Large Evening Meals Research Articles

Association of diurnal calorie trajectory with all-cause mortality: Findings from the National Health and Nutrition Examination Survey

The effect of diurnal variation in energy intake on mortality has not been reported. We investigated the effect of diurnal calorie trajectory on all-cause mortality using data from the National Health and Nutrition Examination Survey (NHANES). Participants in the NHANES from 1999 to 2010 were analyzed. We calculated daily energy intake and the two-hourly calorie intake according to dietary interview questionnaires, in which timing of meals, as well as energy and nutritional components of each food were recorded. The daily energy intake and the two-hourly calorie intake were divided by body weight to determine tertiles of daily energy intake and diurnal calorie trajectories, respectively. Three diurnal calorie trajectories (reference group, excess dinner, and high-calorie) were identified. The mortality data were linked to the National Death Index through the end of 2011. Cox proportional hazards models were used to compare the overall mortality among different groups. Among the 14,356 participants included in our analyses, 886 (6.2%) of them died after a median follow-up of 4.4 years. Daily energy intake tertiles were not associated with all-cause mortality in the fully adjusted model. In contrast, high-calorie trajectory was associated with a higher risk of mortality (hazard ratio 3.128, 95% CI 1.175 to 8.330, p=0.024) compared with the reference group after adjustment for relevant factors. A diurnal high-calorie trajectory was associated with a higher risk of mortality, compared with the reference group. The effect of a large evening meal on mortality merits further investigation.

Are large dinners associated with excess weight, and does eating a smaller dinner achieve greater weight loss? A systematic review and meta-analysis.

There are suggestions that large evening meals are associated with greater BMI. This study reviewed systematically the association between evening energy intake and weight in adults and aimed to determine whether reducing evening intake achieves weight loss. Databases searched were MEDLINE, PubMed, Cinahl, Web of Science, Cochrane Library of Clinical Trials, EMBASE and SCOPUS. Eligible observational studies investigated the relationship between BMI and evening energy intake. Eligible intervention trials compared weight change between groups where the proportion of evening intake was manipulated. Evening intake was defined as energy consumed during a certain time - for example 18.00-21.00 hours - or self-defined meal slots - that is 'dinner'. The search yielded 121 full texts that were reviewed for eligibility by two independent reviewers. In all, ten observational studies and eight clinical trials were included in the systematic review with four and five included in the meta-analyses, respectively. Four observational studies showed a positive association between large evening intake and BMI, five showed no association and one showed an inverse relationship. The meta-analysis of observational studies showed a non-significant trend between BMI and evening intake (P=0·06). The meta-analysis of intervention trials showed no difference in weight change between small and large dinner groups (-0·89 kg; 95 % CI -2·52, 0·75, P=0·29). This analysis was limited by significant heterogeneity, and many trials had an unknown or high risk of bias. Recommendations to reduce evening intake for weight loss cannot be substantiated by clinical evidence, and more well-controlled intervention trials are needed.

Effects of Protein Load Prior to the Main Meal of the Day: A Pilot Trial

Background: High protein diets increase satiety and may decrease energy intake. Many over- weight people overeat in the evening. We hypothesized that ingesting protein prior to the eve- ning meal may limit successive calorie intake and generate weight loss. Aims: To explore whether protein pre-load before the evening meal will lead to weight loss compared to eating as usual. Methods: 129 adults with a Body Mass Index (BMI) ≥25 reporting eating large evening meals were randomized to either consume a 20 g protein bar 30 minutes before their evening meal daily for two weeks (Protein pre-loading (PP) arm) or not (No protein pre-loading (NP) arm). Hunger ratings were recorded, immediately prior to each evening meal. Participants returned at the end of weeks one and two to provide their weight and rating of hunger and any changes in evening food consumption since baseline. Results: There was no significant difference in weight loss between the study arms (Week1 PP: -0.13 kg, (SD=0.74) vs. NP: -0.06 kg, (SD=0.75), not significant (NS); Week2 PP: +0.06 kg, (SD=0.82) vs. NP: -0.005 kg, (SD=0.82), NS). Participants in the PP arm reported less hunger before evening meals than those in the NP arm (Week1: 4.97 (SD=0.94) vs. 3.72(SD=0.65), p<.001; Week2: 4.95 (SD=0.94) vs. 3.69(SD=0.71), p<.001). They also reported eating less at their evening meals (Week1: 2.59(SD=0.53) vs. 2.11(SD=0.54), p<.001; Week2: 2.63(SD=0.49) vs. 2.10(SD=0.50), p<.001). Conclusion: Consuming 20 g of protein before the evening meal reduced hunger and self- reported food intake in the evening, but had no effect on weight.

