Night Eating Research Articles

The impact of later eating rhythm on childhood adiposity: protocol for a systematic review

BackgroundChildhood adiposity has increased dramatically in the last few decades and is an important predictor of adulthood chronic disease. Later eating rhythm, termed night eating (NE), is increasingly prevalent in adults; however, the prevalence of NE in children and relationship between NE and adiposity in children still remains uncertain. The aim of this work is to review the association between adiposity in children and adolescents and NE, in terms of calorie intake, timing and meal frequency in the evening/night.MethodsThe Cochrane library, CINAHL, Embase, MEDLINE (via OVID) and Web of Science databases will be searched from inception to November 2019 for randomised controlled trials (RCTs) and observational studies (cohort, cross-sectional and case-control studies) which investigate the association between later vs. earlier timing of food intake at night or relatively more vs. less energy intake in any eating occasions or time period after 4 pm on adiposity in children and adolescents (4–18 years). The outcomes will be body mass index (BMI)/BMI standard deviation score (BMI-SDS or BMI Z-score), waist circumference (WC), fat mass index (FMI)/percentage of body fat (%BF) or waist to hip ratio (WHR). No language restriction will be applied. Screening for eligibility from the title and abstracts and data extraction from the full texts will be carried out by two reviewers independently. References listed in the included studies will be hand-searched for any additional articles. The quality of included RCT studies will be assessed using Revised Cochrane Risk of Bias tool (RoB 2), and of observational studies using Newcastle Ottawa scale. A qualitative synthesis of the results will be presented, and meta-analysis will be conducted, where appropriate.DiscussionThe planned systematic review will investigate the association between later eating rhythm and adiposity in children and adolescents. Understanding the best meal size, timing of energy intake and meal frequency across the evening time for maintaining healthy weight in children is important in order to give parents the best advice to help prevent adulthood obesity and associated chronic diseases in their children.Systematic review registrationPROSPERO CRD42019134187.

Factor structure of the Night Eating Diagnostic Questionnaire (NEDQ) and an evaluation of the diagnostic criteria of the night eating syndrome

BackgroundThe Night Eating Diagnostic Questionnaire (NEDQ) is a validated assessment of the night eating syndrome (NES) based on the proposed diagnostic criteria. While past results show that NEDQ is associated with psychopathology and body mass index (BMI), the relationships between the proposed NES diagnostic criteria and psychopathology and BMI have not been investigated. Thus, the relationships between the proposed NES diagnostic criteria and factors previously associated with NES, namely depression, “food addiction” (FA), sleep quality, and BMI were examined. Finally, the NEDQ factor structure was examined for the first time in order to determine whether the NEDQ is assessing NES appropriately.MethodsThe NEDQ, depression, sleep quality, and FA questionnaires were administered to a sample of older community members (n = 468) and a student sample (n = 254). Principal Components Analysis (PCA) was performed to examine the factor structure of the NEDQ. The relationships between the proposed diagnostic criteria and depression, sleep quality, FA, and BMI were examined using multiple regression.ResultsThe proposed NES criteria were highly intercorrelated. PCA revealed a single factor solution for the NEDQ. In the community sample, depression was associated with the presence of five of nine proposed diagnostic criteria while poor sleep quality and FA were associated with the presence of seven and six criteria respectively. In the community sample, only the sleep problems and impairment/distress criteria were positively associated with BMI. In the student sample, fewer criteria were associated with psychopathology, and no criteria were associated with BMI.ConclusionsThese findings support the proposed criteria for diagnosis of NES. All proposed criteria were associated with at least one psychopathology measure. BMI was only associated with the sleep problems and impairment/distress criteria in the community sample. The PCA finding of a single factor indicates that the NEDQ is a cohesive assessment of NES, and that the NEDQ is a good measure of NES criteria.

Late-Night Eating-Induced Physiological Dysregulation and Circadian Misalignment Are Accompanied by Microbial Dysbiosis.

