Time-of-day and nutrient composition of eating occasions: prospective association with the metabolic syndrome in the 1946 British birth cohort

Abstract

Background:Diet is a key modifiable factor in the prevention and treatment of the metabolic syndrome. However, few studies have examined the prospective association between time-of-day of nutrient intake and the metabolic syndrome.Objective:To examine the association between time-of-day and nutrient composition of eating occasions and the long-term development of metabolic syndrome in the Medical Research Council (MRC) National Survey of Health and Development (NSHD; 1946 British birth cohort).Methods:The analysis comprised 1488 survey members who completed at least 3 days of estimated diet records at age 43 years (1989) and for whom data on metabolic syndrome at age 53 years (1999) were available. Dietary records were divided into seven meal slots: breakfast, mid-morning, lunch, mid-afternoon, dinner, late evening and extras. Metabolic syndrome was defined by the criteria of the adult treatment panel (ATPIII8), and was modified to include glycosylated haemoglobin instead of fasting glucose. Associations between time-of-day of nutrient intake at age 43 years and prevalence of metabolic syndrome at age 53 years were assessed using multivariate nutrient density logistic models after adjustment for sex, social class, smoking status, region, alcohol intake and recreational physical activity.Results:There were 390 cases of metabolic syndrome at age 53 years. Substituting 5% of energy from carbohydrate for a similar amount of energy from fat at breakfast (odds ratio=0.93; 95% confidence interval=0.89–0.98; P=0.002) and mid-morning at age 43 years (odds ratio=0.96; 95% confidence interval=0.93–0.99; P=0.011) was associated with lower odds of the metabolic syndrome at age 53 years. Carbohydrate intake at breakfast or mid-morning was particularly protective against abdominal obesity (P⩽0.001). Increasing carbohydrate intake at breakfast while simultaneously decreasing fat intake was also negatively related to triacylglycerols (P⩽0.001).Conclusions:Increasing carbohydrate intake in the morning while simultaneously reducing fat intake could be protective against long-term development of the metabolic syndrome and its components.

Temporal Dietary Patterns Derived among the Adult Participants of the National Health and Nutrition Examination Survey 1999-2004 Are Associated with Diet Quality

“…10 These shifts may contribute to health problems, such as metabolic syndrome. 9 This evidence, combined with the results of our study, suggest that the schedule of regular eating times may be a contributing factor to health disparities as may health disparities contribute to the pattern of dietary intake.…”

“…In addition, the methods used to create the temporal dietary patterns described in this paper have addressed some of the obstacles noted in previous studies. 11 The use of time of day, frequency, and proportional energy intake for clustering rather than reported eating occasion labels, 52,53 or consolidated time blocks by eating occasions, 9,10 limits the bias that researchers and study participants may place on the names assigned to eating occasions throughout the day. A limitation was the examination of all days in the analysis rather than separate examination of weekdays and weekend days.…”

“…Examining food or energy intakes temporally provides a relatively objective descriptor of when a food was consumed in comparison to the examination of food or energy intake based on a subjectively labeled intake occasion such as “breakfast” or “dinner”. 9,10 Temporal classification avoids the cultural and personal constructs that are associated with the names assigned to various intake occasions throughout the day. For example, dinner for one individual may be understood as a meal eaten at noon, while for another individual, dinner may imply a meal eaten in the evening.…”

Chrono-nutrition: a review of current evidence from observational studies on global trends in time-of-day of energy intake and its association with obesity

“…To our knowledge, timeof-day of macronutrient intake is critical to obesity, given that lipid and glucose metabolism are influenced by the circadian rhythm, a topic reviewed in a recent article by Oosterman et al (61) . Consistent with this, a longitudinal association between carbohydrate intake at breakfast and the abdominal obesity component of the metabolic syndrome was observed in the 1946 British Birth Cohort (46) . Likewise Dubois et al reported that overweight/obesity in breakfast skippers was related to a higher carbohydrate intake at dinner (41) .…”

The effect of diurnal distribution of carbohydrates and fat on glycaemic control in humans: a randomized controlled trial

“…An improvement of glycaemic control was also observed when carbohydrates were mainly eaten at dinner and protein mainly at lunch18. In contrast, epidemiological studies propose a beneficial effect of a carbohydrate-rich diet at the beginning of the day: an increasing carbohydrate intake at the expense of fat in the morning was shown to be protective against the development of diabetes19 and metabolic syndrome20.…”