Meal Time Research Articles

Optimal Self-Care for Surgeons: Sleep, Diet, and Exercise.

Surgeons face intense stress, causing hormonal imbalances that harm their health, leading to burnout, chronic illness, and shorter lifespans due to their demanding careers. This study explores self-care strategies focusing on sleep, nutrition, and exercise to help surgeons reduce stress and improve their overall well-being and quality of life. A thorough literature review of physiological, metabolic, and psychological principles informed the development of a structured self-care approach. We reviewed existing research on brain-body interactions, highlighting hormonal balance, nutrition, and exercise to mitigate chronic stress. The review underscores the importance of quality sleep for hormonal balance and overall health. Proper nutrition, emphasizing balanced macronutrients and meal timing, supports health. Exercise should be 80% low-intensity aerobic activities, with 20% high-intensity. Combining these elements strengthens resistance to chronic stress and enhances health. A structured self-care approach, prioritizing sleep, followed by nutrition and exercise, effectively reduces stress among surgeons. This sequence improves well-being and quality of life. Surgeons should focus on consistent sleep, balanced nutrition, and regular low-intensity exercise to enhance resilience and achieve a fulfilling professional life.

Chrono-Nutrition, Chrono-Type, and the Prevalence of Type 2 Diabetes Mellitus in a Cross-Sectional Study from the EuroPean Prospective Investigation into Cancer and Nutrition (EPIC) Study.

Background: Previous studies have shown that meal timing, poor sleep quality, and chronotype may play a relevant role in the development of type 2 diabetes mellitus (T2DM). However, its relationship with macronutrients by eating occasions has not been explored deeply. Objective: Our aim was to estimate the association between chrono-nutrition, sleep quality, chronotype, and the prevalence of T2DM. Methods: This cross-sectional study included a subset of 3465 middle-aged Caucasian adults (2068 women) from the European Prospective Investigation into Cancer and Nutrition (EPIC) Spain cohort study. In the 2017-18 follow-up, we assessed chronotype, sleep quality, diet, and sociodemographic data using validated questionnaires. Further, we used blood samples to determine serum levels of glucose. We defined a case of T2DM when serum glucose concentration was ≥126 mg/dL or when participants self-reported diabetes. Results: A higher prevalence of T2DM was associated with poor sleep quality (ORpoorvsgood = 2.90, 95% CI = 1.30, 6.28). Carbohydrate intake at breakfast was inversely associated with the prevalence of T2DM (OR = 0.75, 95% CI = 0.66, 0.85). Finally, lipid intake at breakfast was associated with a 13% higher prevalence of T2DM (OR = 1.13, 95% CI = 1.01, 1.26) for each 1 standard deviation (1-SD) increase. Conclusions: This study concludes that a higher content of carbohydrates at breakfast is correlated with a reduced prevalence of T2DM, while higher lipids intake at breakfast is associated with a higher prevalence of T2DM. Furthermore, poor sleep quality is a potential factor associated with an elevated prevalence of T2DM. Our results emphasize the need for prospective studies to validate and strengthen these observed associations.

Association of Overnight Fasting and Meal Irregularity with Nutrient Quality and Anthropometric Measures in Adults

Background: Timing, frequency, and regularity as chrono-nutrition are emerging fields in nutritional epidemiology. The authors investigated the association of irregularity in energy intake, frequency, and overnight fasting with nutrient quality and health. Methods: Iranian adults who attended the health center of Tehran participated in this cross-sectional study. Dietary intake was derived from 3-day 24-h dietary recalls of 850 participants. Weight, height, and blood pressure of the participants were measured, and frequency, irregularity, and overnight fasting were recorded from 24-h dietary recall. Then, intra-class correlation coefficient (ICC) was used to obtain the consistency of time regarding three main meals. Following that, energy density was measured and nutrient density was calculated using the nutrient rich food (NRF 9.3) index. Obesity was defined as body mass index (BMI) >30 kg/m2, and blood pressure was measured. Results: The highest consistency regarding the time of meal was observed at breakfast. Frequency was positively related to the intake of fruit, energy, carbohydrate, and NRF 9.3 index (P<0.05). Overnight fasting was negatively associated with fruit, vegetable, grain, energy intake, and NRF 9.3 index (P<0.05). Moreover, irregularity in energy intake showed a negative and significant association with fruits, vegetables, and NRF9.3 (P<0.05). Frequency was significantly associated with weight and diastolic blood pressure (DBP) after adjustment with covariates (P<0.05) and overnight fasting was negatively related to body weight (P=0.009). Moreover, irregularity in energy intake showed a significant association with systolic blood pressure (SBP) (P=0.03). Conclusions: Frequency and regularity may have a potential positive association with dietary intake which is not associated with BMI. Nutrient density is higher among the participants with a higher number of eating occasions, more regular eaters, and shorter overnight fasting.