Irregular eating habits, such as late-night eating, will cause increased risk of obesity and other metabolic diseases. The aim of this study is to elucidate the impacts of late-night eating on physiological function and gut microbiota. Male Wistar rats under 16 h/8 h-light/dark cycle are divided into four groups with specific dietary habits, which mimicked breakfast, lunch, dinner, and late-night eating. Late-night eating, including skipping dinner for a night eating (BLN) and skipping breakfast and having a night eating (LDN), causes an increase of body weight, which is associated with decreased physical activity. Additionally, late-night eating results in hepatic lipid accumulation and systemic inflammation in peripheral tissues, compared to those of free feeding (FF) or breakfast, lunch, and dinner (BLD) groups. The phases of key clock genes are similar in FF, BLD, and BLN groups, while LDN feeding causes an overall 4 h phase delay in peripheral tissues. Moreover, late-night eating, especially LDN feeding, results in a significant alternation in the compositions and functions of gut microbiota, which further contributes to the development of metabolic disorder. Late-night eating causes physiological dysregulation and misalignment of circadian rhythm, together with microbial dysbiosis.

Associations of Circadian Eating Pattern and Diet Quality with Substantial Postpartum Weight Retention.

Besides food quantity and quality, food timing and frequency may contribute to weight regulation. It is unclear if these factors during pregnancy can influence maternal weight retention after childbirth. We thus aimed to examine the associations of maternal circadian eating pattern and diet quality in pregnancy with substantial postpartum weight retention (PPWR) at 18 months in an Asian cohort. We assessed circadian eating pattern and diet quality of 687 women using 24-h dietary recalls at 26–28 weeks’ gestation. We calculated PPWR by subtracting maternal weight in the first trimester from weight at 18-month postpartum and defined substantial PPWR as ≥5 kg weight retention. Multivariable binary logistic regression was performed. Overall, 16% of women had substantial PPWR. After the confounders adjustment, night eating, defined by greater night-time caloric intake (odds ratio 1.95; 95% confidence interval 1.05, 3.62), and lower diet quality, classified by median score of the Healthy Eating Index (1.91; 1.17, 3.10), were independently associated with higher odds of substantial PPWR. No associations with substantial PPWR were observed for night fasting duration and number of eating episodes. In conclusion, alignment of eating time with day–night cycles and diet quality during pregnancy may play a role in PPWR, with possible implications for long-term obesity risk.

Diurnal rhythms of cortisol and melatonin in night eating and non-night eating male police officers

Abstract Background Working during the night has in previous studies been associated with behavioural changes and diseases. Disturbance between behavioural and biological circadian rhythms have been suggested as a possible mechanism linking night work with cardiovascular diseases and pre-diabetic changes. The aim of this study was to investigate if night eating during two, four and seven consecutive night shifts is associated with differences in the diurnal rhythms of cortisol and melatonin in male police officers in Denmark. Methods We conducted an experimental study among 37 male police officers in Denmark who all collected data on the last night shift in three different work schedules with two, four and seven consecutive night shifts, respectively. Night eating was self-reported and defined as eating at least one main meal between midnight and early morning. Differences in the diurnal rhythms of concentrations of cortisol and melatonin in saliva were tested by phase changes and amplitude differences. Results Sixteen (43.2%) police officers ate a main meal during the last night shift in all three work schedules. The timing of the lowest cortisol concentration was on average delayed with 2:10 hours (95% CI 0:24-3:56 hours) and the level of the lowest cortisol concentration was on average supressed with 66% (95% CI 47-94%) for night eaters compared to non-night eaters. There was no association with number of consecutive night shifts. The phase and amplitude of melatonin were not statistically significantly different between night eaters and non-night eaters. Conclusions Night eating behaviour is associated with differences in the diurnal rhythm of cortisol in Danish male police officers working during the night. The difference in cortisol rhythm between night eaters and non-night eaters on night shifts is not affected by the number of consecutive night shifts. Key messages Night eating behaviour is associated with differences in the diurnal rhythm of cortisol. Future studies should focus on potential health outcomes of night eating behaviour among night workers.

Depression symptoms and night eating in young adulthood.

