Caloric Distribution Research Articles

Meal Timing and Anthropometric and Metabolic Outcomes

Meal timing strategies, such as time-restricted eating (TRE), reducing meal frequency, or altering calorie distribution across the day, have gained interest for their potential to enhance weight loss and metabolic health, particularly in managing chronic diseases, yet their long-term benefits are not known. To evaluate the association between meal timing strategies (≥12 weeks) and anthropometric and metabolic indicators. Medline, Embase, CINAHL, and Cochrane CENTRAL were searched from inception to October 17, 2023. Randomized clinical trials, regardless of language and publication date, involving adults 18 years and older, evaluating within-day meal timing patterns for 12 or more weeks, and reporting anthropometric measures were included. Studies were excluded if participants had eating disorders, prior significant weight change, underwent bariatric surgery, were pregnant, or if controlled variables differed between groups. Study quality was determined via Risk of Bias 2.0 tool. Data were extracted independently by multiple reviewers. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used. Meta-analysis was performed using random-effects model on pooled continuous outcomes with 2 or more studies. Weight change in kilograms, reported as between-group mean difference with 95% CIs. Sixty-nine reports of 29 randomized clinical trials including 2485 individuals (1703 [69%] female; mean [SD] age, 44 [9.5] years; and mean [SD] body mass index, 33 [3.5]) were included. Study interventions included TRE (17 studies), meal frequency (8 studies), and calorie distribution (4 studies). There were some concerns of risk of bias for 7 studies and high concerns for 22 studies. Statistically significant weight change was observed in TRE when compared with control (-1.37 kg; 95% CI, -1.99 to -0.75 kg). Lower meal frequency and earlier caloric distribution were also both associated with greater change (-1.85 kg; 95% CI, -3.55 to -0.13 kg; and -1.75 kg; 95% CI, -2.37 to -1.13 kg, respectively). The findings of this meta-analysis suggest that TRE, lower meal frequency, and earlier caloric distribution in the day may reduce weight compared with standard care and/or nutritional advice; however, the effect sizes found were small and of uncertain clinical importance. High heterogeneity and risk of bias among included studies led to concerns about the certainty of the underpinning evidence. Further research, including trials with larger sample sizes, standardized interventions with prescribed or matched energy intake, and longer follow-up, are needed.

Effects of a chronotype-adapted diet on weight loss, cardiometabolic health, and gut microbiota: study protocol for a randomized controlled trial

BackgroundObesity and its associated health complications have become a global public health concern, necessitating innovative approaches to weight management. One emerging area of research focuses on the influence of chronotype, an individual’s preferred timing for daily activities, on eating habits, weight regulation, and metabolic health. Recent observational studies suggest that the misalignment between an individual’s chronotype and external cues, such as meal timing, may contribute to metabolic dysregulation and obesity, but evidence from intervention studies is still limited. This study protocol describes a randomized controlled trial designed to explore the effects of a chronotype-adapted diet, compared with a diet with a conventional calorie distribution, on weight loss, cardiometabolic health, and gut microbiota composition.MethodsA total of 150 overweight/obese adults will be recruited for this 4-month parallel-group, randomized, two-arm, open-label, superiority trial with 1:1 allocation ratio. Participants will be randomly assigned to either the intervention group or the control group. The intervention group will receive a low-calorie chronotype-adapted diet with a calorie distribution adapted to the individual chronotype (morning or evening), optimizing meal timing according to their peak metabolic periods. The control group will follow a standardized low-calorie healthy eating plan without considering chronotype. Both diets will have equivalent daily calorie content, adjusted according to gender and starting weight. Anthropometric measurements, body composition, blood, and fecal samples will be obtained from each participant at the beginning and the end of the study. The primary outcome is weight change from baseline. Secondary outcomes are changes from baseline in body mass index (BMI), fat mass, lipid and glycemic profile, fecal microbiota profile, and short-chain fatty acids (SCFAs).DiscussionThe results of this randomized controlled trial have the potential to advance our understanding of the complex interactions between chronotype, diet, body weight, and health outcomes. By providing evidence for personalized dietary interventions based on individuals’ circadian preferences, this research could offer insights into personalized nutrition strategies. Such knowledge could guide the development of innovative dietary interventions to optimize the prevention and management of overweight and obesity, while also improving the risk profile of these individuals.Trial registrationClinicalTrials.gov NCT05941871. Registered on 18 May 2023.

