Search Results (549)

Time-restricted eating (TRE), a dietary strategy that aligns food intake with circadian rhythms, has emerged as a promising non-pharmacological approach for improving glycemic control in patients with type 2 diabetes. This systematic review and meta-analysis evaluated the effects of TRE on glycemic outcomes by analyzing eight randomized controlled trials involving 312 participants with type 2 diabetes or impaired fasting glucose. Meta-analyses of six eligible studies demonstrated that TRE significantly reduced fasting glucose (mean difference [MD]: −0.74 mmol/L; 95% CI: −1.13 to −0.36) and glycated hemoglobin (ΔHbA1c) (MD: −0.11%; 95% CI: −0.15 to −0.07) and increased time in range (TIR) for blood glucose (MD: +10.51%; 95% CI: 6.81 to 14.21). Improvements in fasting glucose and HbA1c were modest but consistent, while the increase in TIR showed no between-study heterogeneity, suggesting a robust and reproducible benefit of TRE on glycemic stability. These findings support the clinical feasibility and effectiveness of TRE as a dietary intervention in diabetes management. However, further high-quality trials with standardized protocols and longer follow-up are needed to confirm long-term efficacy and inform guidelines. Full article

Background/Objectives: Traditional dietary screeners face significant limitations: they rely on subjective self-reporting, average intake estimates, and are influenced by a participant’s awareness of being observed—each of which can distort results. These factors reduce both accuracy and reproducibility. The Guide Against Age-Related Disease (GARD) addresses these issues by applying Assembly Theory to objectively quantify food and food behavior (FFB) complexity. This study aims to validate the GARD as a structured, bias-resistant tool for dietary assessment in clinical and research settings. Methods: The GARD survey was administered in an internal medicine clinic within a suburban hospital system in the southeastern U.S. The tool assessed six daily eating windows, scoring high-complexity FFBs (e.g., fresh plants, social eating, fasting) as +1 and low-complexity FFBs (e.g., ultra-processed foods, refined ingredients, distracted eating) as –1. To minimize bias, patients were unaware of scoring criteria and reported only what they ate the previous day, avoiding broad averages. A computer algorithm then scored responses based on complexity, independent of dietary guidelines. Internal (face, convergent, and discriminant) validity was assessed using Spearman rho correlations. Results: Face validation showed high inter-rater agreement using predefined Assembly Index (A_i) and Copy Number (N_i) thresholds. Positive correlations were found between high-complexity diets and behaviors (rho = 0.533–0.565, p < 0.001), while opposing constructs showed moderate negative correlations (rho = –0.363 to −0.425, p < 0.05). GARD scores aligned with established diet patterns: Mediterranean diets averaged +22; Standard American Diet averaged −10. Full article

Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder characterized by excess body weight, hyperandrogenism, hyperglycemia, and insulin resistance often resulting in hirsutism and infertility. Dietary strategies have been shown to ameliorate metabolic disturbances, hormonal imbalances, and inflammation associated with PCOS. Recent evidence indicates that intermittent fasting (IF) could effectively enhance health outcomes and regulate circadian rhythm; however, its impact on PCOS remain unclear. Objective: Therefore, this systematic review and meta-analysis aims to examine the effect of IF on women diagnosed with PCOS. Methods: Comprehensive research was conducted across three major databases including PubMed, Scopus, and Web of Science without date restrictions. Meta-analysis was performed using Cochrane Review Manager Version 5.4 software. Results: Five studies fulfilled the inclusion criteria. IF significantly reduced body weight (MD = −4.25 kg, 95% CI: −7.71, −0.79; p = 0.02), BMI (MD = −2.05 kg/m², 95% CI: −3.26, −0.85; p = 0.0008), fasting blood glucose (FBG; MD = −2.86 mg/dL, 95% CI: −4.83, −0.89; p = 0.004), fasting blood insulin (FBI; MD = −3.17 μU/mL, 95% CI: −5.18, −1.16; p = 0.002), insulin resistance (HOMA-IR; MD = −0.94, 95% CI: −1.39, −0.50; p < 0.0001), triglycerides (TG; MD = −40.71 mg/dL, 95% CI: −61.53, −19.90; p = 0.0001), dehydroepiandrosterone sulfate (DHEA-S; MD = −33.21 μg/dL, 95% CI: −57.29, −9.13; p = 0.007), free androgen index (FAI; MD = −1.61%, 95% CI: −2.76, −0.45; p = 0.006), and C-reactive protein (CRP; MD = −2.00 mg/L, 95% CI: −3.15, −0.85; p = 0.006), while increasing sex hormone-binding globulin (SHBG; SMD = 0.50, 95% CI: 0.22, 0.77; p = 0.004). No significant changes were observed in waist-to-hip ratio (WHR), total cholesterol (TC), LDL, HDL, total testosterone (TT), or anti-Mullerian hormone (AMH). Conclusions: IF represents a promising strategy for improving weight and metabolic, hormonal, and inflammatory profiles in women with PCOS. However, the existing evidence remains preliminary, necessitating further robust studies to substantiate these findings. Full article

