Night eating behavior and metabolic heath in mothers and fathers enrolled in the QUALITY cohort study

Association of participants who screened positive for night eating syndrome with physical health, sleep problems, and weight status in an Australian adult population

BACKGROUND

Night eating syndrome (NES) is a unique eating disorder characterised by evening hyperphagia and nocturnal ingestions which cause significant distress and/or impairment in functioning. Despite the growing literature, NES remains poorly understood and under diagnosed. As such, this study aims to compare the prevalence of physical health conditions in participants with NES when compared to participants without an eating disorder (ED) and participants with other eating disorders (including anorexia nervosa (AN), binge eating disorder (BED) and bulimia nervosa (BN)) in a general population Australian sample of adults.

METHODS

The data for this study were obtained from the 2017 Health Omnibus Survey (HOS) a multi-stage, cross-sectional survey, conducted by Harrison Research in South Australia. This current study focused on 2547 participants over 18 years of age and specific questions from this population survey including those related to participant demographics and health.

RESULTS

This study identified that participants who screened positive for night eating syndrome (spNES) when compared to participants with other eating disorders (ED) or no ED diagnosis, were significantly more likely to have an increased age, be female, have lower levels of education and have lower household income. Additionally, the spNES group was significantly associated with sleep apnoea (p = 0.031), insomnia or other sleep problems (p < 0.0001), increased BMI (p < 0.0001), increased levels of pain/discomfort and lower physical health-related quality of life. Hypertension, hypercholesterolemia, and diabetes were not significantly associated with the spNES group or the "other ED" group which included participants with AN, BED, BN.

CONCLUSIONS

Several physical health problems were found to be significantly associated with the spNES group including sleep problems, increased BMI, increased levels of pain and lower self-reported physical health-related quality of life. Consequently, future research exploring the complex interaction between NES and these medical conditions may provide further insight into the diagnosis, screening tools and management of NES. Additionally, this study highlights the need for future studies which use larger population-based samples.

LEVEL OF EVIDENCE

Level III. Evidence obtained from well-designed cohort or case-control analytic studies.

A Scoping Review on the Association between Night Eating Syndrome and Physical Health, Health-Related Quality of Life, Sleep and Weight Status in Adults

Night eating syndrome (NES) is characterised by recurrent episodes of night eating, evident through excessive food consumption after the evening meal or eating after awakening from sleep, often associated with significant distress and/or impairment in functioning. This scoping review was conducted according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) guidelines. The search was conducted through the use of PubMed, Medline (OVID) and SCOPUS, to identify relevant articles published within the last 10 years. Search terms including "Night eating*" OR "NES" and Boolean phrases were used to refine the search. Additionally, the age of participants was restricted to 18 years and above, to ensure only adult participants were included. The abstracts of the remaining articles were used to screen for those that were relevant. From a total of 663 citations, 30 studies assessing night eating syndrome met the inclusion criteria to be included in the review. We found inconsistent associations of NES with higher body mass index (BMI), less physical activity, type 2 diabetes mellitus (T2DM) and poorer quality of sleep. These inconsistencies may have been due to the use of different measurement methods, lack of power from small sample sizes of NES in some studies and varying ages of participants, with associations being more likely to be found in higher-quality, representative populations than in university student samples. There were no associations of NES with T2DM in clinical populations and with hypertension, OSA and metabolic syndrome, but sample sizes were small. The impacts of NES on these medical conditions should be addressed in future, using well-sized and long-term studies involving representative populations of adults. In conclusion, NES likely has negative impacts on BMI, T2DM, physical activity, and sleep quality, which in turn may increase cardio-metabolic risk. However, further research is needed to elucidate the interaction between NES and its associated features.

Circadian clock and temporal meal pattern

The central circadian clock in the brain controls the time-of-the-day variations in acute meal responses, with a low glycemic response but a high satiety/thermogenic response to meals consumed at waking compared to other time points. Consistently, studies show that consuming a significant proportion of calories, particularly carbohydrates, in breakfast is beneficial for the chronic management of obesity and its associated metabolic syndrome, compared to consuming identical meals at dinner. Conversely, breakfast skipping or/and late dinner can have unfavorable metabolic outcomes. It remains controversial how meal frequency affects metabolic health. In contrast, irregular meals, especially irregular breakfasts, show consistent adverse metabolic consequences. Time-restricted feeding (TRF), with all calories consumed within less than 12-h per day, can improve metabolism and extend lifespan. A major component of TRF in humans is caloric restriction, which contributes significantly to the beneficial effects of TRF in humans. By comparison, TRF effects in rodents can be independent of caloric restriction and show day/night phase specificity. TRF could alleviate metabolic abnormalities due to circadian disruption, but its effects appear independent of the circadian clock in rodents. Understanding neuroendocrine mechanisms underlying clock-mediated metabolic regulation will shed light on the metabolic effects of temporal meal patterns.

