Late eating is associated with cardiometabolic risk traits, obesogenic behaviors, and impaired weight loss

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.

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.

Advancing Chrononutrition for Cardiometabolic Health: A 2023 National Heart, Lung, and Blood Institute Workshop Report

The circadian system maintains optimal biological functions at the appropriate time of day, and the disruption of this organization can contribute to the pathogenesis of cardiometabolic disorders. The timing of eating is a prominent external time cue that influences the circadian system. "Chrononutrition" is an emerging dimension of nutrition and active area of research that examines how timing-related aspects of eating and nutrition impact circadian rhythms, biological processes, and disease pathogenesis. There is evidence to support chrononutrition as a form of chronotherapy, such that optimizing the timing of eating may serve as an actionable strategy to improve cardiometabolic health. This report summarizes key information from the National Heart, Lung, and Blood Institute's virtual workshop entitled "Chrononutrition: Elucidating the Role of Circadian Biology and Meal Timing in Cardiometabolic Health," which convened on May 2 to 3, 2023, to review current literature and identify critical knowledge gaps and research opportunities. The speakers presented evidence highlighting the impact on cardiometabolic health of earlier and shorter eating windows and more consistent day-to-day eating patterns. The multidimensionality of chrononutrition was a common theme, as it encompasses multiple facets of eating along with the timing of other behaviors including sleep and physical activity. Advancing the emerging field of chrononutrition will require: (1) standardization of terminology and metrics; (2) scalable and precise tools for real-world settings; (3) consideration of individual differences that may act as effect modifiers; and (4) deeper understanding of social, behavioral, and cultural influences. Ultimately, there is great potential for circadian-based dietary interventions to improve cardiometabolic health.

Later eating timing in relation to an individual internal clock is associated with lower insulin sensitivity and affected by genetic factors

BACKGROUND

Although the contribution of the circadian clock to metabolic regulation is widely recognized, the role of eating timing in glucose metabolism and diabetes risk remains insufficiently studied. This study aimed (i) to investigate the link between the eating timing pattern relative to individual clock and glucose homoeostasis and (ii) to explore the contribution of genetic and environmental factors to eating timing parameters.

METHODS

In 92 adult twins (NCT01631123), glycaemic traits were assessed using the oral glucose tolerance test. Parameters of eating timing pattern (eating timing itself, daily calorie distribution, and eating frequency) were extracted from five-day food records. Caloric midpoint defined as the time point at which 50% of daily calories are consumed. Circadian timing of eating was determined as a time interval between the clock time of eating and a corrected midpoint of sleep, a chronotype marker. Heritability of eating timing components was estimated by comparing correlations within monozygotic and dizygotic twin pairs and fitting genetic structural equation models.

FINDINGS

Among components of eating timing, the most associations were found for the circadian time of caloric midpoint (CCM). Later CCM was significantly associated with poorer insulin sensitivity, i.e. with lower ISI Stumvoll (β = 0.304, p = 5.9 × 10-4) and higher HOMA-IR (β = -0.258, p = 0.011) indices, as well as with higher fasting insulin levels (β = -0.259, p = 0.013), even after the model adjustment for sex, age, daily energy intake, and sleep duration. Later CCM also demonstrated robust associations with higher BMI and waist circumference. All eating timing components showed high or moderate heritability and were strongly related to individual sleep timing.

INTERPRETATION

Later eating timing in relation to an individual internal clock is associated with lower insulin sensitivity. Shifting the main calorie intake to earlier circadian times may improve glucose metabolism, but genetic factors could influence the feasibility and effectiveness of eating-timing based interventions. The findings should be investigated in a larger cohort.

FUNDING

This work was supported by the German Research Foundation (DFG RA 3340/4-1 to OP-R, project number 530918029), by the European Association for the Study of Diabetes (Morgagni Prize 2020 to OP-R), and by the German Federal Ministry of Education and Research (BMBF NUGAT 0315424 to AFHP). The DZD is funded by the German Federal Ministry for Education and Research (01GI0925).

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.

The Association Between Midpregnancy Food Intake Timing Patterns and Gestational Weight Gain

Background: This article aims to characterize midpregnancy food timing profiles and examine their association with gestational weight gain (GWG). Materials and Methods: This secondary data analysis of a randomized controlled trial of two gestational diabetes screening approaches included 641 individuals with primary exposures and outcomes data. Food timing indicators (i.e., first and last eating episode time, caloric midpoint time, and the total eating window) were assessed using two 24-hour dietary recalls conducted in midpregnancy. Latent profile analysis was used to identify distinct food timing profiles based on these indicators. Regression analyses explored the associations between individual food intake timing indicators, food timing profiles, and GWG. Results: We identified four food timing profiles: extended window eating (n = 133; earliest first eating episode and the longest eating window), restricted window eating (n = 120; latest first eating episode and shortest eating window), early eating (n = 188; earliest caloric midpoint), and typical eating (n = 200; food intake aligning with the sample median). Participants with a restricted window eating profile (vs. typical eating profile) had an increased risk of insufficient GWG (unadjusted relative risk [RR] = 1.85, 95% confidence interval [CI] 1.12, 3.05). Each hour increase in the timing of the last eating episode was associated with 0.39 kg (0.03, 0.75) higher GWG. Both associations were attenuated in adjusted models and no longer statistically significant in adjusted models. Conclusions: We identified four distinct midpregnancy food timing profiles, but these profiles were not independently associated with GWG. These findings suggest that midpregnancy food timing may not play a major role in GWG.

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.

Neural and hormonal mechanisms of appetite regulation during eating

Numerous animal and clinical studies have demonstrated that the arcuate nucleus of the hypothalamus, a central regulator of appetite, plays a significant role in modulating feeding behavior. However, current research primarily focuses on long-term dietary changes and their effects on the body, with limited investigation into neuroendocrine dynamics during individual meals across diverse populations. In contrast to long-term dietary adjustments, directives for dietary behavior during a specific meal are more actionable, potentially enhancing patient adherence and achieving better outcomes in dietary behavior interventions. This review aimed to explore the neural pathways and endocrine changes activated by gastrointestinal expansion and variations in blood nutrient levels during a single meal, with the goal of informing dietary behavior guidance.

Late eating and shortened fasting are associated with higher ultra-processed food intake across all age groups: a population-based study

PURPOSE

Global dietary patterns are increasingly driven by ultra-processed foods-cheap, highly palatable, and ready-to-eat options. Exploring time-related eating patterns and its association with ultra-processed foods could help in intervention efforts, but knowledge on this topic is still limited. This study assessed the association of time-related eating patterns with unprocessed/minimally processed and ultra-processed food consumption across different life stages.

METHODS

Two 24-hour food recalls from a nationally representative sample in Brazil (Brazilian Household Budget Survey, POF, 2017-2018; n = 46,164) were used to estimate tertiles of first and last intake times, eating midpoint, caloric midpoint time, and night fasting (independent variables). All consumed foods were classified according to the Nova classification system, and the outcomes of interest were consumption of unprocessed/minimally processed and ultra-processed foods. Multiple linear regression models were performed for all individuals and stratified for each age group: adolescents (10-19 years, n = 8,469), adults (20-59 years, n = 29,332), and older individuals (≥ 60 years, n = 8,322).

RESULTS

The later tertile of first food intake time, last food intake time, caloric midpoint, and eating midpoint were positively associated with consumption of ultra-processed foods (β = 3.69, 95%CI = 3.04, 4.34; β = 1.89, 95%CI = 1.32, 2.47; β = 5.20, 95%CI = 4.60, 5.81; β = 3.10, 95%CI = 2.49, 3.71, respectively) and negatively associated with consumption of unprocessed or minimally processed foods (β=-2.79, 95%CI=-3.37; -2.22; β=-1.65, 95%CI=-2.24, -1.05; β=-3.94, 95%CI=-4.44, -3.44; β=- 2.35, 95%CI=-2.93, -1.78, respectively) compared to the first "earlier" tertile (reference). An inverse association was found for night fasting (β=-1.74, 95%CI=-2.28, -1.22 and β = 1.52, 95%CI = 0.98, 2.06 for ultra-processed and unprocessed/minimally processed foods, respectively). These associations were consistent across all age groups.

