Timing of eating, not duration, associated with better cardiometabolic health
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Adults who ate their first meal before 8:30 a.m. each day had lower insulin resistance compared with those who started eating after 8:30 a.m., independent of eating interval duration, according to data presented at the ENDO annual meeting.
“The timing of eating is also an important consideration in addition to duration of eating,” Marriam Ali, MD, an endocrinology fellow in the division of endocrinology, metabolism and molecular medicine at Northwestern Medicine, told Healio. “Our internal biological clocks that control rhythms related to metabolic health play a vital role at the intersection of nutrition and lifestyle that impact metabolic health. Timing of eating was associated with metabolic measures, including insulin resistance, and is a potential area for intervention to combat the increase in metabolic disorders like diabetes.”
Ali and colleagues analyzed data from two nonconsecutive dietary recalls from 10,575 adults aged 18 years and older who participated in the National Health and Nutrition Examination Survey over four cycles from 2005 to 2012. Data on fasting glucose and insulin levels were obtained. Eating interval duration was defined as the time between the first and last eating occasion. Participants were divided into three groups based on eating duration: less than 10 hours, 10 to 13 hours, and more than 13 hours. These groups were divided further into six subgroups based on whether participants began eating before or after 8:30 a.m.
Participants who had an eating duration of less than 10 hours had a mean homeostasis model assessments of insulin resistance (HOMA-IR) of 2.23. Participants with an eating duration of 10 to 13 hours had a slightly lower mean HOMA-IR of 2.2, whereas those with an eating duration of 13 hours or more had the lowest HOMA-IR of the three groups, at 1.97 (P < .05). There was no significant difference in fasting glucose among the three eating duration groups.
When participants were grouped based on both eating interval duration and timing, those who began eating before 8:30 a.m. had a lower mean HOMA-IR than those who started eating after 8:30 a.m. in all three eating interval duration subgroups. A similar pattern was observed with adjusted mean fasting glucose, with participants who began eating before 8:30 a.m. having lower values than those who started eating after 8:30 a.m. in all three eating interval duration subgroups.
“We hypothesized that early eating would be beneficial, but we were most surprised to see that time of eating was more strongly associated with insulin resistance than duration,” Ali said.
In regression models in which eating duration and timing were both continuous variables, eating later was associated with higher glucose and HOMA-IR (P < .001). However, there was no association between eating duration and glucose or HOMA-IR.
Ali said the findings reveal a new approach for providers who want to improve a patient’s glucose levels or insulin resistance. Future research may involve creating an intervention that changes the timing of eating to see what effects that may have.
“Recognizing the significant association of time of eating with insulin resistance has highlighted a need to specifically explore interventions, such as early eating, as a potential strategy to lower risk for diabetes,” Ali said.
Perspective
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Fatima Cody Stanford, MD, MPH, MPA, MBA, MACP, FAAP, FAHA, FAMWA, FTOS
As an obesity medicine physician scientist, I was pleased to see this study and learn of the results. Patients often have questions about how to time their eating to produce meaningful results in terms of their blood sugar. This study demonstrates that eating the first meal before 8:30 a.m. seems to be most ideal for the lowest insulin resistance. I was surprised by the subsequent finding that demonstrates that person with the highest eating duration, 13 hours or more, had the lowest insulin resistance. This deviates from what I would have assumed. I would have thought that those who had a more restrictive eating duration would have the lowest insulin resistance. For clinicians, I would encourage them to personalize the current results to their own patients and recognize that individual patients may have differences from those noted in this large cohort study.
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Ali M, et al. Perfect timing: Associations between dietary timing, eating intervals and metabolic health. Presented at: Endocrine Society Annual Meeting; March 20-23, 2021 (virtual meeting).
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