The Effect of Chronobiology and Variety of Macronutrients on BMI, Waist, Body Fat and HOMA-IR in Patients with Metabolic Syndrome

Abstract

Abstract Objectives The aim of this study was to assess the effect of both meal timing and diet composition on BMI, waist, body fat and HOMA-IR in patients with metabolic syndrome (MS). Methods We studied 77 patients with MS (32 men and 45 women). Detailed analysis of baseline food-diaries showed that 43 patients (56%) were mostly eating after 3 p.m., generally skipping breakfast, and had more frequent carbohydrate snacks. We divided patients into two groups. The first group consisted of patients with most caloric intake after 3 PM, and the second group included patients who were evenly consuming their food throughout the day. Following diet were offered: 3-fold meal (food intake was at 7–9a.m., 1–2p.m. and 6–7p.m.) with very low-carbohydrate (LC) breakfast and dinner, lunch consisted of LC, proteins (P), polyunsaturated fatty acids (PUFAs) and non-starchy vegetables(V); there were absolutely no snacks during the day. Daily calorie intake was reduced by 20% from baseline. Diet intervention lasted 12 weeks. No medication were used during this period. Results 60 patients completed the trial (32 and 28 patients in first and second groups respectively). BMI was reduced from 33,1 ± 5,0 kg/m2 to 29,8 ± 4,6 kg/m2, the effect was similar in both groups (Cohen's d = 0,7, P = 0003). Mean body fat decreased from 40,7 ± 7,0% to 35,8 ± 7,5% in 12 weeks and treatment effect was more pronounced in second group (Cohen's d = 0,76, P = 0007). The most significant changes were observed in HOMA-IR, which decreased from 4,0 ± 1,1 to 2,1 ± 1,1, treatment effect was also more pronounced in second group (Cohen's d = 1,22, P = 0001). Waist circumference statistically decreased too (from 100,9 ± 16,8сm to 92,0 ± 14,6сm), although with more modest effect - Cohen's d = 0,58, P = 0003. Maximum effect size was in HOMA-IR changes. whereas minimum in waist circumference. Conclusions Our findings demonstrate that this diet (low carb, hight fat, 3-fold meal diet with lunch before 3 p.m.) is associated with statistically different changes in BMI, waist, body fat and HOMA-IR and the intervention was more effective among patients in second group. Funding Sources Not funded.