We estimated cross-sectional and longitudinal associations between depression symptoms and night eating in young adults. Data were drawn from a longitudinal investigation of students age 12-13years at inception in 1999-2000, in Montreal, Canada. Depression symptoms were measured with the Depressive Symptoms Scale (DSS) 20times from age 12 to 17, and with the Major Depression Inventory (MDI) post-high school at ages 20 and 24. Night eating was measured at age 24. The association between depression symptoms and night eating was estimated in multivariable logistic regression models adjusted for sex, age and mother university-educated. 9% of 829 participants (n = 77) reported night eating. In cross-sectional analysis, the adjusted odds ratio (OR) estimate for MDI scores (range 0-50) was 1.04 (1.01, 1.07). In longitudinal analyses, the OR estimates were 1.75 (1.20, 2.55) for DSS scores (range 1-4) and 1.03 (1.002, 1.06) for the MDI. Depression symptoms are associated with night eating in young adults cross-sectionally and possibly longitudinally. Treatment of depression symptoms may be important in preventing night eating, a core symptom of the Night Eating Syndrome. Level III, cohort analytic study.

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Associations of Meal Timing and Frequency with Obesity and Metabolic Syndrome among Korean Adults.

Emerging studies indicate that meal timing is linked to cardiometabolic risks by deterioration of circadian rhythms, however limited evidence is available in humans. This large-scale cross-sectional study explored the associations of meal timing and frequency with obesity and metabolic syndrome among Korean adults. Meal timing was defined as nightly fasting duration and morning, evening, and night eating, and meal frequency was estimated as the number of daily eating episodes using a single-day 24-hour dietary recall method. Meal frequency was inversely associated with prevalence of abdominal obesity, elevated blood pressure, and elevated triglycerides in men only. Independent of the nightly fasting duration and eating episodes, morning eating was associated with a lower prevalence of metabolic syndrome (odds ratio (OR), 0.73; 95% confidence interval (CI), 0.57–0.93 for men and OR, 0.69; 95% CI, 0.54–0.89 for women) than no morning eating, whereas night eating was associated with a 48% higher prevalence of metabolic syndrome (OR, 1.48; 95% CI, 1.15–1.90) than no night eating in men only. Longer fasting duration and less sleep were associated with obesity and metabolic syndrome. These findings suggest that overall eating patterns, including energy distribution across the day, eating frequency, and sleep duration, rather than fasting duration alone, are related to cardiometabolic risks in free-living Korean adults.

Night Eating Syndrome and Food Addiction in Turkish Population

Objectives: The aim of this study was to determine the prevalence of food addiction (FA) and night eating syndrome (NES) and to investigate any correlation between them in Turkish population. Materials and Methods: Subjects registered with family medicine centers were randomly invited to participate in the study (415 volunteers). Participants were evaluated with a socio-demographic data form, the Yale Food Addiction Scale (YFAS) and the Night Eating Questionnaire (NEQ). Results: A total of 295 subjects, including 160 females and 135 males, were evaluated in our study. The mean age of the participants was 33.78±10.72 and the mean BMI was 25.11±4.63. 7.8% of the subjects had FA according to the YFAS, and 13.2% had NES according to the NEQ. The prevalence of a coexistence of NES and FA was 2%. Using Pearson correlation analysis, a positive correlation was established between BMI and NEQ (r=0.14, p<0.01) and a positive correlation was found between total scores from the NEQ and the YFAS (r=0.14, p<0.01). With multiple linear regression analysis, it was demonstrated that 18.4% of total NEQ scores could be explained by eight YFAS symptom scores (p<0.001). Conclusion: It should be kept in mind that normal-weight, overweight or obese individuals may have NES or FA or both. Therefore, it could be useful to assess these problematic eating behaviors in individuals presented to family medicine outpatient clinics and to refer those with these problematic eating behaviors to relevant treatment centers.

Bir Üçüncü Basamak Hastanenin Aile Hekimliği Kliniğine Başvuran 18-65 Yaşındaki İnsanlarda Gece Yeme Sendromu Sıklığı

Aim: Night Eating Syndrome is thought to pose a risk for the development of cardiovascular system, endocrinological and psychiatric diseases. The aim of our study was to investigate the frequency of night-eating syndrome and risk factors related to night eating syndrome. Methods: This cross-sectional, descriptive study was carried out among 525 people who admitted to the Family Medicine Clinic of a tertiary hospital between 01 October and 30 November 2018. The night-eating questionnaire was applied to the partcipants using face-to-face interview. Persons with a psychiatric disorder, who have a history of chronic medication or disease, who have alcohol and drug addiction and who are working on the night shift were excluded from the study. p values &lt; 0.05 were considered as statistically significant. Results: Fifty-one (9.7%) of the 525 patients admitted to our clinic met the criteria of Night Eating Syndrome. In our study, there were statistically significant difference between night eating syndrome and non-night eating syndrome groups with respect to smoking status and body mass index. Conclusion: Night eating syndrome is a hidden public health problem which is related to cardiovascular system diseases, diabetes mellitus and psychiatric disorders besides obesity. Because of the presence of serious health problems associated with night eating syndrome, it is very important to determine night eating syndrome in primary care.

