The impact of meal timing on body composition: The role of Chrononutrition O impacto do horário das refeições na composição corporal: O papel da Crononutrição Rita Barracosa da Costa Silva ORIENTADO POR: Dr.ª Maria Raquel Soares de Carvalho Roriz COORIENTADO POR: Prof. Doutor Nuno Pedro Garcia Fernandes Bento Borges REVISÃO TEMÁTICA 1.º CICLO EM CIÊNCIAS DA NUTRIÇÃO | UNIDADE CURRICULAR ESTÁGIO FACULDADE DE CIÊNCIAS DA NUTRIÇÃO E ALIMENTAÇÃO DA UNIVERSIDADE DO PORTO TC PORTO, 2021
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The impact of meal timing on body composition: The role of Chrononutrition O impacto do horário das refeições na composição corporal: O papel da Crononutrição
Rita Barracosa da Costa Silva ORIENTADO POR: Dr.ª Maria Raquel Soares de Carvalho Roriz COORIENTADO POR: Prof. Doutor Nuno Pedro Garcia Fernandes Bento Borges REVISÃO TEMÁTICA 1.º CICLO EM CIÊNCIAS DA NUTRIÇÃO | UNIDADE CURRICULAR ESTÁGIO FACULDADE DE CIÊNCIAS DA NUTRIÇÃO E ALIMENTAÇÃO DA UNIVERSIDADE DO PORTO
TC PORTO, 2021
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Abstract
Chrononutrition is an emerging research topic in nutrition that embraces
the relationship established between temporal eating patterns, daily circadian
rhythms and metabolic health. Preliminary data from observational and
experimental studies suggest that changes in the timing of food intake can impact
body composition and the success of weight loss approaches, regardless of total
daily energy intake and dietary composition, raising the question if when to eat
matters as much as food quantity and quality. This narrative review assesses the
effect of food intake timing on body composition in adults and briefly explores the
mechanisms underlying the impact of meal timing on body composition.
In conclusion, recent data supports that late eating may impair the success
of weight loss strategies and morning loaded energy distribution seems to be a
valuable approach for weight control. In detail, higher morning diet induced
fat mass loss (G1: −6.8 ± 2.1 kg, G2: −4.5 ± 2.9 kg, p=0.031; mean ± SD). These
data reinforce that a low-calorie Mediterranean diet with an upper amount of
energy in the first part of the day could determine a greater reduction in major
obesity-related metabolic parameters(44).
5. Physiological mechanisms underlying the impact of meal timing on
bodyweight
Even though the mechanisms underlying the impact of meal timing on
bodyweight remain unclear, some hypotheses have been suggested(45):
(1) The time when a meal is consumed affects the thermogenic response and
must be considered in the energy balance(19, 41, 46). Previous studies have
shown that DIT is higher in the morning comparative to the evening, after
identical meals(5, 41). The higher obligatory DIT in the morning, can be
explained since various gastrointestinal functions exhibits circadian
rhythmicity, including faster morning gastric emptying and increased
intestinal absorption of peptides, lipids and carbohydrates at the beginning
of the active phase(19). The elevated facultative DIT earlier in the day may
be a result of higher concentrations of adrenaline and noradrenaline during
this time of the day, which increases the metabolic rate and the RQ(41, 47).
Under controlled laboratory conditions, using indirect calorimetry, the DIT
is 40% higher after breakfast than after dinner(41).
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(2) Misalignment between food timing and light/dark cycles can impair satiety
mechanisms throughout leptin and ghrelin(41, 48) and affect thyroid
hormones(49) inducing higher caloric intake(45).
(3) Modification of gene expression in genes responsible for evening eating
preference and weight loss resistance (e.g., SIRT1, CLOCK 3111T/C(50), and
Perilipin1(51)).
(4) The association between evening eating and weight gain can be explained
because insulin sensitivity and glucose tolerance decline gradually
throughout the day with insulin sensitivity reaching a nadir in the
evening(14).
(5) When sleep is restricted and food is provided ad libitum, in controlled
laboratory conditions, participants increase their TDEI, and this extra
consumption of energy occurs after dinner and closer to or after DLMO(52-
54), which contributes to an obesogenic ambient(43). A recent systematic
review, meta-analysis and meta-regression with a cumulative total of
5171710 participants collected from 153 studies revealed that short
sleepers (<6h of sleep) were 38% more likely to have obesity(55).
(6) The individual chronotype may be another factor involved in this equation.
The majority of the studies, considering the chronotype, have shown that
late eaters were more evening types and previous studies suggested that
evening types have more susceptibility to gain weight and have more
struggle to lose it(56, 57). In individuals with morning chronotypes (high
caloric intake during morning hours) the odds of being obese decrease by
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50%, while in evening chronotypes (individuals who eat during the two hours
before sleep) the probability of being obese increases five times(58).