Background: Behavioural heterogeneity in obesity is increasingly recognised, but how specific dietary patterns, food preferences and physical activity vary between obesity classes remains poorly characterised. Methods: We analysed behavioural, dietary, and lifestyle data from 1366 adults attending a tertiary obesity clinic in Italy. Participants were stratified into five obesity classes defined by BMI. Age-adjusted regression models and chi-square tests with Bonferroni correction were used to examine associations between obesity severity and key behavioural outcomes, including food preferences, eating behaviours, physical activity, and self-reported sleep quality. Results: The prevalence of uncontrolled eating, skipping meals, and fast eating significantly increased with obesity severity after adjusting for age (all p < 0.05). Preference for yoghurt and legumes declined with increasing BMI, whereas preferences for meat and dairy remained stable. Age-adjusted sport participation decreased progressively, with significantly lower odds in Obesity I, II, and IIIA compared to the Overweight group. Sleep quality was highest among overweight participants and declined with obesity severity; night-time awakenings were most frequent in Obesity IIIB. Conclusions: Distinct behavioural and lifestyle traits, including lower sport participation, reduced preference for fibre-rich foods, and greater frequency of uncontrolled, fast, and irregular eating, showed overall trends across obesity classes. While these findings suggest the presence of behavioural phenotypes, their interpretation is limited by the cross-sectional design and the use of self-reported, non-validated measures. Future studies should incorporate objective assessments to inform targeted obesity interventions. Full article

Intermittent fasting (IF) and caloric restriction (CR) have garnered attention for their potential to enhance cognitive function, particularly in aging and metabolically compromised populations. This narrative review critically examines whether the cognitive benefits of IF are attributable to its specific fasting patterns or are instead mediated by the production of weight loss, fat loss, and improvements in insulin sensitivity. Evidence from human trials suggests that reductions in body weight, especially visceral adiposity, and improvements in insulin resistance are key factors linked to enhanced cognitive performance. Comparisons between the results of IF and CR trials show comparable cognitive outcomes, supporting the idea that negative energy balance, rather than fasting or altered eating patterns, drive these effects. However, further investigation of specific types of IF patterns, as well as possible cognitive domains to be affected, may identify mechanisms through which IF can yield benefits on neurocognitive health beyond those of loss of body fat and its accompanying inflammatory state. Full article