CONCLUSION

Chrononutrition patterns characterized by late intake timing and shortened overnight fasting were associated with higher consumption of ultra-processed foods and lower intake of unprocessed/minimally processed foods across all age groups.

Circadian rhythms, metabolism, and nutrition support in critically ill adult patients: a narrative review

PURPOSE OF REVIEW

The human circadian system regulates several physiological processes, including metabolism, which becomes significantly disrupted during critical illness. The common use of 24-h continuous nutrition support feeding in the intensive care unit (ICU) may further exacerbate these disruptions; this review evaluates recent evidence comparing continuous and intermittent feeding schedules in critically ill adults.

RECENT FINDINGS

Research comparing different feeding schedules in critically ill adults remains limited. Recent meta-analyses suggest that continuous and intermittent feeding schedules in the ICU have comparable adverse event profiles, including gastrointestinal intolerance. A retrospective study found that continuous feeding did not impact the 24-h glucose variation in critically ill adults, and a randomized controlled trial reported no significant differences in amino acid, lipid-based, or small molecule metabolite profiles between the two feeding regimens. Potential benefits of intermittent feeding include stimulation of muscle protein synthesis, preservation of normal hormone secretion, and improved attainment of nutritional goals.

SUMMARY

Current evidence suggests comparable safety profiles for continuous and intermittent feeding schedules in critically ill adult patients. However, intermittent and daytime cyclic feeding are expected to align more closely with normal circadian physiology. Given the lack of existing supportive data, a dynamic approach - transitioning from continuous feeding in the early-acute metabolic phase to intermittent feeding or daytime cyclic feeding - may be appropriate.

Time Restricted Eating: A Valuable Alternative to Calorie Restriction for Addressing Obesity?

PURPOSE OF REVIEW

In this review, we summarize the molecular effects of time-restricted eating (TRE) and its possible role in appetite regulation. We also discuss the potential clinical benefits of TRE in obesity.

RECENT FINDINGS

TRE is an emerging dietary approach consisting in limiting food intake to a specific window of time each day. The rationale behind this strategy is to restore the circadian misalignment, commonly seen in obesity. Preclinical studies have shown that restricting food intake only during the active phase of the day can positively influence several cellular functions including senescence, mitochondrial activity, inflammation, autophagy and nutrients' sensing pathways. Furthermore, TRE may play a role by modulating appetite and satiety hormones, though further research is needed to clarify its exact mechanisms. Clinical trials involving patients with obesity or type 2 diabetes suggest that TRE can be effective for weight loss, but its broader effects on improving other clinical outcomes, such as cardiovascular risk factors, remain less certain. The epidemic proportions of obesity cause urgency to find dietary, pharmacological and surgical interventions that can be effective in the medium and long term. According to its molecular effects, TRE can be an interesting alternative to caloric restriction in the treatment of obesity, but the considerable variability across clinical trials regarding population, intervention, and follow-up duration makes it difficult to reach definitive conclusions.

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.

Weekday-Weekend Differences in Chrononutritional Variables Depend on Urban or Rural Living

BACKGROUND/OBJECTIVES

Studies have highlighted the impact of work and school schedules on food preferences, suggesting that individuals' dietary choices may change during the week to align with their daily routines. Despite the variation in food composition in the population, there is no evidence identifying differences in food intake times and composition across the days of the week in urban/rural locations. Thus, the study's aim was to identify weekday vs. weekend differences in food intake times and composition (calories) between urban and rural areas.

METHODS

Data from 5770 participants (aged 18-59 years) were analyzed from the National Household Budget Survey (POF-IBGE) consisting of two distinct food diary records (weekday + weekend) per individual, including area (urban or rural) information in Brazil.

RESULTS

During weekdays, the time of the first food intake was significantly earlier, and the last food intake time was significantly later compared to weekends, resulting in a longer eating window on weekdays in both urban and rural areas. People living in urban areas exhibited delayed first and last food intake times, resulting in later caloric and eating midpoints compared to people living in rural areas. Periodogram analysis detected weekly rhythmicity (7 days) at the time of the first food intake and the length of the eating window in urban residents.

CONCLUSIONS

The observed 7-day rhythmic pattern of food intake in urban areas, driven by work and school schedules, underscores the influence of urbanization on dietary timing and composition. In contrast, rural areas exhibited more stable and earlier eating patterns. These results emphasize the need for public health interventions to address meal timing and circadian alignment, particularly in urban settings, to mitigate the risk of metabolic disorders and improve overall health outcomes.

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.

Habitual food consumption, eating behavior and meal-timing among Jordanian adults with elevated Blood pressure: a cross-sectional population-based study

BACKGROUND

The prevalence of elevated blood pressure (BP) has been raised worldwide. Food consumption, eating habits, and nutritional lifestyle related to meal timing, skipping meals, and meal contents have recently received more attention in studies on BP and metabolic syndrome. Purpose: This study evaluated the association between habitual food consumption, eating behavior, and meal timing with BP among Jordanian adults.

METHODS

A cross-sectional study included 771 Jordanian adults. A food frequency questionnaire was completed. Data about eating habits, meal timing, and emotional eating were collected. BP was measured.

RESULTS

The prevalence of less than recommended intake of vegetables, milk, protein, and fruits was higher in participants with elevated BP (69.2%, 90.2%, 58.9%, and 25.5%, respectively) as compared to the normal BP group (p < 0.001). Consuming vegetables and milk less than the recommended was reported to significantly increase the likelihood of elevated BP by OR= (1.60, and 2.75 (95%CI: 1.06-2.40; 1.62-4.66). Hence, consuming more than recommended fruit reduced the risk of elevated BP by OR = 0.56 (95%CI: 0.38-0.82). A 63.2% of elevated BP participants have three meals daily, a higher percentage of intake of one (23.5%) and two (45.7%) snacks. However, they had a higher percentage of morning eaters (50.7%), had lunch between 1:00-6:00 PM (92.7%), and had dinner between 6:00 and 9:00 PM (68.1%).

CONCLUSIONS

Although Jordanian adults with elevated BP appear to have healthy eating habits and meal timing and frequency, their habitual food consumption falls short of the daily recommendations for milk, fruits, vegetables, and protein.

Exploring factors influencing late evening eating and barriers and enablers to changing to earlier eating patterns in adults with overweight and obesity

Late evening eating is a potential risk factor for overconsumption and weight gain. However, there is limited qualitative research investigating the complex factors that influence late evening eating in adults living with obesity. Identifying the factors that influence late evening eating can inform interventions to reduce late evening eating and associated health risks. Therefore, this study aimed to: i) explore factors that contribute to eating late, and ii) apply the Capability, Opportunity, and Motivation Behaviour (COM-B) model to understand the barriers and enablers to changing to earlier food intake timings in UK adults who report eating late. Semi-structured interviews with seventeen participants [32.47 ± 6.65 years; 34.68 ± 7.10 kg/m2; 71% female (n = 12); 41% White (n = 7)] investigated reasons for late evening eating and the potential barriers and enablers to changing to earlier eating patterns. Thematic analysis identified four main contributors to late evening eating: 1) internal signals (e.g., feeling hungry in the evening); 2) external and situational factors (e.g., work schedules and the food-rich environment); 3) social factors (e.g., interactions with family) and 4) behavioural and emotional factors (e.g., personal preferences and negative feelings in the evening). Time constraints and work schedules were identified as main barriers to changing to earlier eating patterns. Whereas, having high motivation (e.g., contentment with eating earlier in the evening) and interpersonal support were identified as main enablers to eating earlier. This study provides in-depth insights into the psychological, social, and environmental factors contributing to late evening eating. The findings highlight potential targets for future interventions to facilitate earlier eating times in individuals at risk of overweight and obesity.

