Breakfast skipping and timing of lunch and dinner: Relationship with BMI and obesity

Determinants of variations in sleep patterns across Brazil: Exploring geographic influences

Objective

To examine the influence of latitude, longitude, sunrise, and daylight, in conjunction with individual and behavioral factors, on sleep duration, wake time, and bedtime in a country with the world's broadest latitude range, yet characterized by homogeneity in language, cultural traits, and consistent time zones.

Methods

Participants (n = 1440; 18-65y) were part of a virtual population-based survey (2021-22). Sleep patterns were spatially represented through maps using Multilevel B-spline Interpolation. Relationships between and within biological/personal/socio-economic, behavioral and environment characteristics, and sleep outcomes were examined by Lasso regression. Restricted cubic splines were employed to examine the shape of the association of latitude and sunrise with sleep variables and of screen time before bed with bedtime.

Results

Latitude emerged as the primary geographic factor influencing variations in sleep duration and wake time, shortening and advancing, respectively, as latitude increased (towards equatorial line). Younger individuals, those living without partners, with depression, engaging in more frequent evening alcohol consumption, and with poorer diet quality, tended to wake up later. All the variables influenced bedtime, with daylight emerging as the environmental factor exerting the strongest association. While the variability in bedtime showed a non-linear association with latitude and sunrise, it displayed a dose-response relationship with screen time before bed.

Conclusions

Given that adults living in the same country, potentially with a similar timetable, could be having shorter sleep durations according to their latitude position, further studies are required to contemplate advocating for policies that implement schedules based on the sun position rather than the national time zone.

Exploring Sedentary and Nutritional Behaviour Patterns in Relation to Overweight and Obesity Among Youth from Different Demographic Backgrounds in Saudi Arabia

BACKGROUND

The prevalence of overweight and obesity has increased over the last three decades, becoming a major public health concern. This issue is particularly pressing in terms of the impact it has on the population of the Kingdom of Saudi Arabia (KSA). Thus, the aim of this research was to explore the nutritional and lifestyle habits of youth in the Al-Ahsa region of the KSA.

METHODS

This cross-sectional study included a total of 1270 secondary-school boys and girls (15-19 years) from all five of the Al-Ahsa Governorate districts. BMI and waist circumference measurements were recorded using anthropometric measurements, and the lifestyle-Arab Teens Lifestyle Survey (ATLS) was used to measure sedentary and eating habits.

RESULTS

Chi-square analysis revealed that a higher proportion of females (90.68%) than males (79.18%) exceeded two hours of daily sedentary time. Frequent sugary drink consumption (>3 times per week) was similar in males (67.40%) and females (66.11%). Students from different geographical locations showed significant differences in exceeding cut-off scores for fast food (χ2 = 24.503, p < 0.001), cakes/doughnuts (χ2 = 8.414, p = 0.015), sweets/candy (χ2 = 19.613, p < 0.001), and energy drinks (χ2 = 21.650, p < 0.001).

CONCLUSIONS

Al-Ahsa is the largest governorate in the KSA. It has some of the largest health risks regarding obesity and poor lifestyle habits. This study highlights the major need for future research and policy interventions.

The impact of breakfast skipping on plasma glucose levels in non-diabetic individuals: gender-based differences and implications

Chrono-nutritional factors may play a significant role in glucose regulation and the risk of type 2 diabetes (T2D). We investigated the association between breakfast skipping (BS) and fasting plasma glucose (FPG) levels in a non-diabetic cohort of the ABCD project (nutrition, cardiovascular wellness and diabetes) representing the general population of Palermo, Italy Among the 623 participants included in the analysis, 118 individuals were identified as BS. In men, BS was associated with higher values of FPG (p < .05), glycated haemoglobin (p < .01), triglycerides (p < .05) and insulin (p < .005). Among women, no significant differences were observed between BS and non-skippers. Multivariate regression analysis confirmed that BS was an independent predictor of higher FPG levels in men (p < .01); waist circumference emerged as the primary predictor of FPG in women (p < .001). This study supports the importance of dietary habits in glycaemic control and T2D risk.