High carbohydrate is preferable to high lipid parenteral nutrition in healthy dogs undergoing prolonged sedation.

Parenteral nutrition (PN) is commonly used in intensive care units (ICUs) and is associated with earlier hospital outcome. However, there is scarcity of information about the metabolic effects of PN caloric distribution for dogs. Considering the high tolerance of dogs to lipids and, also, that hospitalized animals usually present insulin resistance, PN formulation with high fat instead high glucose can provide metabolic benefits in this specie. This study evaluated two PN protocols, based on high lipid or high carbohydrate in 12 healthy dogs under sedation/ventilation during 24h. For baseline data, blood samples were collected 24h before the study beginning. After fasting, the dogs were anesthetized and put under mechanical ventilation without energy support for 12h to obtain: daily energy expenditure (DEE), respiratory quotient (RQ), oxygen consumption (VO2), carbon dioxide production (VCO2), lactate, glucose, cholesterol, and triglycerides concentrations. After, the dogs were allocated into two groups: lipid-based energy group (LEG) and carbohydrate-based energy group (CEG). Both groups received the PN infusions at a rate of 3 mL/kg/h for 12h. Blood tests were performed 12, 24, and 48h after infusion's completion. VO2 increased after PN in LEG, increasing energy expenditure compared to CEG. RQ remained close to 1 in CEG, indicating carbohydrate preferential consumption. Triglycerides increased in both groups after propofol infusion, remaining higher in LEG until the end of the evaluation. Glycaemia increased in CEG compared to baseline. In conclusion, both PN protocols can be used in healthy animals undergoing prolonged sedation protocols. However, high lipid PN had higher VO2 and DEE, and resulted in higher triglycerides concentrations and lower glycaemia indexes than carbohydrate, making high carbohydrate PN preferable to high lipid PN. Therefore, for use in critically ill patients, the data obtained in this study should be extrapolated, taking into consideration the specificity of each case.

GENERAL REQUIREMENTS FOR THE ORGANIZATION OF MEALS FOR CHILDREN AND ADOLESCENTS IN RESTAURANTS

The article is devoted to the consideration of the organization of food for children and adolescents in restaurants. General requirements for the organization of nutrition for children and adolescents have been established, that the organization of nutrition for children and adolescents involves rational nutrition, a variety of dishes, taking into account dietary needs and restrictions, as well as creating comfortable conditions for their reception. Maintaining these requirements contributes to the formation of healthy eating habits and ensures the normal growth and development of children and adolescents. The peculiarities of children’s nutrition at different age periods are given, which indicate the need to adapt the diet and food products to the agerelated needs and capabilities of the child’s body, their eating habits, the ability to digest various products, as well as the specifics of growth and development. The relevance of the topic of nutrition among children and adolescents in modern conditions has been studied. The main factors affecting the nutritional disorders of children older than 1-2 years and adolescents of older age groups are considered. Recommendations were provided on the distribution of calories per day for older children and adolescents with 4 meals a day. Features of nutrition of children and adolescents in different age periods and daily physiological norms of nutrition for children of different ages are given. It has been established that in order to ensure healthy nutrition for children and adolescents, special attention should be paid to the composition of food, in particular to the presence of essential amino acids, which are the main building material for new cells and tissues. Recommendations are provided that are important for ensuring proper physical and mental development, health and well-being of this population category. In addition, it is important to teach children and adolescents the basics of healthy eating. Understanding the importance of a balanced diet and a healthy lifestyle can contribute to the formation of good habits that will be beneficial for their future. The practical significance of the obtained results lies in the opportunity to provide and help restaurants serving the younger generation and improve their conditions.

Aiming at low nitrogen leaching diets based on nitrogen fertilizer regulatory policy: A regional bio-economic assessment of the Zayandeh-Rud river basin-Iran