Late eating is associated with poor glucose tolerance, independent of body weight, fat mass, energy intake and diet composition in prediabetes or early onset type 2 diabetes

This study investigates the impact of habitual late calorie intake on glucose metabolism in adults with overweight or obesity and diet or metformin-controlled prediabetes or type 2 diabetes independently of body weight, fat mass, energy intake or diet composition. Participants (n = 26) were classified as Later Eaters (LE) if ≥45% daily calories were consumed after 5 pm and Early Eaters (EE) if not, based on daily caloric intake assessed over 2-wk. EE and LE did not differ in anthropometrics or daily energy intake, but LE consumed more carbohydrates (p = 0.038) and fats (p = 0.039) after 5 pm. Fasting glucose, insulin, and C-peptide did not differ between groups but LE exhibited higher glucose concentrations after an oral glucose tolerance test (p = 0.001), even after adjusting for body weight, fat mass, energy intake and diet composition (p < 0.05). Glucose results remained when participants with T2D were excluded (p = 0.031). After diabetes status adjustment, differences in glucose concentrations were higher in LE for time 30 (p = 0.028) and 60 min (p = 0.036). LE, compared to EE, had poorer glucose tolerance, independent of body weight, fat mass, daily energy intake and diet composition. ClinicalTrials.gov: NCT04465721.

Approach to the Treatment of Children and Adolescents with Obesity

Pediatric obesity continues to be an omnipresent disease; 1 in 5 children and adolescents have obesity in the United States. The comorbidities associated with youth-onset obesity tend to have a more severe disease progression in youth compared to their adult counterparts with the same obesity-related condition. A comorbidity of focus in this study is metabolism-associated steatotic liver disease (MASLD), which has rapidly evolved into the most common liver disease seen in the pediatric population. A direct association exists between the treatment of MASLD and the treatment of pediatric obesity. The current evidence supports that obesity treatment is safe and effective.

Food-Related Online Media (Mukbang and Cookbang) Exposure and Dietary Risk Behaviors in Korean Adolescents

BACKGROUND

Studies have shown that prolonged smartphone use is associated with dietary risk behaviors among adolescents. However, little is known about whether the exposure to food-related online media contents, such as mukbang (eating broadcast) and cookbang (cooking broadcast), is associated with unhealthy dietary behaviors, independent of overall duration of smartphone use.

OBJECTIVES

This study investigated the associations between the frequency of mukbang/cookbang watching and dietary risk behaviors among Korean adolescents, using nationally representative survey data.

METHODS

In this cross-sectional study, we examined the data from 50,044 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2022. Participants reported their frequency of mukbang/cookbang watching, mean duration of smartphone use, frequency of breakfast eating, frequency of nighttime eating, and intakes of fast foods, sugar-sweetened beverages (SSBs), and high-caffeine drinks. We performed multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between mukbang/cookbang watching and dietary risk behaviors, accounting for complex survey sampling and adjusting for potential confounders.

RESULTS

Frequent mukbang/cookbang watching (≥5 times/wk compared with never) was positively associated with dietary risk behaviors, including frequent breakfast skipping (OR: 1.20; 95% CI: 1.13, 1.28), frequent nighttime eating (OR: 1.43; 95% CI: 1.33, 1.54), and frequent intakes of fast foods (OR: 1.69; 95% CI: 1.58, 1.80), SSBs (OR: 1.47; 95% CI: 1.30, 1.66), and high-caffeine drinks (OR: 1.41; 95% CI: 1.33, 1.50), adjusting for duration of smartphone use. All mukbang/cookbang viewers, including those who perceived that mukbang/cookbang videos had "no influence" on their dietary behavior, had higher prevalence of dietary risk behaviors than nonviewers (perceived "no influence" compared with nonviewers-OR: 1.18; 95% CI: 1.10, 1.26, breakfast skipping; OR: 1.15; 95% CI: 1.06, 1.24, nighttime eating; OR: 1.40; 95% CI: 1.30, 1.50, fast foods; OR: 1.22; 95% CI: 1.07, 1.38, SSBs; OR: 1.28; 95% CI: 1.20, 1.37, high-caffeine drinks).

CONCLUSIONS

Our findings suggest that frequent mukbang/cookbang watching may be associated with unhealthy dietary behaviors among Korean adolescents.

Plant-based and Early Time-restricted Eating for Prevention and Treatment of Type 2 Diabetes in Adults: A Narrative Review

Type 2 diabetes (T2D) is a significant public health challenge for which effective lifestyle interventions are needed. A growing body of evidence supports the use of both plant-based eating patterns and early time-restricted eating (eTRE) for the prevention and treatment of T2D, but research has not yet explored the potential of these dietary strategies in combination. In this narrative review, we assessed the evidence by which plant-based diets, in conjunction with eTRE, could support T2D care. The electronic databases MEDLINE and the Web of Science were searched for relevant articles published throughout the last decade. Observational research has shown that healthy plant-based eating patterns and eTRE are associated with reductions in T2D risk. Interventional trials demonstrated that plant-based diets promote improvements in glycated hemoglobin, insulin resistance, glycemic management, and cardiometabolic risk factors. These changes may be mediated, in part, by reductions in oxidative stress, dietary acid load, and hepatocellular and intramyocellular lipids. The eTRE strategies were also shown to improve insulin resistance and glycemic management, and mechanisms of action included enhanced regulation of circadian rhythm and increased metabolic flexibility. Integrating these dietary strategies may produce additive benefits, mediated by reduced visceral adiposity and beneficial shifts in gut microbiota composition. However, potential barriers to concurrent implementation of these interventions may exist, including social challenges, scheduling constraints, and tolerance. Prospective trials are needed to examine their acceptability and clinical effects.

Association between dinner-bedtime interval and type 2 diabetes mellitus: a large-scale cross-sectional study

Objective

Glucose metabolism is impacted by circadian disruption. Dinner-bedtime interval (DBI) was an accessible indicator to reflect the alignment between dinner time and circadian clock. We aimed to investigate the association of DBI with type 2 diabetes mellitus (T2DM).

Methods

7676 adult subjects from the Henan Rural Cohort were included. Their demographic information including dinner time and bedtime was collected. Fasting venous blood samples were collected for biochemical determinations. Generalized linear regression model was used to analyze the factors influencing DBI. Furthermore, logistic regression incorporated with restricted cubic spline model was applied to evaluate the association between DBI and T2DM.

Results

The results of multiple linear regression model showed that age (β: -0.018, 95% CI: -0.021, -0.015) was negatively correlated with DBI. Female (β: 0.311, 95% CI: 0.229, 0.393), junior high school education (β: 0.246, 95% CI: 0.187, 0.306), high school education or above (β: 0.346, 95% CI: 0.259, 0.433), average monthly income with 1000-1999 CNY(0.102, 95% CI: 0.032, 0.171), average monthly income ≥ 2000 CNY (β: 0.164, 95% CI: 0.076, 0.251), moderate physical activity (β: 0.134, 95% CI: 0.071, 0.197), current smokers (β: 0.214, 95% CI: 0.118, 0.309), current drinkers (β: 0.099, 95% CI: 0.008, 0.190) were positively correlated with DBI. Furthermore, DBI was significantly associated with T2DM (adjusted OR: 0.910, 95%CI: 0.845-0.979, P = 0.012). DBI longer than 3 h was associated with decreased risk of T2DM (adjusted OR: 0.773, 95%CI: 0.648-0.921, P = 0.004).

Conclusions

DBI larger than 3 h is beneficial to T2DM prevention. Further investigation is required to verify the association.

Examining the evidence between screen time and night eating behaviour with dietary intake related to metabolic syndrome: A narrative review

Screen time (ST) on digital devices has increased in recent decades due to digital development. Furthermore, constant engagement with digital devices alters sleep patterns, leading to nocturnal eating behaviour among users. These phenomena are therefore of great concern, as digital device addiction and night eating are associated with unhealthy food intake, increasing the metabolic syndrome (MetS) risks. The purpose of this review was to examine the evidence of the influence of ST and night eating behaviour (NEB) on dietary intake and its association with MetS based on previous literature. Prolonged ST and NEB have an association with excessive intake of energy from overconsumption of high-sugar and high-fat foods. However, the relationship between digital content and its influence on food intake is inconsistent. A higher MetS risk was found in individuals with longer ST due to a sedentary lifestyle, while positive energy balance and a shift in circadian rhythm contributed to night eaters. ST and NEB presented with a significant influence on food intake in adults. Additionally, unhealthy food intake due to excessive consumption of empty-calorie foods such as sweet and fatty foods due to addiction to electronic devices and eating at night has a detrimental effect on metabolic function. Therefore, improving food intake by reducing ST and night binges is essential to reduce the risk of MetS.

