Chrono-nutrition and its Association with Chronotype and Blood Glucose Control Among People with Type 2 Diabetes

Abstract

Background: Recent studies have revealed conflicting results for low glycaemic index (GI) meals in the prevention and treatment of metabolic disorders. Diurnal variations in glucose homeostasis, which are frequently overlooked in epidemiological studies, may help to explain some of these discrepancies. Food is an external cue to entrain the circadian rhythm, and meal timing is a crucial factor for glucose homeostasis. The study examines the relationship between chrono-nutrition, chronotype, and blood glucose control among people with Type 2 diabetes. Materials and Methods: Chrono-nutrition questionnaire assessed eating window, breakfast skipping, evening latency, evening eating, night eating, and largest meal of patients with Type 2 diabetes. Glycaemic control was assessed using a HbA1c test, fasting blood sugar, and 2-hour post-prandial blood sugar test. Insulin resistance was assessed by fasting triglyceride glucose index (TyG). Results: There was a significant association between late dining with dysglycaemia, irrespective of GI of the meal (p<0.05). Participants who had the largest meal during the active phase had better glycaemic control (p<0.05). Shorter eating windows and evening latency of at least 2 hours not only aided in glycaemic control, but also gave good sleep (p<0.05). Participants with the evening chronotype ate almost twice the amount of carbohydrates and fat at dinner than at breakfast. Evening chronotypes were associated with lesser servings of vegetables and fruits, and greater servings of sweets and caffeinated beverages, in comparison with morning chronotypes. Conclusions: Late diners had significantly worse blood glucose levels, irrespective of the GI of the meal. This may have public health implications, as calorie-dense meals are often consumed during late evenings, which can desynchronise the circadian rhythms. Eating meals as per the circadian rhythm could be an alternative non-pharmacological strategy to prevent diabetes and its complications.