Preventing Maternal and Pediatric Obesity by Optimizing Meal Properties

Maternal obesity especially in visceral and abdominal regions is a rising problem that increases pediatric morbidity and reduces life quality. Minimizing the problem requires optimizing meal properties. This means optimizing meal size, frequency, timing and sequence. Frequent smaller meals evenly distributed over day-time with no large evening meals, and inclusion of fibrous plant meals in-between are an obligation for pre-gestating and pregnant women. These meal related strategies will allow the gut to maintain its healthiness towards optimal maternal and pediatric splanchnic and peripheral metabolism.

Circadian Ingestion Behaviors: Animal Models Outlooks

Submit Manuscript | http://medcraveonline.com Grazing occurs mainly around sunrise and sunset. In grazing sheep, the maximum jaw movement occurs in the late afternoon before sunset. Dairy cows exhibit three main grazing bouts of dawn, afternoon, and dusk. However, the diurnal patterns in grazing appear to vary across seasons. In Western Australia with hot summers and mild winters, the main summer grazing activity occurs during early morning and late afternoon with a smaller activity around midnight. Sheep and cattle likely have comparable grazing patterns in summer. In winter, however, the cattle show intensive grazing activities not only in the morning and afternoon but also during the period from 2000-0100 h. Unlike in summer, in winter, sheep has a progressive grazing activity from 0600 through 1700 with low activity in the evening. Under intensive feeding systems, dairy cows and finishing bulls fed only once daily in the morning exhibit two peaks in eating activity. The greatest one is right after feeding and another around dusk. The eating/ grazing pattern has circadian patterns [1]. Cows seem to stop the morning eating before reaching the maximum rumen capacity. The observation that rumen capacity peaks at dusk but not during the morning and afternoon grazing has implications. It is found that time spent eating during the dusk grazing bout is longer than that during the dawn and afternoon bouts. Moreover, during dawn and afternoon bouts, the cows finish eating before reaching a rumen capacity which was reached during the dusk bout. Therefore, the rumen fill has probably a more significant role in regulating the dusk feed intake compared to dawn and afternoon feed intakes [2,3]. Despite feeding adequate coarse corn silage as 45% of diet dry matter (DM), finishing bulls select the coarse particles for as long as 16-h post-feeding. Such a late selection of the more structured total mixed ration particles is an effort to optimize the intake of long roughage particles. In beef cattle, the herbage allocation time (e.g., 0700 h vs. 1500 h) alters daily patterns in eating, ruminating, and idling behaviors in heifers. The heifers turned unto the ungrazed strip at 0700 h have more intense evening grazing with faster bite rates compared with the heifers allotted the herbage at 1500 h. The morning grazing is 36-39% of total daily grazing time in the latter group but only 25-28% in the former group. The nutritional status of the animal before feeding can affect the postfeeding eating intensity. Fasting, for instance, hastens eating by increasing the bite rate and enlarging the bite mass. However, the data on the effects of feeding strategies on diurnal patterns in feed intake of non-grazing ruminants is scarce [3-5]. The large evening meals in grazing cows are partly linked to an optimal foraging strategy. The plant content of DM and water soluble carbohydrates rises and NDF decreases as day progresses. The accumulation of highly-digestible nutrients in the evening is due to the daylight photosynthesis in plant leaves. This may partly explain why cattle, sheep, and goats prefer the fresh forage grass and legumes harvested at sunset compared to that harvested at sunrise. A higher in vitro true DM digestibility for PM-cut than for AM-cut alfalfa hay is known. Ruminants may have greater feed intake and greater total tract DM digestibility when they are offered the sunset-cut alfalfa hay instead of the sunrise-cut alfalfa hay. The grazing ruminants appear to learn the time of maximum plant nutrient quality, leading to a more intensive eating in the evening than in the morning [4-6].