Negative environmental impacts of nitrogen (N) intensive diets have triggered global debates on sustainable nitrogen management. Solutions such as dietary transitions, cropland reallocation and N Regulatory Policy (NRP) have been proposed to mitigate the adverse environmental impacts of N use in food production. However, there is still insufficient understanding of how NRPs could be designed to minimize negative environmental impact across diverse agro-ecological zones without sacrificing human dietary requirements. To increase this understanding, we evaluated the consequences of three NRP scenarios (low, moderate, and high N fertilizer rates) on the amount of livestock and non-livestock diet components as well as the associated N leaching and farmers' Gross Margin (GM) by optimizing the allocation of cropland between food and feed crops. We developed a bio-economic Interval Fuzzy Multi-Objective Programming (bio-economic IFMOP) model for the Zayandeh-Rud river basin, Iran, and a procedure that accounts for annual average availability of calories per capita, calorie sources from livestock and non-livestock components of three dietary preferences, and inequality in calorie distribution. The interaction among soil, climate and weather variability and NRPs across nine sub-regions of the case study region was handled by crop yield simulation using the DSSAT software. The solution of farmers' GM, derived from the optimization problem across possibilities of water fluctuations, was assessed to determine the uncertainty in GM. We also introduced an N leaching per Block of Distributed Calories (BDC) criterion based on solutions of supplied calories and associated N leaching. The upper bound of the moderate NRP scenario resulted in the smallest N leaching per BDC. This corresponded to ∼0.34, ∼0.34, ∼3.77 and 19.00 million BDC of meat, dairy, wheat and potato, respectively. Also, the upper bound of this scenario satisfied the lowest instability in farmers’ GM against water fluctuation compared with low and high NRP scenarios. The affordable volume of N leaching per BDC varied across sub-regions between [1.53,3.49], [1.52,3.33], [0.76,0.99] and [0.05,0.08] kg for meat, dairy, wheat and potato, respectively. Our results highlighted both optimistic and pessimistic prospects of producing low N leaching diets. The approach of this study could also be applied to other regions and countries.

Pre-illness dietary risk factors in dogs with chronic enteropathy.

Dietary factors have been extensively studied as potential triggers of inflammatory bowel disease in humans. Scant literature exists regarding diet as a pre-illness risk factor in dogs with chronic enteropathy (CE). To evaluate possible pre-illness dietary risk factors in dogs with CE. Ninety-five client-owned dogs; 48 with CE (25 presumptive and 23 confirmed) and 47 without a history of signs of gastrointestinal disease. Retrospective case-control questionnaire-based study at a veterinary referral teaching hospital in the United Kingdom. Diet history was obtained relating to the onset of initial presenting signs for all dogs. The main diet consumed underwent ingredient analysis and caloric distribution calculation using a guaranteed analysis convertor software. Length of time the main diet was fed and adherence to the World Small Animal Veterinary Association Global Nutrition Committee guidelines was also recorded. The frequency of the main diet containing no carbohydrate was greater for controls (5/47 dogs, 11%) vs the combined presumptive and confirmed CE dogs (0/48 dogs, 0%; P = .05). Fewer dogs with confirmed CE were fed a main diet containing red meat as the primary protein source (2/23 dogs, 9%) vs controls (15/47 dogs, 32%; P = .03). A main diet moisture percentage of ≤14% as fed was significantly associated with confirmed CE in logistic regression analysis (OR 5.71 [95% CI: 1.18-27.69]; P = .03). The presence of dietary carbohydrate, protein source, and dietary moisture content, or factors related to moisture content such as preservatives, might play a role as potential pre-illness dietary risk factors in dogs with CE.

Relationship between eating habits, sleep patterns and physical activity and the degree of obesity in children and adolescents

IntroductionChildhood obesity is an extremely prevalent pathology and, in order to be able to address it, it is necessary to understand the factors that influence on its genesis and maintenance. We hypothesise that the timing of meals and sleep, the regularity of these throughout the week and a sedentary lifestyle influence the degree of obesity. Material and methodsWe included children and adolescents with obesity who attended a first check-up visit at the Childhood Obesity Unit between January 2018 and February 2020. The data were obtained from a questionnaire on food (36-h intake, frequency of consumption, eating times and habits) and sleep. ResultsThe degree of obesity was influenced to a greater extent by later meal times and the distribution of calories throughout the day (less at breakfast, more at dinner) than by the total number of calories ingested. In addition, a lower consumption of vegetables was related to a higher degree of obesity. The difference between the hours of sleep at weekends and on weekdays correlated positively with a higher degree of obesity. Finally, the anthropometric data correlated negatively with the number of hours of physical activity. Almost half of the children did not exercise after school. ConclusionIn the approach to childhood obesity, it is necessary to include recommendations on the regularity of meal and sleep times, as well as the distribution of calories throughout the day. Additionally, it is necessary to encourage the practice of physical exercise.

