Consume with time: Chrononutrition could improve cardiometabolic health, but more RCTs needed

Chrono-specific-diets-could-boost-cardiometabolic-health-Review.jpg
Chrononutrition has immense potential in contributing to the management of cardiometabolic health, claims researchers. ©Getty Images (Getty Images/iStockphoto)

Chrononutrition has immense potential for improving cardiometabolic health by aligning food intake timings, calories and macronutrient distribution within the circadian rhythm, but more robust RCTs are urgently needed, claim researchers.

The conclusions were derived from a Singapore review titled “Is There a Utility of Chrono-Specific Diets in Improving Cardiometabolic Health?” published in the journal Molecular Nutrition and Food Research.

“The core clock influences circadian rhythms expressed in a multitude of other downstream genes involved in physiological, metabolic, and homeostatic processes and are crucial in the maintenance, synchronisation and optimisation of life processes. On the other hand, various peripheral organs possess localised clocks responsible for regulating tissue-specific processes, such as hormone release, substrate energy metabolism, and storage.

“In an ideal situation, the synchrony of both central and peripheral clocks with the external environment could enable the optimisation of energy homeostasis and the coordination of various systems. However, with irregular sleep-wake schedules, jetlag and increased availability of food round the clock, this leads to greater evening or night-time food consumption and giving rise to circadian desynchrony,” said the researchers.

The team then sought to investigate the potential applications of the evidence relating to various dietary components to tackle the increasing burden of cardiometabolic diseases. They attempted to establish optimal intake timing and distribution aligned to the circadian system and their role as zeitgebers or chronobiotics capable of modifying it.

Time for food

Current literature has shown that late-night eating has been associated with weight gain and increased risk of cardiometabolic and cardiovascular diseases and diabetes, such as H. S. Dashti et al. (2021),  Gu C. et al. (2020), Yoshida J. et al. (2018) and Han T. et al. (2020).

For carbohydrates, a higher proportion was recommended to be consumed earlier in the day, while high-carb dinners are to be avoided for glycaemic control as shown in previous studies, such as those conducted by C. J. Henry et al. (2020), Yamanaka Y. (2020) and Barrea L. et al. (2021). However, the notion might not extend to patients with Type 2 diabetes, who might experience the “dawn phenomenon” or compromised insulin sensitivity in the mornings.

In contrast, resistant starch or dietary fibre has shown the potential to counteract disruptions in gene expression for pancreatic cancer in mice. When discussing dietary fibre, past research showed its ability to modulate circadian rhythms vis-à-vis the gut microbiota. Several studies, such as Kim H.K. et al. (2020), proved this phenomenon.

For fat consumption, studies showed that minimising fat intake was recommended for later parts of the day, such as the research done by Han T. et al. (2020) and Ren X. et al. (2021). The reason was that there were effects like impacted circadian rhythmicity, as proven by Chen R. et al. (2020) and Genzer Y. et al. (2015).

Overall, based on the current literature, the current study suggests that half the total daily energy intake could be prioritised for consumption in the morning. As the day progresses, the intake of carbohydrates and fats should also be reduced.

However, the absolute protein intake was recommended to be constant. Several dietary components could also, directly and indirectly, affect the circadian system and act as zeitgebers or chronobiotics; hence, they should also be analysed.

“The science of chrononutrition has an immense potential to contribute as part of a multitude of approaches in the management of cardiometabolic health… More robust RCTs need to be undertaken to further translate findings from in vitro and in vivo animal studies. Future studies also need to take into account the timing of intake of nutrients and non-nutrient bioactives as an additional factor while establishing the associations between exposure of these dietary components and health,” concluded the researchers.

Source: Molecular Nutrition and Food Research

“Is There a Utility of Chrono-Specific Diets in Improving Cardiometabolic Health?”

DOI: 10.1002/mnfr.202200043

Authors: Yong Yi Ning et al.

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