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Circadian Misalignment, Nutrition, and Cardiometabolic Health

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Metabolism".

Deadline for manuscript submissions: closed (31 August 2020) | Viewed by 38172

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Dr. Andrew McHill

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Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR, 3181 SW Sam Jackson Park Road—L606, USA
Interests: circadian misalignment; cardiometabolic health; meal timing; insufficient and disrupted sleep
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Dear Colleagues,

With the invention of electrical lighting, humans have the ability to extend work and social activities far into the biological night, when melatonin levels are high and the internal circadian timing system is promoting sleep. Wakefulness during this ‘circadian misalignment’ is associated with decreased mood and performance, impaired daytime sleep, excessive sleepiness, and a multitude of adverse health outcomes including metabolic syndrome, diabetes, and obesity. While recent evidence has begun to elucidate how eating during circadian misalignment influences health, more information is needed about mechanisms and specifics of how diet, metabolism, and cardiometabolic health interact during circadian misliangment. This is of particular importance in the shift-working population, as shift workers compose ~20% of the United States workforce, and the need for 24-hour operations is unavoidable. Moreover, there is limited information available on the timing and quality of diet in shift workers on their habitual work schedules.

Original research at mechanistic, observational, and epidemiological levels on topics regarding circadian timing and energy metabolism, meal timing, meal composition, and all aspects of cardiometabolic health are encouraged. Reviews of the literature are also welcome.

Dr. Andrew McHill
Guest Editor

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Keywords

circadian
meal timing
metabolism
metabolic syndrome
hypertension
diabetes
obesity
health
macronutrients
calories
sleep

Published Papers (7 papers)

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Research

22 pages, 1637 KiB

Open AccessArticle

Time-Restricted Eating as a Nutrition Strategy for Individuals with Type 2 Diabetes: A Feasibility Study

by Evelyn B. Parr, Brooke L. Devlin, Karen H. C. Lim, Laura N. Z. Moresi, Claudia Geils, Leah Brennan and John A. Hawley

Nutrients 2020, 12(11), 3228; https://doi.org/10.3390/nu12113228 - 22 Oct 2020

Cited by 71 | Viewed by 11324

Abstract

Individuals with type 2 diabetes (T2D) require a long-term dietary strategy for blood glucose management and may benefit from time-restricted eating (TRE, where the duration between the first and last energy intake is restricted to 8–10 h/day). We aimed to determine the feasibility of TRE for individuals with T2D. Participants with T2D (HbA1c >6.5 to <9%, eating window >12 h/day) were recruited to a pre-post, non-randomised intervention consisting of a 2-week Habitual period to establish baseline dietary intake, followed by a 4-weeks TRE intervention during which they were instructed to limit all eating occasions to between 10:00 and 19:00 h on as many days of each week as possible. Recruitment, retention, acceptability, and safety were recorded throughout the study as indicators of feasibility. Dietary intake, glycaemic control, psychological well-being, acceptability, cognitive outcomes, and physiological measures were explored as secondary outcomes. From 594 interested persons, and 27 eligible individuals, 24 participants enrolled and 19 participants (mean ± SD; age: 50 ± 9 years, BMI: 34 ± 5 kg/m², HbA1c: 7.6 ± 1.1%) completed the 6-week study. Overall daily dietary intake did not change between Habitual (~8400 kJ/d; 35% carbohydrate, 20% protein, 41% fat, 1% alcohol) and TRE periods (~8500 kJ/d; 35% carbohydrate, 19% protein, 42% fat, 1% alcohol). Compliance to the 9 h TRE period was 72 ± 24% of 28 days (i.e., ~5 days/week), with varied adherence (range: 4–100%). Comparisons of adherent vs. non-adherent TRE days showed that adherence to the 9-h TRE window reduced daily energy intake through lower absolute carbohydrate and alcohol intakes. Overall, TRE did not significantly improve measures of glycaemic control (HbA1c −0.2 ± 0.4%; p = 0.053) or reduce body mass. TRE did not impair or improve psychological well-being, with variable effects on cognitive function. Participants described hunger, daily stressors, and emotions as the main barriers to adherence. We demonstrate that 4-weeks of TRE is feasible and achievable for these individuals with T2D to adhere to for at least 5 days/week. The degree of adherence to TRE strongly influenced daily energy intake. Future trials may benefit from supporting participants to incorporate TRE in regular daily life and to overcome barriers to adherence. Full article