The impacts of sex and the 5xFAD model of Alzheimer's disease on the sleep and spatial learning responses to feeding time.

The relationships between the feeding rhythm, sleep and cognition in Alzheimer's disease (AD) are incompletely understood, but meal time could provide an easy-to-implement method of curtailing disease-associated disruptions in sleep and cognition. Furthermore, known sex differences in AD incidence could relate to sex differences in circadian rhythm/sleep/cognition interactions. The 5xFAD transgenic mouse model of AD and non-transgenic wild-type controls were studied. Both female and male mice were used. Food access was restricted each day to either the 12-h light phase (light-fed groups) or the 12-h dark phase (dark-fed groups). Sleep (electroencephalographic/electromyographic) recording and cognitive behavior measures were collected. The 5xFAD genotype reduces NREM and REM as well as the number of sleep spindles. In wild-type mice, light-fed groups had disrupted vigilance state amounts, characteristics, and rhythms relative to dark-fed groups. These feeding time differences were reduced in 5xFAD mice. Sex modulates these effects. 5xFAD mice display poorer spatial memory that, in female mice, is curtailed by dark phase feeding. Similarly, female 5xFAD mice have decreased anxiety-associated behavior. These emotional and cognitive measures are correlated with REM amount. Our study demonstrates that the timing of feeding can alter many aspects of wake, NREM and REM. Unexpectedly, 5xFAD mice are less sensitive to these feeding time effects. 5xFAD mice demonstrate deficits in cognition which are correlated with REM, suggesting that this circadian-timed aspect of sleep may link feeding time and cognition. Sex plays an important role in regulating the impact of feeding time on sleep and cognition in both wild-type and 5xFAD mice, with females showing a greater cognitive response to feeding time than males.

The effects of time-restricted eating on sleep in adults: a systematic review of randomized controlled trials.

Time-restricted eating (TRE), a dietary pattern reducing the duration of daily food consumption, has recently gained popularity. Existing studies show the potential benefits of TRE for cardiometabolic health. Uncertainty remains about whether these benefits are solely from altered meal timing or influences on other health behaviors, including sleep. Despite growing scientific interest in the effects of TRE on sleep parameters, the topic has not been systematically explored. This review examined the effects of TRE interventions (daily fasting duration ≥14 h) lasting at least 8 weeks on objective and subjective sleep parameters. Six randomized control trials were identified through Pubmed, Embase, Google Scholar, and Scopus through September 2023. Of the included studies, three employed objective sleep measures using wearables and five studies assessed sleep subjectively through self-report questionnaires. Only one study reported significant improvements in subjective sleep quality following a TRE intervention. Additionally, one study found significant decreases in sleep duration, two studies found significant decreases in sleep efficiency, and one found significant increases in sleep onset latency. Current evidence indicates that short to mid-term TRE does not typically worsen sleep parameters. However, some populations may experience reduced sleep disturbances, while others may experience reductions in sleep efficiency. Longer duration studies with objective sleep assessments are needed to better understand the effects of TRE on sleep parameters.

