Chronotype and Adherence to the Mediterranean Diet in Obesity: Results from the Opera Prevention Project

Abstract

Chronotype is the attitude of a subject in determining individual circadian preference in behavioral and biological rhythm relative to the external light–dark cycle. Obesity and unhealthy eating habits have been associated with evening chronotype. The Mediterranean diet (MD) is a healthy nutritional pattern that has been reported to be associated with better health and quality of sleep. Thus, the aim of the study was to investigate the association of chronotype categories with adherence to the MD in a population of middle-aged Italian adults. This cross-sectional study included 172 middle-aged adults (71.5% females; 51.8 ± 15.7 years) that were consecutively enrolled in a campaign to prevent obesity called the OPERA (obesity, programs of nutrition, education, research and assessment of the best treatment) Prevention Project that was held in Naples on 11–13 October 2019. Anthropometric parameters, adherence to the MD and chronotype were studied. Chronotype was classified as morning in 58.1% of subjects, evening in 12.8% and intermediate in 28.1%. Our results demonstrated that individuals with evening chronotype, when compared to intermediate (p < 0.001) and morning chronotype (p < 0.001), were more prone to follow unhealthy lifestyle, performing less regular activity and being more frequently smokers. In addition, they showed the lowest adherence to the MD compared to morning (p < 0.001) and intermediate chronotypes (p < 0.001). The lower the chronotype score, the higher body mass index (BMI) values in the whole population (r = −0.158; p = 0.038), thus suggesting that evening chronotype was a common finding in subjects with obesity. In addition, positive correlations of chronotype score with age (r = 0.159; p = 0.037) and PREDIMED score (r = 0.656; p < 0.001) were found. The adherence to the MD, more than the intake of the single food items, was found to predict morning and evening chronotypes. In conclusion, evening chronotype was associated with unhealthy lifestyle and low adherence to the MD. Chronotype score was inversely associated to BMI and positively associated to age and adherence to the MD. Thus, the assessment of chronotype should be taken into account in the management of obesity and in the development of nutritional strategies.

Phase Angle as an Easy Diagnostic Tool of Meta-Inflammation for the Nutritionist

“…Similarly, the participants were divided into current smokers (when smoking at least one cigarette per day) or non-current smokers, those who do not smoke any cigarettes a day, as we reported earlier [ 35 , 36 ].…”

Association of the Chronotype Score with Circulating Trimethylamine N-Oxide (TMAO) Concentrations

“…Chronotype was obtained with the questionnaire MEQ [ 6 ], including 19 items about the subjective sensation of sleep and energy during the day and the preferred time to rest and to carry out demanding activities, with a score ranging from 16–84. Based on the score obtained, the participants were classified as being a morning (59–86), neither (42–58), or evening (16–41) chronotype, as previously reported [ 45 ].…”

Time-Restricted Feeding and Metabolic Outcomes in a Cohort of Italian Adults

“…Similarly, later chronotype has been also associated with breakfast skipping and both contribute to poorer glycemic control [52]. Concerning diet quality, several studies showed a relationship between higher adherence to the Mediterranean diet, morning chronotype, and health outcomes [53,54]. Although reducing the feeding time window during the day may be beneficial, shifting food intake to the darkest hours can partially reverse circadian rhythms and have null, if not detrimental, effects on metabolic outcomes; there is a large body of scientific literature showing that individuals consuming a larger daily caloric intake during the evening are more likely to be overweight and obese [55][56][57][58][59][60]; moreover, other studies showed that nocturnal eaters had an increased coronary heart disease risk [61] and reduced insulin sensitivity assessed by HOMA-IR index [62].…”