Misled by the Morning "Fasting" Plasma Glucose.

Because of its ease and simplicity of its measurement, the morning fasting plasma glucose (FPG), has been as used a surrogate marker for the entire basal day when titrating once-nightly basal insulin. Common in obese insulin-treated patients with type 2 diabetes, late and large evening meals elevate the FPG. This has led to dosing of basal insulin well beyond the basal requirements and contributes to hypoglycemia and weight gain seen with this therapy. It is recommended that during basal insulin titration, the evening meal be limited and hypoglycemia be monitored early in the morning, that bewitching time when the "peakless" basal insulin's action is peaking and the predawn phenomenon insulin sensitivity is higher.

Scheduling Exercise-Eating to Optimize Gut Probiotics: A Global Invention

This article describes how optimizing exercise timing can improve gut physiology and health. The goal is to avoid prolonged gut retention of digesta especially overnight. Suboptimal fermentation and eating-exercise timing are among shortcuts to unhealthy gut. It is suggested that early morning and evening physical work supplemented by small and minor evening and night food meals minimizes risks of unnecessary overdigestion and hindgut ill-fermentation, thus improving gut integrity and metabolism. Large evening meals must be avoided in any scenario. Day-time meals should be frequent but small. This helps ensure continuous and modest ingesta digestion and splanchnic metabolism and well-managed waste.

Eating time modulations of physiology and health: life lessons from human and ruminant models.

Tissue nutrient supply may be synchronized with endogenous physiological rhythms to optimize animal and human health. Glucose tolerance and insulin sensitivity have endogenous rhythms that are not essentially dependent on food type and eating. Human glucose tolerance declines as day comes into night. Based on such evolutionary findings, large evening meals must be avoided to reduce risks of visceral adiposity, diabetes, hypertension and related cardiovascular complexities. Ruminants as extremely important food-producing livestock have evolved to ruminate mostly overnight when little grazing occurs, and when rumen reaches a larger volume and fermentation capacity. As such, eating time (e.g., evening vs. morning) will alter postprandial and diurnal patterns of food intake, rumen and peripheral metabolites production and supply, and milk and meat production efficiency. Most recent discoveries suggest that eating time modulates postprandial intake and metabolism patterns in non-grazing lactating cows. Eating rate and absolute intake can increase by evening vs. morning feeding in dairy cows. Evening feeding increased postprandial rumen volatile fatty acids (VFA) peak, and surges of blood insulin, lactate and beta-hydroxybutyrate, and induced a peripartal decline in blood glucose. As a result, milk fat and energy production were increased. While being unfavorable to human health, evening and night feeding have proved beneficial to ruminants. These findings establish a differential chronological basis for food intake and nutrient metabolism in man and food-producing animals. Eating time is a major external cue and a feasible life strategy that affects production and health physiology.

Overnight closed loop insulin delivery (artificial pancreas) in adults with type 1 diabetes: crossover randomised controlled studies

Objective To compare the safety and efficacy of overnight closed loop delivery of insulin (artificial pancreas) with conventional insulin pump therapy in adults with type 1 diabetes.Design Two sequential, open...

Comparison of Humalog Mix 50 with human insulin Mix 30 in type 2 diabetes patients during Ramadan

To compare hypoglycaemic events, glycated haemoglobin (HbA1c) and changes in body weight in Muslim patients with Type 2 diabetes receiving Humalog Mix 50 and human Mixtard 30 twice daily during Ramadan fasting. Data were collected from Muslim patients with Type 2 diabetes attending primary care practices in North-West London, who were on Mixtard 30 insulin twice daily before Ramadan. Group 1 had their evening insulin changed to Humalog Mix 50 (n = 26) 2 weeks before Ramadan, i.e. taking Mixtard 30 at predawn meal and Humalog Mix 50 at the sunset meal during Ramadan. As the major proportion of the daily caloric intake was consumed at the sunset meal, the rationale of switching the evening dose from human Mixtard 30 to Humalog Mix 50 was to provide more rapid-acting insulin that has shorter time of onset and peak time for the large evening meal to improve the postprandial glucose control without increasing the risk of hypoglycaemia. Group 2 continued on Mixtard 30 twice daily (n = 26). All patients received structured education about how to identify and manage hypoglycaemia during Ramadan. Group 1 had a mean HbA1c reduction of 0.48% (p = 0.0001) before and after Ramadan, whereas group 2 had a mean HbA1c increase of 0.28% (p = 0.007). Group 1 was associated with a small reduction of 0.04 (p = 0.81) in the mean number of hypoglycaemic events during Ramadan compared with before Ramadan, whereas group 2 was associated with an increase of 0.15 (p = 0.43), although these differences between the groups were not statistically significant following adjustment for baseline factors [LSM difference between groups = 0.135, p = 0.36, 95% confidence limits (-0.16, 0.43)]. Changing to humalog Mix 50 during Ramadan resulted in improvement in glycaemic control without increasing the incidence of hypoglycaemia.

