Late meal intake is associated with abdominal obesity and metabolic disorders related to metabolic syndrome: A chrononutrition approach using data from NHANES 2015-2018

Personal 24-hour light exposure pattern with obesity and adiposity-related parameters in school-aged children: A cross-sectional study based on compositional data analysis

The 24-h light exposure pattern is an essential feature of circadian rhythms and a potential contributor to body fat health. However, no previous studies have investigated 24-h light exposure patterns in relation to adiposity-related parameters in children. This cross-sectional study recruited school-aged children in Chuzhou, Anhui province, China. Personal 24-h light exposure was collected for 5 days and was divided into four measures: light at daytime (LAD)≥100 lx and <100 lx; light at night (LAN)≥1 lx and <1 lx. Adiposity-related parameters were measured via a body composition analyzer. The association of light exposure with adiposity-related parameters was analyzed using compositional data analysis (CoDA). This study included 831 children 8.53 ± 0.62 years, who were exposed to LAD≥100 lx for 490.1 ± 92.7 min and LAN≥1 lx for 311.2 ± 98.5 min. The proportion of time spent in LAD≥100 lx increasing by 1 % (14.4 min/day) was linked to a decline of 3.10 % in percentage of body fat (PBF). In contrast, prolonged exposure to LAN≥1 lx by 14.4 min/day was associated with an increase of 3.49 % in PBF (All P < 0.01). These associations were robust in boys after gender stratification. CoDA estimated that reducing the time of LAN≥1 lx had more influence in decreasing the odds of childhood overweight/obesity than increasing the time of LAD≥100 lx. Suboptimal 24-h light exposure patterns (brighter nights, darker days) play a threatening role in childhood overweight/obesity. Bright LAN replaced with darker LAN or bright LAD might help decrease the odds of childhood overweight/obesity.

Meal timing, nutritional status and diet quality in a group of Spanish children

INTRODUCTION

Some studies suggest that meal timing is involved in obesity and metabolic health. However, little is known about children, so the aim was to assess whether meal timing patterns affect nutritional status and diet quality in children.

METHODS

A cross-sectional study was conducted on 880 children (8-13 years). Participants were classified according to the median timing of their first meal, last meal and the length of their eating window (12 h). Adjusted linear regression was used to evaluate associations between first meal timing, last meal timing or eating window and anthropometric, biochemical and dietary variables.

RESULTS

A later last meal was associated with lower scores on the Healthy Eating Index (HEI-2020), Mediterranean Diet Score (MDS) and DASH diet [β (95% CI): -1.139 (-2.258; -0.021), -0.207 (-0.408; -0.007) and - 0.582 (-1.072; -0.092), respectively]. A longer eating window was associated with higher glucose levels, LDL-c, and the ratio LDL-c/HDL-c [β (95% CI): 3.204 (1.876; 4.532), 4.725 (1.109; 8.342), and 0.090 (0.014; 0.166), respectively].

CONCLUSION

Later meal timing and a prolonged eating window were linked to poorer diet quality and unfavourable metabolic markers. It may be relevant to consider meal timing as a preventive health strategy in the development of future dietary guidelines.

Nutritional profile of the diet according to circadian clock genes in the European Prospective Investigation into Cancer and Nutrition (EPIC) chronodiet study

BACKGROUND & AIMS

Circadian rhythms seem to impact both dietary intake and metabolism, depending on the individual's chronotype. We aimed to explore whether the nutritional composition of meals throughout the day is influenced by genetics linked to the circadian clock and chronotype within the "European Prospective Investigation into Cancer and Nutrition (EPIC) chronodiet" study.

METHODS

The study population comprised 3,183 subjects with information on diet and twelve genetic variants of six genes (PER1, PER2, PER3, CRY1, NR1D1, CLOCK). The associations between the variants with chrononutrition variables (macronutrients and serving sizes of each meal) were evaluated using linear regression, considering an additive genetic model, and adjusting for sex, age and center, among others. The β coefficients, 95 % confidence intervals (CI), and p-values corrected for multiple comparisons were estimated. A genetic risk score (GRS) that was associated to the evening/late chronotype as well as overweight/obesity in a previous study, the chronotype-GRS, was tested for its association with chrononutrition variables.