Analysis of the actual nutrition in primary school students of the Republic of Bashkortostan

Introduction. A comprehensive hygienic research was aimed at studying the actual nutrition in primary school children living in the city of Ufa and the large village of Iglino. Materials and methods. The nature and structure of the actual diet of the students was studied by the method of 24-hour reproduction of the diet, one day prior to the survey. The findings were compared with measures of norms of physiological energy and food requirements for children and adolescents. The study involved seven hundred 7-11 year students of grades 1-4 from nine schools in Ufa (460 cases) and village of Iglino (240 children). Results. The diet in children of the studied group is adequate in energy value and consumption of proteins and fats. The amount of carbohydrate consumption is reduced relative to the norms of physiological needs (NPN) by 25%, but at the same time the share of admission with the diet of simple carbohydrates exceeds the norm. Increased intake of added salt 1.4-fold revealed. The average daily diet is provided with vitamins, but is deficient in calcium, the intake of which is 68% of the NPN. The actual nutrition of younger schoolchildren living in the city of Ufa is characterized by the excess intake of sodium is almost 4 times. The Ca : Mg to Ca : P ratio is broken. The distribution of calories in individual meals made it possible to identify a reduced share of calories in breakfast (19% instead of 25%) and dinner (22% instead of 35-40%). Limitations. The study analyzed only the actual nutrition of children aged 7-11 years. In the future, it is planned to study the nutrition of schoolchildren of other age groups. Conclusion. The main nutritional disorders in primary school children are expressed in increased consumption of saturated fatty acids, simple carbohydrates and added salt. In combination with calcium deficiency and excess sodium, such an imbalance can further cause the risk of developing alimental-dependent diseases.

Investigation on dietary nutrition of college basketball players

Basketball sport has the characteristics of high intensity, long time, high density, fierce confrontation, and reasonable dietary nutrition supplement can improve the athletes' physical level, athletic ability, eliminate sports fatigue. The nutrition of basketball players mainly consists of sugar, water and electrolytes, protein, creatine and vitamins. This paper analyzes the dietary nutritional status of college basketball players. The results show that there are several problems in the players' diet: insufficient total energy intake, insufficient carbohydrate intake, excessive fat and protein intake, insufficient intake of some vitamins and minerals, unreasonable distribution of calories in three meals. In this paper, the dietary structure of Chinese college basketball players is basically consistent with the composition of balanced diet pagoda of Chinese residents. The types of food are reasonable, but the amount of food is low and the eating behavior is unreasonable. Nutrition education should be strengthened to promote the balanced diet of students.

Timing of daily calorie loading affects appetite and hunger responses without changes in energy metabolism in healthy subjects with obesity

SummaryMorning loaded calorie intake in humans has been advocated as a dietary strategy to improve weight loss. This is also supported by animal studies suggesting time of eating can prevent weight gain. However, the underlying mechanisms through which timing of eating could promote weight loss in humans are unclear. In a randomized crossover trial (NCT03305237), 30 subjects with obesity/overweight underwent two 4-week calorie-restricted but isoenergetic weight loss diets, with morning loaded or evening loaded calories (45%:35%:20% versus 20%:35%:45% calories at breakfast, lunch, and dinner, respectively). We demonstrate no differences in total daily energy expenditure or resting metabolic rate related to the timing of calorie distribution, and no difference in weight loss. Participants consuming the morning loaded diet reported significantly lower hunger. Thus, morning loaded intake (big breakfast) may assist with compliance to weight loss regime through a greater suppression of appetite.

Relación de los hábitos alimentarios, los patrones de sueño y el grado de actividad física con el grado de obesidad en niños y adolescentes

IntroductionChildhood obesity is an extremely prevalent pathology and, in order to be able to address it, it is necessary to understand the factors that influence on its genesis and maintenance. We hypothesise that the timing of meals and sleep, the regularity of these throughout the week and a sedentary lifestyle influence the degree of obesity. Material and methodsWe included children and adolescents with obesity who attended a first check-up visit at the Childhood Obesity Unit between January 2018 and February 2020. The data were obtained from a questionnaire on food (36-hour intake, frequency of consumption, eating times and habits) and sleep. ResultsThe degree of obesity was influenced to a greater extent by later meal times and the distribution of calories throughout the day (less at breakfast, more at dinner) than by the total number of calories ingested. In addition, a lower consumption of vegetables was related to a higher degree of obesity. The difference between the hours of sleep at weekends and on weekdays correlated positively with a higher degree of obesity. Finally, the anthropometric data correlated negatively with the number of hours of physical activity. Almost half of the children did not exercise after school. ConclusionIn the approach to childhood obesity, it is necessary to include recommendations on the regularity of meal and sleep times, as well as the distribution of calories throughout the day. Additionally, it is necessary to encourage the practice of physical exercise.