Chrononutrition patterns and their association with body weight: Differences across multiple chronotypes

INTRODUCTION

In recent years, the focus of research on obesity and its management has expanded beyond traditional dietary factors to include the timing of food intake - in relation to the body's circadian rhythms - known as chrononutrition. However, chrononutrition patterns remain largely unexplored in low-medium income countries. Our study aimed to investigate the association between chrononutrition patterns and BMI.

MATERIAL AND METHODS

Utilizing data from the virtual Survey SONAR-Brazil (n=2137,18-65 y), we defined the following chrononutrition patterns: 1. The clock time of the first, mid, and last eating events; 2. Morning and evening latencies (from wake-up time until the first eating event, and from the last eating event until bedtime); and 3. Eating window. Linear regression analyses assessed associations between chrononutrition variables and BMI. Quantile regression and restricted cubic splines were used to explore distributional correlations and association shapes.

RESULTS

Among all participants, BMI increased with each additional hour of the first eating event (β=0.17; 95% CI, 0.05,0.29; P=0.005), morning latency (β=0.27; 95% CI, 0.12,0.42; P<0.001), and eating midpoint (β=0.21; 95% CI, 0.05,0.38; P=0.01) and the effect was even stronger with higher BMI percentiles. There was no effect of eating times among intermediate and late chronotypes. However, among early types, positive associations were seen between the BMI and the timing of the first eating event, morning latency, and eating midpoint, as well as a negative association with evening eating.

CONCLUSIONS

Our findings suggest that delaying the first eating event, the eating midpoint, and extending morning latency are associated with higher BMI, particularly in early chronotypes. These results highlight the importance of aligning eating patterns with chronotypes and support personalized dietary recommendations.

Association of Evening Eating with Sleep Quality and Insomnia among Adults in a Brazilian National Survey

Objective  To examine the association of evening eating clock time, its elapsed time to the midpoint of sleep (TEM), consumption of caffeine and sugary foods, and reporting dinner as the largest meal with sleep quality indicators and insomnia. Methods  Participants ( n  = 2,050;18-65y) were part of population-based research, with virtual data collection. Logistic regression models were fitted to assess differences in the ORs(95%CI) of sleep duration < 7 hours, sleep latency > 30 minutes, poor sleep quality, and insomnia (outcomes) with the evening diet-related variables. Linear regression analyses evaluated differences in sleep duration and latency associated with the same variables. Restricted cubic splines were used to study the shape of the association of eating event clock time and TEM with sleep duration and latency. Results  Each additional hour of evening eating clock time and of the TEM, respectively increased and decreased, the odds of sleep duration < 7/h [OR(95%CI):1.30(1.20,1.40); OR(95%CI):0.51(0.47,0.56)], sleep latency > 30min [OR(95%CI):1.14(1.07,1.22); 0.88(0.83,0.94)], poor sleep quality [OR(95%CI):1.21(1.13,1.30); 0.80(0.76,0.85)] and insomnia [OR(95%CI):1.12(1.04,1.20); 0.89(0.84,0.95)]. We found a dose-response association between evening eating (clock time and TEM) and sleep duration. The shortest latency was seen when evening eating was ∼20:00 and ∼7-8 hours before the midpoint of sleep. Participants who reported dinner as the largest meal and consumed caffeine and sugary foods/beverages after 18:00 presented higher odds of sleep duration < 7 hours, poor quality, and insomnia. Conclusions  Our findings indicate that an early-eating schedule has beneficial sleep effects and that it will be necessary to consider evening eating patterns and timing, along with the existing sleep and circadian hygiene, to improve sleep quality and circadian health.