Background/Objectives: Daily caloric restriction (DCR) is a common dietary weight loss strategy, but leads to metabolic and behavioral adaptations, including maladaptive eating behaviors and dysregulated appetite. Intermittent fasting (IMF) may mitigate these effects by offering diet flexibility during energy restriction. This secondary analysis compared changes in eating behaviors and appetite-related hormones between 4:3 intermittent fasting (4:3 IMF) and DCR and examined their association with weight loss over 12 months. Methods: Adults with overweight or obesity were randomized to 4:3 IMF or DCR for 12 months. Both randomized groups received a matched targeted weekly dietary energy deficit (34%), comprehensive group-based behavioral support, and a prescription to increase moderate-intensity aerobic activity to 300 min/week. Eating behaviors were assessed using validated questionnaires at baseline and months 3, 6, and 12. Fasting levels of leptin, ghrelin, peptide YY, brain-derived neurotrophic factor, and adiponectin were measured at baseline and months 6 and 12. Linear mixed models and Pearson correlations were used to evaluate outcomes. Results: Included in this analysis were 165 adults (mean ± SD; age 42 ± 9 years, BMI 34.2 ± 4.3 kg/m², 74% female) randomized to 4:3 IMF (n = 84) or DCR (n = 81). At 12 months, binge eating and uncontrolled eating scores decreased in 4:3 IMF but increased in DCR (p < 0.01 for between-group differences). Among 4:3 IMF, greater weight loss was associated with decreased uncontrolled eating (r = −0.27, p = 0.03), emotional eating (r = −0.37, p < 0.01), and increased cognitive restraint (r = 0.35, p < 0.01) at 12 months. There were no between-group differences in changes in fasting appetite-related hormones at any time point. Conclusions: Compared to DCR, 4:3 IMF exhibited improved binge eating and uncontrolled eating behaviors at 12 months. This may, in part, explain the greater weight loss achieved by 4:3 IMF versus DCR. Future studies should examine mechanisms underlying eating behavior changes with 4:3 IMF and their long-term sustainability. Full article

The appearance rate of nutrients into systemic circulation affects hormones like insulin and through that efficiency of growth. This also affects mineral requirements critical for metabolism, notably phosphate (P), magnesium (Mg), and potassium (K). Fasting animals have a downregulated metabolism, upon which P, Mg, and K are exported from their cells into the blood and are subsequently excreted in their urine. Abrupt resumption of feed intake, especially of highly glycemic feeds, creates an acute need for these minerals, which can result in deficiency symptoms, particularly with P deficiency. In human medicine, this is called refeeding syndrome: a large meal after a period of fasting can prove fatal. Young animals seem to be especially sensitive, likely driven by their ability to grow rapidly and thus to drastically upregulate their metabolism in response to insulin. Symptoms of P deficiency are fairly a-specific and, consequently, not often recognized. They include edema, which makes it appear as if piglets are growing well, explaining the high gain/feed rate typically seen immediately after weaning, even when piglets are eating at or below the maintenance requirements. Phosphate deficiency can also result in hypoxia and hypercarbia, which may trigger ear necrosis, Streptococcus suis infections, or even death. Hypophosphatemia can also trigger rhabdomyolysis, which may contribute to tail-biting, but this requires further study. Arguably, when fasting cannot be avoided, diets for newly weaned piglets should be formulated to avoid these problems by lowering their glycemic load and by formulating diets according to the piglets’ actual requirements inspired by their genuine intake and health and not simply by extrapolating from older animals. Full article

Background/Objectives: Psychological distress is common among university students and often co-occurs with unhealthy lifestyle patterns. However, most studies examine physical activity (PA) and dietary intake (DI) in isolation, overlooking how these behaviors interact under stress. This study aimed to identify and compare integrated PA and DI behavior patterns among students with low vs. high psychological distress. Methods: A cross-sectional case–control design was used with 209 students (aged 19–21). Questionnaires included the International Physical Activity Questionnaire (IPAQ), Questionnaire of Eating Behavior (QEB), and Depression Anxiety Stress Scales-21 items (DASS-21). Behavioral patterns were assessed using a cophylogenetic approach (tanglegrams, cophenetic statistics), and predictive behaviors were analyzed using stepwise logistic regression. Results: Permutational Multivariate Analysis of Variance (PERMANOVA) revealed significant group differences in PA–DI structure (F = 3.91, R² = 0.0185, p = 0.001). Tanglegram and PACo analyses showed tighter PA–DI alignment in high-distress individuals, suggesting more rigid, compensatory behavior profiles. Logistic regression identified vigorous PA (OR = 1.80, 95% CI: 1.33–2.50, p < 0.001) and fast food intake (OR = 1.43, 95% CI: 1.05–1.98, p = 0.026) as significant distress indicators. Sweets intake showed a non-significant trend (OR = 1.33, p = 0.064). Conclusions: Students with higher psychological distress exhibit complex lifestyle co-patterns combining risk (e.g., fast food) and compensatory behaviors (e.g., vigorous PA). Health promotion should address PA and DI jointly, and screening for distress should be integrated into student wellness programs. Full article