(This article belongs to the Special Issue Circadian Misalignment, Nutrition, and Cardiometabolic Health)

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18 pages, 1688 KiB

Open AccessArticle

Quantifying Diet Intake and Its Association with Cardiometabolic Risk in the UK Airwave Health Monitoring Study: A Data-Driven Approach

by Larissa C. Hunt, Hassan S. Dashti, Queenie Chan, Rachel Gibson and Céline Vetter

Nutrients 2020, 12(4), 1170; https://doi.org/10.3390/nu12041170 - 22 Apr 2020

Cited by 3 | Viewed by 3082

Abstract

We used data-driven approaches to identify independent diet exposures among 45 candidate variables, for which we then probed cross-sectional associations with cardiometabolic risk (CMR). We derived average daily caloric intake and macronutrient composition, daily meal frequencies, and irregularity of energy and macronutrient intake from 7-day food diaries in the Airwave Health Monitoring Study participants (N = 8090). We used K-means and hierarchical clustering to identify non-redundant diet exposures with representative exposures for each cluster chosen by silhouette value. We then used multi-variable adjusted logistic regression to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI) for CMR (≥3 criteria: dyslipidemia, hypertension, central adiposity, inflammation and impaired glucose control) across diet exposure quartiles. We identified four clusters: i) fat intake, ii) carbohydrate intake, iii) protein intake and intake regularity, and iv) meal frequencies and energy intake. Of these clusters, higher carbohydrate intake was associated with lower likelihood of CMR (PR = 0.89, 95%CI = 0.81–0.98; p_trend = 0.02), as was higher fiber intake (PR = 0.76, 95%CI = 0.68–0.85; p_tren_d < 0.001). Higher meal frequency was also associated with lower likelihood of CMR (PR = 0.76, 95%CI = 0.68–0.85; p_trend < 0.001). Our results highlight a novel, data-driven approach to select non-redundant, minimally collinear, primary exposures across a host of potentially relevant exposures (including diet composition, temporal distribution, and regularity), as often encountered in nutritional epidemiology. Full article

(This article belongs to the Special Issue Circadian Misalignment, Nutrition, and Cardiometabolic Health)

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18 pages, 1335 KiB

Open AccessArticle

Hot, Tired and Hungry: The Snacking Behaviour and Food Cravings of Firefighters during Multi-Day Simulated Wildfire Suppression

by Charlotte C. Gupta, Sally A. Ferguson, Brad Aisbett, Michelle Dominiak, Stephanie E. Chappel, Madeline Sprajcer, Hugh H. K. Fullagar, Saman Khalesi, Joshua H. Guy and Grace E. Vincent

Nutrients 2020, 12(4), 1160; https://doi.org/10.3390/nu12041160 - 21 Apr 2020

Cited by 9 | Viewed by 4331

Abstract

Firefighters are exposed to numerous stressors during wildfire suppression, including working in hot temperatures and sleep restricted conditions. Research has shown that when sleep restricted, individuals choose foods higher in carbohydrates, fat, and sugar, and have increased cravings for calorie dense foods. However, there is currently no research on the combined effect of heat and sleep restriction on snacking behaviour. Conducting secondary analyses from a larger study, the current study aimed to investigate the impact of heat and sleep restriction on snacking behaviour and food cravings. Sixty-six firefighters completed three days of simulated physically demanding firefighting work and were randomly allocated to either the control (n = 18, CON; 19 °C, 8 h sleep opportunity), sleep restricted (n = 16, SR; 19 °C, 4-h sleep opportunity), hot (n = 18, HOT; 33 °C, 8 h sleep opportunity), or hot and sleep restricted (n = 14 HOT + SR; 33 °C, 4-h sleep opportunity) condition. During rest periods firefighters were able to self-select sweet, savoury, or healthy snacks from a ration pack and were asked to rate their hunger, fullness, and cravings every two hours (eating block). Mixed model analyses revealed no difference in total energy intake between conditions, however there was a significant interaction between eating block and condition, with those in the CON, HOT, and HOT + SR condition consuming significantly more energy between 1230 and 1430 compared to the SR condition (p = 0.002). Sleep restriction and heat did not impact feelings of hunger and fullness across the day, and did not lead to greater cravings for snacks, with no differences between conditions. These findings suggest that under various simulated firefighting conditions, it is not the amount of food that differs but the timing of food intake, with those that are required to work in hot conditions while sleep restricted more likely to consume food between 1230 and 1430. This has potential implications for the time of day in which a greater amount of food should be available for firefighters. Full article