A Young Man With a New Diagnosis of Achalasia

d Clinical Scenario A 32-year-old man began to experience food sticking ntermittently in the midchest about 2 years ago. By the time he resents to the gastroenterology clinic, he is complaining of ysphagia at every meal for most hard, solid foods (ie, bread, eats, uncooked vegetables), and for the past 4 months he has oted dysphagia for liquids, especially cold beverages. Once or wice a week, after his large evening meal, he experiences reguritation of recently eaten food with a nonacidic taste. His wife omplains he “gurgles” at night and sometimes awakes her with oughing. He denies chest pain, but does complain of “hearturn,” improving with over-the-counter Prilosec (Proctor & amble, Cincinnati, OH). His weight is down 10 lb. The complaints of dysphagia for both solids and liquids aise the suspicion of achalasia. A barium esophagram shows a ildly dilated esophagus with a column of barium maintained ust below the clavicles with no emptying in the upright posiion over a 5-minute period. The distal esophagus has narowed, with a small amount of barium intermittently streaming nto the stomach. No orderly peristalsis is seen on fluoroscopy. sophageal manometry confirms the diagnosis, finding a high ower esophageal sphincter (LES) pressure (56 mm Hg) with ncomplete relaxation and low-amplitude, simultaneous mirror mage waves after all swallows of water. The patient and his wife return to your office after completng his tests. They have read extensively about achalasia on the nternet. They have many questions: Will I ever be able to eat ormally? Can you cure this disease? What is the best treatent—pneumatic dilation, surgical myotomy, or botulinum oxin injections? What are the side effects and which one will ive me the most relief for a long time?

Maximally Utilizing the Available Agents for the Treatment of Type 2 DIabetes

Maximally Utilizing the Available Agents for the Treatment of Type 2 DIabetes

Improved diabetes control after prolonged fasting — the Ramadan model

AbstractWe studied the effect of one large evening meal (gorging‐type diet) on patients with diabetes mellitus, during the month of Ramadan. Observant Muslims refrain from food and drink during the day and eat a large meal after sundown. It was an observational study carried out under field conditions in the Bedouin town of Rahat, in the northern Negev area of Israel. Fasting diabetic subjects were studied before, at the end of, and one month after Ramadan. Body weight, changes in medication, frequency of acute complications, plasma glucose and hemoglobin A1c were determined. Sixty‐seven fasting Muslim diabetic patients were studied. A significant decrease in hemoglobin A1c (HbA1c; p&lt;0.001) was observed at the end of the month of fasting. There was no significant change in the total daily dose of antidiabetic agents, or in the incidence of acute diabetic complications. The gorging‐type diet, followed for one month, was well tolerated and safe. A statistically significant decrease in HbA1c suggests a beneficial effect of the Ramadan fast in these patients. Copyright © 2001 John Wiley &amp; Sons, Ltd.