RESULTS

The nutritional profile of the diet differed according to the individual's chronotype, with evening/late chronotypes exhibiting an unbalanced intake during breakfast and dinner compared to the intermediate and early chronotypes (e.g., percentage of fats consumed at breakfast relative to the total fat intake: 13 % and 9 %, respectively). However, significant differences were not encountered by the chronotype-GRS. In multivariate analyses, individual associations between the genetic variants and the nutrients revealed some nominal associations (e.g., rs1801260 and rs2070062 with carbohydrates at breakfast: β = -0.06 to 0.08). Higher scorings of the chronotype-GRS were inversely associated with the intake of proteins and carbohydrates (β = -0.46 and -0.41; nominal p-value<0.006; corrected = 0.25) during breakfast. Also, there was an inverse association between the chronotype-GRS and the breakfast's portion size (β = -0.3; nominal p-value = 0.03; corrected = 0.1).

CONCLUSIONS

Genetic susceptibility to an evening-like chronotype prone to overweight/obesity seems to be associated with a smaller serving size during breakfast, with lower protein and carbohydrate content.

Daily Eating Window and Obesity Markers in a Sample of Schoolchildren from Vienna: Insights from the EDDY Study

BACKGROUND/OBJECTIVES

The eating window concept has been understudied in children, with no reports from Austria. This study explored meal timing and its association with obesity-related variables in a sample of Viennese schoolchildren. The effect of a healthy intervention on obesity variables according to the daily eating window was assessed.

METHODS

The EDDY study included 138 third-grade students from three Vienna schools. Baseline meal timing was assessed using self-administered questionnaires, and the daily eating window-the time between the first and last meal-was calculated and categorized into tertiles. Anthropometric and body fat measurements were taken at baseline and after 21 months. Baseline outcomes were compared between children with long (LEW; 3rd tertile) and short (SEW; 1st tertile) eating windows using adjusted linear regression analysis. Longitudinal changes were analyzed using mixed models for repeated measures.

RESULTS

The median age was 7.9 years, and 26.8% were classified with overweight/obesity. The children's eating window spanned 11:40 h, from 7:00 to 19:00. More than half (52.2%) reported fasting 1-2 h before bed. Children had four daily meals; 16.4% skipped breakfast, while 51.5% ate it regularly. Meal timing variables did not differ by weight status. Children with a LEW (≥12:05 h) had lower BMI-SDS (-0.66) and fat mass index (-1.06) than those with a SEW (≤11:05 h). No longitudinal changes in BMI-SDS, fat mass index, or waist-to-height ratio were observed across eating window tertiles following the intervention.

CONCLUSIONS

In a non-representative sample of Viennese children, the eating window ranged from 9:30 to 13:30 h, similar to Austrian adults but differing from other Western European countries.

Obesity mediate associations between depression and wet overactive bladder: Results from 2005 to 2020 NHANES

BACKGROUND

The specific relationship among depression, obesity, and wet-overactive bladder (wet-OAB) lacked comprehensiveness.

METHODS

This cross-sectional study included 23,154 participants from the 2005-2020 National Health and Nutrition Examination Survey (NHANES). The study outcome was wet-OAB risk. depression levels were the primary exposure and graded to none (0-4), low (5-9), moderate (10-14), and severe (≥ 15) using the Patient Health Questionnaire-9. General and abdominal obesity were assessed based on body mass index (BMI) and waist circumference (WC), respectively. The logistic regression and restricted cubic spline (RCS) analysis were applied to probe their association based on complex multistage sampling designs. Mediation effect analysis was constructed to address the mediating role of obesity.

RESULTS

In fully adjusted models, a positive association was suggested between wet-OAB and depression levels with OR(95 %CI) of 2.34(1.98-2.75) in mild, 2.66(2.13-3.31) in moderate, and 3.14(2.34-4.20) in severe depression. General and abdominal obesity were significantly associated with increasing depression levels and wet-OAB risk (P for trend < 0.001). RCS analyses showed Log-shaped non-linear associations between depression levels and wet-OAB, especially in overweight, obesity subgroups, and abdominal obesity. General obesity with BMI and abdominal obesity with WC performed respectively a partially mediated proportion of 5.16 % and 4.25 % between depression levels and wet-OAB (P for indirect effect < 0.001).