A Root in Synapsis and the Other One in the Gut Microbiome-Brain Axis: Are the Two Poles of Ketogenic Diet Enough to Challenge Glioblastoma?

Glioblastoma is the most frequent and aggressive brain cancer in adults. While precision medicine in oncology has produced remarkable progress in several malignancies, treatment of glioblastoma has still limited available options and a dismal prognosis. After first-line treatment with surgery followed by radiochemotherapy based on the 2005 STUPP trial, no significant therapeutic advancements have been registered. While waiting that genomic characterization moves from a prognostic/predictive value into therapeutic applications, practical and easy-to-use approaches are eagerly awaited. Medical reports on the role of the ketogenic diet in adult neurological disorders and in glioblastoma suggest that nutritional interventions may condition outcomes and be associated with standard therapies. The acceptable macronutrient distribution of daily calories in a regular diet are 45–65% of daily calories from carbohydrates, 20–35% from fats, and 10–35% from protein. Basically, the ketogenic diet follows an approach based on low carbohydrates/high fat intake. In carbohydrates starvation, body energy derives from fat storage which is used to produce ketones and act as glucose surrogates. The ketogenic diet has several effects: metabolic interference with glucose and insulin and IGF-1 pathways, influence on neurotransmission, reduction of oxidative stress and inflammation, direct effect on gene expression through epigenetic mechanisms. Apart from these central effects working at the synapsis level, recent evidence also suggests a role for microbiome and gut-brain axis induced by a ketogenic diet. This review focuses on rationales supporting the ketogenic diet and clinical studies will be reported, looking at future possible perspectives.

Caloric contribution of imported and locally produced food in Puerto Rico

The aim of this article is to evaluate the caloric contribution of the top imported and locally produced foods in Puerto Rico. Data from the USDA and Puerto Rico Planning Board were used to estimate caloric needs in different demographic groups and projected until 2025. In analyzing Puerto Rican produce, the caloric contribution of local production was estimated to be around 18 percent. By contrast, when the caloric contribution of 50 foods imported and produced in Puerto Rico was evaluated, these foods account for 115 percent of the calories needed daily for the population to maintain a normal weight. Sugar, rice, vegetable oil, milk and corn make the greatest contribution to the Puerto Rican diet, representing an estimated 58 percent of average number of calories that Puerto Ricans should consume. The distribution of calories identified in these 50 articles consumed in Puerto Rico (e.g., fruits, vegetables, dairy products, proteins, carbohydrates, etc.) shows serious discrepancies from the distribution suggested by the 2015-2020 Dietary Guidelines developed by experts of the U.S. Department of Health and Human Services and the U.S. Department of Agriculture. For example, 34 percent of the calories consumed in Puerto Rico correspond to foods high in sugar and fat.

Food security and the nutritional status of children in foster care: new horizons in the protection of a fragile population.

The nutritional status of foster children, the quality of daily menus in group homes and the Food Security inside these organizations have been poorly studied and this study means to investigate them. A sample of 125 children, ranging in age from 0-17 years, among seven group homes (group A) was compared with 121 children of the general population we (group B). To evaluate nutritional status, BMI percentiles were used. Mean percentiles of both groups were compared through statistical analysis. Both nutritional and caloric daily distributions in each organization were obtained using the 24-hour recall method. A specific questionnaire was administered to evaluate Food Security. From the analysis of mean BMI-for-age (or height-for-length) percentiles, did not observe statistically significant differences between group A and group B. The average daily nutrient and calorie distribution in group homes proves to be nearly optimal with the exception of a slight excess in proteins and a slight deficiency in PUFAs. Moreover, a low intake of iron and calcium was revealed. All organizations obtained a "High Food Security" profile. Nutritional conditions of foster children are no worse than that of children of the general population. Foster care provides the necessary conditions to support their growth.

Replacing ultra-processed foods with fresh foods to meet the dietary recomendations: a matter of cost?