Associations between temporal eating patterns and body composition in young adults: a cross-sectional study

PURPOSE

The aim of this study was to examine the associations between body composition and temporal eating patterns, including time of first eating occasion, time of last eating occasion, eating window, and eating jet lag (the variability in meal timing between weekdays and weekends).

METHODS

A total of 131 participants were included in the study. Temporal eating pattern information was collected through consecutive 7-day eat timing questionnaires and photographic food records. Body composition was assessed by bioelectrical impedance analysis. Multiple linear regression models were used to evaluate the relationships of temporal eating patterns with body composition, and age was adjusted. Eating midpoint was additionally adjusted in the analysis of eating window.

RESULTS

On weekdays, both later first eating occasion and last eating occasion were associated with lower lean mass, and longer eating window was associated with lower body fat percentage. On weekends, both later first eating occasion and last eating occasion were associated with lower lean mass, and longer eating window was associated with higher FFMI. Longer first eating occasion jet lag was associated with lower lean mass.

CONCLUSION

Our study suggested that earlier and more regular eating patterns may have a benefit on body composition.

Longitudinal associations of skipping breakfast and night eating with 4-year changes in weight and waist circumference among Chinese adults

BACKGROUND

The longitudinal association between specific eating behaviors, such as skipping breakfast and night eating, and changes in weight and waist circumference (WC) has been understudied.

OBJECTIVES

The objective of this study was to investigate whether skipping breakfast and night eating were individually or jointly associated with the annual changes in weight and WC.

METHODS

In the current longitudinal study, included were 48,150 Chinese adults (mean age: 50.1 ± 13.9 y) who were free of diabetes, cardiovascular diseases, and cancer in 2014, when data on dietary intake and the presence of night-eating behavior and skipping breakfast were collected via questionnaires. Weight and WC were measured repeatedly in 2014, 2016, and 2018. The associations between night eating and/or skipping breakfast and annual changes in weight and WC were evaluated using the generalized estimating equation models, adjusting for age, sex, total energy, diet quality, and other potential confounders.

RESULTS

During 4-y of follow-up, among people who had both 2 unhealthy eating behaviors, the mean difference in annual weight change was 0.53 kg (95% confidence interval: 0.43, 0.63 kg) and 0.41 cm (95% confidence interval: 0.27, 0.55 cm) in annual WC change, compared with participants without either behavior. The associations of eating behaviors and change in weight and WC were more pronounced in participants with higher baseline body mass index (in kg/m2) relative to their counterparts. Similarly, the associations between these eating behaviors and WC change were stronger in those with poorer diet quality relative to those with better diet quality.

CONCLUSIONS

Individuals with frequent skipping breakfast and/or night eating experienced faster gains in weight and WC, even after adjusting for diet quality and energy intake.

Circadian misalignment proxies, BMI, and chronic conditions: the role for weekday to weekend sleep differences

OBJECTIVE

To evaluate whether social jet lag (SJL) and weekend catch-up sleep (CUS), proxies of circadian misalignment, were associated with BMI and chronic conditions.

METHODS

Participants (n = 2,050,18-65y) were part of a virtual cross-sectional and population-based research. We examined CUS and SJL as continuous and categorical (< 1 h,1-2 h, > 2 h). Linear regression analyses were performed to assess the differences in BMI (outcome) associated with CUS and SJL. Restricted cubic splines were performed to explore the shape of the relationship between weekday-to-weekend variability in sleep duration, midpoint, wake time, and bedtime. Logistic regression models were used to estimate ORs(95%CIs) for chronic conditions and overweight related to CUS and SJL. Analyses were adjusted for sleep duration, biological and behavior-related variables.

RESULTS

We found a positive association of SJL and CUS with BMI. The effects remained even after adjustment for weekly sleep duration and demonstrated a proportional increase with the magnitude of sleep variability. Among participants with SJL > 2 h, BMI increased by 2.29 kg/m2 (95%CI:0.84;3.74,p:0.002). They also had 129% higher odds of chronic conditions (95%CI:1.16;4.52, p:0.01) and 119% higher odds of overweight (95%CI: 1.20;3.98,p:0.01). Individuals with CUS > 2 h presented 78% higher odds of overweight (95%CI:1.27;2.50,p:0.001) and an increase of 1.61 kg/m2 in BMI (95%CI: 0.81; 2.40,p < 0.001).