Investigation of Night Eating Syndrome Frequency in Adults in a Family Health Center

Objective: In this study, it was aimed to determine the frequency of&#x0D; night eating syndrome (NES) risk in adults who appealed to a family health&#x0D; center. Method: The research was structured as a cross-sectional study at&#x0D; Gümüşhane Kürtün Family Health Center between February 2018 and August 2018. In&#x0D; this study, sociodemographic information questionnaire and the Night Eating&#x0D; Questionnaire (NEQ) were administered to 403 volunteers aged 18 years and over&#x0D; who appealed to the family health center for any reasons. Participants who&#x0D; received 25 points and above from the NEQ were considered positive for the risk&#x0D; of NES. Also, the height and&#x0D; weight of the participants were recorded. Results: The average age of participants was 40.5±15.4 years. Of these, 45.4% (n=183)&#x0D; were male and 54.6% (n=220) were female. A total&#x0D; of 11.7% (n= 47) of the sample screened positive for NES with a total NEQ score&#x0D; of ≥25. No statistically significant association was found between a&#x0D; positive NES screening result and some of the sociodemographic parameters&#x0D; (gender, marital status, working status, place of residency)&#x0D; (p&amp;gt;0.05). Significant positive associations emerged between a positive NES&#x0D; screening and body mass index, age and smoking status (p&amp;lt;0.05). NES&#x0D; was significantly more common in the participants who were living alone and&#x0D; those with lower education (p&amp;lt;0.05). Conclusion: In this study, the&#x0D; frequency of NES was found higher than in the other community based studies.&#x0D; NES which can be observed in the general population and especially in obese&#x0D; patients is overlooked even in family medicine and even in obesity polyclinics.&#x0D; The diagnosis of individuals with NES will contribute to prevention of obesity.&#x0D; In this context, it would be beneficial to disseminate screening for NES in primary&#x0D; care.&amp;nbsp;&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Amaç: Bu çalışmada, bir&#x0D; aile sağlığı merkezine başvuran erişkin bireylerde gece yeme sendromu (GYS)&#x0D; riski sıklığının değerlendirilmesi amaçlanmıştır. Yöntem: Bu araştırma Gümüşhane iline bağlı Kürtün 01 No’lu Aile&#x0D; Sağlığı Merkezi’nde Şubat 2018 ile Ağustos 2018 tarihleri arasında kesitsel&#x0D; olarak yapıldı. Çalışmada aile sağlığı merkezine herhangi bir sebeple başvuran&#x0D; 18 yaş ve üstü 403 gönüllü bireye sosyodemografik bilgi anketi ve gece yeme&#x0D; anketi (GYA) uygulandı. GYA’dan 25 puan ve üzeri alanlar Gece Yeme Sendromu&#x0D; (GYS) riski açısından pozitif kabul edildi. Ayrıca kişilerin boy ve vücut&#x0D; ağırlıkları ölçülerek beden kitle indeksleri hesaplanıp kaydedildi. Bulgular: Katılımcıların yaş ortalaması&#x0D; 40,5±15,4 yıldı. Katılımcıların %45.4’ü (n=183) erkek, %54.6’sı (n=220)&#x0D; kadındı.%11,7’si (n=47) GYA’dan ≥25 puan aldı. GYS taraması sonucunda pozitif&#x0D; ve negatif gruplar arasında bazı sosyodemografik değişkenler (cinsiyet, medeni&#x0D; durum, yaşadığı yer, çalışma durumu) açısından anlamlı bir ilişki tespit&#x0D; edilmedi (p&amp;gt;0,05). Yaş, beden kitle indeksi ve sigara kullanımıyla GYS riski&#x0D; arasında pozitif bir ilişki vardı ve fark istatistiksel olarak anlamlıydı&#x0D; (p&amp;lt;0,05). GYS, yalnız yaşayanlarda ve eğitim durumu düşük olanlarda anlamlı&#x0D; derecede daha sık görüldü (p&amp;lt;0,05).&#x0D; Sonuç: Bu çalışmamızda GYS sıklığı diğer toplum temelli araştırmalara&#x0D; kıyasla daha yüksek tespit edildi. Toplum genelinde özellikle de obezlerde&#x0D; görülebilen GYS, aile hekimliği ve hatta obezite polikliniklerinde bile gözden&#x0D; kaçmaktadır. GYS’li bireylerin tespit edilmesi obezite ile mücadeleye de katkı&#x0D; sağlayacaktır. Bu bağlamda birinci basamak sağlık hizmetleri kapsamında GYS&#x0D; taramasının yaygınlaştırılması faydalı olabilir.

