Chrononutrition during Pregnancy and Its Association with Maternal and Offspring Outcomes: A Systematic Review and Meta-Analysis of Ramadan and Non-Ramadan Studies

Abstract

Much evidence suggests that food intakes and eating patterns are major determinants of the phase of peripheral circadian clocks, and desynchronization between them is thought to contribute to the development of metabolic disorders. However, much remains to be understood about how different dimensions of chrononutrition during pregnancy affect pregnant women’s and their offspring’s health outcomes. Therefore, we systematically reviewed and integrated all emerging evidence on chrononutrition during pregnancy (including meal skipping, meal frequency, night eating, and (Ramadan) fasting) and their relationships with maternal and offspring outcomes. The results suggest that meal skipping and night eating during pregnancy were generally associated with adverse pregnancy and birth outcomes, whereas no strong conclusion could be reached for meal frequency. In our meta-analysis, Ramadan fasting did not seem to be related with birth weight or gestational age at birth, but evidence for other mother–offspring outcomes was inconsistent. To further elucidate the effect of chrononutrition factors on maternal and offspring health outcomes, larger and well-conducted prospective cohort and interventional studies are needed. In addition, information on covariates such as physical activity, sleep, diet quality and quantity, fasting days, fasting period per day, and trimester exposure should also be collected and considered during analysis.

Nighttime eating during pregnancy and infant adiposity at 6 months of life

“…A broader set of studies have assessed Ramadan fasting and perinatal outcomes, but this type of practice differs from a non-religious habitual dietary behavior. A recent meta-analysis showed that Ramadan-related fasting affected lower GWG during fasting but did not affect weight gain throughout pregnancy, gestational age at birth, preterm birth, birthweight, low birthweight, or other maternal-infant outcomes ( 56 ).…”

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

“…26 The timing of eating has been associated with various health outcomes, and previous research has also correlated it with gestational parameters such as gestational weight gain, [27][28][29] gestational diabetes, 30,31 and fetal growth. 32,33 It is inferred that the timing of maternal food intake has the potential to influence maternal and fetal circadian rhythms, fetal development during pregnancy, and the subsequent metabolic health of the offspring, [34][35][36] though this is still not fully understood. Previous studies conducted with pregnant women in our group have shown that pregnant women who tend to be evening chronotype consume breakfast later in the day, have poorer dietary patterns concerning total fruit intake, 37 have a higher energy and carbohydrate consumption at night, and exhibit a worse pattern of gestational weight gain in the third trimester (T), 38 as well as a higher likelihood of gaining weight early in the gestational period.…”

Association between sleep duration and quality with food intake, chrononutrition patterns, and weight gain during pregnancy

“…During pregnancy, the deterioration of sleep and the occurrence of insomnia (3,4,7) are compounded by hormonal changes, such as increased progesterone levels and leptin resistance (23) , which can lead to heightened appetite and increased food consumption (24) . Moreover, poor sleep during pregnancy can impact chrononutrition patterns through associations between sleep and food consumption (25)(26)(27) . Recent studies involving pregnant women and chrononutrition, which explore the relationship between the circadian clock, metabolic physiology and nutrition (25,26) , have demonstrated that eating during times that go against the body's natural circadian rhythms, such as the inactive/sleep phase, negatively affects nocturnal metabolism, resulting in worsened glycaemic, insulinemic and lipidemic responses, as well as greater weight gain (25)(26)(27)(28) .…”