CONCLUSIONS

Individuals with elevated depression levels tend to have a higher risk of wet-OAB, especially in obesity. General and abdominal obesity are important partial mediators in the effects of depression levels on wet-OAB. Patients with wet-OAB need to pay attention to mental health interventions and weight control.

Chrononutrition behaviors in relation to diet quality and obesity: do dietary assessment methods and energy intake misreporting matter?

BACKGROUND

Inconsistent epidemiologic findings on the associations of chrononutrition behaviors with diet quality and adiposity measures may be due to the use of different dietary assessment methodologies and a lack of consideration of dietary misreporting. We aimed to investigate the associations by using questionnaires and diaries, with adjustment for energy intake (EI) misreporting.

METHODS

This cross-sectional study included 1047 Japanese adults aged 20-69 years. We used the Chrono-Nutrition Behavior Questionnaire (CNBQ) or 11-day diaries to assess chrononutrition behaviors (meal frequency, snack frequency, total eating frequency, timing of first eating occasion, timing of last eating occasion, duration of eating window, and eating midpoint) for workdays and non-workdays separately. Eating jetlag was defined as the eating midpoint difference between workdays and non-workdays. Diet quality was assessed using the Healthy Eating Index-2020, based on the Meal-based Diet History Questionnaire (MDHQ) or 4-day weighed food diaries. EI misreporting was evaluated using the Goldberg cut-off principle.

RESULTS

Using questionnaire data (CNBQ and MDHQ), we found inverse associations of snack and total eating frequencies, timing of last eating occasion, eating midpoint, and eating jetlag with diet quality (P < 0.05), irrespective of adjustment for EI misreporting. Also, we found positive associations of meal, snack, and total eating frequencies and duration of eating window with the prevalence of general obesity (body mass index ≥ 25 kg/m2), abdominal obesity (waist circumference ≥ 90 cm for males; ≥ 80 cm for females), or both; many of these associations were only evident (P < 0.05) after adjustment for EI misreporting. In contrast, using diary data, we found no associations between chrononutrition behaviors and diet quality, general obesity, or abdominal obesity, regardless of adjustment for EI misreporting (except for inverse associations of timings of first and last eating occasions and eating midpoint on workdays with diet quality).

CONCLUSIONS

The associations of chrononutrition behaviors with diet quality and obesity were dependent on the methodology used to assess these behaviors. Adjustment for EI misreporting radically changed only the associations with obesity in the questionnaire-based analysis. These findings suggest the importance of careful consideration of dietary assessment method selection and EI misreporting in chrononutrition research.

Association of meal time patterns with dietary intake and body mass index: a chrononutrition approach from NHANES 2017-2018

BACKGROUND

Chrononutrition studies suggest that eating later and extending the eating window are linked to higher energy intake and obesity. However, the relationship between chrononutrition variables and dietary intake, as well as with BMI, is still little explored at a population level. This study explored how chrononutrition variables relate to dietary intake and BMI at a population level.

METHODS

We analyzed data from the NHANES 2017-2018, including 2937 participants aged 18 years or older. Dietary intake was assessed by two 24-h dietary recalls. Caloric midpoint, eating window duration, sleep end-first meal and last meal-sleep onset intervals were determined by mealtime.

RESULTS

The findings indicate a trend of increased total consumption of energy (kcal) (p < 0.001; p < 0.001; p < 0.001; p < 0.001), carbohydrates (g) (p = 0.001; p < 0.001; p < 0.001; p < 0.001); protein (g) (p < 0.001; p = 0.008; p < 0.001; p < 0.001), fat (g) (p < 0.001; p = 0.007; p < 0.001; p < 0.001), and sugar (g) (p < 0.001; p < 0.001; p < 0.001; p < 0.001) as the sleep end-first meal interval decreases and the last meal-sleep onset interval, eating window, and energy intake after 8 pm increases, respectively. In addition, our findings suggest a trend of increased BMI in the group with BMI ≥ 30 kg/m² (p = 0.018) as sleep end-first meal interval increases and in the group with BMI < 25 kg/m² (p = 0.006) as the eating window increases.

CONCLUSION

Our findings suggest that eating later and having longer eating window are associated with higher dietary intake and higher BMI.