Relationship between Night Eating Syndrome and Self-esteem: A Cross-sectional Population-based Study in Karachi, Pakistan.

BackgroundThe amount of literature shedding light upon eating disorders in developing countries, such as Pakistan, is scarce. This is partially because talking about such matters is considered taboo in the general population. Night Eating Syndrome’s (NES) link with depression and obesity has been established; however, presently, no study has been conducted which solely focuses on NES’s correlation with self-esteem. Therefore, to bridge this knowledge gap, we conducted this study to assess the prevalence of NES in Karachi and its association with self-esteem.MethodsWe conducted a cross-sectional study in August 2018 using convenience sampling in 395 individuals, out of which 197 belonged to the age group 18-24 and 198 to 25-30. The participants were interviewed for their gender, body mass index (BMI), and their level of education. The participants were asked to complete a structured, standardized questionnaire assessment, which comprised of questions from the Night Eating Questionnaire (NEQ) and Rosenberg Self-Esteem scale (RSE). The eating habits of the participants and the level of self-esteem were assessed using four- and five-point Likert scales. Kruskal-Wallis and chi-square tests were used as the primary statistical tests.ResultsOut of the 395 respondents, more than half of the respondents were females (n = 235/395, 59.5%). About one-fourth (n = 92/395, 23.3%) of the participants had a BMI of greater than 25.0 kg/m2. More than one-third of the underweight (n = 20/55, 36.4%) and overweight population (n = 33/92, 35.9%) had low self-esteem, while more than one-fourth (n = 25/92, 27.2%) of the overweight participants fulfilled the criteria of NES. The final outcomes showed that 14.4% of the participants had NES, and 4.6% of the participants had low self-esteem.ConclusionOur results pointed out to a significant relationship between NES and self-esteem. Furthermore, NES and self-esteem also had a significant association with age, gender, and BMI. Additionally, awareness regarding eating and mental disorders should be done in countries like Pakistan, where talking in regard to such matters is considered taboo. Given the various factors that further strengthen the positive relationship between NES and low self-esteem, these factors can be the targets on which the treatment can be focused.

"Making weight" during military service is related to binge eating and eating pathology for veterans later in life.

"Making weight" behaviors are unhealthy weight control strategies intended to reduce weight in an effort to meet weight requirements. This study aimed to examine a brief measure of making weight and to investigate the relationship between making weight and weight, binge eating, and eating pathology later in life. Participants were veterans [N = 120, mean age 61.7, mean body mass index (BMI) 38.0, 89.2% male, 74.2% Caucasian] who were overweight/obese and seeking weight management treatment. Participants completed the making weight inventory (MWI), a measure of making weight behaviors engaged in during military service, and validated measures of eating behavior. Analyses compared participants who engaged in at least one making weight behavior (MWI+) versus those who did not (MWI-). The MWI had good internal consistency. One-third of participants were MWI+ and two-thirds were MWI-. The most frequently reported behavior was excessive exercise, reported in one-quarter of the sample, followed by fasting/skipping meals, sauna/rubber suit, laxatives, diuretics, and vomiting. MWI+ participants were significantly more likely to be in a younger cohort of veterans, to be an ethnic/racial minority, and to engage in current maladaptive eating behaviors, including binge eating, vomiting, emotional eating, food addiction, and night eating, compared to the MWI- group. Groups did not differ on BMI. One-third of veterans who were overweight/obese screened positive for engaging in making weight behaviors during military service. Findings provide evidence that efforts to "make weight" are related to binge eating and eating pathology later in life. Future research and clinical efforts should address how to best eliminate unhealthy weight control strategies in military service while also supporting healthy weight management efforts.