Reality of Organizing Meal Times For 3 - 4 Year Olds Kindergarten Children At Some Private Nursing Schools In Thu Dau Mot City

Reality of Organizing Meal Times For 3 - 4 Year Olds Kindergarten Children At Some Private Nursing Schools In Thu Dau Mot City

Evaluation of daily eating patterns on overall diet quality using decision tree analyses

BackgroundPreliminary evidence suggests that meal timing is associated with higher quality diets. Less is known about whether types of food consumed during specific eating episodes (i.e., day-level eating patterns) predict diet quality. ObjectivesWe investigated the association between day-level eating patterns and diet quality. MethodsDecision tree models were built using 24-h dietary recall data from the National Health and Nutrition Examination Survey 2015 and 2017 cycles in a cross-sectional study. Sixteen food groups and 12 eating episodes (e.g., breakfast, lunch) were included as input parameters. Diet quality was scored using the Healthy Eating Index-2020 and categorized as higher or lower quality diets based on the median score. Mean decrease in impurity (MDI) ± standard deviation determined the relative contribution that day-level eating patterns had on diet quality; higher values represented greater contributions. ResultsWe analyzed 12,597 dietary recalls from 9347 United States adults who were aged 18 y and older with ≥1 complete recall. Meals (breakfast, lunch, dinner) and respective snacking episodes had the greatest variety of dietary groups that contributed to the Healthy Eating Index-2020 score. Any whole-grain intake at breakfast predicted a higher quality diet (MDI = 0.08 ± 0.00), followed by lower solid fat intake (<8.94 g; MDI = 0.07 ± 0.00) and any plant protein intake at dinner (MDI = 0.05 ± 0.00). ConclusionsDay-level eating patterns were associated with diet quality, emphasizing the relevance of both food type and timing in relation to a high-quality diet. Future interventions should investigate the potential impact of targeting food type and timing to improve diet quality.

Factors contributing to frailty in institutionalized older adults: a multi-institutional cross-sectional study

To reveal the characteristics and the oral function of institutionalized frail older adults and the factors contributing to frailty. This multicenter, cross-sectional study included 214 patients. A questionnaire was administered to registered dietitians from these institutions. Sex, age, height, weight, grip strength, calf circumference, level of care need, FRAIL-NH, MNA® -SF, dysphagia, food form and water thickening, number of medications, major diseases, comorbidities, independence in daily living of older people with dementia, use of medication with dry mouth, nutritional care issues (malnutrition-related problems) by multiple occupations in Nutrition and Eating Swallowing Screening, Assessment and Monitoring, and nine oral-related items were evaluated. One hundred six patients (49.5%) were classified as frail, 75% of the patients were women, and the mean BMI was 19.7 kg/m2. Older adults with frailty were characterized by high care needs, malnutrition, multiple comorbidities, multiple medications, eating and swallowing disorders, the requirement of feeding assistance, and the need to adjust the shape of meals and fluids. The multivariable OR (95%CI) for "choking and residue problems" was 1.81 (1.20-2.73), while that for "dietary concentration problems" was 4.28 (2.10-8.74). Caregivers must maintain posture and provide meal assistance. Professionals in various occupations must adjust the proper food form and medication content. Meal times must be examined in consideration of the times at which drugs will be most effective. Oral care must be provided, and an environment must be created to help the subject concentrate. Focusing on problems of choking, residue, and concentration on meals is expected to improve frailty, aspiration pneumonia, and the prognosis of institutionalized older adults.

Length of Overnight Fasting and 6-year Weight Change in the Cancer Prevention Study-3