Unfavorable Mealtime, Meal Skipping, and Shiftwork Are Associated with Circadian Syndrome in Adults Participating in NHANES 2005-2016

The concept of Circadian Syndrome (CircS) aims to emphasize the circadian disruptions underlying cardiometabolic conditions. Meal timing and shiftwork may disrupt circadian rhythms, increasing cardiometabolic risk. This study aimed to assess the associations of meal timing, meal skipping, and shiftwork with CircS in US adults and explore effect modifications by sociodemographic and lifestyle factors. CircS was defined using Metabolic Syndrome components in addition to short sleep and depression symptoms. Data from 10,486 participants of the National Health and Nutrition Examination Survey 2005-2016 were analyzed cross-sectionally. Mealtime was assessed by calculating the midpoint of intake between breakfast and dinner and dichotomizing it into favorable mealtime (between 12:30 and 13:15) and unfavorable mealtime using a data-driven approach. Meal skippers were categorized separately. Participants working evening, night, or rotating shifts were classified as shift workers. In the multivariable logistic regression analysis, an unfavorable mealtime, meal skipping, and shiftwork were associated with a higher likelihood of CircS (OR = 1.24; 95%CI 1.07-1.44, OR = 1.39; 95%CI 1.16-1.67, and OR = 1.37; 95%CI 1.01-1.87, respectively). Subgroup analyses revealed no significant interactions between meal timing, meal skipping, or shiftwork and socioeconomic status or lifestyle regarding CircS. These findings highlight the importance of aligning mealtimes with circadian rhythms for improved circadian health.

Impact of polygenic score for BMI on weight loss effectiveness and genome-wide association analysis

BACKGROUND

While environmental factors play an important role in weight loss effectiveness, genetics may also influence its success. We examined whether a genome-wide polygenic score for BMI was associated with weight loss effectiveness and aimed to identify common genetic variants associated with weight loss.

METHODS

Participants in the ONTIME study (n = 1210) followed a uniform, multimodal behavioral weight-loss intervention. We first tested associations between a genome-wide polygenic score for higher BMI and weight loss effectiveness (total weight loss, rate of weight loss, and attrition). We then conducted a genome-wide association study (GWAS) for weight loss in the ONTIME study and performed the largest weight loss meta-analysis with earlier studies (n = 3056). Lastly, we ran exploratory GWAS in the ONTIME study for other weight loss outcomes and related factors.

RESULTS

We found that each standard deviation increment in the polygenic score was associated with a decrease in the rate of weight loss (Beta (95% CI) = -0.04 kg per week (-0.06, -0.01); P = 3.7 × 10-03) and with higher attrition after adjusting by treatment duration. No associations reached genome-wide significance in meta-analysis with previous GWAS studies for weight loss. However, associations in the ONTIME study showed effects consistent with published studies for rs545936 (MIR486/NKX6.3/ANK1), a previously noted weight loss locus. In the meta-analysis, each copy of the minor A allele was associated with 0.12 (0.03) kg/m2 higher BMI at week five of treatment (P = 3.9 × 10-06). In the ONTIME study, we also identified two genome-wide significant (P < 5×10-08) loci for the rate of weight loss near genes implicated in lipolysis, body weight, and metabolic regulation: rs146905606 near NFIP1/SPRY4/FGF1; and rs151313458 near LSAMP.

CONCLUSION

Our findings are expected to help in developing personalized weight loss approaches based on genetics.

CLINICAL TRIAL REGISTRATION

Obesity, Nutrigenetics, Timing, and Mediterranean (ONTIME; clinicaltrials.gov: NCT02829619) study.

Time-Restricted Feeding Attenuates Metabolic Dysfunction-Associated Steatohepatitis and Hepatocellular Carcinoma in Obese Male Mice

Metabolic dysfunction-associated steatotic liver disease (MASLD) has surpassed the hepatitis B virus and hepatitis C virus as the leading cause of chronic liver disease in most parts of the Western world. MASLD (formerly known as NAFLD) encompasses both simple steatosis and more aggressive metabolic dysfunction-associated steatohepatitis (MASH), which is accompanied by inflammation, fibrosis, and cirrhosis, and ultimately can lead to hepatocellular carcinoma (HCC). There are currently very few approved therapies for MASH. Weight loss strategies such as caloric restriction can ameliorate the harmful metabolic effect of MASH and inhibit HCC; however, it is difficult to implement and maintain in daily life, especially in individuals diagnosed with HCC. In this study, we tested a time-restricted feeding (TRF) nutritional intervention in mouse models of MASH and HCC. We show that TRF abrogated metabolic dysregulation induced by a Western diet without any calorie restriction or weight loss. TRF improved insulin sensitivity and reduced hyperinsulinemia, liver steatosis, inflammation, and fibrosis. Importantly, TRF inhibited liver tumors in two mouse models of obesity-driven HCC. Our data suggest that TRF is likely to be effective in abrogating MASH and HCC and warrant further studies of time-restricted eating in humans with MASH who are at higher risk of developing HCC.

Unhealthy diets increase the likelihood of being overweight or obese among African migrant students in China, but not among African non-migrant students: a cross-sectional study

Background

The impact of non-communicable diseases (NCDs) is disproportionately felt by immigrants from low- to medium-income countries (LMICs), partly due to their dietary habits. To thrive in their new environment, migrants either omit or consume certain food items, which could lead to nutritional deficits. As a result, most migrants experience more NCDs than their compatriots in their native countries. Therefore, we evaluated the difference in dietary habits, quality, and the influencing factors of overweight or obesity among African migrant students in Nanjing (China) and non-migrant students in Africa using cross-sectional data.

Methods

The researchers used the food frequency questionnaire and the global diet quality score metrics to assess food intake and quality, respectively. Then, cross-tabulation was employed to explore the differences between the groups in meal skipping, eating habits, and diet quality. Finally, the factors associated with overweight or obesity were assessed with binary logistic regression stratified by African students in Nanjing and students in their native countries.

Results

Approximately 678 responses were received, mainly between 18-25 years (46.7%) and 26-36 years (45.4 %). The majority of them (52.3%) were international students. The non-migrant African students' diets lacked citrus fruits (22.2%), deep orange fruits (15.4%), deep orange vegetables (18%), cruciferous vegetables (24.6%), and dark leafy vegetables (26.5%). While the African migrant students consumed more high-fat dairy (50.7%), processed meats (23.9%), sweets and ice creams (51.3%), sugar-sweetened beverages (40.5%), and juice (61.5%), p < 0.001. Furthermore, consuming late-night meals constantly [Exp (B) = 39.607, p = 0.049], eating twice a day [Exp (B) = 6.527, p = 0.036], consuming red meat [Exp (B) = 29.287, p = 0.001], processed meats [Exp (B) = 719.979, p = 0.0011], refined grains and baked foods [Exp (B) = 15.752, p = 0.013], and sweets and ice cream [Exp (B) = 193.633, p = 0.006] were factors inducing overweight or obesity among only African migrant students.

Conclusion

Controlling the what (Western diet and nature of late-night meals) and the when of eating can drastically reduce their influence on obesogenic condition formation in African migrant students in China and elsewhere.

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.

Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes

Novel strategies are required to reduce the risk of developing diabetes and/or clinical outcomes and complications of diabetes. In this regard, the role of the circadian system may be a potential candidate for the prevention of diabetes. We reviewed evidence from animal, clinical, and epidemiological studies linking the circadian system to various aspects of the pathophysiology and clinical outcomes of diabetes. The circadian clock governs genetic, metabolic, hormonal, and behavioral signals in anticipation of cyclic 24-hour events through interactions between a "central clock" in the suprachiasmatic nucleus and "peripheral clocks" in the whole body. Currently, circadian rhythmicity in humans can be subjectively or objectively assessed by measuring melatonin and glucocorticoid levels, core body temperature, peripheral blood, oral mucosa, hair follicles, rest-activity cycles, sleep diaries, and circadian chronotypes. In this review, we summarized various circadian misalignments, such as altered light-dark, sleep-wake, rest-activity, fasting-feeding, shift work, evening chronotype, and social jetlag, as well as mutations in clock genes that could contribute to the development of diabetes and poor glycemic status in patients with diabetes. Targeting critical components of the circadian system could deliver potential candidates for the treatment and prevention of type 2 diabetes mellitus in the future.

Beyond sleep duration: Sleep timing is associated with BMI among Brazilian adults

OBJECTIVES

To examine the association of sleep duration and timing with BMI among adults. Also, to identify obesogenic and unhealthy behaviors (e.g.diet/sleep quality, physical activity, screen time, smoking) associated with short sleep duration and late bedtime.

PARTICIPANTS

Participants (n=755) were part of exploratory, population-based research, with data collection in a virtual environment.

METHODS

For purposes of characterizing the population we considered short sleepers<7h/night, and the population bedtime median was used to stratify participants into early and late sleepers (before and after 23:08). Student's t-test and chi-square test were performed to assess differences in characteristics between groups. Linear regression analyses were conducted to determine the association of sleep duration, bedtime, and wake-up time with BMI. Quantile regression was estimated for the 25th, 50th, and 75th quantiles to identify the distributional correlations between BMI and sleep variables. Restricted cubic splines were also used to study the shape of the association between sleep-BMI. Analyses were adjusted for potential confounding variables.

RESULTS

BMI decreased by 0.40Kg/m2 for each additional hour of sleep duration [95%CI=-0.68,-0.12,p=0.005] and increased by 0.37 kg/m2 for each additional hour of bedtime [95%CI=0.12,0.61,p=0.003]. The association between bedtime and BMI remained even after adjustment for sleep duration. These effects were higher and stronger with higher BMI values (p75th). Wake-up time did not show statistically significant associations.

CONCLUSIONS

Because we found that beyond sleep duration, bedtime was significantly associated with BMI, our data reflect the pertinence of assessing sleep timing patterns in disentangling sleep-obesity association. Insights into the characteristics, obesogenic and unhealthy behaviors related to short and late sleep may support specific strategies to prevent and treat excess body adiposity and other negative health outcomes.

Temporal patterns of energy intake identified by the latent class analysis in relation to prevalence of overweight and obesity in Iranian adults

We aimed to identify temporal patterns of energy intake and investigate their association with adiposity. We performed a cross-sectional study of 775 adults in Iran. Information about eating occasions across the day was collected by three 24-h dietary recalls. Latent class analysis (LCA) was used to identify temporal eating patterns based on whether or not an eating occasion occurred within each hour of the day. We applied binary logistic regression to estimate the OR and 95 % CI of overweight and obesity (defined as BMI of 25-29·9 and ≥ 30 kg/m2, respectively) across temporal eating patterns while controlling for potential confounders. LCA grouped participants into three exclusive sub-groups named 'Conventional', 'Earlier breakfast' and 'Later lunch'. The 'Conventional' class was characterised by high probability of eating occasions at conventional meal times. 'Earlier breakfast' class was characterised by high probability of a breakfast eating occasion 1 h before the conventional pattern and a dinner eating occasion 1 h after the conventional pattern, and the 'Later lunch' class was characterised by a high probability of a lunch eating occasion 1 h after the conventional pattern. Participants in the 'Earlier breakfast' pattern had a lower likelihood of obesity (adjusted OR: 0·56, 95 % CI: 0·35, 0·95) as compared with the 'Conventional' pattern. There was no difference in the prevalence of obesity or overweight between participants in the 'Later lunch' and the 'Conventional' patterns. We found an inverse association between earlier eating pattern and the likelihood of obesity, but reverse causation may be a plausible explanation.

Temporal Patterns of Diet and Physical Activity and of Diet Alone Have More Numerous Relationships With Health and Disease Status Indicators Compared to Temporal Patterns of Physical Activity Alone

BACKGROUND

Daily temporal patterns of energy intake (temporal dietary patterns [TDPs]) and physical activity (temporal physical activity patterns [TPAPs]) have been independently and jointly (temporal dietary and physical activity patterns [TDPAPs]) associated with health and disease status indicators.

OBJECTIVE

The aim of this study was to compare the number and strength of association between clusters of daily TDPs, TPAPs, and TDPAPs and multiple health and disease status indicators.

DESIGN

This cross-sectional study used 1 reliable weekday dietary recall and 1 random weekday of accelerometer data to partition to create clusters of participants representing the 3 temporal patterns. Four clusters were created via kernel-k means clustering algorithm of the same constrained dynamic time warping distance computed over the time series for each temporal pattern.

PARTICIPANTS/SETTING

From the National Health and Nutrition Examination Survey (2003-2006), 1,836 US adults aged 20 through 65 years who were not pregnant and had valid diet, physical activity, sociodemographic, anthropometric, questionnaire, and health and disease status indicator data were included.

MAIN OUTCOME MEASURES

Health status indicators used as outcome measures were body mass index, waist circumference, fasting plasma glucose, hemoglobin A1c, triglycerides, high-density lipoprotein cholesterol, total cholesterol, and systolic and diastolic blood pressure; disease status indicators included obesity, type 2 diabetes mellitus, and metabolic syndrome.

STATISTICAL ANALYSES PERFORMED

Multivariate regression models determined associations between the clusters representing each pattern and health and disease status indicators, controlling for confounders and adjusting for multiple comparisons. The number of significant differences among clusters and adjusted R2 and Akaike information criterion compared the strength of associations between clusters of patterns and continuous and categorical health and disease status indicators.

RESULTS

TDPAPs showed 21 significant associations with health and disease status indicators, including body mass index, waist circumference, obesity, and type 2 diabetes; TDPs showed 19 significant associations; and TPAPs showed 8 significant associations.

CONCLUSIONS

TDPAPs and TDPs had stronger and more numerous associations with health and disease status indicators compared with TPAPs. Patterns representing the integration of daily dietary habits hold promise for early detection of obesity.

Effect of skipping breakfast on cardiovascular risk factors: a grade-assessed systematic review and meta-analysis of randomized controlled trials and prospective cohort studies

Skipping breakfast is one of the most prevalent irregular eating habits. Several pieces of evidence have reported the association between breakfast omission and a higher risk of cardiovascular diseases. Numerous publications have focused on the impact of skipping breakfast on various cardiovascular risk factors. Therefore, the current systematic review and meta-analysis aimed to assess this impact, especially with regard to anthropometric measurements, serum lipid profiles, blood pressure, and glycemic control indicators. A comprehensive search was performed in PubMed, Web of Science, Embase, Scopus, and the Cochrane Central Register of Controlled Trials up to 1 April 2023. A total of 11 eligible trials were identified to evaluate the combined effects of skipping breakfast. Final integrated results demonstrated that breakfast omission significantly decreased the body weight (mean difference = -0.66, 95% CI: -1.09 to -0.24, p = 0.002, I2 = 0.0) and increased the level of serum low-density lipoprotein cholesterol (LDL-C) (mean difference = 9.89, 95% CI: 5.14 to 14.63, p = 0.000, I2 = 17.3). Subgroup analysis also revealed potential factors that may affect the outcomes, for example, the physiological condition of participants, duration, gender, and type of breakfast. In conclusion, skipping breakfast may reduce body weight while increasing the level of serum LDL-C at the same time. In view of the limited trials, further studies are needed to expound the role of breakfast omission in cardiovascular diseases.