The study aimed to analyze the economic impact of the adoption of optimized and nutritionally balanced diets to Brazilian families, considering the Brazilian dietary guidelines and the economic disparities of the population. Data from the Brazilian Household Budget Survey from 2008-2009 (550 strata; 55,970 households) were used. About 1,700 foods and beverages purchased by the Brazilians were classified into 4 groups according to NOVA system. Linear programming models estimated isoenergetic diets preserving the current diet as baseline and optimizing healthier diets gradually based on the "golden rule" of the Brazilian dietary guidelines, respecting nutritional restrictions for macronutrients and micronutrients (based on international recommendations) and food acceptance limits (10th and 90th percentiles of the per capita calorie distribution from the population). The diet cost was defined based on the sum of the average cost of each food group, both in the current and optimized diets (BRL per 2,000Kcal/person/day). The economic impact of the Brazilian dietary guidelines to Brazilian household budget was analyzed by comparison the cost of the optimized diets to the cost of the current diet, calculated for the total population and by income level. Three healthier diets were optimized. Current diet cost was BRL 3.37, differed among low- and high-income strata (BRL 2.62 and BRL 4.17, respectively). Regardless of income, diet cost decreased when approaching the guidelines. However, low-income strata compromised their household budget more than two times the high-income strata (20.2% and 7.96%, respectively). Thus, the adoption of healthier eating practices can be performed with the same or lower budget.

The Experience in Organizing and Conducting the Analysis of Data on Nutrition of School-Aged Children in the Sverdlovsk Region within the Federal Public Health Promotion Project

Introduction: Implementation of the Federal Public Health Promotion Project should raise awareness and develop skills of healthy nutrition in children, thus contributing to disease prevention. Our objective was to evaluate the results of pilot nutrition monitoring in school-aged children of the Sverdlovsk Region as part of the Federal Public Health Promotion Project and the National Demography Project. Results: We established that school meals were generally satisfactory: the rations complied with physiological needs of children in terms of their nutritional value, basic nutrients, energy, and distribution of calories by main meals. We noted differences in the cost and nutritional value of meals and the variety of dishes and foodstuffs used between urban and rural areas. As a rule, pupils have one or two school meals a day. Outside of school, their consumption of dairy products and fruit is limited. Conclusions: Our findings may promote the elaboration of municipal programs aimed, inter alia, at changing the amount of sugar and salt used in the manufacture of public catering products, the cost of dishes with a high content of sugar, saturated fats, and salt, and subsidies on healthy nutrition.

Evaluation of nutrient content and caloric density in commercially available foods formulated for senior cats.

BackgroundCat foods marketed for senior cats (≥7 years) are available to owners. The variability in the nutritional content of these foods is unknown.ObjectivesTo measure the caloric density and caloric distribution of crude protein, crude fiber, crude fat, phosphorus, calcium, magnesium, sodium, potassium, and vitamin D3 in commercially available foods for senior cats and to compare nutrient content with foods for adult cats.SamplesThirty‐one senior and 59 adult commercial nontherapeutic cat food products.MethodsDescriptive study. Crude protein, crude fiber, and crude fat were measured using Dumas nitrogen combustion, Ankom filter bag technique, and acid hydrolysis, respectively. Mineral concentrations were measured using inductively coupled argon plasma‐optical emission spectroscopy. Vitamin D3 was determined by liquid chromatography with tandem mass spectrometry. Caloric density was calculated using modified Atwater values.ResultsThe evaluated nutrient concentrations in all foods for senior cats met the values of the Association of American Feed Control Officials Cat Food Nutrient Profile for adult maintenance. Foods for senior cats had significantly higher crude fiber content when compared to foods for adult cats (P < .0001). No significant difference in crude protein, crude fat and mineral concentrations was found between foods for senior and adult cats.Conclusions and Clinical ImportanceFoods marketed for senior cats are highly variable in their caloric density and nutrient content and, except for crude fiber, are similar to foods for adult cats. Veterinarians should avoid broad recommendations regarding commercially available foods for senior cats, and dietary recommendations should reflect the patient's individual needs.

A Case-Control Study on Food Frequency and Meal Pattern Distribution in Coronary Artery Disease Patients Attending Tertiary Care Teaching Hospitals.