BackgroundLonger overnight fasting (ONF) is a potential strategy for weight control. Although promising, the evidence from large population-based studies is limited. ObjectivesTo examine the association of self-reported ONF duration with 3- and 6-y weight change in the American Cancer Society’s Cancer Prevention Study-3 prospective cohort. MethodsUnited States adult Cancer Prevention Study-3 participants completed a 24-h validated meal and snack timing and frequency grid (weekday and weekend) in 2015, from which weighted ONF hours were calculated. Participants reported body weight in 2015, 2018, and 2021. Three- and 6-y weight change (kg, and % body weight) were assessed. ResultsAmong 104,420 mostly female (78.5%) participants aged 52.7 ± 9.5 (standard deviation) y followed for 6 y, a 1-h increase in ONF length was associated with a small but statistically significant reduction in weight gain over 3- and 6-y periods [multivariable-adjusted mean difference in % body weight = −0.02, 95% confidence interval (CI): −0.05, −0.00, P = 0.03 and −0.04, 95% CI: −0.07, −0.01, P < 0.01, respectively]. The mean difference of 6-y % reduction in weight gain was slightly greater among individuals with overweight (−0.05, 95% CI: −0.10, 0.00, P = 0.05) and obesity (−0.06, 95% CI: −0.12, 0.01, P = 0.08) compared with those with healthy body mass index (−0.03, 95% CI:−0.07, 0.01, P = 0.13) or underweight (0.16, 95% CI: −0.04, 0.36, P = 0.13, Pinteraction < 0.0001). Stronger associations were observed among those ≤55 y than 56+ (P < 0.001), and those with higher waist circumference (Pinteraction < 0.0001) but not by sex or earlier/later fasting period. ConclusionsLonger ONF was associated with slightly lower body weight in adult males and females over 6 y that was stronger among those with overweight or obesity, higher waist circumference, and those aged ≤55 y. The magnitude of weight change, although in the hypothesized direction, suggests that prolonged ONF may have modest impact on weight control over time.

Dietary Rhythmicity and Mental Health Among Airline Personnel

Misaligned dietary rhythmicity has been associated with metabolic diseases; however, its association with mental health remains largely unexplored. To examine the association between dietary rhythms and the mental health condition of shift workers, specifically airline crew members. This cross-sectional study analyzed data collected from the Civil Aviation Health Cohort of China, an ongoing large-scale health survey of pilots, flight attendants, and air security officers employed by major airline companies in China. Participants aged 18 to 60 years were invited through text messages to complete a web-based survey. The data collection period was December 2022 to March 2023. Statistical analysis was performed from July 24, 2023, to April 12, 2024. Data on timing of breakfast and dinner on workdays and rest days, daily time windows for food intake, and meal and eating jet lags were collected and calculated. Anxiety and depressive symptoms were measured using the 7-item Generalized Anxiety Disorder Assessment and the 9-item Patient Health Questionnaire. Multivariate logistic regressions were performed to evaluate the associations of anxiety and depression with meal timing, eating window time, meal jet lag (ie, delayed meals), and eating jet lag (ie, delayed eating). All models were adjusted for individual socioeconomic, demographic, and lifestyle characteristics. Of the 22 617 participants (median [IQR] age, 29.1 [26.3-33.7] years; 13 712 males [60.6%]), 1755 (7.8%) had anxiety and 2768 (12.2%) had depression. After controlling for confounding factors, having dinner after 8 pm on morning-shift days was associated with increased odds of anxiety (adjusted odds ratio [AOR], 1.78; 95% CI, 1.53-2.05) and depression (AOR, 2.01; 95% CI, 1.78-2.27), compared with consuming dinner before 8 pm. Similar results were observed on night-shift days and rest days. An eating window of less than 12 hours was associated with reduced odds of anxiety (AOR, 0.84; 95% CI, 0.75-0.93) and depression (AOR, 0.81; 95% CI, 0.75-0.89) on morning-shift days; the results remained significant on rest days. Delayed dinner on morning-shift days was associated with increased odds of anxiety (AOR, 1.32; 95% CI, 1.13-1.54) and depression (AOR, 1.39; 95% CI, 1.22-1.58). On night-shift days, delayed dinner was associated with higher odds of anxiety (AOR, 1.22; 95% CI, 1.06-1.39) and depression (AOR, 1.21; 95% CI, 1.08-1.36). On morning-shift days, delayed eating rhythms were associated with higher odds of depression (AOR, 1.35; 95% CI, 1.13-1.61), whereas advanced eating rhythms were associated with lower odds of anxiety (AOR, 0.78; 95% CI, 0.70-0.87). This cross-sectional study found that meal timing, long eating window, and meal jet lags were associated with increased odds of depression and anxiety. These findings underscore the need for interventions and supportive policies that help mitigate the adverse implications of shift work and irregular working hours for the mental health of shift workers.