Daylight Saving Time transitions and Cardiovascular Disease in Andalusia: Time Series Modeling and Analysis Using Visibility Graphs

The present study aimed to determine whether transitions both to and from daylight saving time (DST) led to an increase in the incidence of hospital admissions for major acute cardiovascular events (MACE). To support the analysis, natural visibility graphs (NVGs) were used with data from Andalusian public hospitals between 2009 and 2019. We calculated the incidence rates of hospital admissions for MACE, and specifically acute myocardial infarction and ischemic stroke during the 2 weeks leading up to, and 2 weeks after, the DST transition. NVG were applied to identify dynamic patterns. The study included 157 221 patients diagnosed with MACE, 71 992 with AMI (42 975 ST-elevation myocardial infarction (STEMI) and 26 752 non-ST-elevation myocardial infarction (NSTEMI)), and 51 420 with ischemic stroke. Observed/expected ratios shown an increased risk of AMI (1.06; 95% CI (1.00-1.11); P = .044), NSTEMI (1.12; 95% CI (1.02-1.22); P = .013), and acute coronary syndrome (1.05; 95% CI (1.00-1.10); P = .04) around the autumn DST. The NVG showed slight variations in the daily pattern of pre-DST and post-DST hospitalization admissions for all pathologies, but indicated that the increase in the incidence of hospital admissions after the DST is not sufficient to change the normal pattern significantly.

Comprehensive assessment of chrononutrition behaviors among nationally representative adults: Insights from National Health and Nutrition Examination Survey (NHANES) data

BACKGROUND

Aligning the time of food intake, i.e., chrononutrition, with the body's circadian clock can have a significant impact on overall health, particularly cardiometabolic health. However, there is a lack of population-based information on various chrononutrition behaviors in the United States, where the prevalence of obesity is high.

OBJECTIVE

Our primary aim was to characterize chrononutrition behaviors and their 15-year trends among US adults. We also explored the temporal associations between trends in chrononutrition behaviors and trends in obesity.

DESIGN

We utilized data from 8 cycles (2003-2018) of the National Health and Nutrition Examination Survey (NHANES) on 34,470 adults (age >19 years). The clock time of food/beverage consumption was extracted from two 24-h food recalls. The following chrononutrition behaviors were defined: 1) The clock time of the first, last, and midpoint (when 50% of total daily energy was consumed) of food/beverage intake; 2) Eating window (the time elapsed between the first and last intake); 3) Late-night eating (food intake between 21:00-23:59); and 4) Eating frequency. Survey-weighted % or mean ± standard error (SE) was used to demonstrate chrononutrition behaviors and survey-weighted regression models were utilized to evaluate trends in chrononutrition behaviors, BMI, and obesity over a 15-year period.

RESULTS

Thirty five percent of US adults had long eating windows lasting 13 h or more, with 59% of individuals consuming calories after 9 PM. The patterns of food intake among American adults were skewed, with the highest proportion of their daily energy intake (36%) being consumed during dinner meals. Notable differences in chrononutrition behaviors observed among different population subgroups. Young adults and men had longer eating windows with a higher prevalence of late-night eating compared to their age- and sex-counterparts. Black individuals had shorter eating periods due to delayed breakfast, the highest proportion (68%) of late-night eating, and obtained a greater amount of energy intake from snacks compared to other racial/ethnic groups. Over the 15-year span, there were only minor changes in a few aspects of chrononutrition behaviors, including 2% reduction in the time of eating window, while most other meal timing behaviors remained unchanged. Trends in chrononutrition behaviors were disproportionately smaller than the trends in obesity rates.

CONCLUSIONS

US adults persistently consume higher amounts of daily energy intake later in the day. Despite calls for Americans to shift intake to earlier parts of the day, this study shows that there is little change in the overall population over the 15-year period reviewed.

A micro-randomized pilot study to examine the impact of just-in-time nudging on after-dinner snacking in adults with type 2 diabetes: A study protocol

AIM

To determine whether a digital nudge soon after dinner reduces after-dinner snacking events as measured objectively by continuous glucose monitoring (CGM) in patients with type 2 diabetes (T2D).

METHODS

This is a single-site micro-randomized trial (MRT). People with T2D, aged 18-75 years, managed with diet or a stable dose of oral antidiabetic medications for at least 3 months, and who habitual snack after dinner at least 3 nights per week, will be recruited. Picto-graphic nudges were designed by mixed research methods. After a 2-week lead-in phase to determine eligibility and snacking behaviours by a CGM detection algorithm developed by the investigators, participants will be micro-randomized daily (1:1) to a second 2-week period to either a picto-graphic nudge delivered-in-time (Intui Research) or no nudge. During lead-in and MRT phases, 24-hour glucose will be measured by CGM, sleep will be tracked by an under-mattress sleep sensor, and dinner timing will be captured daily by photographing the evening meal.

RESULTS

The primary outcome is the difference in the incremental area under the CGM curve between nudging and non-nudging days during the period from 90 minutes after dinner until 04:00 AM. Secondary outcomes include the effect of baseline characteristics on treatment, and comparisons of glucose peaks and time-in-range between nudging and non-nudging days. The feasibility of 'just-in-time' messaging and nudge acceptability will be evaluated, along with the analysis of sleep quality measures and their night-to-night variability.

CONCLUSIONS

This study will provide preliminary evidence of the impact of appropriately timed digital nudges on 24 -hour intertitial glucose levels resulting from altered after-dinner snacking in people with T2D. An exploratory sleep substudy will provide evidence of a bidirectional relationship between after-dinner snacking behaviour, glycaemia and sleep. Ultimately, this study will allow for the design of a future confirmatory study of the potential for digital nudging to improve health related behaviours and health outcomes.

Association of Timing of Moderate-to-Vigorous Physical Activity With Changes in Glycemic Control Over 4 Years in Adults With Type 2 Diabetes From the Look AHEAD Trial

OBJECTIVE

We aimed to determine the association of the time-of-day of bout-related moderate-to-vigorous physical activity (bMVPA) with changes in glycemic control across 4 years in adults with overweight/obesity and type 2 diabetes.

RESEARCH DESIGN AND METHODS

Among 2,416 participants (57% women; mean age, 59 years) with 7-day waist-worn accelerometry recording at year 1 or 4, we assigned bMVPA timing groups based on the participants' temporal distribution of bMVPA at year 1 and recategorized them at year 4. The time-varying exposure of bMVPA (≥10-min bout) timing was defined as ≥50% of bMVPA occurring during the same time period (morning, midday, afternoon, or evening), <50% of bMVPA in any time period (mixed), and ≤1 day with bMVPA per week (inactive).

RESULTS

HbA1c reduction at year 1 varied among bMVPA timing groups (P = 0.02), independent of weekly bMVPA volume and intensity. The afternoon group had the greatest HbA1c reduction versus inactive (-0.22% [95%CI -0.39%, -0.06%]), the magnitude of which was 30-50% larger than the other groups. The odds of discontinuation versus maintaining or initiating glucose-lowering medications at year 1 differed by bMVPA timing (P = 0.04). The afternoon group had the highest odds (odds ratio 2.13 [95% CI 1.29, 3.52]). For all the year-4 bMVPA timing groups, there were no significant changes in HbA1c between year 1 and 4.

CONCLUSIONS

bMVPA performed in the afternoon is associated with improvements in glycemic control in adults with diabetes, especially within the initial 12 months of an intervention. Experimental studies are needed to examine causality.

Associations of timing of food intake with energy intake, eating behaviour traits and psychosocial factors in adults with overweight and obesity

Introduction

Whether a late distribution of food intake impacts obesity through increased energy intake remains uncertain and the behavioural characterization of late eating needs to be further investigated. The first objective of this study was to assess the associations between late eating and body mass index (BMI) and total energy intake (TEI), and whether TEI mediates the association between late eating and BMI. The second objective was to assess the associations between late eating and eating behaviour traits or psychosocial factors and whether eating behaviour traits mediate the association between late eating and TEI.

Methods

Baseline data from 301 individuals (56% women, age = 38.7 ± 8.5 years; BMI = 33.2 ± 3.4 kg/m²), who participated in four weight loss studies were used in this cross-sectional study. Total energy intake was assessed using a three-day food record from which the percentage of TEI after 17:00 and after 20:00 was calculated. Eating behaviour traits and psychosocial factors were assessed with questionnaires. Pearson correlations and mediation analyses adjusted for age, sex, underreporting of energy intake, sleep duration and bedtime were performed.