CONCLUSIONS

Our findings, which demonstrate that even a slight weekend sleep extension and variability of just 1 h is associated with higher values of BMI, suggest incorporating measures for sleep consistency and regularity into clinical protocols and public health guidelines to prevent and treat obesity and related diseases.

Effects of Postprandial Factors and Second Meal Intake Time on Bioequivalence Investigation of Tadalafil-Loaded Orodispersible Films in Human Volunteers

Tadalafil (TD) has poor water solubility but is well absorbed without affecting food intake when administered orally. Owing to patient adherence and therapeutic characteristics, a TD-loaded orodispersible film (TDF) is preferable. However, the mechanistic role of dietary status on the clinical pharmacokinetic analysis of TDF in human volunteers should be investigated because the gastrointestinal environment varies periodically according to meal intervals, although commercial 20 mg TD-loaded tablets (TD-TAB, Cialis® tablet) may be taken with or without food. TDF was prepared by dispersing TD in an aqueous solution and polyethylene glycol 400 to ensure good dispersibility of the TD particles. In the fasting state, each T/R of Cmax and AUC between TD-TAB and TDF showed bioequivalence with 0.936-1.105 and 1.012-1.153, respectively, and dissolution rates in 1000 mL water containing 0.5% SLS were equivalent. In contrast, TDF was not bioequivalent to TD-TAB under the fed conditions by the Cmax T/R of 0.610-0.798. The increased dissolution rate of TDF via the micronization of drug particles and the reduced viscosity of the second meal content did not significantly affect the bioequivalence. Interestingly, an increase in second meal intake time from 4 h to 6 h resulted in the bioequivalence by the Cmax T/R of 0.851-0.998 of TD-TAB and TDF. The predictive diffusion direction model for physical digestion of TD-TAB and TDF in the stomach after the first and second meal intake was successfully simulated using computational fluid dynamics modeling, accounting for the delayed drug diffusion of TDF caused by prolonged digestion of stomach contents under postprandial conditions.

Effect of recommendations of breakfast and late-evening snack habits on body composition and blood pressure: A pilot randomized trial

Breakfast skipping and late-evening snack are prevalent in young adults. This randomized controlled intervention aimed to evaluate the influence of meal habit recommendations on young adults' body composition and blood pressure. Nonpregnant adults (≥20 y old) who were eligible for bioelectrical impedance analysis examination (neither pacemaker installed nor medications that would affect body composition, like diuretics or corticosteroids) were enrolled after they provided informed consent (n = 125). Subjects were randomized into three groups, every group receiving one of the following recommendations: (a) daily breakfast consumption (within 2 h after waking up), (b) avoidance of late-evening snacks (after 21:00h or within 4 h before sleep, with the exception of water), and (c) both recommendations. Body composition and blood pressure were measured before randomization at baseline and at the follow-up 1 y later. Intent-to-treat analysis showed that the recommendation of daily breakfast may contribute to a lower increment of diastolic blood pressure by 3.23 mmHg (95% CI: 0.17-6.28). Receiving the breakfast recommendation was associated with more reduction of total body fat percent by 2.99% (95% CI: 0.23-5.74) and percent trunk fat by 3.63% (95% CI: 0.40-6.86) in inactive youths. Recommendation of avoiding late-evening snack did not significantly affect the outcome measures (ClinicalTrials.gov Identifier: NCT03828812).

