Is time of eating associated with BMI and obesity? A population-based study.

PURPOSE: Time-related eating patterns have been associated with metabolic and nutritional diseases such as obesity. However, there is a lack of representative studies on this subject. This study's aim was to assess the association between the timing of eating and obesity in a large and representative sample of the Brazilian adult population (POF 2008-2009 survey). METHODS: Two days of adults' food diary (n = 21,020) were used to estimate tertiles of first and last meal intake times, eating midpoint, caloric midpoint time, and calories consumed from 18:00 h onwards. BMI was estimated and its values, as well as excess weight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) were used as outcomes. Multiple linear and logistic regressions were performed. RESULTS: The first (ß = 0.65, 95% CI 0.37-0.93) and last food intake time (ß = 0.40, 95% CI 0.14-0.66), eating midpoint (ß = 0.61, 95% CI 0.34-0.88) and calories consumed after 21:00 h (ß = 0.74, 95% CI 0.32-1.16) and 22:00 h (ß = 0.75, 95% CI 0.18-1.32) were positively associated with BMI. The likelihood of having excess weight or obesity was significantly higher in the third tertile of the first food intake time (OR = 1.28, 95% CI 1.13-1.45 and OR = 1.34, 95% CI 1.13-1.58, respectively), last food intake time (OR = 1.16, 95% CI 1.03-1.32; and OR = 1.18, 95% CI 1.00-1.41, respectively), eating midpoint (OR = 1.28, 95% CI 1.13-1.45; and OR = 1.35, 95% CI 1.14-1.59, respectively) and energy consumption after 21:00 h (OR = 1.33, 95% CI 1.10-1.59). CONCLUSION: Chrononutrition meal patterns indicative of late meal intake were significantly associated with high BMI, excess weight and obesity in the Brazilian population.

Role of chronotype in dietary intake, meal timing, and obesity: a systematic review.

CONTEXT: Recent studies show that dietary habits and obesity seem to be influenced by chronotype, which reflects an individual's preference for the timing of sleeping, eating, and activity in a 24-hour period. OBJECTIVE: This review aimed to analyze the association of chronotype with dietary habits, namely energy and macronutrient intakes, meal timing, and eating patterns, as well as with obesity. DATA SOURCES: PubMed/MEDLINE, LILACS, and Google Scholar databases were searched between 2004 and 2020. Study selection was performed by 2 authors independently; disagreements on eligibility of articles were resolved by a third author. After assessment of 12 060 abstracts, 43 studies (21 articles on obesity; 13 on food consumption, meal timing, and eating patterns; and 9 that addressed both obesity and dietary behavior) were included. DATA EXTRACTION: A standard form was used to extract study design, country, number of participants, method of chronotype determination, and main findings. DATA ANALYSIS: Approximately 95% of included studies showed an association between eveningness and at least 1 unhealthy eating habit. Morningness was associated with regular consumption of fresh and minimally processed foods. In addition, about 47% of studies showed a higher association between late types and obesity. CONCLUSION: Late types are more likely to present unhealthy eating habits, such as eating late at night, skipping breakfast often, and eating processed/ultraprocessed foods, while early types are more likely to have healthy and protective habits, such as eating early and eating predominantly fresh/minimally processed foods. Intermediate types tend to have a pattern of health and eating more similar to early types than to late types. Late types are also more likely to present higher weight and body mass index than early or intermediate types. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021256078.

Eating Earlier and More Frequently Is Associated With Better Diet Quality in Female Brazilian Breast Cancer Survivors Using Tamoxifen.

