Tuesday, May 16, 2023

Chrononutrition: Food timing, circadian fasting...

 

Chrononutrition: Food Timing, Circadian Fasting, and Resetting the Body’s Internal Clock

Circadian cycles are part of the body’s internal clock, and disruption to these biological rhythms may result in adverse health outcomes. Aligning meal timing with the body’s circadian cycle for optimal glucose and insulin responsiveness may be effective for improving metabolic health. In the field of chrononutrition, time-restricted feeding has been prominent in research, studied for its benefits on metabolic health and as a means for realigning and supporting the body’s internal clock. How do circadian considerations potentially benefit personalized health interventions for chronic disease treatment or prevention?


Timing influences human physiology. Circadian cycles are a property of the body’s internal clock, and disruption to these biological rhythms may result in adverse health outcomes. The field of chronobiology is dynamic and continues to elucidate the associations between circadian rhythms and health implications, from neurodegenerative risks to metabolic dysfunctions.1,2 Chrononutrition is the focused study of the relationship between food, metabolism, meal timing, and the circadian system. Is there metabolic benefit when aligning lifestyle behaviors such as food timing with the body’s internal clock? How do circadian considerations influence personalized health interventions for chronic disease prevention or treatment?

Aligning Food Timing With Circadian Rhythms

Most cells and tissues of the body show molecular clock activity and express cellular clock genes that contribute to tissue and system function. In metabolic processes, circadian-related components modulate the activation and expression of hormones, enzymes, and signaling pathways.3,4 Aligning meal timing with the body’s circadian cycle for optimal glucose and insulin responsiveness, as well as with hormones such as cortisol and leptin that are also affected by circadian oscillations,3 may be effective for improving metabolic health. A 2023 meta-analysis of nine RCTs (n=485 total participants) compared higher energy consumption earlier in the day with higher consumption later in the day on weight loss and metabolic parameters.5 Researchers reported a significantly greater weight loss in groups with higher energy intakes earlier compared to groups with high energy intake later in the day. In addition, significantly greater reductions in LDL cholesterol, fasting glucose, and insulin resistance (measured by HOMA-IR) were reported in groups with earlier energy intakes compared with later intakes.5

Both glucose tolerance and insulin sensitivity have been shown to be lower in the evening than in the morning,6which may contribute to an increased risk of metabolic dysfunctions for those who habitually eat meals during the evening hours. A 2020 meta-analysis (n=10 acute postprandial studies) investigated whether acute glucose and insulin responses after night-time meals (8 pm–4 am) differed from the responses after day-time meals (7 am–4 pm) in healthy adults.7 Results indicated that after an identical meal, the postprandial glucose and insulin responses were both significantly lower in the day compared to the night.7 Interestingly, specific to carbohydrate intake, a 2022 systematic review of eight randomized clinical trials (n=116 healthy adults) indicated that consumption of carbohydrates at night also led to higher postprandial glycemic values than morning consumption; however, no significant difference between morning and night carbohydrate consumption was found for postprandial insulin values.8

TIME-RESTRICTED FEEDING & CIRCADIAN REALIGNMENT

As the field of chrononutrition continues to expand and develop, time-restricted feeding (TRF) has been prominent in research, studied for its benefits on metabolic health and as a means for realigning and supporting the body’s circadian clock.9,10 As a form of circadian fasting, TRF is a dietary pattern that optimizes circadian elements by consuming food and beverage within a shortened window of time during the day, extending a person’s nightly fast to 12 hours or more. A 2022 systematic review of 22 TRF-related randomized controlled trials suggested that among adults with overweight/obesity, TRF may lead to improved insulin resistance and glycemic responsiveness throughout the day.11 Of note, most of the reviewed studies assessed the effects of a 16-hour fast/8-hour feeding regimen (day-time feeding window variable), with only one included study comparing the early TRF (eating between 6 am and 3 pm) with the mid-day TRF (eating between 11 am and 8 pm).11

Synchronizing lifestyle habits such as food timing with circadian biological rhythms has been studied in a range of health areas, including the management of non-alcoholic fatty liver disease,12,13 the reduction of blood pressure,14inflammation,15 reduced cognitive decline,16 and cancer risk.17 Evaluating the feasibility of this therapeutic nutritional approach continues to evolve. A recent pilot study tested the feasibility of implementing TRF in adults with overweight and obesity through a smartphone intervention.18 Fifty participants with a normal eating duration of 14 hours or more were enrolled. After the 90-day TRF trial, the average adherence to logging meal activities and to reducing eating windows was 64% and 47% respectively.18 Of note, 16 of the TRF participants reduced their eating window from an average of 16 hours to approximately 12 hours. In addition, decreases in body weight, waist circumference, and systolic blood pressure were reported.18

Chronotype & Personalized Nutrition

It is important to note that some patients may not be suitable candidates for therapeutic fasting treatments due to preexisting conditions. However, for some patients, TRF interventions that optimize circadian elements by encouraging energy intake earlier in the day and increasing the fasting window have the potential to improve metabolic outcomes.