6. Critical Analysis
Clarifying the effect of meal timing on body composition is highly complex and
presents a challenge in the field of nutrition. This narrative review is in line with
prior findings revealing that timed caloric intake can impact body weight and
adiposity markers(4, 7, 13-18). In the present study, later eating in the day was
negatively associated with the success of weight loss therapies and morning loaded
energy intake revealed to be a bright approach to control body weight. Supporting
these conclusions, Garaulet et al. revealed that late lunch eaters lost fewer
weight and displayed a slower weight-loss rate during the treatment(7). Other
studies corroborate the hypothesis that individuals with high energy breakfast lose
more weight and have a greater WC reduction, when compared with high energy
at dinner(14, 15) and high energy lunch results in greater reductions in weight and
BMI comparing to high energy dinner(13, 15). Even though one meta-analysis
included in this study considered it difficult to draw a clear conclusion, the high
heterogeneity and small number of experimental studies could be responsible for
it(4). Regarding body fat, McHill et al. found that non-lean individuals consume a
greater proportion of TDEI at a later circadian phase, when compared to lean
participants, assessed by DLMO(16, 17) and Lombardo et al. showed that those who
consume most of the energy in the first time of the day lost more body fat. As
plausible mechanisms, eating closer to or after DLMO may decrease TEF(16, 46),
which would contribute to a positive energy balance and weight gain. Also,
misalignment between food timing and light/dark cycles can impair satiety
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mechanisms and induce higher caloric intake(41, 45, 48, 49). Other factors such as
genetic variants(50, 51), metabolic changes(14), differences in sleep duration(52-54)
and individual´s chronotype (56-58) may be implicated in the observed differences
in body composition between late and early eaters.
Regarding circadian rhythm disruption, the strongest evidence of metabolic
misalignment is in night shift-workers. Data from two meta-analyses proposes that
these individuals are more likely to be obese, independently of TDEI(25, 26).
Surprisingly, milder circadian disruption in individuals with eating jet lag was also
associated with overweight and obesity(6, 24, 30). Zéron-Rugerio et al. found that
BMI was 1.34 kg/m2 higher in subjects who reported more than 3.5 h of eating jet
lag(24). In these populations, later mealtime consumption and poorer diet can
explain the differences in body weight between the groups(6, 24, 30), however, the
majority of the studies related to eating jet lag were cross-sectional. In future
research it will be imperative to confirm the direction of these associations and
evaluate the impact of the chronic variability in meal timing on bodyweight over
the time. Regarding this is an emerging topic, one of the main limitations has been
the lack of standardized definition for ‘meals’ and ‘snacks’, which may result in
inconsistent findings when the outcomes of interest are timing, frequency or
regularity of food intake. The majority of the studies have focused on conventional
meal categories (i.e., breakfast, lunch, and dinner), which differ cross-culturally,
and may not reflect the real eating pattern of diverse people. Furthermore,
considering the exogenous clock time to assess the link between timing of food
intake and individual´s circadian rhythms may not be physiologically significant to
accurately characterize meal timing in the context of the internal circadian timing
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system. Another challenge has been failure to adjust for energy misreporting in
several studies and the lack of well-defined evidence considering the underlying
mechanisms for greater weight loss with earlier meal consumption. Finally, future
research should emphasis on human clinical trials and aimed to clarify the role of
eating time in mechanisms of energy balance, such as in TDEI, appetite and TDEE,
such as RMR, TEF and physical activity. Upcoming interventions should also assess
the individual´s chronotype, as a valuable addition to the evidence, given the
higher risk of adverse cardiometabolic health in evening chronotypes.
7. Conclusions
In conclusion, literature describing the impact of meal time is in its early
stages, however there is an increasing number of publications exposing the effect
of meal timing on obesity and adiposity markers(4, 7, 13-18). Early evidence supports
that late eating may impair the success of weight loss strategies and morning
loaded energy distribution seems to be a helpful approach for weight control. In
theory, morning enhanced DIT, circadian misalignment with consequent impaired
satiety mechanisms, genetic variants, metabolic changes, differences in sleep
duration and individual´s chronotype may be implicated in the observed
differences in weight loss between late and early eaters. These findings emphasize
the relevance of taking into account the internal circadian timing of food
consumption. Novel therapeutic approaches should combine not only the daily
caloric intake, macronutrient distribution and physical activity but as well
implementing dietary guidelines directed at meal timing and at the reduction of
the variability between meal timing on weekends versus weekdays for the
prevention of obesity among general population.
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