Reestablishment of ad libitum feeding following partial food deprivation: Impact on locomotor activity, visceral fat, food intake, and circadian glycemic curve

Food deprivation has been associated with the development of metabolic pathologies. Few studies have explored the repercussions of a partial food deprivation following the reestablishment of an ad libitum diet. This study investigates the impact of a partial food deprivation (an 8-hour food intake restriction coupled with a 4-hour feeding window during the active phase) and the subsequent return to ad libitum feeding on the glycemic curve, food intake, and locomotor behavior. Wistar rats aged 45 days were subjected to 6 weeks of a partial food deprivation followed by 6 weeks of ad libitum feeding. Body weight, visceral fat, food intake, circadian glycemia, oral glucose tolerance, and locomotor activity were evaluated. It was found that the partial food deprivation resulted in the reduction of both the body weight and food intake; however, it increased visceral fat by 60%. Circadian glycemic values were altered at all intervals during the light phase, and glucose sensitivity improved at 60 minutes in the oral glucose tolerance test (OGTT). In the food-deprived group, the locomotor activity rhythm was reduced, with an observed delay in the peak of activity, reduction in total activity, and a decrease in the rhythmicity percentage. After the reestablishment of the ad libitum feeding, there was recovery of body weight, no difference in visceral fat, normalization of the food intake pattern, circadian glycemia, and oral glucose tolerance. Additionally, the return to ad libitum feeding restored locomotor activity, although the duration required for its complete recovery warrants further investigation. In conclusion, partial food deprivation induces physio-metabolic changes in rats, most of which are reversed after reestablishing ad libitum feeding.

Association of largest meal timing and eating frequency with body mass index and obesity

BACKGROUND AND AIMS

The circadian pattern of eating behaviors has garnered increasing interest as a strategy for obesity prevention and weight loss. It is believed that the benefits stem from aligning food intake with the body's natural daily rhythms. However, the existing body of evidence is limited in scale and scope and there has been insufficient evaluation of temporal eating behaviors, such as the specific time of day in which the highest calorie consumption occurs, meal frequency, and distribution. This research aims to explore the association between the timing of the largest meal of the day and eating frequency with Body Mass Index (BMI) and obesity.

METHODS

Participants (n = 2050, 18-65y) were part of an exploratory cross-sectional and population-based research, with data collection in a virtual environment. Linear regression analyses and restricted cubic splines evaluated differences in BMI associated with independent eating variables [timing of the largest meal, number of meals/day (as continuous and categorical: ≤3 or >3/day), and each largest meal of the day (breakfast/lunch/dinner)]. Logistic regression models were fitted to assess Odds Ratios (OR) and 95 % Confidence Intervals (CI) of obesity associated with the same independent variables.

RESULTS

Our main findings were that the timing of the largest meal and reporting dinner as the largest meal were associated with higher values of BMI (respectively, 0.07 kg/m2 and 0.85 kg/m2) and increased odds of obesity [respectively OR(95%CI):1.04(1.01,1.08), and OR(95%CI):1.67(1.18,2.38)]. Those who realized more than 3 meals/day presented lower values of BMI (-0.14 kg/m2) and 32 % lower odds of having obesity [OR(95%CI):0.68(0.52,0.89)]. Reporting lunch as the largest meal also protected against obesity [OR(95%CI):0.71(0.54,0.93)]. These associations were statistically significant and independent of sex, age, marital status, education level, diet quality, sleep duration, and weekly frequency of physical exercise.

CONCLUSION

Having the largest meal earlier in the day, concentrating the majority of caloric intake during lunch, and consuming more than three meals a day, may present a promising intervention for preventing and treating obesity/overweight.