As research develops, determining the optimal time period for TRF interventions (early TRF versus mid-day TRF) may be clarified. Ultimately, ideal eating times and habits could be associated with a patient’s chronotype. Genetic variations in clock genes contribute to varied circadian inclinations among individuals and may impact best sleep and meal schedules for any given person. Specific chronotypes, for example, an “early-bird” or “night-owl,” describes not only at what time a person is naturally inclined to sleep and to be awake but may also influence appetite and physical activity.19,20 Studies continue to investigate the impact of chronotype on disease development,21 and chrononutrition trials are beginning to explore chronotype influences on interventions for improved metabolic health.22

As part of a personalized, lifestyle-based approach, nutritional therapies tailored to the individual patient are crucial for effectiveness and sustainability. Circadian rhythms are just one component to consider when creating and implementing dietary interventions. A variety of factors such as potential underlying nutrient deficiencies, presentation of disease symptoms, food sensitivities, accessibility, and personal preferences may all shape personalized treatments. IFM’s suite of therapeutic food plans are all available for modification based on an individual’s health needs. Learn more about food plan personalization within the IFM framework and creating effective and sustainable nutrition-based strategies to promote health through the online course Therapeutic Food Plans: A Component of Personalized Nutrition.

Source: <https://www.ifm.org/news-insights/chrononutrition-food-timing-circadian-fasting-and-the-bodys-internal-clock/?utm_campaign=Newsletter&utm_medium=email&_hsmi=251085985&_hsenc=p2ANqtz-8T_k3YJCFivLIRpT-UCW4IK1x8vKKGfijKRnr4-astzNGhHDqTj9WiCepB_vUcJE-ZK70SXU68vmHZtY9rEmT8JsGpZA&utm_content=251085983&utm_source=hs_email>

References:

  • 1) Leng Y, Musiek ES, Hu K, Cappuccio FP, Yaffe K. Association between circadian rhythms and neurodegenerative diseases. Lancet Neurol. 2019;18(3):307-318. doi:1016/S1474-4422(18)30461-7
  • 2) Chaput JP, McHill AW, Cox RC, et al. The role of insufficient sleep and circadian misalignment in obesity. Nat Rev Endocrinol. 2023;19(2):82-97. doi:1038/s41574-022-00747-7
  • 3) Serin Y, Acar Tek N. Effect of circadian rhythm on metabolic processes and the regulation of energy balance. Ann Nutr Metab. 2019;74(4):322-330. doi:1159/000500071
  • 4) Flanagan A, Bechtold DA, Pot GK, Johnston JD. Chrono-nutrition: From molecular and neuronal mechanisms to human epidemiology and timed feeding patterns. J Neurochem. 2021;157(1):53-72. doi:1111/jnc.15246
  • 5) Young IE, Poobalan A, Steinbeck K, O’Connor HT, Parker HM. Distribution of energy intake across the day and weight loss: a systematic review and meta-analysis. Obes Rev. 2023;24(3):e13537. doi:1111/obr.13537
  • 6) Mason IC, Qian J, Adler GK, Scheer FAJL. Impact of circadian disruption on glucose metabolism: implications for type 2 diabetes. Diabetologia. 2020;63(3):462-472. doi:1007/s00125-019-05059-6
  • 7) Leung GKW, Huggins CE, Ware RS, Bonham MP. Time of day difference in postprandial glucose and insulin responses: systematic review and meta-analysis of acute postprandial studies. Chronobiol Int. 2020;37(3):311-326. doi:1080/07420528.2019.1683856
  • 8) de Almeida RS, Marot LP, Latorraca COC, Oliveira RÁ, Crispim CA. Is evening carbohydrate intake in healthy individuals associated with higher postprandial glycemia and insulinemia when compared to morning intake? A systematic review and meta-analysis of randomized crossover studies. J Am Nutr Assoc. Published online March 1, 2022. doi:1080/07315724.2022.2043199
  • 9) Adafer R, Messaadi W, Meddahi M, et al. Food timing, circadian rhythm and chrononutrition: a systematic review of time-restricted eating’s effects on human health. Nutrients. 2020;12(12):3770. doi:3390/nu12123770
  •  10) Zeb F, Wu X, Fatima S, et al. Time-restricted feeding regulates molecular mechanisms with involvement of circadian rhythm to prevent metabolic diseases. Nutrition. 2021;89:111244. doi:1016/j.nut.2021.111244
  •  11) Tsitsou S, Zacharodimos N, Poulia KA, Karatzi K, Dimitriadis G, Papakonstantinou E. Effects of time-restricted feeding and Ramadan fasting on body weight, body composition, glucose responses, and insulin resistance: a systematic review of randomized controlled trials. Nutrients. 2022;14(22):4778. doi:3390/nu14224778
  •  12) Perez-Diaz-Del-Campo N, Castelnuovo G, Caviglia GP, Armandi A, Rosso C, Bugianesi E. Role of circadian clock on the pathogenesis and lifestyle management in non-alcoholic fatty liver disease. Nutrients. 2022;14(23):5053. doi:3390/nu14235053
  • 13) Kord-Varkaneh H, Salehi-Sahlabadi A, Tinsley GM, Santos HO, Hekmatdoost A. Effects of time-restricted feeding (16/8) combined with a low-sugar diet on the management of non-alcoholic fatty liver disease: a randomized controlled trial. Nutrition. 2023;105:111847. doi:1016/j.nut.2022.111847
  •  14) Xie Z, He Z, Ye Y, Mao Y. Effects of time-restricted feeding with different feeding windows on metabolic health: a systematic review of human studies. Nutrition. 2022;102:111764. doi:1016/j.nut.2022.111764
  •  15) Ramos-Lopez O, Martinez-Urbistondo D, Vargas-Nuñez JA, Martinez JA. The role of nutrition on meta-inflammation: insights and potential targets in communicable and chronic disease management. Curr Obes Rep. 2022;11(4):305-335. doi:1007/s13679-022-00490-0
  •  16) Currenti W, Godos J, Castellano S, et al. Association between time restricted feeding and cognitive status in older Italian adults. Nutrients. 2021;13(1):191. doi:3390/nu13010191
  •  17) Palomar-Cros A, Espinosa A, Straif K, et al. The association of nighttime fasting duration and prostate cancer risk: results from the Multicase-Control (MCC) study in Spain. Nutrients. 2021;13(8):2662. doi:3390/nu13082662
  •  18)Prasad M, Fine K, Gee A, et al. A smartphone intervention to promote time restricted eating reduces body weight and blood pressure in adults with overweight and obesity: a pilot study. Nutrients. 2021;13(7):2148. doi:3390/nu13072148
  •  19) Beaulieu K, Oustric P, Alkahtani S, et al. Impact of meal timing and chronotype on food reward and appetite control in young adults. Nutrients. 2020;12(5):1506. doi:3390/nu12051506
  •  20) Sempere-Rubio N, Aguas M, Faubel R. Association between chronotype, physical activity and sedentary behaviour: a systematic review. Int J Environ Res Public Health. 2022;19(15):9646. doi:3390/ijerph19159646
  •  21) Barrea L, Vetrani C, Altieri B, et al. The importance of being a ‘lark’ in post-menopausal women with obesity: a ploy to prevent type 2 diabetes mellitus? Nutrients. 2021;13(11):3762. doi:3390/nu13113762
  •  22) Mazri FH, Manaf ZA, Shahar S, Mat Ludin AF, Abdul Basir SM. Development and evaluation of integrated chrono-nutrition weight reduction program among overweight/obese with morning and evening chronotypes. Int J Environ Res Public Health. 2022;19(8):4469. doi:3390/ijerph19084469
  • Sunday, May 14, 2023