Background/Objectives: Imposed sleep restriction leads to increased feelings of appetite and hedonic eating behaviors (or food rewards). No study to date has assessed home-based measures of sleep with appetite and food rewards exclusively in Black emerging adults (ages 18–28 years), despite higher risks of short sleep and obesity in this population. We examined associations between 6-month changes in sleep with changes in appetite and food reward in Black emerging adults. Methods: Fifteen Black emerging adults (12 females; age, 21 ± 2.5 years; body mass index, 25.7 ± 4.5 kg/m²; body fat, 25.8 ± 11.9%) completed two identical 7-day measurement bursts at baseline and 6 months. Sleep (duration, efficiency, and architecture) was captured via 7 days of actigraphy and 2 nights of in-home polysomnography. During a laboratory visit, participants completed appetite measures (desire to eat, hunger, fullness, and prospective food consumption) via visual analog scales before and for 3 h following standard breakfast intake. The food reward for the fat and sweet categories of food was measured before lunch with the Leeds Food Preference Questionnaire. Results: Fasting fullness scores decreased from baseline to 6 months (−8.9 mm, p < 0.01) despite increases in body weight (2.6 kg, p < 0.01) and waist circumference (2.4 cm, p = 0.03). Increases in actigraph-measured sleep duration were associated with decreases in fasting desire to eat (r = −0.58, p = 0.04). Increases in actigraph-measured sleep efficiency were also associated with decreases in explicit liking for sweet foods (r = −0.60, p = 0.03). Conclusions: Our findings suggest that improvements in sleep duration and sleep efficiency may lead to decreased feelings of appetite and food reward in Black emerging adults. Full article

Background: Early time-restricted eating combined with energy restriction (eTRE + ER) has been shown to reduce fat mass, diastolic blood pressure (DBP) and fasting glucose more effectively than late TRE with energy restriction (lTRE + ER) or energy restriction (ER) alone. Given the gut microbiome’s sensitivity to circadian rhythms, we examined whether adding TRE, particularly eTRE, to ER alters gut microbiota composition beyond ER alone, and whether such effects persist during follow-up. Methods: We analysed anthropometric, biochemical and gut microbiome data from 76 participants at baseline and after a 3-month intervention (eTRE + ER: n = 33; lTRE + ER: n = 23; ER: n = 20). Follow-up microbiome data 6-months after the end of intervention were available for 43 participants. Gut microbiota composition was assessed via 16S rRNA gene sequencing of stool samples. Results: No significant between-group differences in beta diversity were observed over time. However, changes in alpha diversity differed significantly across groups at the end of the intervention (Shannon: F = 5.72, p < 0.001; Simpson: F = 6.72, p < 0.001; Richness: F = 3.99, p = 0.01) and at follow-up (Richness: F = 3.77, p = 0.02). lTRE + ER led to the greatest reductions in diversity post intervention, while ER was least favourable during follow-up. Although no significant between-group differences were observed at the phylum level either at the end of the intervention or during follow-up, only the eTRE + ER group exhibited a significant decrease in Bacillota and an increase in Bacteroidota during follow-up. At the genus level, differential abundance analysis revealed significant shifts in taxa such as Faecalibacterium, Subdoligranulum, and other genera within the Ruminococcaceae and Oscillospiraceae families. In the eTRE + ER, Faecalibacterium and Subdoligranulum increased, while in other groups decreased. Notably, the changes in Faecalibacterium were negatively correlated with fasting glucose, while the increase in Subdoligranulum was inversely associated with DBP; however, both associations were weak in strength. Conclusions: eTRE + ER may promote beneficial, lasting shifts in the gut microbiome associated with improved metabolic outcomes. These results support further research into personalized TRE strategies for treatment of obesity. Full article