Effects of a Large Supper on Glucose Levels the Following Morning in Patients with Type 2 Diabetes

Seventeen patients were studied to test the hypothesis that a large evening meal influences the fasting glucose level and glucose tolerance the following morning in patients with type 2 diabetes. Oral hypoglycemic agents were discontinued for 2 weeks. The baseline fasting plasma glucose levels were 12.3 ± 0.9 mmol/L. Fasting and postprandial (post-Sustacal) glucose, insulin, and C-peptide measurements were performed the morning after the patients received three separate meal protocols spaced 1 week apart. The caloric distribution of the meal protocols was (1) 7 kcal/kg of ideal body weight breakfast and lunch and 14 kcal/kg supper (small supper); (2) 7 kcal/kg breakfast and lunch and 28 kcal/kg for supper (large supper); and (3) 14 kcal/kg breakfast and lunch (no supper). Fasting glucose levels were higher the morning after the large supper compared to no supper (13.6 ± 0.7 versus 12.3 ± 0.5 mmol/L, p < 0.05) and also to the small supper (13.6 ± 0.7 versus 12.5 ± 0..6 mmol/L, p = 0.05). No difference was observed in the fasting glucose levels between the small supper and no supper ( p > 0.2). The fasting insulin and C-peptide levels, and the post-Sustacal areas under the curve of glucose, insulin, and C-peptide did not differ among the meals. In patients with type 2 diabetes, a large evening meal is associated with a modest elevation in fasting glucose the following morning.

Weight Loss is Greater with Consumption of Large Morning Meals and Fat-Free Mass Is Preserved with Large Evening Meals in Women on a Controlled Weight Reduction Regimen ,

The purpose of this study was to determine whether meal ingestion pattern [large morning meals (AM) vs. large evening meals (PM)] affects changes in body weight, body composition or energy utilization during weight loss. Ten women completed a metabolic ward study of 3-wk weight stabilization followed by 12 wk of weight loss with a moderately energy restricted diet [mean energy intake ± SD = 107 ± 6 kJ/(kg·d)] and regular exercise. The weight loss phase was divided into two 6-wk periods. During period 1, 70% of daily energy intake was taken as two meals in the AM (n = 4) or in the PM (n = 6). Subjects crossed over to the alternate meal time in period 2. Both weight loss and fat-free mass loss were greater with the AM than the PM meal pattern: 3.90 ± 0.19 vs. 3.27 ± 0.26 kg/6 wk, P < 0.05, and 1.28 ± 0.14 vs. 0.25 ± 0.16 kg/6 wk, P < 0.001, respectively. Change in fat mass and loss of body energy were affected by order of meal pattern ingestion. The PM pattern resulted in greater loss of fat mass in period 1 (P < 0.01) but not in period 2. Likewise, resting mid-afternoon fat oxidation rate was higher with the PM pattern in period 1 (P < 0.05) but not in period 2, corresponding with the fat mass changes. To conclude, ingestion of larger AM meals resulted in slightly greater weight loss, but ingestion of larger PM meals resulted in better maintenance of fat-free mass. Thus, incorporation of larger PM meals in a weight loss regimen may be important in minimizing the loss of fat-free mass.

Relationship of Diet, Abdominal Obesity, and Physical Activity to Plasma Lipoprotein Levels in Asian Indian Physicians Residing in the United States

Objective To examine the relationship of total fat, saturated fat, carbohydrate and energy intake, leisure-time activity, waist-to-hip ratio (WHR), and body mass index to the prevalence of atherogenic plasma triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) levels in Asian Indians living in the United States. High plasma TG and low HDL-C levels have been documented in Asian Indians worldwide. Design This exploratory study examined medical history, demographics, anthropometries, plasma lipids levels, food intake frequency, and self-reported leisure-time activity. Subjects 153 Asian Indian male physicians (mean age=47 years) were recruited at two annual national conferences of the American Association of Physicians from India, with free medical assessments as incentives. Statistical analyses performed Correlational and multiple regression analyses were performed. Results Subjects’ diets averaged 56% energy from carbohydrate, 32% from total fat, and 8% from saturated fat. High total fat intake was associated with high WHR ( r=.2l, P<.01) and high total carbohydrate intake (grams per day) was associated with high TG level ( r=.24, P<.05). Leisure-time activity averaged 136 minutes/week and negatively correlated with total plasma cholesterol level ( r=−.22, P<.01) and low-density lipoprotein cholesterol level ( r=−.25, P<.001). Applications Dietitians should recommend moderate dietary carbohydrate intake and meal patterns with energy distributed throughout the day, in addition to decreasing fat consumption, to Asian Indian clients at risk for coronary artery disease. High carbohydrate intake and uneven diurnal distribution (no breakfast and large evening meals) are associated with high TG and low HDL-C levels in this population. J Am Diet Assoc. 1996; 96:257-261.