(This article belongs to the Special Issue Circadian Misalignment, Nutrition, and Cardiometabolic Health)

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17 pages, 2057 KiB

Open AccessArticle

Moderate Weight Loss Modifies Leptin and Ghrelin Synthesis Rhythms but Not the Subjective Sensations of Appetite in Obesity Patients

by Juan José Hernández Morante, Inmaculada Díaz Soler, Joaquín S. Galindo Muñoz, Horacio Pérez Sánchez, Mª del Carmen Barberá Ortega, Carlos Manuel Martínez and Juana Mª Morillas Ruiz

Nutrients 2020, 12(4), 916; https://doi.org/10.3390/nu12040916 - 27 Mar 2020

Cited by 9 | Viewed by 4484

Abstract

Obesity is characterized by a resistance to appetite-regulating hormones, leading to a misalignment between the physiological signals and the perceived hunger/satiety signal. A disruption of the synthesis rhythm may explain this situation. The aim of this study was to evaluate the effect of dietary-induced weight loss on the daily rhythms of leptin and ghrelin and its influence on the daily variability of the appetite sensations of patients with obesity. Twenty subjects with obesity underwent a hypocaloric dietary intervention for 12 weeks. Plasma leptin and ghrelin were analyzed at baseline and at the end of the intervention and in 13 normal-weight controls. Appetite ratings were analyzed. Weight loss decreased leptin synthesis (p_auc < 0.001) but not the rhythm characteristics, except the mean variability value (p_mesor = 0.020). By contrast, the mean ghrelin level increased after weight loss. The rhythm characteristics were also modified until a rhythm similar to the normal-weight subjects was reached. The amount of variability of leptin and ghrelin was correlated with the effectiveness of the dietary intervention (p < 0.020 and p < 0.001, respectively). Losing weight partially restores the daily rhythms of leptin and modifies the ghrelin rhythms, but appetite sensations are barely modified, thus confirming that these hormones cannot exercise their physiological function properly. Full article

(This article belongs to the Special Issue Circadian Misalignment, Nutrition, and Cardiometabolic Health)

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11 pages, 984 KiB

Open AccessArticle

Early Morning Food Intake as a Risk Factor for Metabolic Dysregulation

by Ellen R. Stothard, Hannah K. Ritchie, Brian R. Birks, Robert H. Eckel, Janine Higgins, Edward L. Melanson, Kenneth P. Wright Jr. and Andrew W. McHill

Nutrients 2020, 12(3), 756; https://doi.org/10.3390/nu12030756 - 13 Mar 2020

Cited by 6 | Viewed by 4324

Abstract

Increased risk of obesity and diabetes in shift workers may be related to food intake at adverse circadian times. Early morning shiftwork represents the largest proportion of shift workers in the United States, yet little is known about the impact of food intake in the early morning on metabolism. Eighteen participants (9 female) completed a counterbalanced 16 day design with two conditions separated by ~1 week: 8 h sleep opportunity at habitual time and simulated early morning shiftwork with 6.5 h sleep opportunity starting ~1 h earlier than habitual time. After wake time, resting energy expenditure (REE) was measured and blood was sampled for melatonin and fasting glucose and insulin. Following breakfast, post-prandial blood samples were collected every 40 min for 2 h and the thermic effect of food (TEF) was assessed for 3.25 h. Total sleep time was decreased by ~85 min (p < 0.0001), melatonin levels were higher (p < 0.0001) and post-prandial glucose levels were higher (p < 0.05) after one day of simulated early morning shiftwork compared with habitual wake time. REE was lower after simulated early morning shiftwork; however, TEF after breakfast was similar to habitual wake time. Insufficient sleep and caloric intake during a circadian phase of high melatonin levels may contribute to metabolic dysregulation in early morning shift workers. Full article

