Prolonged Nightly Fasting and Breast Cancer Risk: Findings from NHANES (2009–2010)

Marinac, Catherine R.; Sears, Dorothy D.; Gallo, Linda C.; Hartman, Sheri J.; Arredondo, Elva M.; Patterson, Ruth E.

doi:10.1158/1055-9965.epi-14-1292

Cited by 78 publications

(71 citation statements)

References 39 publications

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“…This TRF study, as well as published mouse and human studies, support the translational potential of TRF regimens in modulating obesity-related disease risk [13, 23, 44, 45]. In fact, we have recently shown that restricting the majority of food intake to <11 hours per day was prospectively associated with reduced incidence of breast cancer recurrence [46], the first report of a clinical outcome associated with TRF.…”

Section: Discussionsupporting

confidence: 65%

Time-restricted feeding improves insulin resistance and hepatic steatosis in a mouse model of postmenopausal obesity

et al. 2016

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Background Menopause is associated with significant hormonal changes that result in increased total body fat and abdominal fat, amplifying the risk for metabolic syndrome and diseases such as diabetes, cardiovascular disease and cancer in postmenopausal women. Intermittent fasting regimens hold significant health benefit promise for obese humans, however, regimens that include extreme daytime calorie restriction or daytime fasting are generally associated with hunger and irritability, hampering long-term compliance and adoption in the clinical setting. Time-restricted feeding (TRF), a regimen allowing eating only during a specific period in the normal circadian feeding cycle, without calorie restriction, may increase compliance and provide a more clinically viable method for reducing the detrimental metabolic consequences associated with obesity. Methods We tested TRF as an intervention in a mouse model of postmenopausal obesity. Metabolic parameters were measured using Clinical Laboratory Animal Monitoring System (CLAMS) and we carried out glucose tolerance tests. We also stained liver sections with oil red O to examine steatosis and measured gene expression related to gluconeogenesis. Results Preexisting metabolic disease was significantly attenuated during 7 wk of TRF. Despite having access to the same high fat diet (HFD) as ad libitum fed (ALF) mice, TRF mice experienced rapid weight loss followed by a delayed improvement in insulin resistance and a reduced severity of hepatic steatosis by having access to the HFD for only 8 h during their normal nocturnal feeding period. The lower respiratory exchange ratio in the TRF group compared with the ALF group early in the dark phase suggested that fat was the predominant fuel source in the TRF group and correlated with gene expression analyses that suggested a switch from gluconeogenesis to ketogenesis. In addition, TRF mice were more physically active than ALF fed mice. Conclusions Our data support further analysis of TRF as a clinically viable form of intermittent fasting to improve metabolic health due to obesity.

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Section: Discussionsupporting

confidence: 65%

Time-restricted feeding improves insulin resistance and hepatic steatosis in a mouse model of postmenopausal obesity

et al. 2016

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“…However, studies on how nighttime eating behavior influences the risk of breast cancer are very limited. Our results are consistent with previous findings based on data from the NHANES and the Women’s Healthy Eating and Living study, in which longer nighttime fasting was associated with reduced risk of breast cancer and recurrence of breast cancer [14, 26]. In addition, our findings related to food choice are also in line with previous literature reporting that only the intake of large quantities of high-energy food, and not small low-energy snacks, at night had a negative health impact [27–32].…”

Section: Discussionsupporting

confidence: 93%

Nighttime eating and breast cancer among Chinese women in Hong Kong

Tse

Chan³

et al. 2017

Breast Cancer Res

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BackgroundA novel line of research suggests that eating at nighttime may have several metabolic consequences that are highly relevant to breast cancer. We investigated the association between nighttime eating habits after 10 p.m. and breast cancer in Hong Kong women.MethodsA hospital-based case-control study was conducted during 2012–2015. A total of 922 patients with incident breast cancer (cases) and 913 hospital controls were recruited and interviewed using a standard questionnaire including information on eating behavior during both daytime and nighttime. We collected the timing, duration, types and frequencies of food intake of eating at nighttime. Odds ratios (ORs) for the risk of breast cancer in relation to nighttime eating-related variables were calculated by unconditional multivariable logistic regression.ResultsEating at night after 10 pm was significantly associated with breast cancer with an adjusted OR of 1.50 (95% confidence interval (CI) 1.06–2.12, P = 0.02), and the associations were stronger in women who had the longest duration of nighttime eating (≥20 years) (adjusted OR = 2.28 (95% CI 1.13–4.61, P = 0.02) and who ate late (midnight to 2 a.m.) (adjusted OR = 2.73, 95% CI 1.01–6.99, P = 0.04). Interestingly, nighttime eating was only associated with breast cancer among women who consumed staple foods (OR = 2.16, 95% CI 1.42–3.29, P < 0.001) but not those who ate vegetables or fruits as nighttime meals. The significant association between nighttime eating and breast cancer was observed among women with body mass index (BMI) <25 (OR = 2.29, 95% CI 1.48–3.52, P < 0.001) but not among women with BMI ≥25.ConclusionsResults from this study suggest a possible association between nighttime eating behavior and breast cancer. These findings need to be confirmed by independent large studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s13058-017-0821-x) contains supplementary material, which is available to authorized users.