Associations between night eating syndrome and metabolic parameters in pregnant women.

Objective:In this study, we aimed to evaluate the incidence of night eating in pregnancy and the relationship between night eating scores and nutritional status, insulin resistance, and lipid profile in pregnant women.Materials and Methods:In this study, 148 pregnant women who presented to the Gynecology and Obstetrics Clinics at Konya Training and Research Hospital in Konya were divided into two groups according to their night eating scores. These two groups were compared in terms of their nutritional attitudes and metabolic parameters.Results:Comparisons of participants meeting night eating syndrome (NES) scores versus women without NES indicated that patients with NES exhibited fever hunger at breakfast time, more breakfast skipping (p<0.05) than those without NES. Also homeostatic model assessment insulin resistance, insulin, and high-density lipoprotein cholesterol parameters were significantly higher in pregnant women in the NES group (p<0.05). Also, correlations were found between higher night eating questionnaire total scores and higher HbA1c, insulin resistance, insulin, and more breakfast skipping.Conclusion:The results of this study suggest that night eating symptoms during pregnancy may increase and this is able to effect glucose metabolism.

Searching food during the night: the role of video-polysomnography in the characterization of the night eating syndrome

ObjectivesTo describe the video-polysomnographic (VPSG) features of the night eating syndrome (NES), exploring the existence of potential subtypes. MethodsIn this study, 20 consecutive patients with NES according to the most recent diagnostic criteria underwent an overnight VPSG. None of them presented with a sleep-related eating disorder (SRED). VPSG recordings were reviewed identifying all eating episodes. For each episode, eating latency (time delay from awakening to food intake), eating duration (time between eating onset to eating offset) and sleep latency after eating offset (time delay from eating offset to sleep) were calculated. Total episode duration was considered as the time between awakening and sleep latency after eating offset. ResultsTen patients fulfilled the A1 core criterion for NES (evening hyperphagia with consumption of at least 25% of the daily caloric intake after the evening meal); within this group, eight patients also fulfilled the A2 criterion (at least two episodes of nocturnal eating per week) and were thus included in the evening hyperphagia (EH) subgroup. The remaining 10 patients satisfied only the A2 core criterion for NES, constituting the nocturnal ingestion (NI) subgroup. We recorded 20 eating episodes, seven in the EH group and 13 in the NI group. In the EH subgroup, three eating episodes occurred before sleep onset, one after an awakening from non-rapid eye movement (NREM) stage 1 sleep, two from NREM stage 2 and one from REM sleep. All 13 NI episodes occurred after an awakening from sleep (1 from NREM stage 1 sleep, 8 from NREM stage 2 and four from NREM stage 3). In EH patients, eating latency, total episode duration and sleep latency after eating offset were significantly longer than in NI patients. ConclusionOur VPSG data from a case series of 20 patients referred to our center for nocturnal eating indicate potential different NES subtypes. This distinction may have an impact on patients’ treatment and follow-up.

Glycaemic response at night is improved after eating a high protein meal compared with a standard meal: A cross-over study