The Role of Gut Microbiome in Sleep Quality and Health: Dietary Strategies for Microbiota Support.

Dietary components, including dietary fiber, unsaturated fatty acids, and polyphenols, along with meal timing and spacing, significantly affect the microbiota's capacity to produce various metabolites essential for quality sleep and overall health. This review explores the role of gut microbiota in regulating sleep through various metabolites such as short-chain fatty acids, tryptophan, serotonin, melatonin, and gamma-aminobutyric acid. A balanced diet rich in plant-based foods enhances the production of these sleep-regulating metabolites, potentially benefiting overall health. This review aims to investigate how dietary habits affect gut microbiota composition, the metabolites it produces, and the subsequent impact on sleep quality and related health conditions.

Effects of meal timing on human plasma metabolite rhythms

The term ‘chrono-nutrition’ describes the interaction between circadian timing and nutritional intake, as demonstrated by a wealth of animal and human studies(1). This relationship is bidirectional, with post-prandial response varying across the day and meal timing acting as a synchronising signal for some circadian rhythms. In humans, we have demonstrated that meal timing is a strong synchroniser of plasma glucose rhythms(2). Our recent data also suggest that interstitial glucose concentration can anticipate large meals(3). However, little is known about the effects of meal timing on other metabolic pathways. The existence of circadian rhythms in human plasma metabolites(4-6) provides a clear opportunity to address this timely issue. Here, in a controlled laboratory protocol, we tested the hypothesis that the anticipation of large meals is observed in human plasma metabolites.Twenty-four male participants undertook an 8-day laboratory study, with strict sleep-wake schedules, light-dark schedules, and food intake. For 6 days, participants consumed either hourly small meals throughout the waking period or two large daily meals (7.5 and 14.5 h after wake-up). Isocaloric meals were calculated using the Mifflin St Jeor formula, and contained 55% carbohydrate, 15% protein, 30% fat(2). All participants then undertook a 37-h constant routine. Samples were collected across a 30-h period in the middle of the constant routine. Plasma was collected every 30 minutes for targeted UPLC-MS/MS metabolomics analysis (Absolute p180 Biocrates kit), and saliva was collected hourly for assessment of melatonin onset, a marker of circadian timing. Data were statistically evaluated by cosinor analysis, unpaired t-test, and repeated measures ANOVA.There was no difference (p &gt;0.05) in melatonin onset between the two groups. Rhythms, as indicated by significant (p &lt; 0.05) cosinor fit, were detected in 64 plasma metabolites (out of 141 detected) in both groups. These metabolites included glucose, triglyceride, cholesterol, plus multiple amino acids, acylcarnitines, phospholipids and sphingolipids. Consistent with previous work, there was a large (c. 7-hour) difference in the phase of plasma glucose between groups, with no significant difference in the phase of plasma triglyceride. Some other metabolites (e.g. histidine and proline) exhibited phase changes like that of glucose, but the phase was mostly unchanged. Glucose, alanine, arginine, citrulline, glutamine, methionine, phenylalanine, met-SO, 3 acylcarnitines and 13 phospholipids exhibited a significant interaction (FDR &lt;0.05 meal-size x time, n=25). Totalcholesterol, asparagine, glutamate, glycine, isoleucine, leucine, ornithine, proline, serine, threonine, tryptophan, tyrosine, kynurenine, SDMA, sarcosine, t4-OH-Pro, taurine, 6 acylcarnitines, 25 phospholipids and SMC18:1 exhibited a significant effect of meal-size and time. A further 8 metabolites had a significant effect of time only. Sixteen metabolites had no significant differences in neither meal size nor time. Our data therefore reveal novel effects of meal timing on multiple metabolite rhythms and average daily concentrations.