Night eating syndrome is associated with mental health issues among palestinian undergraduate students-cross sectional study

BACKGROUND

University students are exposed to several factors associated with Night Eating Syndrome NES, which is distinguished by nocturnal consumption and/or evening hyperphagia. The main purpose of the current study is to examine the state of NES, and to explore its relationship with selected factors (e.g. sociodemographic factors, lifestyle habits, body mass index "BMI", and mental health) among a sample of undergraduates.

METHODS

A cross-section design was done among undergraduates recruited from three universities in the southern part of Palestine. Students completed a self-administrated questionnaire including demographic information, lifestyle habits, medical profile, and the Arabic version of Night Eating Questionnaire (NEQ). Mental health status was also assessed using the Arabic version of the 12-item General Health Questionnaire (GHQ-12). Cronbach alpha was used to check the reliability of the Arabic version of NEQ. Data were analyzed using univariate and multivariate approach.

RESULTS

A total of 475 participants were included in the study, 197 (47%) males, 253(54%) females. Mean age was 19.8 ± 1.4 years, ranged from 18 to 25 years old. It is found that 141 university students (29.7%) screened positive for NES. According to univariate analysis, NES was significantly related to gender (p = 0.023), major (p = 0.005), personal monthly income (p = 0.007), source of funding (p = 0.005), and mental health (p < 0.005). Besides, the results of binary logistic regression revealed that having mental health problems (Exp (B) = 4.18; 95% CI = 2.50-6.98; p = 0.000), males (Exp (B) = 1.99; 95% CI = 1.17-3.39; p = 0.014), and those who study expenses was not covered either by scholarship or parents (Exp (B) = 2.75; 95% CI = 1.29-5.8; p = 0.08) were significantly associated with NES.

CONCLUSION

It is found that NES is common among Palestinian university students. In this study, NES was significantly more prevalent among males, and those who were studying scientific majors, having a personal income between 500 and 1000 new Israeli shekel per month, and having mental problems, and those whose studies were funded by neither by a scholarship nor by their parents.

Psychiatric and medical comorbidities of eating disorders: findings from a rapid review of the literature

BACKGROUND

Eating disorders (EDs) are potentially severe, complex, and life-threatening illnesses. The mortality rate of EDs is significantly elevated compared to other psychiatric conditions, primarily due to medical complications and suicide. The current rapid review aimed to summarise the literature and identify gaps in knowledge relating to any psychiatric and medical comorbidities of eating disorders.

METHODS

This paper forms part of a rapid review) series scoping the evidence base for the field of EDs, conducted to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded and released by the Australian Government. ScienceDirect, PubMed and Ovid/Medline were searched for English-language studies focused on the psychiatric and medical comorbidities of EDs, published between 2009 and 2021. High-level evidence such as meta-analyses, large population studies and Randomised Control Trials were prioritised.

RESULTS

A total of 202 studies were included in this review, with 58% pertaining to psychiatric comorbidities and 42% to medical comorbidities. For EDs in general, the most prevalent psychiatric comorbidities were anxiety (up to 62%), mood (up to 54%) and substance use and post-traumatic stress disorders (similar comorbidity rates up to 27%). The review also noted associations between specific EDs and non-suicidal self-injury, personality disorders, and neurodevelopmental disorders. EDs were complicated by medical comorbidities across the neuroendocrine, skeletal, nutritional, gastrointestinal, dental, and reproductive systems. Medical comorbidities can precede, occur alongside or emerge as a complication of the ED.

CONCLUSIONS

This review provides a thorough overview of the comorbid psychiatric and medical conditions co-occurring with EDs. High psychiatric and medical comorbidity rates were observed in people with EDs, with comorbidities contributing to increased ED symptom severity, maintenance of some ED behaviours, and poorer functioning as well as treatment outcomes. Early identification and management of psychiatric and medical comorbidities in people with an ED may improve response to treatment and overall outcomes.

Night eating, weight, and health behaviors in adults participating in the Daily24 study

BACKGROUND

Night eating syndrome (NES) is associated with adverse health outcomes. This study evaluated the relationship between night eating severity, weight, and health behaviors.

