Chronotype Differences in Energy Intake, Cardiometabolic Risk Parameters, Cancer, and Depression: A Systematic Review with Meta-Analysis of Observational Studies

Sep 22, 2021Advances in nutrition (Bethesda, Md.)

How Morning or Evening Body Clocks Relate to Energy Intake, Heart and Metabolic Health, Cancer, and Depression: A Review and Analysis of Observational Studies

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Abstract

A total of 377,797 subjects were analyzed, revealing that evening chronotype is associated with significantly higher levels of blood glucose, glycated hemoglobin, LDL cholesterol, and triglycerides.

Evening chronotype individuals exhibited higher concentrations of blood glucose (mean difference: 7.82), glycated hemoglobin (mean difference: 7.64), LDL cholesterol (mean difference: 13.69), and triglycerides (mean difference: 12.62) compared to morning types.
An association was found between evening chronotype and an increased risk of diabetes (odds ratio: 1.30), cancer (odds ratio: 1.18), and depression (odds ratio: 1.86).
No significant differences were detected between chronotypes regarding energy intake, anthropometric parameters, blood pressure, insulin levels, total and HDL cholesterol, or hypertension risk.

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Chronotype is a behavioral manifestation of the internal circadian clock system. It refers to the specific activity-rest preference of an individual over a 24-h period and can be assessed using different methodologies that classify individuals into morning or evening chronotype. In recent years, several studies have suggested a relation between individual chronotype, eating habits, and the risk of developing obesity and other conditions. Our aim was to evaluate the association between chronotype, energy intake, and health status through a meta-analytic approach. A comprehensive search of MEDLINE, Embase, Scopus, Web of Science, and Cochrane Database was conducted. Observational studies that reported a measure of association between chronotype, energy intake, and health indicators were considered eligible. Overall, 39 observational studies (37 cross-sectional studies, 2 prospective cohort studies) were included in the systematic review, with a total of 377,797 subjects. By comparing morning and evening subjects, pooled analyses of cross-sectional studies showed significantly (P < 0.001) higher concentrations of blood glucose [mean difference (MD): 7.82; 95% CI: 3.18, 12.45], glycated hemoglobin (MD: 7.64; 95% CI: 3.08, 12.21), LDL cholesterol (MD: 13.69; 95% CI: 6.84, 20.54), and triglycerides (MD: 12.62; 95% CI: 0.90, 24.35) in evening subjects. Furthermore, an association between evening type and the risk of diabetes (OR: 1.30; 95% CI: 1.20, 1.41), cancer (OR: 1.18; 95% CI: 1.08, 1.30), and depression (OR: 1.86; 95% CI: 1.20, 2.88) was reported. Regarding the other outcomes examined, no significant differences were observed between the groups in terms of energy intake, anthropometric parameters, blood pressure, insulin, total and HDL cholesterol, and hypertension risk. In conclusion, evening chronotype was associated with a worse cardiometabolic risk profile and higher risk of diabetes, cancer, and depression. Further studies are needed to confirm these results and to better elucidate the interplay between chronotype, nutrition, and health status. This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42021231044.

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Chronotype Differences in Energy Intake, Cardiometabolic Risk Parameters, Cancer, and Depression: A Systematic Review with Meta-Analysis of Observational Studies

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