Chrononutrition and risk of type 2 diabetes: a prospective cohort study

Background

The timing of food intake interacts with circadian biology and may influence metabolic disease risk, yet correlations among chrononutritional behaviours complicate their joint evaluation. Therefore, we applied alternative approaches to better capture the complex patterns of chrononutritional behaviours and their association with type 2 diabetes (T2D).

Methods

Using data from the Spanish prospective GCAT cohort, we applied multivariable logistic regression models to assess the associations between individual meal-timing variables and incident T2D. Furthermore, we fitted quantile g-computation to evaluate the joint association of the mixture of chrononutrition variables and the contribution of each variable to the overall risk.

Results

Among 6,858 adults (59% women, median age 52y [IQR: 47-58]), 152 developed T2D over a median follow-up of 6 years. A 1h increase in nighttime fasting and in the time of the first meal was associated with a reduced risk of T2D (OR 0.78 [0.68, 0.90] and 0.82 [0.71, 0.95] respectively), while a later last meal was associated with higher risk (OR 1.34 [1.07, 1.69]). A longer interval between waking up and the first meal showed a protective effect (OR 0.86 [0.74, 0.98]), while no link was observed for the interval between dinner and bedtime or the number of eating occasions. The mixture analyses showed a lower T2D risk associated with a one-IQR increase in the overall mixture (OR 0.61 [0.41, 0.90]). Nighttime fasting, eating frequency and the interval between dinner and bedtime were the main contributors to the overall association, suggesting potential synergies among chrononutrition variables.

Conclusions

Nighttime fasting shows a consistent protective association, suggesting that aligning food intake with endogenous circadian rhythms may represent a practical, low-cost behavioural target for diabetes prevention that could be incorporated into public health policy and nutritional guidelines to help reduce the burden of T2D.

Key messages

• Promoting awareness of the importance of aligning eating patterns with circadian rhythms may offer a low-cost public health strategy to prevent type 2 diabetes in the general population.

• Longer nighttime fasting obtained with both earlier last meal and later first meal are associated with lower type 2 diabetes risk, highlighting the importance of meal timing for metabolic health.