Eating at night, compared to day-time, results in a relative hyperglycaemia contributing to an increased risk of Type 2 diabetes for those who habitually eat at night, such as shift workers. Meal choice at night can adversely impact postprandial glycaemia. Meals high in protein have the capacity to favourably reduce night time perturbations in glucose. The aim of this study was to examine if a high protein meal attenuates postprandial glucose at night, compared with a standard protein meal. In a 2×2 factor cross over design, healthy adults completed four acute meal challenges. Test meals were consumed at 8am and 8pm on separate occasions; a high protein (HP) meal (41% of energy from protein, 29% from carbohydrates) or isocaloric standard meal (15% from protein, 46% from carbohydrate). Bloods were sampled at fasting and for three hours postprandially and incremental area under the curve (iAUC) determined using the trapezoid rule. Freidman's test was conducted prior to post hoc Wilcoxon sign test, and significance set at p<0.0083 after Bonferroni correction. Plasma glucose median (IQR) iAUC after the HP meal was similar to the standard meal when consumed in the morning (12.9 (19.9) vs. 36.4 (99.6)mmol/L.3h, p=0.028). The HP meal elicited a significantly lower glucose iAUC (59.6 (117.0)mmol/L.3h) compared to the standard meal (208.8 (154.1)mmol/L.3h) when consumed at night (p=0.005). No significant differences in insulin responses were found between test meals, at either time of day (p=0.100). A HP meal is effective in attenuating the postprandial glucose excursion observed with night eating by 71.4%, compared to a meal with a macronutrient composition within dietary guidelines. If eating at night, reducing the carbohydrate content of a meal, and replacing this with protein, can result in a more favourable postprandial metabolic response. Trial ID number: ACTRN12617000294358, Website of trial registry: http://www.anzctr.org.au/.

Dysfunctional eating in type 2 diabetes mellitus: A multicenter Italian study of socio-demographic and clinical associations

Background and aimsDysfunctional eating might impact on the management and metabolic control of type 2 diabetes (T2DM), modifying adherence to healthy diet and food choices. Methods and resultsIn a multicenter study, we assessed the prevalence of dysfunctional eating in 895 adult outpatients with T2DM (51% males, median age 67, median BMI 30.3 kg/m2). Socio-demographic and clinical characteristics were recorded; dysfunctional eating was tested by validated questionnaires (Eating Attitude Test-EAT-26, Binge Eating Scale-BES; Night Eating Questionnaire-NEQ); food intake and adherence to Mediterranean diet were also measured (in-house developed questionnaire and Mediterranean Diet Score–MDS). Obesity was present in 52% of cases (10% obesity class III), with higher rates in women; 22% had HbA1c ≥ 8%. The EAT-26 was positive in 19.6% of women vs. 10.2% of men; BES scores outside the normal range were recorded in 9.4% of women and 4.4% of men, with 3.0% and 1.5% suggestive of binge eating disorder, respectively. Night eating (NEQ) was only present in 3.2% of women and 0.4% of men. Critical EAT and BES values were associated with higher BMI, and all NEQ + ve cases, but one, were clustered among BES + ve individuals. Calorie intake increased with BES, NEQ, and BMI, and decreased with age and with higher adherence to Mediterranean diet. In multivariable logistic regression analysis, female sex, and younger age were associated with increase risk of dysfunctional eating. ConclusionDysfunctional eating is present across the whole spectrum of T2DM and significantly impacts on adherence to dietary restriction and food choices.

Examining Sleep Quality Following Sleeve Gastrectomy Among Patients with Loss-of-Control Eating.

Sleep is associated with post-bariatric surgical outcomes; however, little is known about sleep in bariatric patients with loss-of-control (LOC) eating, a consistent predictor of poorer weight outcomes. This study examined sleep quality and clinical correlates in sleeve gastrectomy patients with LOC eating. Participants (N = 145) were treatment-seeking post-operative sleeve gastrectomy patients with LOC eating. Eating-disorder features were assessed with the Eating Disorder Examination-Bariatric Surgery Version Interview (EDE-BSV) and participants completed established measures assessing sleep, health-related quality of life, perceived stress, depression, and night eating. 58.6% of participants were characterized with "poor" sleep. Poor sleep quality was significantly associated with greater eating-disorder psychopathology, physical and mental functioning, night eating, perceived stress, and less % excess weight loss (EWL); these findings remained significant after controlling for %EWL and race. Regression analyses, adjusting for correlated variables, revealed that sleep quality significantly predicted mental functioning. Poor sleep quality was common among post-operative sleeve gastrectomy patients with LOC eating. Sleep quality was significantly associated with eating-disorder psychopathology, less post-operative weight loss, and psychosocial and physical functioning problems. These findings suggest the importance of assessment and treatment of sleep problems following sleeve gastrectomy. ClinicalTrials.gov identifier NCT02259322.