METHODS

Participants (N = 1017; 77.6% female, mean Body Mass Index (BMI) = 30.5, SD = 7.8 kg/m², age = 51.1, SD = 15.0 years) were recruited from three health systems. Participants completed the Night Eating Questionnaire (NEQ) and questionnaires assessing sleep, chronotype, physical activity, diet, weight, and napping.

RESULTS

In the overall sample, higher NEQ scores were associated with higher BMI (p < .001) and consumption of sugar-sweetened beverages (p < .001), as well as lower fruit/vegetable consumption (p = .001). Higher NEQ scores were associated with increased odds of having overweight/obesity (p < .001), eating fast food (p < .001), moderate-vigorous physical activity (p = .005), and smoking (p = .004). Participants who exceeded the screening threshold for NES (n = 48, 4.7%) reported elevated BMI (p = .014), an increased likelihood of overweight/obesity (p = .004), greater sugar-sweetened beverages consumption (p < .001), napping less than twice per week (p = .029), shorter sleep duration (p = .012), and a later chronotype (M = 4:55, SD = 2:45).

CONCLUSION

Night eating severity was associated with obesity and intake of fast food and sugar-sweetened beverages. Interventions to address night eating and associated behaviors may enhance the efficacy of weight management interventions and promote engagement in positive health behaviors.

'In the night kitchen': A scoping review on the night eating syndrome

BACKGROUND

First described in 1955, night eating syndrome refers to an abnormal eating behavior clinically defined by the presence of evening hyperphagia (>25% of daily caloric intake) and/or nocturnal awaking with food ingestion occurring ⩾ 2 times per week.

AIMS

Although the syndrome is frequently comorbid with obesity, metabolic and psychiatric disorders, its etiopathogenesis, diagnosis, assessment and treatment still remain not fully understood.

METHODS

This review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines; PubMed database was searched until 31 October 2020, using the key terms: 'Night Eating Syndrome' AND 'complications' OR 'diagnosis' OR 'drug therapy' OR 'epidemiology' OR 'etiology' OR 'physiology' OR 'physiopathology' OR 'psychology' OR 'therapy'.

RESULTS

From a total of 239 citations, 120 studies assessing night eating syndrome met the inclusion criteria to be included in the review.

CONCLUSION

The inclusion of night eating syndrome into the Diagnostic and Statistical Manual of Mental Disorders-5 'Other Specified Feeding or Eating Disorders' category should drive the attention of clinician and researchers toward this syndrome that is still defined by evolving diagnostic criteria. The correct identification and assessment of NES could facilitate the detection and the diagnosis of this disorder, whose bio-psycho-social roots support its multifactorial nature. The significant rates of comorbid illnesses associated with NES and the overlapping symptoms with other eating disorders require a focused clinical attention. Treatment options for night eating syndrome include both pharmacological (selective serotonin reuptake inhibitors, topiramate and melatonergic drugs) and non-pharmachological approaches; the combination of such strategies within a multidisciplinary approach should be addressed in future, well-sized and long-term studies.

Time-restricted feeding normalizes hyperinsulinemia to inhibit breast cancer in obese postmenopausal mouse models

Accumulating evidence indicates that obesity with its associated metabolic dysregulation, including hyperinsulinemia and aberrant circadian rhythms, increases the risk for a variety of cancers including postmenopausal breast cancer. Caloric restriction can ameliorate the harmful metabolic effects of obesity and inhibit cancer progression but is difficult to implement and maintain outside of the clinic. In this study, we aim to test a time-restricted feeding (TRF) approach on mouse models of obesity-driven postmenopausal breast cancer. We show that TRF abrogates the obesity-enhanced mammary tumor growth in two orthotopic models in the absence of calorie restriction or weight loss. TRF also reduces breast cancer metastasis to the lung. Furthermore, TRF delays tumor initiation in a transgenic model of mammary tumorigenesis prior to the onset of obesity. Notably, TRF increases whole-body insulin sensitivity, reduces hyperinsulinemia, restores diurnal gene expression rhythms in the tumor, and attenuates tumor growth and insulin signaling. Importantly, inhibition of insulin secretion with diazoxide mimics TRF whereas artificial elevation of insulin through insulin pumps implantation reverses the effect of TRF, suggesting that TRF acts through modulating hyperinsulinemia. Our data suggest that TRF is likely to be effective in breast cancer prevention and therapy.