(1) Eating disorders (EDs), characterized by symptoms such as restrictive eating, binge eating, compensatory behaviors, and emotional dysregulation, are associated with autonomic nervous system dysregulation, which may contribute to cardiovascular complications. This review systematically examines the relationship between heart rate variability (HRV) and core ED symptoms to identify specific autonomic patterns linked to behaviors like fasting, binge eating, and emotional dysregulation. (2) A total of 16 cross-sectional and longitudinal studies were narratively synthesized following PRISMA guidelines. All studies were selected from the Science Direct, PubMed, Web of Science, and Scopus databases. (3) Findings indicate that individuals with anorexia nervosa exhibit blunted sympathetic reactivity and reduced parasympathetic flexibility, particularly during stress or physical activity, with HRV measures normalizing after weight restoration. In contrast, binge eating and loss-of-control eating are associated with lower resting HRV, which correlates with the severity of eating behaviors. Reactive HRV also varies with food cues and emotional states, showing complex autonomic responses in individuals with EDs. Emotional dysregulation, consistently marked by reduced high-frequency HRV, is a key feature across these disorders. (4) These results suggest that HRV patterns may serve as physiological markers of ED symptomatology, offering insights for targeted interventions aimed at improving both emotional regulation and cardiovascular health in affected individuals. Full article

Obesity and metabolic disorders remain major global health concerns, traditionally attributed to excessive caloric intake and poor diet quality. Recent studies emphasize that the timing of meals plays a crucial role in determining metabolic health. This review explores chrononutrition, a growing field that examines how food intake patterns interact with endogenous circadian rhythms to influence energy balance, glucose and lipid metabolism, and cardiometabolic risk. The circadian system, which includes a central clock in the suprachiasmatic nucleus and peripheral clocks in metabolic tissues, regulates physiological functions on a 24 h cycle. While light entrains the central clock, feeding schedules act as key synchronizers for peripheral clocks. Disrupting this alignment—common in modern lifestyles involving shift work or late-night eating—can impair hormonal rhythms, reduce insulin sensitivity, and promote adiposity. Evidence from clinical and preclinical studies suggests that early time-restricted eating, where food intake is confined to the morning or early afternoon, offers significant benefits for weight control, glycemic regulation, lipid profiles, and mitochondrial efficiency, even in the absence of caloric restriction. These effects are particularly relevant for populations vulnerable to circadian disruption, such as adolescents, older adults, and night-shift workers. In conclusion, aligning food intake with circadian biology represents a promising, low-cost, and modifiable strategy to improve metabolic outcomes. Integrating chrononutrition into clinical and public health strategies may enhance dietary adherence and treatment efficacy. Future large-scale studies are needed to define optimal eating windows, assess long-term sustainability, and establish population-specific chrononutritional guidelines. Full article

Background/Objectives: Nocturnal glucose regulation is a critical but underexplored determinant of next-day fasting glucose (FG), particularly in individuals with dysglycemia. This study examined the role of glucose levels after the last eating occasion (LEO) and during the overnight fast in predicting FG, considering the potential influence of carbohydrate content in LEO and insulin sensitivity. Methods: In a controlled 24 h protocol, 33 adults (50–75 years) with prediabetes or diet-controlled type 2 diabetes followed a standardized feeding schedule with meals at fixed times, including a LEO at 10:00 p.m. Continuous glucose monitoring was used to assess glucose during the 3 h postprandial period (LEO-PPGR) and two fasting intervals: chronological overnight fast (COF) and biological overnight fast (BOF). Associations with FG were tested using general linear models, adjusting for carbohydrate intake and insulin sensitivity (Matsuda index). Results: Glucose responses during LEO-PPGR—assessed by mean glucose, peak, and AUC—were strongly correlated with FG the next morning (r = 0.704, 0.535, and 0.708, p < 0.001). Similarly, glucose levels during COF and BOF were also correlated with FG (r = 0.878, p < 0.001 for both), but these associations weakened after adjustment for LEO carbohydrate content. The Matsuda index was positively correlated with glucose in all three periods (p < 0.05), yet its inclusion in the model attenuated all previously significant associations with FG. Conclusions: These findings suggest that the glycemic response to the last meal and subsequent overnight glucose levels contribute to next-day FG, but their impact is modulated by carbohydrate content and individual insulin sensitivity. Understanding nocturnal glycemic dynamics may inform strategies for improving metabolic outcomes in dysglycemia. Full article

