Chronotype as a predictor of weight loss and body composition improvements in women with overweight or obesity undergoing a very low-calorie ketogenic diet (VLCKD)

May 26, 2023Clinical nutrition (Edinburgh, Scotland)

How Sleep Timing Predicts Weight Loss and Body Changes in Women on a Very Low-Calorie Ketogenic Diet

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Abstract

Women with evening chronotype experienced significantly less weight loss after a very low-calorie ketogenic diet (VLCKD).

All 248 women in the study saw significant reductions in weight, BMI, waist circumference, fat mass, and fat-free mass after 31 days on VLCKD.
Women with evening chronotype had lower weight loss and lower reductions in fat mass compared to those with morning chronotype.
Evening chronotype was associated with increased fat-free mass and phase angle after the VLCKD program.
Chronotype score negatively correlated with changes in weight, BMI, waist circumference, and fat mass, while positively correlating with changes in fat-free mass and phase angle.
Chronotype score was identified as a significant predictor of weight loss achieved with VLCKD.

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BACKGROUND & AIM: Recent studies reported that chronotype play a role in the development of metabolic comorbidities and in determining dietary habits in obesity. However, little is known if chronotype could predict the efficacy of nutritional approaches for obesity. The aim of this study was to investigate whether chronotype categories can have a role in determining the efficacy of very low-calorie ketogenic diet (VLCKD) in terms of weight loss and changes of body composition in women with overweight or obesity.

METHODS: In this retrospective study we analyzed data from 248 women (BMI 36.03 ± 5.20 kg/m, aged 38.76 ± 14.05 years) clinically referred for weight loss and who completed a VLCKD program. In all women, we assessed anthropometric parameters (weight, height, and waist circumference), body composition and phase angle (through bioimpedance analysis, Akern BIA 101) at the baseline and after 31 days of active phase of VLCKD. Chronotype score was assessed using Morningness-Eveningness questionnaire (MEQ) at baseline. 2

RESULTS: After 31 days of active phase of VLCKD all enrolled women experienced significant weight loss (p < 0.001) and reduction of BMI (p < 0.001), waist circumference (p < 0.001), fat mass (kg and %) (p < 0.001), and free fat mass (kg) (p < 0.001). Women with evening chronotype experienced significantly less weight loss (p < 0.001) and reduced fat mass (kg and %) (p < 0.001), increased fat free mass (kg and %) (p < 0.001) and phase angle (p < 0.001) than women with morning chronotype. In addition, chronotype score correlated negatively with percentage changes in weight (p < 0.001), BMI (p < 0.001), waist circumference (p < 0.001) and fat mass (p < 0.001) and positively with fat free mass (p < 0.001) and phase angle (p < 0.001) from baseline to the 31st day of active phase of VLCKD. Using a linear regression model, chronotype score (p < 0.001) was the main predictors of weight loss achieved with VLCKD.

CONCLUSION: Evening chronotype is associated with a lower efficacy in terms of weight loss and improvements of body composition after VLCKD in obesity.

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Chronotype as a predictor of weight loss and body composition improvements in women with overweight or obesity undergoing a very low-calorie ketogenic diet (VLCKD)

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