Results

Percent TEI after 17:00 and after 20:00 were associated with TEI (r = 0.13, p = 0.03 for both), and TEI mediated the association between percent TEI after 17:00 and BMI (β = 0.01 ± 0.01, 95% CI: 0.001, 0.02). Percent TEI after 17:00 was associated with disinhibition (r = 0.13, p = 0.03) and percent TEI after 20:00 was associated with susceptibility to hunger (r = 0.13, p = 0.03), stress (r = 0.24, p = 0.002) and anxiety (r = 0.28, p = 0.0004). In women, disinhibition mediated the association between percent TEI after 17:00 and TEI (β = 3.41 ± 1.43, 95% CI: 0.92, 6.47). Susceptibility to hunger mediated the association between percent TEI after 20:00 and TEI (β = 0.96 ± 0.59, 95% CI: 0.02, 2.34) in men and women.

Conclusion

Late eating is associated with TEI and suboptimal eating behaviours which could contribute to explaining the association between timing of food intake and obesity.

Circadian control of white and brown adipose tissues

White and brown adipose tissues are highly dynamic organs anticipating and responding to changes in the environment. The circadian timing system facilitates anticipation, and it is therefore not surprising that circadian disturbances, a prominent feature of modern 24/7 society, increase the risk for (cardio)metabolic diseases. In this mini-review, we will address mechanisms and strategies to mitigate disease risk associated with circadian disturbances. In addition, we discuss the opportunities arising from the knowledge we gained about circadian rhythms in these adipose tissues, including the application of chronotherapy, optimizing endogenous circadian rhythms to allow for more effective intervention, and the identification of novel therapeutic targets.

Association of meal timing with body composition and cardiometabolic risk factors in young adults

PURPOSE

To investigate the association of meal timing with body composition and cardiometabolic risk factors in young adults.

METHODS

In this cross-sectional study participated 118 young adults (82 women; 22 ± 2 years old; BMI: 25.1 ± 4.6 kg/m²). Meal timing was determined via three non-consecutive 24-h dietary recalls. Sleep outcomes were objectively assessed using accelerometry. The eating window (time between first and last caloric intake), caloric midpoint (local time at which ≥ 50% of daily calories are consumed), eating jetlag (variability of the eating midpoint between non-working and working days), time from the midsleep point to first food intake, and time from last food intake to midsleep point were calculated. Body composition was determined by DXA. Blood pressure and fasting cardiometabolic risk factors (i.e., triglycerides, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and insulin resistance) were measured.

RESULTS

Meal timing was not associated with body composition (p > 0.05). The eating window was negatively related to HOMA-IR and cardiometabolic risk score in men (R² = 0.348, β = - 0.605; R² = 0.234, β = - 0.508; all p ≤ 0.003). The time from midsleep point to first food intake was positively related to HOMA-IR and cardiometabolic risk score in men (R² = 0.212, β = 0.485; R² = 0.228, β = 0.502; all p = 0.003). These associations remained after adjusting for confounders and multiplicity (all p ≤ 0.011).

CONCLUSIONS

Meal timing seems unrelated to body composition in young adults. However, a longer daily eating window and a shorter time from midsleep point to first food intake (i.e., earlier first food intake in a 24 h cycle) are associated with better cardiometabolic health in young men.

CLINICAL TRIAL REGISTRATION

NCT02365129 ( https://www.

CLINICALTRIALS

gov/ct2/show/NCT02365129?term=ACTIBATE&draw=2&rank=1 ).

A hypothetical intervention of the timing of dietary intake on weight and body composition after initial weight loss

OBJECTIVE

This study estimated the effect of hypothetical interventions of higher and lower frequency of breakfast and post-dinner snack consumption (breakfast consumption 0-4 vs. 5-7 times/week and post-dinner snack consumption 0-2 vs. 3-7 times/week) on changes in body weight and composition over 18 months after a successful 6-month standard behavioral weight-loss program.

METHODS

The study analyzed data from the Innovative Approaches to Diet, Exercise and Activity (IDEA) study.

RESULTS

If all participants consumed a breakfast meal 5 to 7 times/week over 18 months, they would have regained 2.95 kg of body weight on average (95% CI: 2.01 to 3.96), which is 0.59 kg (95% CI: -0.86 to -0.32) lower than if all participants consumed breakfast 0 to 4 times/week. If all participants consumed a post-dinner snack 0 to 2 times/week, they would have regained 2.86 kg of body weight on average (95% CI: 0.99 to 5.25), which is 0.83 kg (95% CI: -1.06 to -0.59) lower than if all consumed a post-dinner snack 3 to 7 times/week.

CONCLUSIONS

Regular breakfast consumption and minimizing post-dinner snacking may modestly mitigate weight and body fat regain over 18 months after initial weight loss.

Intermittent fasting plus early time-restricted eating versus calorie restriction and standard care in adults at risk of type 2 diabetes: a randomized controlled trial

Intermittent fasting appears an equivalent alternative to calorie restriction (CR) to improve health in humans. However, few trials have considered applying meal timing during the 'fasting' day, which may be a limitation. We developed a novel intermittent fasting plus early time-restricted eating (iTRE) approach. Adults (N = 209, 58 ± 10 years, 34.8 ± 4.7 kg m-2) at increased risk of developing type 2 diabetes were randomized to one of three groups (2:2:1): iTRE (30% energy requirements between 0800 and 1200 hours and followed by a 20-h fasting period on three nonconsecutive days per week, and ad libitum eating on other days); CR (70% of energy requirements daily, without time prescription); or standard care (weight loss booklet). This open-label, parallel group, three-arm randomized controlled trial provided nutritional support to participants in the iTRE and CR arms for 6 months, with an additional 12-month follow-up. The primary outcome was change in glucose area under the curve in response to a mixed-meal tolerance test at month 6 in iTRE versus CR. Glucose tolerance was improved to a greater extent in iTRE compared with CR (-10.10 (95% confidence interval -14.08, -6.11) versus -3.57 (95% confidence interval -7.72, 0.57) mg dl-1 min-1; P = 0.03) at month 6, but these differences were lost at month 18. Adverse events were transient and generally mild. Reports of fatigue were higher in iTRE versus CR and standard care, whereas reports of constipation and headache were higher in iTRE and CR versus standard care. In conclusion, incorporating advice for meal timing with prolonged fasting led to greater improvements in postprandial glucose metabolism in adults at increased risk of developing type 2 diabetes. ClinicalTrials.gov identifier NCT03689608 .

Reciprocal Interactions between Circadian Clocks, Food Intake, and Energy Metabolism

Like other biological functions, food intake and energy metabolism display daily rhythms controlled by the circadian timing system that comprises a main circadian clock and numerous secondary clocks in the brain and peripheral tissues. Each secondary circadian clock delivers local temporal cues based on intracellular transcriptional and translational feedback loops that are tightly interconnected to intracellular nutrient-sensing pathways. Genetic impairment of molecular clocks and alteration in the rhythmic synchronizing cues, such as ambient light at night or mistimed meals, lead to circadian disruption that, in turn, negatively impacts metabolic health. Not all circadian clocks are sensitive to the same synchronizing signals. The master clock in the suprachiasmatic nuclei of the hypothalamus is mostly synchronized by ambient light and, to a lesser extent, by behavioral cues coupled to arousal and exercise. Secondary clocks are generally phase-shifted by timed metabolic cues associated with feeding, exercise, and changes in temperature. Furthermore, both the master and secondary clocks are modulated by calorie restriction and high-fat feeding. Taking into account the regularity of daily meals, the duration of eating periods, chronotype, and sex, chrononutritional strategies may be useful for improving the robustness of daily rhythmicity and maintaining or even restoring the appropriate energy balance.