2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

BACKGROUND

The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2025 AHA Statistical Update is the product of a full year's worth of effort in 2024 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. This year's edition includes a continued focus on health equity across several key domains and enhanced global data that reflect improved methods and incorporation of ≈3000 new data sources since last year's Statistical Update.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Chrononutrition in Chronic Kidney Disease

Chrononutrition, the study of the interaction between biological rhythms and nutrition, has emerged as a promising field for addressing metabolic health. However, its role in chronic kidney disease (CKD) remains underexplored. CKD patients often experience circadian disruptions due to renal, metabolic, treatment-related, and lifestyle factors, which may influence their nutritional status and clinical outcomes. Objective: to synthesize and analyze the existing evidence on chrononutrition in CKD patients, identify knowledge gaps, and propose directions for future research across different stages of CKD. Initially, this review contextualizes circadian physiology, alignment, and chronodisruption to explore such factors in CKD patients, focusing on chrononutrition variables already studied in the general population. We discuss how dietary timing and habit adjustments could influence CKD clinical outcomes, offering insights into circadian impacts on disease management. This new approach could optimize patient care, encouraging further research, particularly in the development of personalized strategies for different stages of the disease.

Consequences of Exposure to Famine Exposure on the Later Life eGFR Decline Among Survivors of the Great Chinese Famine: A Retrospective Study

OBJECTIVES

Chronic kidney disease (CKD) significantly contributes to the socio-economic burden both in China and worldwide. Previous research has shown that experiencing childhood famine is linked to various chronic conditions like diabetes, hypertension, and proteinuria. However, the long-term effects of early-life famine exposure on adult kidney function remain unclear. This study investigates whether exposure to the Chinese Great Famine (1959-1962) is associated with a decline in glomerular filtration rate (GFR) later in life.

DESIGN AND METHODS

China Health and Retirement Longitudinal Study is a population-based observational study. We analyzed data from 8,828 participants in the 2011-2012 baseline survey, updated in 2014. Participants were categorized based on their birth year into fetal-exposed (1959-1962), childhood-exposed (1949-1958), adolescence/adult-exposed (1912-1948), and nonexposed (1963-1989) groups. The estimated GFR (eGFR) was calculated using the CKD-EPI-Cr-Cys equation (2021), with CKD defined as an eGFR below 60 mL/min/1.73 m2.

RESULTS

Average eGFR values were 103.0, 96.8, 91.2, and 76.3 mL/min/1.73 m2 for the fetal-exposed, childhood-exposed, adolescence/adult-exposed, and nonexposed groups, respectively. The eGFR in the exposed groups was significantly lower compared to the nonexposed group. Specifically, famine exposure correlated with a lower eGFR (coefficient estimates [CE] -9.14, 95% confidence interval [CI] -9.46, -8.82), with the strongest association observed in the adolescence/adult-exposed group (CE -26.74, 95% CI -27.75, -25.74). Adjusting for variables such as demographics, physical and laboratory tests, complications, and personal habits like smoking and drinking did not qualitatively alter this association (CE -1.38, 95% CI -1.72, -1.04). Further stratification by sex, body mass index, alcohol consumption history, hypertension, diabetes, Center for Epidemiologic Studies Depression score, and education level showed that the association remained consistent.

CONCLUSIONS

Exposure to famine during different life stages can have enduring effects on GFR decline in humans.

Chronobiological Factors Influencing Glycemic Control and Birth Outcomes in Gestational Diabetes Mellitus

BACKGROUND/OBJECTIVES

Studies have shown that chronobiological factors may adversely affect glycemic control in patients with type 2 diabetes mellitus. We assessed the association of chronobiological factors with glycemic control and neonatal birth weight in women with GDM.

METHODS

A prospective cohort study included 208 women aged 18-45 years with a singleton pregnancy who were randomly selected from among women undergoing follow-up for GDM at the Maternal-Fetal Medicine Unit of a tertiary medical center. Nutrition, sleep, and lifestyle patterns were assessed from onset of GDM until birth along with glycemic control and birth outcomes.