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“…8 In this WHEL study cohort, longer nightly fasting duration and more frequent eating were associated with a significantly lower HbA 1c level, consistent with a previous analysis of 2212 women in the National Health and Nutrition Examination Survey. 9 As noted in the American Diabetes Association/American Cancer Society consensus report on diabetes and cancer risk, 14 there may be a subset of tumors for which hyperglycemia confers a growth advantage. Several studies have reported associations between diabetes and/or hyperglycemia and breast cancer prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…In the first analysis, among 2122 women without diabetes mellitus, longer nightly fasting was associated with significant improvements in biomarkers of glycemic control. 9 In the second analysis, a longer duration of nightly fasting was associated with significantly lower C-reactive protein (CRP) concentrations in women who eat less than 30% of their total daily energy intake after 5 pm . 10 Taken together, the rodent and human data support the hypothesis that a prolonged nightly fasting interval could reduce cancer risk and improve cancer outcomes.…”

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confidence: 99%

Prolonged Nightly Fasting and Breast Cancer Prognosis

et al. 2016

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IMPORTANCE Rodent studies demonstrate that prolonged fasting during the sleep phase positively influences carcinogenesis and metabolic processes that are putatively associated with risk and prognosis of breast cancer. To our knowledge, no studies in humans have examined nightly fasting duration and cancer outcomes. OBJECTIVE To investigate whether duration of nightly fasting predicted recurrence and mortality among women with early-stage breast cancer and, if so, whether it was associated with risk factors for poor outcomes, including glucoregulation (hemoglobin A1c), chronic inflammation (C-reactive protein), obesity, and sleep. DESIGN, SETTING, AND PARTICIPANTS Data were collected from 2413 women with breast cancer but without diabetes mellitus who were aged 27 to 70 years at diagnosis and participated in the prospective Women’s Healthy Eating and Living study between March 1, 1995, and May 3, 2007. Data analysis was conducted from May 18 to October 5, 2015. EXPOSURES Nightly fasting duration was estimated from 24-hour dietary recalls collected at baseline, year 1, and year 4. MAIN OUTCOMES AND MEASURES Clinical outcomes were invasive breast cancer recurrence and new primary breast tumors during a mean of 7.3 years of study follow-up as well as death from breast cancer or any cause during a mean of 11.4 years of surveillance. Baseline sleep duration was self-reported, and archived blood samples were used to assess concentrations of hemoglobin A1c and C-reactive protein. RESULTS The cohort of 2413 women (mean [SD] age, 52.4 [8.9] years) reported a mean (SD) fasting duration of 12.5 (1.7) hours per night. In repeated-measures Cox proportional hazards regression models, fasting less than 13 hours per night (lower 2 tertiles of nightly fasting distribution) was associated with an increase in the risk of breast cancer recurrence compared with fasting 13 or more hours per night (hazard ratio, 1.36; 95% CI, 1.05-1.76). Nightly fasting less than 13 hours was not associated with a statistically significant higher risk of breast cancer mortality (hazard ratio, 1.21; 95% CI, 0.91-1.60) or a statistically significant higher risk of all-cause mortality (hazard ratio, 1.22; 95% CI, 0.95-1.56). In multivariable linear regression models, each 2-hour increase in the nightly fasting duration was associated with significantly lower hemoglobin A1c levels (β = −0.37; 95% CI, −0.72 to −0.01) and a longer duration of nighttime sleep (β = 0.20; 95% CI, 0.14-0.26). CONCLUSIONS AND RELEVANCE Prolonging the length of the nightly fasting interval may be a simple, nonpharmacologic strategy for reducing the risk of breast cancer recurrence. Improvements in glucoregulation and sleep may be mechanisms linking nightly fasting with breast cancer prognosis.

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Prolonged Nightly Fasting and Breast Cancer Risk: Findings from NHANES (2009–2010)

Cited by 78 publications

References 39 publications

Time-restricted feeding improves insulin resistance and hepatic steatosis in a mouse model of postmenopausal obesity

Time-restricted feeding improves insulin resistance and hepatic steatosis in a mouse model of postmenopausal obesity

Nighttime eating and breast cancer among Chinese women in Hong Kong

Prolonged Nightly Fasting and Breast Cancer Prognosis

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