Women with Breast Cancer: A Prospective Study

Certain food groups are often rejected during chemotherapy (CT) due to the side effects of treatment, which may interfere with adequate diet and nutritional status. The aim of this study was to evaluate the treatment impact on the diet and nutritional status of women with breast cancer (BC). In this prospective longitudinal study, conducted in 2014-2015, 55 women diagnosed with BC, with a mean age 51.5±10.1 years, were followed and data were collected at three different times. Anthropometric and dietary assessments were performed, the latter by applying nine 24h dietary recalls, by using the Brazilian Healthy Eating Index Revised (BHEI-R), and calculating the prevalence of inadequacy by the EAR cut-off point method. Regarding the BHEI-R analysis, the majority of women had a "diet requires modification', both at the beginning (T0, 58.2%, n = 32) and during treatment (T1, 54.5%, n = 30). However, after the end of the CT, the greater percentage of patients (T2, 49.1%, n = 27) were classified as having an "inadequate diet", since the Total Fruit consumption as well as the Dark Green and Orange Vegetable and Legume consumption decreased significantly during treatment (p = 0.043 and p = 0.026, respectively). There was a significant reduction in the intake of macro and micronutrients, with a high prevalence of inadequacy, of up to 100%, for calcium, iron, phosphorus, magnesium, niacin, riboflavin, thiamin, vitamin B6, vitamin C and zinc. Assessment of the nutritional status indicated that 56% (n = 31) of patients were overweight at these three different times. Weight, BMI and Waist Circumference increased significantly, indicating a worse nutritional status, and there was a correlation between poor diet quality and higher values for BMI, Waist-Hip Ratio and Waist-to-Height Ratio. Chemotherapy interferes in the patients' diet generating a negative impact on the quality and intake of micro and macronutrients, as well as an impact on their nutritional status, with an increase in anthropometric measurements.

Body composition and risk for metabolic alterations in female adolescents

OBJECTIVE

To study anthropometrical and body composition variables as predictors of risk for metabolic alterations and metabolic syndrome in female adolescents.

METHODS

Biochemical, clinical and corporal composition data of 100 adolescents from 14 to 17 years old, who attended public schools in Viçosa, Southeastern Brazil, were collected.

RESULTS

Regarding nutritional status, 83, 11 and 6% showed eutrophia, overweight/obesity and low weight, respectively, and 61% presented high body fat percent. Total cholesterol presented the highest percentage of inadequacy (57%), followed by high-density lipoprotein (HDL - 50%), low-density lipoprotein (LDL - 47%) and triacylglycerol (22%). Inadequacy was observed in 11, 9, 3 and 4% in relation to insulin resistance, fasting insulin, blood pressure and glycemia, respectively. The highest values of the fasting insulin and the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) were verified at the highest quartiles of body mass index (BMI), waist perimeter, waist-to-height ratio and body fat percent. Body mass index, waist perimeter, and waist-to-height ratio were the better predictors for high levels of HOMA-IR, blood glucose and fasting insulin. Waist-to-hip ratio was associated to arterial hypertension diagnosis. All body composition variables were effective in metabolic syndrome diagnosis.

CONCLUSIONS

Waist perimeter, BMI and waist-to-height ratio showed to be good predictors for metabolic alterations in female adolescents and then should be used together for the nutritional assessment in this age range.