RESULTS

Multivariate analyses on a cohort of 208 women revealed that suboptimal glycemic control was associated with a late breakfast (RR = 2.26; 95% CI 1.09-4.67), increased carbohydrate intake in the evening (RR = 1.19; 95% CI 1.003-1.42), and poor sleep quality (RR = 2.14; 95% CI 1.04-4.41). The adjusted relative risk for neonatal birth weight above the 85th percentile was associated with increased carbohydrate intake in the morning (RR = 1.70; 95% CI 1.30-2.23) and increased carbohydrate intake in the evening (RR = 1.39; 95% CI 1.16-1.67).

CONCLUSIONS

Chronobiological factors are associated with suboptimal glycemic control and birth weight above the 85th percentile in women with GDM. The study was registered under ClinicalTrials.gov.org, identifier: NCT02916667.

Sex-specific association between later circadian timing of food intake and adiposity among Chinese young adults living in real-world settings

Timing of food intake is an emerging aspect of nutrition; however, there is a lack of research accurately assessing food timing in the context of the circadian system. The study aimed to investigate the relation between food timing relative to clock time and endogenous circadian timing with adiposity and further explore sex differences in these associations among 151 young adults aged 18-25 years. Participants wore wrist actigraphy and documented sleep and food schedules in real time for 7 consecutive days. Circadian timing was determined by dim-light melatonin onset (DLMO). The duration between last eating occasion and DLMO (last EO-DLMO) was used to calculate the circadian timing of food intake. Adiposity was assessed using bioelectrical impedance analysis. Of the 151 participants, 133 were included in the statistical analysis finally. The results demonstrated that associations of adiposity with food timing relative to circadian timing rather than clock time among young adults living in real-world settings. Sex-stratified analyses revealed that associations between last EO-DLMO and adiposity were significant in females but not males. For females, each hour increase in last EO-DLMO was associated with higher BMI by 0·51 kg/m2 (P = 0·01), higher percent body fat by 1·05 % (P = 0·007), higher fat mass by 0·99 kg (P = 0·01) and higher visceral fat area by 4·75 cm2 (P = 0·02), whereas non-significant associations were present among males. The findings highlight the importance of considering the timing of food intake relative to endogenous circadian timing instead of only as clock time.

Chrononutrition behaviors and cardiometabolic risk in adolescence: an ecological momentary assessment study

PURPOSE

To investigate the potential associations between unhealthy chrononutrition behaviors (meal timing, frequency, and regularity) and their combined impact on cardiometabolic risk in adolescence.

METHODS

Chrononutrition behaviors were assessed using a 7-day ecological momentary assessment (EMA). The unhealthy chrononutrition score (ranging from 0 to 8) was determined based on late meal timing, low meal frequency, and meal irregularity. The cardiometabolic (CM)-risk z score was calculated utilizing age- and sex-specific reference values for waist circumference (WC), mean arterial pressure (MAP), homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). Restricted cubic splines were employed to estimate the dose-response relationships between the unhealthy chrononutrition score and outcomes.

RESULTS

Among 458 participants [mean (SD) age, 17.9 (0.7) years; 340 (74.2%) Female], 14.3% had an unhealthy chrononutrition score ≥ 6, who exhibited higher MAP (β = 3.86; 95% CI 1.24, 6.47), higher CM-risk scores (β = 1.80; 95% CI 0.70, 2.90), and lower HDL-C (β = 0.18; 95% CI - 0.30, - 0.06), as opposed to those with a healthy score ≤ 2 (n = 136, 31.4%). Moreover, late breakfast (later than 9AM compared to earlier than 8AM), low meal frequency (eating two or fewer meals versus three meals a day), and meal irregularity (score of 3-5 compared to a good score of 6-9) were associated with an increased risk of CM-risk outcomes.

CONCLUSION

The findings suggest a clustering of unhealthy chrononutrition behaviors that collectively impact cardiometabolic health in adolescence. Further prospective and interventional investigations is necessary to validate these findings and explore the underlying mechanisms.