Association between Late-Eating Pattern and Higher Consumption of Ultra-Processed Food among Italian Adults: Findings from the INHES Study

Late eating is reportedly associated with adverse metabolic health, possibly through poor diet quality. We tested the hypothesis that meal timing could also be linked to food processing, an independent predictor of health outcomes. We analysed data on 8688 Italians (aged > 19years) from the Italian Nutrition & HEalth Survey (INHES) established in 2010-2013 throughout Italy. Dietary data were collected through a single 24 h dietary recall, and the NOVA classification was used to categorize foods according to increasing levels of processing: (1) minimally processed foods (e.g., fruits); (2) culinary ingredients (e.g., butter); (3) processed foods (e.g., canned fish); (4) ultra-processed foods (UPFs; e.g., carbonated drinks, processed meat). We then calculated the proportion (%) of each NOVA group on the total weight of food eaten (g/d) by creating a weight ratio. Subjects were classified as early or late eaters based on the population's median timing for breakfast, lunch and dinner. In multivariable-adjusted regression models, late eaters reported a lower intake of minimally processed food (β = -1.23; 95% CI -1.75 to -0.71), a higher intake of UPF (β = 0.93; 0.60 to 1.25) and reduced adherence to a Mediterranean Diet (β = -0.07; -0.12 to -0.03) as compared to early eaters. Future studies are warranted to examine whether increased UPF consumption may underpin the associations of late eating with adverse metabolic health reported in prior cohorts.

Distribution of energy intake across the day and weight loss: A systematic review and meta-analysis

Consuming a greater proportion of total energy intake earlier in the day rather than in the evening is proposed to positively influence weight loss and health, potentially due to greater synchronization of human body circadian rhythms. This systematic review provides an update on existing evidence regarding earlier distributed eating patterns in weight loss interventions. Using a robust search strategy in five electronic databases, nine randomized controlled trials investigating the impact of energy intake distribution on weight loss were identified. Following critical appraisal, a random-effects meta-analyses found that, in the context of an energy-reduced diet, distributing energy intake with a focus on earlier intake resulted in significantly greater weight loss (-1.23 kg; 95% CI 2.40, -0.06, p = 0.04). Improvements in HOMA-IR, fasting glucose, and LDL cholesterol were also seen. The current study provides a timely update on the evidence linking distribution of total daily energy intake and health, showing that a focus on earlier intakes can result in greater short-term weight loss compared with later intakes. Future studies are needed to elucidate the impact that earlier intakes may have on weight management and metabolic health.

Improvement in chrono-nutrition is associated with robust weight loss outcomes: An extension of the feasibility study

Previously we had demonstrated the development and feasibility of an integrated chrono-nutrition weight reduction program among non-shift workers with morning and evening chronotypes. In this current paper, we described the association between the changes in chrono-nutrition practice and weight loss outcomes upon completing the weight reduction program. A total of 91 overweight/obese non-shift workers participated in the 12-week integrated chrono-nutrition weight reduction program (Age: 39.6 ± 6.3 y; 74.7% women; BMI: 31.2 ± 4.5 kg/m²). All the assessments including anthropometry, dietary, sleep habits, physical activity, and process of change were measured during pre- and post-intervention. Participants who had lost ≥3% of their body weight were categorized as satisfactory weight loss outcome, and those who did not achieve 3% weight loss were categorized as unsatisfactory weight loss. The satisfactory weight loss had greater daily percent energy intake during earlier in the day from protein (Mean difference (MD): +3.2%, 95% CI: 1.6, 4.9, p < .001) and smaller intake from fat during later in the day (MD: -2.6%, 95% CI: -5.1, -0.1, p = .045), earlier last mealtime (MD: -49.5 min, 95% CI: -86.5, -12.6, p = .009) and midpoint of eating (MD: -27.3 min, 95% CI: -46.3, -8.2, p = .006), shorter eating window (-0.8 h, 95% CI: -1.4, -0.1, p = .031) and greater reduction in night eating syndrome score (MD: -2.4, 95% CI: -4.3, -0.5, p = .015) compared to unsatisfactory weight loss outcome. After accounting for potential confounders, the temporal pattern of energy, protein, and fat intake were associated with greater odds of achieving a satisfactory weight loss. The findings suggest a promising role of chrono-nutrition as one of the strategies in weight reduction intervention.

Later energy intake relative to mathematically modeled circadian time is associated with higher percentage body fat

OBJECTIVE

Later circadian timing of energy intake is associated with higher body fat percentage. Current methods for obtaining accurate circadian timing are labor- and cost-intensive, limiting practical application of this relationship. This study investigated whether the timing of energy intake relative to a mathematically modeled circadian time, derived from easily collected ambulatory data, would differ between participants with a lean or overweight/obesity body fat percentage.

METHODS

Participants (N = 87) wore a light- and activity-measuring device (actigraph) throughout a cross-sectional 30-day study. For 7 consecutive days within these 30 days, participants used a time-stamped-picture phone application to record energy intake. Body fat percentage was recorded. Circadian time was defined using melatonin onset from in-laboratory collected repeat saliva sampling or using light and activity or activity data alone entered into a mathematical model.

RESULTS

Participants with overweight/obesity body fat percentages ate 50% of their daily calories significantly closer to model-predicted melatonin onset from light and activity data (0.61 hours closer) or activity data alone (0.86 hours closer; both log-rank p < 0.05).

CONCLUSIONS

Use of mathematically modeled circadian timing resulted in similar relationships between the timing of energy intake and body composition as that observed using in-laboratory collected metrics. These findings may facilitate use of circadian timing in time-based interventions.

Associations between Timing and Duration of Eating and Glucose Metabolism: A Nationally Representative Study in the U.S

Diabetes is highly prevalent and is associated with dietary behaviors. Time-restricted eating, which consolidates caloric intake to a shortened eating duration, has demonstrated improvement in metabolic health. Timing of eating could also impact metabolism. Our objective was to examine whether the timing of eating was associated with metabolic health independently of eating duration. Data (n = 7619) are from four cycles (2005-2012) of the National Health and Nutrition Examination Survey (NHANES), a nationally representative U.S. survey that included surveys, physical examinations, and dietary recalls. The primary exposures are eating duration and eating start time estimated from two non-consecutive dietary recalls. Primary outcomes were fasting glucose and estimated insulin resistance using the homeostatic model assessment method (HOMA-IR). The mean (95% CI) eating duration was 12.0 h (11.9-12.0) and the mean (95% CI) start time was 8:21 (8:15-8:26). Earlier eating start time was significantly associated with lower fasting glucose and estimated insulin resistance but eating interval duration was not. Every hour later that eating commenced was associated with approximately 0.6% higher glucose level and 3% higher HOMA-IR (both p < 0.001). In this cross-sectional study, earlier eating start time was associated with more favorable metabolic measures, indicating that meal timing is another important characteristic of dietary patterns that may influence metabolism.

Impact of early time-restricted eating on diet quality, meal frequency, appetite, and eating behaviors: A randomized trial

OBJECTIVE

Time-restricted eating (TRE) can reduce body weight, but it is unclear how it influences dietary patterns and behavior. Therefore, this study assessed the effects of TRE on diet quality, appetite, and several eating behaviors.

METHODS

Adults with obesity were randomized to early TRE plus energy restriction (eTRE + ER; 8-hour eating window from 7:00 a.m. to 3:00 p.m.) or a control eating schedule plus energy restriction (CON + ER; ≥12-hour window) for 14 weeks. Food intake was assessed via the Remote Food Photography Method, while eating patterns, appetite, and eating behaviors were assessed via questionnaires.

RESULTS

A total of 59 participants completed the trial, of whom 45 had valid food records. eTRE + ER did not affect eating frequency, eating restraint, emotional eating, or the consistency of mealtimes relative to CON + ER. eTRE + ER also did not affect overall diet quality. The intensity and frequency of hunger and fullness were similar between groups, although the eTRE + ER group was hungrier while fasting.

CONCLUSIONS

When combined with a weight-loss program, eTRE does not affect diet quality, meal frequency, eating restraint, emotional eating, or other eating behaviors relative to eating over more than a 12-hour window. Rather, participants implement eTRE as a simple timing rule by condensing their normal eating patterns into a smaller eating window.