Accommodation of Particular Foods or Beverages into Spontaneously Ingested Evening Meals

Previous research has indicated that individual foods or beverages are ingested independently and do not produce adjustments to the intake of other constituents in the diet (de Castro, 1993; Wilson, 1991). In other to eliminate time of day as a potential contaminant, the present study investigated the accommodation of foods and beverages into the amount ingested at large evening meals only. Adults ( n = 601) were paid to maintain detailed diaries of the timings, quantities and preparation techniques of everything they ingested for seven consecutive days. With the exceptions of soup, beef and chicken, 12 out of 15 types of drinks or foods were found to add to the total calories ingested in evening meals without displacing calories ingested in other forms, while ingestion of non-caloric diet sodas was not associated with differences in intake. The fat and protein, but not carbohydrate, contents of the items correlated with a measure of the satiating properties of the particular food or beverage, namely the correlation between the amount ingested of the particular type and the amounts of other nutrients ingested in the meal. The results confirm that intake at a meal is quite elastic and can be significantly influenced by the presence or absence of particular components of the meal and their constituents.

Effects of sward height and concentrate supplementation on the ingestive behaviour of spring-calving dairy cows grazing grass-clover swards

Forty-eight, lactating, spring-calving, multiparous, Holstein-Friesian cows, continuously stocked on mixed grass-clover swards, were blocked by calving date, parity and milk yields in week 2 of lactation and randomly allocated to six treatments: 0 (U) or 4 (S) kg concentrate supplementation at sward heights of 40, 60 or 80 mm as measured by a rising plate meter. Jaw movements were recorded automatically for 24 h for a different cow on each treatment on each of 6 days during two periods (15–25 June (P1) and 25 July–6 August (P2)). Swards of 40 mm height were not used in P2. Total time grazing, ruminating or idling, and the number and duration of bouts of these activities, biting rate while grazing and chewing rate, number of boluses and chews per bolus while ruminating were recorded. Data were smoothed to give a minimum bout duration of 5 min. Herbage intakes were estimated using n-alkanes. Grazing time was greater at 40 mm than at 60 or 80 mm when unsupplemented but less when supplemented. Proportionately 0.88 of grazing time and 0.67 of ruminating time by dairy cows occurred during daylight with a large evening meal particularly evident. On the 40 mm sward unsupplemented animals grazed for longer with a higher biting rate but lower bite mass and less mastication and rumination. When supplement was offered at the 40 mm sward height animals appeared to ‘give up’ harvesting the sward more readily. Durations of ruminating and idling bouts were similar across all treatments with low variability.

Intravenous Regional Anesthesia of the Upper Extremity in Children

One of the more perplexing problems facing the anesthesiologist is provision of adequate and safe anesthesia for young children who have suffered fractures or large lacerations of the hand and forearm. Most children who receive general anesthesia for major suturing or closed reduction of fractures require hospital admission for at least 8 to 24 hours. This communication is a report of a safe and effective method of handling these procedures on an outpatient basis. A 7-year-old girl, weighing 20 kg (44 lb), was admitted to the operating room from the emergency room for full-thickness free skin graft to the left middle finger from which the tip had been avulsed. She had eaten a large evening meal shortly before the injury was sustained. Though moderately apprehensive, she quickly agreed to just one needle stick for anesthesia. Two narrow inflatable tourniquets were placed on the upper arm. A 25-gauge scalp vein needle

MYOCARDIAL INFARCTION

A 17-year-old man presented himself at the emergency room of Cape Fear Valley Hospital on the evening of Sept. 20, 1959, complaining chiefly of severe chest pain of one and one-half hours' duration. The patient was in good health until the night prior to admission to the hospital, when he had an episode of transient nausea and vomiting unaccompanied by pain. On the day of admission, about 30 minutes after eating a large evening meal, the patient began having severe substernal chest pain which did not radiate. He became nauseated and vomited once on the way to the hospital. The chest pain continued for one and one-half hours, until the patient was seen at Cape Fear Valley Hospital. At that time he complained of numbness in his arms. There was no radiation of the pain into the jaw, the arms, or the back. The patient's father, who was 50 years