BACKGROUND: Emerging literature demonstrates that eating time and frequency are associated with quality and quantity of food consumption and anthropometric measurements. Considering that unhealthy dietary choices and obesity are important modifiable risk factors for breast cancer incidence and recurrence, this subject is relevant and has not been studied sufficiently in breast cancer survivors. OBJECTIVE: This study's aim was to examine the association of eating time and frequency with diet quality, quantity of food consumption, anthropometric measurements, and body composition parameters in female breast cancer survivors using tamoxifen. DESIGN: This was a cross-sectional study. PARTICIPANTS/SETTING: This study was conducted from March 2015 to March 2016 at a Brazilian university hospital (Clinic's Hospital, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil) and included an assessment of 84 female breast cancer survivors using tamoxifen (mean [SD] age was 53.1 [8.7] years). MAIN OUTCOME MEASURES: Quantitative dietary assessment consisted of three 24-hour dietary recalls. The Brazilian Healthy Eating Index Revised was used for the qualitative diet analysis. Participants were classified by median eating time (early or late eaters of breakfast, lunch, and dinner), as well as by considering the middle time point between the first and last meal of the day (early or late midpoint eaters). Participants were also classified by median eating frequency (<5 or ≥5 eating episodes per day). Anthropometric measurements and body fat percentage by bioelectrical impedance were obtained. STATISTICAL ANALYSIS: Generalized linear models and generalized mixed models were used to assess the associations between variables. RESULTS: Early breakfast and dinner eating and early midpoint eating were associated with better scores for specific Brazilian Healthy Eating Index Revised components (P < .05). Early breakfast and dinner eating were also associated with better scores for the total index (P = .035 and P = .017, respectively). Early dinner eaters and early midpoint eaters had significantly lower daily energy consumption (P = .007 and P = .002, respectively). Eating ≥5 episodes per day was also associated with better scores of specific Brazilian Healthy Eating Index Revised components and the total index (P < .05). No significant associations between eating time and frequency with anthropometric measurements and body composition parameters were found (P > .05). However, women in the healthy body mass index category vs women in the overweight/obesity category had higher energy consumption at breakfast (P = .046). CONCLUSIONS: Earlier food intake time was associated with better diet quality and lower daily energy consumption. Higher frequency of eating was also associated with better diet quality. Future studies, such as randomized controlled trials, are needed to evaluate interventions addressing the timing and frequency of meals and their effect on diet quality and quantity in breast cancer survivors.

A Nutritional Counseling Program Prevents an Increase in Workers' Dietary Intake and Body Weight During the COVID-19 Pandemic.

The COVID-19 pandemic caused thousands of deaths and changed lives all over the world. Daily life has also altered people's eating habits, mainly among those who stayed working at home. However, changes in the eating habits of workers who remained working during the pandemic are still unknown. The aim of this study was to evaluate the impact of the COVID-19 pandemic on the dietary habits of day and shift workers from a condominium management company, as well as to measure adherence to a nutritional counseling program and its effect on workers' food intake and body weight. One hundred and fifty-one workers (77.5% of day workers and 22.5% of shift workers) were followed up in the pre-pandemic period and during the pandemic. Data on anthropometry, food consumption, and adherence to nutritional counseling were collected during nutritional meetings, which focused on qualitative modification of food intake and control of energy consumption. The rate of adherence to the program did not differ between shifts. The pandemic significantly increased the intake of calories, macronutrients, and several micronutrients in workers of both shifts. Adherence to the nutritional counseling program had an impact on the consumption of proteins and some micronutrients, and also promoted a reduction in body weight and body mass index of workers of both shifts. Evening/night shift workers overall ate their meals later than day workers and also presented an earlier afternoon snack during the pandemic when compared with the pre-pandemic period. In conclusion, the pandemic seems to contribute to the increase in food intake of workers, regardless of the work shift. Those who joined a nutritional counseling program managed their food intake and lost weight.

A High-Protein Meal during a Night Shift Does Not Improve Postprandial Metabolic Response the Following Breakfast: A Randomized Crossover Study with Night Workers.

The aim of this study was to compare the acute effect of a high-protein/moderate carbohydrate (HP-MCHO) versus low-protein/high-carbohydrate (LP-HCHO) meal served at night on the postprandial metabolic response of male night workers the following breakfast. A randomized crossover study was performed with 14 male night workers (40.9 ± 8.9 years old; 29.1 ± 5.3 kg/m2). Participants underwent two different isocaloric dietary conditions at 1:00 h of the night shift: HP-MCHO (45 en% carbohydrate, 35 en% protein and 20 en% fat) and LP-HCHO (65 en% carbohydrate, 15 en% protein and 20 en% fat). Postprandial capillary glucose levels were determined immediately before the intake of the test meal and 30, 60, 90 and 120 min after the end of the meal. At the end of the work shift (6:30 h), participants received a standard breakfast and postprandial levels of glucose, insulin and triglycerides were determined immediately before and then every 30 min for 2 h (30, 60, 90 and 120 min). Higher values of capillary glucose were found after the LP-HCHO condition compared to the HP-MCHO condition (area under the curve (AUC) = 119.46 ± 1.49 mg/dL × min and 102.95 ± 1.28 mg/dL × min, respectively; p < 0.001). For the metabolic response to standard breakfast as the following meal, no significant differences in glucose, insulin, triglyceride, and HOMA-IR levels were found between interventions. A night meal with a higher percentage of protein and a lower percentage of carbohydrate led to minor postprandial glucose levels during the night shift but exerted no effect on the metabolic response of the following meal. This trial was registered at ClinicalTrials.gov as NCT03456219.

Association between inflammatory potential of the diet and sleep parameters in sleep apnea patients.