(This article belongs to the Special Issue Circadian Misalignment, Nutrition, and Cardiometabolic Health)

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10 pages, 260 KiB

Open AccessArticle

Uric Acid and Potassium Serum Levels Are Independent Predictors of Blood Pressure Non-Dipping in Overweight or Obese Subjects

by Roberta Zupo, Fabio Castellana, Barbara Boninfante, Luisa Lampignano, Antonio Lattanzio, Rodolfo Sardone, Gianluigi Giannelli and Giovanni De Pergola

Nutrients 2019, 11(12), 2970; https://doi.org/10.3390/nu11122970 - 05 Dec 2019

Cited by 10 | Viewed by 4083

Abstract

Background: Obesity and sleeping blood pressure (BP) abnormalities are well recognized as some of the main risk factors for hypertension and cardiovascular diseases (CVDs). The primary objective of this study was to evaluate the prevalence of hypertension and non-dipping profile in overweight/obese subjects. Methods: A sample of 100 consecutive healthy overweight/obese subjects, aged 20–69 years and never treated with antihypertensive drugs was examined. Ambulatory 24 h BP monitoring was performed to diagnose hypertension and a non-dipping profile. Anthropometric, metabolic and routine hematochemical parameters were assessed. All subjects underwent ultrasound measurement of common carotid intima–media thickness. Results: Hypertension was demonstrated in 69% (n = 69) and 27% of the sample (n = 27) had a non-dipping profile. Among the hematochemical variables, estimated glomerular filtration rate (eGFR) (p = 0.02) and FT4 (p = 0.01) serum levels were higher in the hypertensive group than in the normotensive group. Lower potassium and uric acid serum levels (p = 0.05) were independent predictive factors of a non-dipping BP profile. Conclusions: This study shows, for the first time, that 1) an unexpectedly high percentage (69%) of overweight/obese subjects is affected by hypertension; 2) early hypertensive subjects have an increased eGFR and higher FT4 serum levels; 3) lower potassium and uric acid levels are independent predictors of pathological nocturnal non-dipping. Full article

(This article belongs to the Special Issue Circadian Misalignment, Nutrition, and Cardiometabolic Health)

13 pages, 593 KiB

Open AccessArticle

Associations of Circadian Eating Pattern and Diet Quality with Substantial Postpartum Weight Retention

by See Ling Loy, Yin Bun Cheung, Marjorelee T. Colega, Airu Chia, Chad Yixian Han, Keith M. Godfrey, Yap-Seng Chong, Lynette Pei-Chi Shek, Kok Hian Tan, Ngee Lek, Jerry Kok Yen Chan, Mary Foong-Fong Chong and Fabian Yap

Nutrients 2019, 11(11), 2686; https://doi.org/10.3390/nu11112686 - 06 Nov 2019

Cited by 6 | Viewed by 5997

Abstract

Besides food quantity and quality, food timing and frequency may contribute to weight regulation. It is unclear if these factors during pregnancy can influence maternal weight retention after childbirth. We thus aimed to examine the associations of maternal circadian eating pattern and diet quality in pregnancy with substantial postpartum weight retention (PPWR) at 18 months in an Asian cohort. We assessed circadian eating pattern and diet quality of 687 women using 24-h dietary recalls at 26–28 weeks’ gestation. We calculated PPWR by subtracting maternal weight in the first trimester from weight at 18-month postpartum and defined substantial PPWR as ≥5 kg weight retention. Multivariable binary logistic regression was performed. Overall, 16% of women had substantial PPWR. After the confounders adjustment, night eating, defined by greater night-time caloric intake (odds ratio 1.95; 95% confidence interval 1.05, 3.62), and lower diet quality, classified by median score of the Healthy Eating Index (1.91; 1.17, 3.10), were independently associated with higher odds of substantial PPWR. No associations with substantial PPWR were observed for night fasting duration and number of eating episodes. In conclusion, alignment of eating time with day–night cycles and diet quality during pregnancy may play a role in PPWR, with possible implications for long-term obesity risk. Full article

(This article belongs to the Special Issue Circadian Misalignment, Nutrition, and Cardiometabolic Health)

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