Association of chrononutrition patterns with biological aging: evidence from a nationally representative cross-sectional study

Previous studies mostly focused on the benefits of caloric restriction and fasting on longevity. However, whether the timing and frequency of eating affect aging remains unclear. Here, we investigated the associations between chrononutrition patterns and biological aging, and explored whether and to what extent dietary inflammation mediated this association. 16 531 adults aged 20 to 84 years from the National Health and Nutrition Examination Survey were collected. Chrononutrition patterns were determined with two 24-hour dietary recalls. Phenotypic age was calculated to reflect the biological aging status. The dietary inflammatory index (DII) was used to assess the dietary inflammation. After adjustment of the survey weight and multiple covariates including total energy intake, participants in the third tertile of the time of the first meal (mean 10 : 26) exhibited more advanced biological age (β 0.64; 95% CI, 0.26-1.00) and a higher incidence of accelerated aging (odds ratio (OR) 1.25; 95% CI, 1.06-1.47) compared to those of the first tertile (mean 6 : 14). Higher eating frequency was associated with delayed biological aging in both multivariable linear (β -0.31; 95% CI, -0.44 to -0.19) and logistic regression model (OR 0.90; 95% CI, 0.85-0.95). Furthermore, we found that DII rather than metabolic factors mediated the inverse association between eating frequency and biological aging (mediation proportion 24.67%; 95% CI, 19.83%-32.00%). Our findings demonstrated the association between chrononutrition patterns and biological aging among the US general population and the potential role of dietary inflammation in this association, suggesting that modifying chrononutrition patterns may be a practical and cost-effective strategy for combating aging.

Diet and Meal Pattern Determinants of Glucose Levels and Variability in Adults with and without Prediabetes or Early-Onset Type 2 Diabetes: A Pilot Study

This observational pilot study examined the association between diet, meal pattern and glucose over a 2-week period under free-living conditions in 26 adults with dysglycemia (D-GLYC) and 14 with normoglycemia (N-GLYC). We hypothesized that a prolonged eating window and late eating occasions (EOs), along with a higher dietary carbohydrate intake, would result in higher glucose levels and glucose variability (GV). General linear models were run with meal timing with time-stamped photographs in real time, and diet composition by dietary recalls, and their variability (SD), as predictors and glucose variables (mean glucose, mean amplitude of glucose excursions [MAGE], largest amplitude of glucose excursions [LAGE] and GV) as dependent variables. After adjusting for calories and nutrients, a later eating midpoint predicted a lower GV (β = -2.3, SE = 1.0, p = 0.03) in D-GLYC, while a later last EO predicted a higher GV (β = 1.5, SE = 0.6, p = 0.04) in N-GLYC. A higher carbohydrate intake predicted a higher MAGE (β = 0.9, SE = 0.4, p = 0.02) and GV (β = 0.4, SE = 0.2, p = 0.04) in N-GLYC, but not D-GLYC. In summary, our data suggest that meal patterns interact with dietary composition and should be evaluated as potential modifiable determinants of glucose in adults with and without dysglycemia. Future research should evaluate causality with controlled diets.

A late eating midpoint is associated with increased risk of diabetic kidney disease: a cross-sectional study based on NHANES 2013-2020

BACKGROUND

Modifying diet is crucial for diabetes and complication management. Numerous studies have shown that adjusting eating habits to align with the circadian rhythm may positively affect metabolic health. However, eating midpoint, eating duration, and their associations with diabetic kidney disease (DKD) are poorly understood.

METHODS

The National Health and Nutrition Examination Survey (2013-2020) was examined for information on diabetes and dietary habits. From the beginning and ending times of each meal, we calculated the eating midpoint and eating duration. Urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g and/or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 were the specific diagnostic criteria for DKD.

RESULTS

In total, details of 2194 subjects with diabetes were collected for analysis. The overall population were divided into four subgroups based on the eating midpoint quartiles. The prevalence of DKD varied noticeably (P = 0.037) across the four categories. When comparing subjects in the second and fourth quartiles of eating midpoint to those in the first one, the odds ratios (ORs) of DKD were 1.31 (95% CI, 1.03 to 1.67) and 1.33 (95% CI, 1.05 to 1.70), respectively. And after controlling for potential confounders, the corresponding ORs of DKD in the second and fourth quartiles were 1.42 (95% CI, 1.07 to 1.90) and 1.39 (95% CI, 1.04 to 1.85), respectively.

CONCLUSIONS

A strong correlation was found between an earlier eating midpoint and a reduced incidence of DKD. Eating early in the day may potentially improve renal outcomes in patients with diabetes.