Meal Timing From Self-Report Dietary Assessment Methods Compared With That Based on Image Time Stamps Captured by a Wearable Camera

Meal Timing From Self-Report Dietary Assessment Methods Compared With That Based on Image Time Stamps Captured by a Wearable Camera

Meal Timing Trajectories and All-Cause Mortality in Older Adults

Meal Timing Trajectories and All-Cause Mortality in Older Adults

Sex and Menopausal Status Modulate the Impact of Meal Timing on Postprandial Glucose: Data From the ZOE PREDICT 1 Study

Sex and Menopausal Status Modulate the Impact of Meal Timing on Postprandial Glucose: Data From the ZOE PREDICT 1 Study

Effect of Meal-Timing on the Association of Unsaturated Fatty Acids with All-Cause and Cardiovascular Mortality among Adults: A Prospective Cohort Study with 10-Year Follow-Up.

Conflicting results have been reported on the association of dietary unsaturated fatty acids (UFAs) with longevity and cardiovascular health. Most previous studies have focused only on the amount of UFAs consumed, not the timing of intake. This prospective cohort study used data from 30,136 adults aged 18 years and older. Intakes of UFAs by meal time and types were assessed by a 24-h dietary recall for two days. The covariate-adjusted survey-weighted Cox proportional hazards models were performed to evaluate the associations of dietary total unsaturated fatty acid (TUFA), polyunsaturated fatty acid (PUFA), and monounsaturated fatty acid (MUFA) intakes throughout the day and three meals with mortality. During a median of 10.0 years of follow-up, 4510 total deaths occurred. All-cause mortality decreased with increasing intakes at dinner of TUFA (HR: 0.87 [0.77-0.98]), PUFA (HR: 0.81 [0.73-0.91]), and MUFA (HR: 0.88 [0.77-0.99]). With an increased intake of PUFA at dinner, CVD mortality showed a decreasing trend. However, the inverted L-shaped non-linear trend in all-cause mortality was found with increasing intake at breakfast of TUFA (HR: 1.35 [1.17-1.57], Q3 vs. Q1), PUFA (HR: 1.30 [1.13-1.50]), and MUFA (HR: 1.28 [1.13-1.45]). Meanwhile, increased breakfast intake of UFAs was associated with increased CVD and heart disease mortality. Meal timing influences the association of UFAs with all-cause and CVD-related mortality.

Association between Eating-Fasting and Sleep-Wake Cycles with Eating Times and Food Consumption throughout the Day: Longitudinal Study with Pregnant Women

Abstract Objective To investigate the associations of the sleep–eating interval with eating times and food consumption throughout the day in pregnant women. Materials and Methods A longitudinal study with 100 pregnant women treated at the public health network in the city of Uberlândia, state of Minas Gerais (MG), Brazil, during the entire gestational period. The time intervals between waking up and the first eating episode and between the last eating episode and going to sleep (independent variables) were investigated. Outcome measures were meal and sleep times, as well as food consumption throughout the day. Results Food consumption closer to sleep at night is associated with higher total daily caloric intake in the first (β = −0.337, p = 0.016) and second trimesters (Ts) of pregnancy (β = −0.240, p = 0.023), and with longer sleep duration on weekdays (p &lt; 0.05 for all three trimesters). We did not find associations between the wake-up to first eating episode interval and total calories (p &gt; 0.05 for all three trimesters), but the longer this interval, the greater the percentage of calories at dinner (1T: β = 0.266, p = 0.003; 2T: β = 0.269, p = 0.045) and at the last meal (1T: β = 0.324, p = 0.001; 2T: β = 0.231, p = 0.033). Discussion Taking longer to eat the first meal after waking up is associated with higher caloric intake later in the day, while taking longer to sleep after eating the last meal is associated with higher total daily caloric intake and shorter sleep duration, especially in the beginning and middle of pregnancy.