OBJECTIVES: The aim of this study was to analyze the association between the inflammatory potential of diet and sleep parameters in individuals with obstructive sleep apnea (OSA) and to evaluate the sensitivity and specificity of the dietary inflammatory index (DII) at predicting sleep pattern. METHODS: Patients diagnosed with mild to severe OSA were included in the study (N = 296). Sleep pattern was analyzed by polysomnography and subjective sleep parameters. DII scores were calculated from a validated food frequency questionnaire. Receiver operating characteristic curve analysis and generalized linear models were conducted. RESULTS: DII scores were efficient at predicting apnea severity (P < 0.05) and daytime sleepiness (P = 0.02) in age stratification and predicting rapid eye movement latency in obese individuals (P = 0.03). No significant associations were found between DII scores and the majority of sleep parameters. The DII was only associated with daytime sleepiness; patients with a more proinflammatory diet (quintile 4) showed more subjective sleepiness than the group with a more anti-inflammatory diet (quintile 1; P < 0.05). CONCLUSION: Findings from this study indicated that the DII could be sensitive and specific for predicting apnea severity in individuals commonly associated with OSA. Although the DII was not associated with most of the sleep parameters, the few associations found demonstrated the need for more studies that evaluate whether DII is associated with the risk for OSA symptoms.

Night workers have lower levels of antioxidant defenses and higher levels of oxidative stress damage when compared to day workers.

The effects of circadian misalignment and work shift on oxidative stress profile of shift workers have not been explored in the literature. The present study aimed to evaluate the role of shift work (day and night) and social jetlag - a measure of circadian misalignment - with oxidative stress markers. A cross-sectional study was performed with 79 men (21-65 years old, 27.56 ± 4.0 kg/m2) who worked the night shift (n = 37) or daytime (n = 42). The analyzed variables included anthropometric measures and determination of systemic levels of markers of oxidative damage and antioxidant defense. Social jetlag was calculated by the absolute difference between the mean sleep point on working and rest days. The night group presented higher systemic values of thiobarbituric acid reactive substances and hydrogen peroxide, and lower levels of nitrite, total antioxidant capacity, and catalase and superoxide dismutase activities in relation to the day group. However, social jetlag was not associated with oxidative stress-related biomarkers analyzed in the night group. These results suggest that the night worker has higher levels of oxidative stress damage and lower levels of antioxidant defenses, while social jetlag was not a possible responsible factor for this condition.

Estilo de vida e formação médica: impacto sobre o perfil nutricional / Lifestyle and medical education: impact on the nutritional profile

A formação do profissional médico impõe modificações nocivas ao estilo de vida, predispondo ao ganho de peso. O objetivo deste estudo foi realizar uma revisão acerca das prevalências de sobrepeso e obesidade e possíveis fatores causais destas taxas em estudantes de Medicina (EM) e médicos residentes (MR). Realizou-se uma busca nas bases de dados on-line PubMed/Medline (US National Library of Medicine), Scielo e Lilacs, com as palavras-chave: "estudantes de medicina" e "médicos residentes", associadas com cada um dos termos: "índice de massa corporal (IMC)"; "obesidade"; "sobrepeso"; "ingestão alimentar"; "sedentarismo" e "sono", e suas traduções para a língua inglesa. Foram selecionados 31 estudos, dos quais 25 foram realizados com EM, cinco com MR e um com ambas as populações. Dezesseis estudos retrataram altas prevalências de sobrepeso e obesidade (taxas de 15% a 83%). Em relação aos fatores associados ao aumento de peso, destacaram-se os hábitos alimentares inadequados. Sonolência excessiva diurna, privação do sono e sedentarismo também foram amplamente identificados. Estes resultados ressaltam a necessidade de desenvolver ações para minimizar os efeitos negativos da rotina imposta pelo processo de formação médica, em especial os aspectos relacionados a excesso de peso.

The training of the medical profession imposes harmful changes to lifestyle, which predisposes to weight gain. The aim of this study was to review the prevalence of overweight and obesity and possible causative factors in these rates in medical students (MS) and residents physicians (RP). We conducted a search of the databases online: PubMed / Medline (U.S. National Library of Medicine), Scielo and Lilacs with the keywords: "medical students" and "residents" associated with each of the terms: "body mass index (BMI)", "obesity", "overweight", "food intake", "sendentarism" and "sleep", and using the translation of these terms for the English language Thirty one studies were selected, where 25 were performed with EM, five with MR and one with both the populations. Sixteen studies indicated high prevalences of overweight and obesity (ranging between 15% and 83%). Regarding factors associated with weight gain, have stand out inadequate food intake. The excessive daytime sleepiness, sleep deprivation and sedentarism were widely identified. These results underscore the need to develop actions to minimize the negative effects of routine imposed by the process of medical training, especially those aspects related to excess weight.