Definition and Multiple Factors of Recurrent Spontaneous Abortion

Recurrent spontaneous abortion (RSA) is usually defined as three or more spontaneous abortions prior to 20-28 weeks gestation. RSA affects approximately 2-5% of all women of childbearing age, and it brings tremendous psychological and psychiatric trauma to the women and also results in economic burden. The causes could be female age, anatomical and chromosomal abnormalities, genetic, endocrinological, placental anomalies, infection, smoking and alcohol consumption, psychological factor, exposure to environmental factors such as heavy metal, environment pollution, and radiation.

Hypoxia induces a time- and tissue-specific response that elicits intertissue circadian clock misalignment

The occurrence and sequelae of disorders that lead to hypoxic spells such as asthma, chronic obstructive pulmonary disease, and obstructive sleep apnea (OSA) exhibit daily variance. This prompted us to examine the interaction between the hypoxic response and the circadian clock in vivo. We found that the global transcriptional response to acute hypoxia is tissue-specific and time-of-day-dependent. In particular, clock components differentially responded at the transcriptional and posttranscriptional level, and these responses depended on an intact circadian clock. Importantly, exposure to hypoxia phase-shifted clocks in a tissue-dependent manner led to intertissue circadian clock misalignment. This differential response relied on the intrinsic properties of each tissue and could be recapitulated ex vivo. Notably, circadian misalignment was also elicited by intermittent hypoxia, a widely used model for OSA. Given that phase coherence between circadian clocks is considered favorable, we propose that hypoxia leads to circadian misalignment, contributing to the pathophysiology of OSA and potentially other diseases that involve hypoxia.

The association between the timing of energy intake and the risk of overweight and obesity among Saudi female university student

OBJECTIVES

To investigate the relationship between the timing of energy intake and obesity. Methods: A cross-sectional study was conducted between September 2018 and December 2018. A total of 450 Saudi female students from the University of Tabuk, Tabuk, Saudi Arabia were recruited. A 4-day dietary record was used to estimate the total energy intake per day and per meal. Height and weight were measured to calculate body mass index. Results: The study showed a significant negative association between obesity and energy intake at breakfast (r = -0.70, p less than 0.05) and mid-morning (r = -0.53, p less than 0.05) as well as a significant positive association between obesity and energy intake at dinner (r = 0.85, p less than 0.05). Additionally, there was no significant difference between the obese and normal weight groups in the total energy intake per day or the total percentage of energy from fat, carbohydrate, and protein per day. However, the total energy intake for each meal and the percentage of energy from fat, carbohydrate, and protein per meal were significantly different between the groups. Conclusion: The greater intake of energy at dinner was positively associated with obesity, while greater energy intake at breakfast were negatively associated with overweight and obesity.

A Review of the Relationship between Night Eating Syndrome and Body Mass Index

PURPOSE OF THE REVIEW

To review literature on night eating syndrome (NES) and body mass index (BMI, kg/m²) published in the last 5 years.

RECENT FINDINGS

Since December, 2013, 11 studies examined the association between NES and BMI. Five of these studies reported a positive relationship, five showed no relationship, and one produced mixed findings. Emotional eating and age were moderators. Twelve studies examined whether there was a difference in BMI between those with and without NES with only five of these finding differences. A primary weakness of the recent literature base is that it is almost entirely cross-sectional. Recent findings regarding the relationship between NES and BMI are mixed. Future research should examine the relationship between these variables longitudinally and continue to examine moderating variables that explain why some individuals manifest excess weight with NES and others do not.

Spontaneous ketonuria and risk of incident diabetes: a 12 year prospective study

AIMS/HYPOTHESIS

Ketones may be regarded as a thrifty fuel for peripheral tissues, but their clinical prognostic significance remains unclear. We investigated the association between spontaneous fasting ketonuria and incident diabetes in conjunction with changes in metabolic variables in a large population-based observational study.

METHODS

We analysed 8703 individuals free of diabetes at baseline enrolled in the Korean Genome and Epidemiology Study, a community-based 12 year prospective study. Individuals with (n = 195) or without fasting ketonuria were matched 1:4 by propensity score. Incident diabetes was defined as fasting plasma glucose ≥7.0 mmol/l, post-load 2 h glucose ≥11.1 mmol/l on biennial OGTTs, or current use of glucose-lowering medication. Using Cox regression models, HRs for developing diabetes associated with the presence of ketonuria at baseline were analysed.