Targeting the intestinal circadian clock by meal timing ameliorates gastrointestinal inflammation

The expression of clock genes has been observed to be impaired in biopsies from patients with inflammatory bowel disease (IBD). Disruption of circadian rhythms, which occurs in shift workers, has been linked to an increased risk of gastrointestinal diseases, including IBD. The peripheral circadian clock in intestinal epithelial cells (IECs) was previously shown to balance gastrointestinal homeostasis by regulating the microbiome. Here, we demonstrated that the intestinal clock is disrupted in an IBD-relevant mouse model (IL-10−/−). A lack of the intestinal clock gene (Bmal1) in intestinal epithelial cells (IECs) in a chemically and a novel genetically induced colitis model (DSS, Bmal1IEC−/−xIL-10−/−) promoted colitis and dramatically reduced survival rates. Germ-free Bmal1IEC−/− mice colonized with disease-associated microbiota from IL-10−/− mice exhibited increased inflammatory responses, highlighting the importance of the local intestinal clock for microbiota-induced IBD development. Targeting the intestinal clock directly by timed restricted feeding (RF) in IL-10−/− mice restored intestinal clock functions, including immune cell recruitment and microbial rhythmicity; improved inflammatory responses; dramatically enhanced survival rates and rescued the histopathological phenotype. In contrast, RF failed to improve IBD symptoms in Bmal1IEC−/−xIL-10−/− mice, demonstrating the significance of the intestinal clock in determining the beneficial effect of RF. Overall, we provide evidence that intestinal clock dysfunction triggers host immune imbalance and promotes the development and progression of IBD-like colitis. Enhancing intestinal clock function by RF modulates the pathogenesis of IBD and thus could become a novel strategy to ameliorate symptoms in IBD patients.

Point-of-care Glycated Hemoglobin (POC-A1c) Testing Helps Early Diagnosis of Diabetes

Just like the DIPSI Guidelines for GDM in India, we must have a rapid screening tool like POC-A1c, which gives an estimate of long-term hyperglycemia and helps early detection. Traditional gold standard methods may delay the diagnosis for an indefinite time, as we have seen in our observations that of those who did not opt for POC-A1c, about 34% did not turn up even after three months. We infer that random capillary blood glucose (with a history of meal timings) of more than 140 mg% using POC-A1c helps in instant diagnosis accuracy of about 93%, or exclusion and necessary action can be taken immediately compared to traditional gold standard methods. It also saves time and is cost-effective as no preparation is required, transportation can be avoided, and it also removes the stress or burden of being positive immediately. We know the important role of POC-A1c in treatment intensification or deintensification in the management of known T2DM patients. We also know that POC-A1c is not recommended for the diagnosis of DM by ADA, but evidence suggests we can opt for RPG and POC-A1c to screen and confirm or exclude T2DM. At the same time, we also recommend large-scale cross sectional studies to recommend POC-A1c as a tool for early screening and diagnosis and definitely reconfirmation is always possible and can be recommended.

Effect of meal timing and frequency on lipid profile in adults: an overview of systematic reviews and meta-analyses

PurposeDyslipidaemia is an established risk factor for cardiovascular diseases. Calorie restriction and adopting a heart-healthy diet like the Mediterranean diet are the main dietary interventions for dyslipidaemia. Other dietary behaviours, such as changes in meal frequency and timing, are not included in the major dietary advice guidelines despite the potential correlation between eating patterns and lipid metabolism. This overview of systematic reviews and meta-analyses aims to summarise the effect of meal timing and frequency on lipid profile and make possible recommendations on which meal timing pattern is superior in reducing lipid levels.Design/methodology/approachAccording to the protocol published on PROSPERO (CRD42021248956), five databases were searched for systematic reviews and meta-analyses investigating the effects of meal timing and frequency on lipid profile in adults.FindingsFive reviews were included, with two reviews on breakfast skipping and meal frequency, respectively, and one review on night-time eating. Increasing meal frequency while maintaining the total calorie intake was reported to reduce total cholesterol and low-density lipoprotein (LDL) levels with low- to moderate-quality evidence. There was a correlation between breakfast skipping and an undesirable increase in LDL levels with low-quality evidence. However, there needs to be more high-quality evidence to conclude the effect of dietary behaviours on blood lipid levels.Originality/valueThis overview provides a comprehensive summary of evidence examining the effects of meal timing and frequency on adult lipid profiles. The current low- or moderate-quality evidence could not support the recommendation of alteration of meal frequency as an alternative to conventional non-pharmacological treatments for dyslipidaemia.