Tactical athletes and military personnel engaged in intense exercise need to consume enough quality protein in their diet to maintain protein balance and promote recovery. Plant-based protein sources contain fewer essential amino acids (EAAs), while pork loin contains a higher concentration of EAAs and creatine than most other animal protein sources. This study aimed to determine whether the ingestion of plant-based or pork-based military-style meals ready-to-eat (MREs) affects recovery from and subsequent Army Combat Fitness Test (ACFT) performance. Methods: Twenty-three (n = 23) University Corps of Cadets members participated in a randomized, double-blind, placebo-controlled, and crossover-designed study. Diets were prepared by a dietitian, food scientist, and chef to have similar taste, appearance, texture, and macronutrient content. The chef also labeled the meals for double-blind administration. Participants refrained from intense exercise for 48 h before reporting to the lab in a fasted condition with a 24 h urine sample. Participants donated a blood sample, completed questionnaires and cognitive function tests, and consumed a pre-exercise meal. After four hours, participants performed the ACFT according to military standards. Participants were fed three MREs daily while returning to the lab in a fasted condition at 0600 with 24 h urine samples after 24, 48, and 72 h of recovery. On day 3, participants repeated the ACFT four hours after consuming an MRE for breakfast. Participants resumed normal training and returned to the lab after 2–3 weeks to repeat the experiment while consuming the alternate diet. Data were analyzed using general linear model statistics with repeated measures and percent changes from baseline with 95% confidence intervals. Results: Results revealed that 3 days were sufficient for participants to replicate ACFT performance. However, those consuming the pork-based diet experienced less muscle soreness, urinary urea excretion, cortisol, inflammation, and depression scores while experiencing a higher testosterone/cortisol ratio and appetite satisfaction. There was also evidence of more favorable changes in red and white blood cells. Conversely, blood lipid profiles were more favorably changed when following a plant-based diet. Conclusions: These findings suggest that protein quality and the availability of creatine in the diet can affect recovery from intense military-style exercise. Minimally, plant-based MREs should include 6–10 g/d of EAA and 2–3 g/d of creatine monohydrate to offset dietary deficiencies, particularly in military personnel following a vegetarian diet. Registered clinical trial #ISRCTN47322504. Full article

Obesity among adolescents has increased over the past decades in most parts of the world in low- and middle-income countries. This study aimed to investigate the dietary practices and anthropometric status of the rural university students in Limpopo Province. A cross-sectional study was conducted among university students in Limpopo Province. A total of 363 students aged 18 to 42 years residing at the university residences were randomly selected. A structured self-administered questionnaire was used to collect data. Anthropometric measurements were conducted by a qualified biokinetist. Data were analysed using SPSS version 29. More than half (57.3%) of the students were females. About 42.1% reported that they consume fast food once per week. The prevalences of overweight and obesity were 21.8% and 7.5%, respectively. A chi-square analysis revealed a significant association between soft drinks, juice, and energised drink consumption frequency and BMI status (p = 0.006). Results revealed a significant association between the frequency of eating processed food per week and the WHR status (p = 0.013). Overweight and consuming fast food and sugary drinks are significant concerns amongst rural-based university students. The current study recommends that regular nutrition education campaigns be conducted at the university to encourage students to make healthier eating choices. Full article