RESULTS

Over 12 years, of the 925 participants in the propensity score-matched cohort, 190 (20.5%) developed diabetes. The incidence rate of diabetes was significantly lower in participants with spontaneous ketonuria compared with those without ketonuria (HR 0.63; 95% CI 0.41, 0.97). Results were virtually identical when participants with fasting ketonuria were compared against all participants without ketonuria (after multivariate adjustment, HR 0.66; 95% CI 0.45, 0.96). During follow-up, participants with baseline ketonuria maintained lower post-load 1 h and 2 h glucose levels and a higher insulinogenic index despite comparable baseline values.

CONCLUSIONS/INTERPRETATION

The presence of spontaneous fasting ketonuria was significantly associated with a reduced risk of diabetes, independently of metabolic variables. Our findings suggest that spontaneous fasting ketonuria may have a potential preventive role in the development of diabetes.

Timing of eating in adults across the weight spectrum: Metabolic factors and potential circadian mechanisms

Timing of eating is recognized as a significant contributor to body weight regulation. Disruption of sleep-wake cycles from a predominantly diurnal (daytime) to a delayed (evening) lifestyle leads to altered circadian rhythms and metabolic dysfunction. This article reviews current evidence for timed and delayed eating in individuals of normal weight and those with overweight or obesity: although some findings indicate a benefit of eating earlier in the daytime on weight and/or metabolic outcomes, results have not been uniformly consistent, and more rigorous and longer-duration studies are needed. We also review potential circadian mechanisms underlying the metabolic- and weight-related changes resulting from timed and delayed eating. Further identification of such mechanisms using deep phenotyping is required to determine targets for medical interventions for obesity and for prevention of metabolic syndrome and diabetes, and to inform clinical guidelines regarding eating schedules for management of weight and metabolic disease.

Metabolic Impact of Light Phase-Restricted Fructose Consumption Is Linked to Changes in Hypothalamic AMPK Phosphorylation and Melatonin Production in Rats

Recent studies show that the metabolic effects of fructose may vary depending on the phase of its consumption along with the light/dark cycle. Here, we investigated the metabolic outcomes of fructose consumption by rats during either the light (LPF) or the dark (DPF) phases of the light/dark cycle. This experimental approach was combined with other interventions, including restriction of chow availability to the dark phase, melatonin administration or intracerebroventricular inhibition of adenosine monophosphate-activated protein kinase (AMPK) with Compound C. LPF, but not DPF rats, exhibited increased hypothalamic AMPK phosphorylation, glucose intolerance, reduced urinary 6-sulfatoxymelatonin (6-S-Mel) (a metabolite of melatonin) and increased corticosterone levels. LPF, but not DPF rats, also exhibited increased chow ingestion during the light phase. The mentioned changes were blunted by Compound C. LPF rats subjected to dark phase-restricted feeding still exhibited increased hypothalamic AMPK phosphorylation but failed to develop the endocrine and metabolic changes. Moreover, melatonin administration to LPF rats reduced corticosterone and prevented glucose intolerance. Altogether, the present data suggests that consumption of fructose during the light phase results in out-of-phase feeding due to increased hypothalamic AMPK phosphorylation. This shift in spontaneous chow ingestion is responsible for the reduction of 6-S-Mel and glucose intolerance.

Latino Parents' Insight on Optimal Sleep for Their Preschool-Age Child: Does Context Matter?

OBJECTIVE

Insufficient sleep is a risk factor for pediatric obesity. Latino children are among those groups in which both short sleep duration and obesity are prevalent. Therefore, this study sought to explore Latino parents' views about ideal sleep duration and sleep-related practices for their preschool-age children in an urban setting.

METHODS

Between October 2013 and January 2014, Latino parents of 2- to 5-year-old children were interviewed at 3 pediatric clinics (San Francisco, Calif). Using a semistructured interview guide, parents were asked to describe bedtime routines and sleep practices of their preschool-age children, including behavioral, parental, social, and contextual factors that may affect children's sleep. Interviews were conducted in Spanish and English. Parents also completed a brief survey on demographic information. Interviews were analyzed on the basis of a priori and emergent themes.

RESULTS

Latino parents (n = 18) were mostly female, with a mean age of 31 years; most were foreign born; and more than half had a monthly household income of $2000 or less. The following themes emerged: parents' ideas about optimal sleep duration for their preschool-age child, consistent bedtime routines, room sharing and bed sharing, parent work and child school schedules that affect children's sleep, and crowded housing and neighborhood noise that disrupt children's sleep.

CONCLUSIONS

These findings increase our understanding of the factors related to achieving optimal sleep duration among Latino children living in urban and often crowded housing. Findings could be used to inform future research on how to increase parental knowledge of healthy sleep practices and adequate sleep among Latino parents of young children.