Context:Coronary artery disease (CAD) is the blockage of coronary arteries, usually consequent to atherosclerosis. CAD is a lifestyle disease with an increasing disease burden in society. Evaluation of risk factors for CAD is crucial for its prevention. Lifestyle components like calorie consumption chronology, saturated fatty acid (SAFA) intake, reclining time, nocturnal eating and intermittent fasting were considered.Aims:To correlate calorie distribution, SAFA intake, reclining time, nocturnal eating and intermittent fasting with occurrence of CAD.Study Design/Materials and Methods:A case-control study consisting of 235 cases and 185 controls. Questionnaire was self-designed according to NIN guidelines. Study was ICMR funded and data analysis was done using Microsoft Excel and IBM SPSS.Results:Across case and control groups, total calorie consumption difference was insignificant (P = 0.42). Calories consumed in breakfast slot (P = 0.001) and dinner slot (P = 0.003) were significantly different possibly due to discrepancy among circadian variation in insulin sensitivity and calorie consumption distribution. Reclining time <1 h in afternoon (odds ratio [OR] = 2.24, 95%, 1.481–3.356) and night (OR = 2.05, 95% confidence limit [CL], 1.233–3.410), SAFA consumption (OR = 2.006, 95% CL, 1.214–3.316), intermittent fasting (OR = 1.748, 95% CL, 0.997–3.067) and nocturnal eating (OR = 1.291, 95% CL, 0.779–-2.141) are potential risk factors.Conclusions:Calorie consumption chronology, SAFA intake, Reclining time, Nocturnal eating and intermittent fasting emerged as significant risk factors.

Relationship of the Frequency, Distribution, and Content of Meals/Snacks to Glycaemic Control in Gestational Diabetes: The myfood24 GDM Pilot Study.

This study examines nutritional intakes in Gestational diabetes mellitus piloting the myfood24 tool, to explore frequency of meals/snacks, and daily distribution of calories and carbohydrates in relation to glycaemic control. A total of 200 women aged 20–43 years were recruited into this prospective observational study between February 2015 and February 2016. Diet was assessed using myfood24, a novel online 24-h dietary recall tool. Out of 200 women 102 completed both ≥1 dietary recalls and all blood glucose measurements. Blood glucose was self-measured as part of usual care. Differences between groups meeting and exceeding glucose targets in relation to frequency of meal/snack consumption and nutrients were assessed using chi-squared and Mann–Whitney tests. Women achieving a fasting glucose target <5.3 mmol/L, compared to those exceeding it, consumed three meals (92% vs. 78%: p = 0.04) and three snacks (10% vs. 4%: p = 0.06) per day, compared with two or less; and in relation to evening snacks, consumed a higher percentage of daily energy (6% vs. 5%: p = 0.03) and carbohydrates (8% vs. 6%: p = 0.01). Achieving glycaemic control throughout the day was positively associated with snacking (p = 0.008). Achieving glucose targets was associated with having more snacks across the day, and may be associated with frequency and distribution of meals and nutrients. A larger study is required to confirm this.

Greater social jetlag associates with higher HbA1c in adults with type 2 diabetes: a cross sectional study

Background/ObjectivesLater chronotype has been associated with poorer glycemic control in type 2 diabetes. It is unclear whether this is a direct relationship, or if personality factors or social jetlag ([SJL], ie, chronic circadian misalignment reflecting the discrepancy between the entrained phase of the circadian clock and socially-determined behavioural cycles) play a role. This study aimed to determine the relationships among chronotype, SJL, personality factors and glycemic control in type 2 diabetes, independently of sleep disturbances and daily caloric distribution. MethodsIn sum, 252 type 2 diabetes patients attending an annual review outpatients' clinic completed questionnaires, including the Munich Chronotype Questionnaire to assess chronotype and SJL, the Pittsburgh Sleep Quality index (PSQI), the Big Five Personality Inventory and the Center for Epidemiologic Studies Depression Scale. Chart review provided information on diabetes duration, Hemoglobin A1c (HbA1c), body mass index (BMI) and other clinical variables. Caloric intake was assessed via 24-h dietary recall. ResultsHierarchical linear regression revealed that SJL, but not chronotype or personality factors, was a significant predictor of HbA1c levels (β = 0.16, p < 0.05). There was a significant relationship between later chronotype and HbA1c levels, but only in patients who had more than 90 min SJL (r = 0.51, p = 0.002). Younger age was associated with a higher HbA1c (r = −0.23, p < 0.001), and this effect was partially mediated through SJL (Pm = 0.22). ConclusionsWe identify SJL as a novel factor that may impact on glycemic control in type 2 diabetes. Further study is needed to determine whether interventions aimed at reducing SJL may lead to improvements in glycemic control.