Characteristics Associated with Food Insecurity in Patients Presenting for Bariatric Surgery (P21-019-19)

ObjectivesBariatric surgery is an effective treatment for patients with severe obesity (e.g., BMI > 35). To prevent complications, postoperative patients must comply with dietary requirements and nutritional supplementation. A potential barrier to adherence to dietary requirements is food insecurity (FI). In 2017, the national prevalence of FI was 11.8% and a recent study of a pre-bariatric sample found 18% were FI and 27% were marginally FI. Despite this high prevalence, the characteristics associated with FI in preoperative bariatric patients is not known. The purpose of this study was to identify characteristics associated with FI in a sample of patients presenting to an academic medical center for preoperative bariatric surgery assessment. Methods238 participants aged 17–70 with a BMI > 35 were included in the study. Height and weight were measured by clinical staff. Participants completed questionnaires including demographics, the 10-item USDA Adult FI Survey Module (score range 0–10, 0 = food secure, 1–2 = marginal FI, and >3 = FI), the Beck Depression Inventory-II (BDI, range 0–68), the Binge Eating Scale (BES, range 0–48), and the Night Eating Questionnaire (NEQ, range 0–52). An ordinal logistic generalized linear model (GLM) was used with FI as the dependent variable (ordinal, 3 levels) and all variables above as independent variables. ResultsThe overall sample had a mean age of 41.1 years and a mean BMI of 48.3. It was predominantly female (75%, n = 180), white (71.3%, n = 171), and had less than a college education (77.1%, n = 185). The overall mean FI, BDI, BES, and NEQ scores were 1.1, 9.0, 13.7, 15.2, respectively. The prevalence of marginal FI was 26% (n = 62) and FI was 15.8% (n = 38). In the GLM, FI was significantly associated with having less than a college education (OR 2.08, P = .04), being non-white (OR 2.12, P = .01), younger age (OR 1.05, P = .002), higher depression scores (1.05, P = .03) and higher night eating scores (1.06, P = .04). ConclusionsIn our sample, the proportion of patients reporting FI was similar to previously reported bariatric samples, and higher than national estimates. Bariatric programs should consider screening for FI as part of routine preoperative evaluations. Further studies are needed to understand the impact of FI on postoperative outcomes. Funding SourcesNone.

Nighttime Eating Is Associated with Poor Diet Quality in Adult Females (P21-055-19)

ObjectivesNight Eating Syndrome (NES) is a disordered eating pattern characterized by nighttime hyperphagia. Previous research suggests that nighttime eating, especially in individuals with NES, is associated with obesity and higher intake of energy, sodium, saturated fat, and processed foods. The purpose of this study was to examine the effect of nighttime eating on diet quality and weight status in adult females. MethodsAn online survey was administered to 516 women (age 18–65) from July 2018 thru January 2019. The survey included the validated Night Eating Questionnaire and the National Cancer Institute Diet History Questionnaire (DHQ) II. Diet quality was assessed using the Healthy Eating Index (HEI) 2015. The Diet*Calc program analyzed the DHQ II output to generate estimates of nutrient and food group intake. NCI SAS macros were used to calculate the HEI 2015 component and total scores. IBM SPSS Statistics (version 25) was used to run descriptive statistics and inferential statistics (chi-square tests, independent samples t-tests). ResultsOf the 516 women, 36 were classified as night eaters and 480 were classified as non-night eaters. The majority of participants were employed (70.3%) and highly educated (95.1% reported some college or higher). Night eaters worked night shifts more often than non-night eaters (P ≤ 0.001). Mean HEI scores were lower in night eaters (58.6 ± 11.1) than in non-night eaters (64.9 ± 9.8) (P ≤ 0.001). There was no difference between the two groups (night eaters, non-night eaters) for BMI; the mean BMI for all participants was 24.1.7 ± 5.5 kg/m2. However, a higher proportion of night eaters than expected were underweight and obese (P ≤ 0.001). There was also an association between nighttime eating and history of eating disorder diagnosis (P ≤ 0.001). ConclusionsThese findings are consistent with previous research suggesting that nighttime eating is associated with reduced diet quality, unhealthy weight status, and disordered eating. Further research should be directed at understanding hormonal responses to nighttime eating and its affect on weight status and dietary choices. Funding SourcesNone.