Association of Meal Timing with Sleep Quality and Anxiety According to Chronotype: A Study of University Students

There are several determinants of mental health symptoms, ranging from individual characteristics to social factors. Consistent with patterns in the general population, students with evening characteristics tend to exhibit more anxiety symptoms and poorer sleep quality compared to morning students. Meal timing also appears to affect sleep and may be associated with mental health symptoms. In this context, the aim of the present study was to investigate the association of the timing of the main and last meals of the day with sleep quality and anxiety levels, according to the chronotype of university students. This study was conducted in colleges in São Paulo, Brazil, and involved application of a questionnaire to 162 university students. The questionnaire collected sociodemographic information meal and study times, and included scales assessing eveningness and morningness, sleep quality, and anxiety. Students demonstrating a phase delay in both chronotype and dinner timing exhibited higher levels of anxiety compared to morning-type students. Although no associations were observed between meal timing and sleep quality, sleeping later was associated with poorer sleep quality. The study suggests that evening students and those who eat late at night are more prone to presenting mental health symptoms. More studies are needed to further investigate this association.

Sleep and circadian hygiene practices association with sleep quality among Brazilian adults

Objective

To investigate the association of sleep and circadian hygiene practices (sleep-promoting and sleep-disturbing behaviors) with sleep quality indicators.

Methods

Participants (n = 2050; 18-65 y) were part of virtual population-based research. Logistic regression models were fitted to assess differences in the OR (95% CI) of poor quality with sleep-promoting/disturbing practices (time-of-day of exercise, pre-bedtime routine, naps, electronic devices with illuminated screens, caffeine and alcohol consumption, and smoking). Linear regression analyses evaluated differences in sleep duration, latency, and awakenings associated with the same variables. Restricted cubic splines were used to study the shape of the association of screen time before bed with sleep duration, latency, and awakenings. Analyses were adjusted for age, sex, region, marital status, educational level, evening diet quality, and BMI.

Results

Evening use of electronic devices with illuminated screens showed a negative effect on all sleep parameters. Reporting dinner as the largest meal and evening caffeine consumption was associated with shorter sleep duration and longer sleep latency. Smokers had higher odds of longer latency. A protective effect of morning exercises was demonstrated on sleep quality, latency, and awakenings. Alcohol consumers presented lower odds of poor quality and lower frequency of awakenings. Pre-bedtime practices showed no or negative effect on sleep outcomes.

Conclusions

Recommendations to promote sleep quality and prevent sleep-related problems, with corresponding circadian health benefits, should include engaging in regular exercise, preferably in the morning, and avoiding naps, heavy meals close to bedtime, caffeine, smoking, and evening screen exposure.

Association between dinner timing and glucose metabolism in rural China: A large-scale cross-sectional study

OBJECTIVES

Meal timing is a major risk factor for metabolic disease. The aim of this study was to assess the relationship between dinner timing and glucose metabolism in the rural Chinese population.

METHODS

This cross-sectional study included 7701 participants from a Henan rural cohort study. Basic information was collected by in-person questionnaires. Multiple linear regression analysis was used to evaluate the relationship between dinner timing and fasting insulin (FINS), fasting plasma glucose (FPG), and homeostatic model assessment for insulin resistance (HOMA-IR). Restricted cubic spline was employed to investigate the dose-response relationship between dinner timing and FINS, FPG, and HOMA-IR. A generalized linear model was used to explore the interaction effect of age and dinner timing on FINS, FPG, and HOMA-IR.

RESULTS

After adjusting for confounding factors, FINS concentration was reduced by 0.482 mmol/L (P < 0.001) for each hour delay in dinner timing. Furthermore, the HOMA-IR index decreased by 0.122 mmol/L for each hour delay. The results indicated a noticeable trend of decreasing values associated with later dinner timing (FINS: Poverall association < 0.001, Pnonlinear association = 0.144; HOMA-IR: Poverall association = 0.001, Pnonlinear association = 0.186). The interaction between age and dinner time significantly correlated with FINS and HOMA-IR (P < 0.05). This relationship was statistically significant before 69 y (P < 0.05).

CONCLUSION

A significant association between dinner timing and glucose metabolism was observed in the rural Chinese population. Delayed dinner timing may be associated with lower fasting insulin. The negative effect of dinner timing on FINS and HOMA-IR was diminished with age.