    Are your prenatal vitamins measuring up?

     Another interesting research article I came across in Medscape on Prenatal supplements…


    "Although drugstore shelves might suggest otherwise, affordable dietary supplements that provide critical nutrients in appropriate doses for pregnant women are virtually nonexistent, researchers have found.

    In a new study published this month (April 2023), in the American Journal of Clinical Nutrition, investigators observed what many physicians have long suspected: most prenatal vitamins and other supplements do not adequately make up the difference of what food-based intake of nutrients leave lacking. Despite patients believing they are getting everything they need with their product purchase, they fall short of guideline-recommended requirements. (see attached research study below)

    The researchers analyzed 24-hour dietary intake data from 2450 study participants across five states from 2007 to 2019. Sauder and colleagues focused on six of the more than 20 key nutrients recommended for pregnant people, and determined the target dose for vitamin A, vitamin D, folate, calcium, iron, and omega-3 fatty acids.

    The researchers tested more than 20,500 dietary supplements, of which 421 were prenatal products. Only 69 products — three prenatal — included all six nutrients. Just seven products — two prenatal — contained target doses for five nutrients. Only one product, which was not marketed as prenatal, contained target doses for all six nutrients but required seven tablets a serving and cost patients approximately $200 a month.  

    More than half of pregnant people in the United States are at risk of inadequate intake of vitamin D, folate, and iron from their diet alone, and one third are at risk for insufficient intake of vitamin A and calcium.

    Although more than 70% of pregnant women take dietary supplements, the products do not eliminate the risks for deficiencies. The effects of inadequate nutrition during pregnancy may include neural tube defects, alterations in cardiovascular structure, and impaired neurocognitive development.


    I thought it would be interesting to see how our Everyday Essentials Pregnancy (R275P), and Prenatal (R714), formulas compared to what the researchers determined as the target dose for vitamin A, vitamin D, folate, calcium, iron, and omega-3 fatty acids:

    The target daily dose for Vitamin A was ≥198 mcg retinol activity equivalents (RAE) of total vitamin A (with ≤2063 mcg preformed retinol):

    • Everyday Essentials Pregnancy (per daily packet): 1,500 mcg RAE (80% as mixed carotenoids and 20% as retinyl palmitate)
    • Prenatal (six capsules daily): 1,500 mcg RAE (80% as mixed carotenoids and 20% as retinyl palmitate)

    The target daily dose for Vitamin D3 was 7–91 mcg:

    •  Everyday Essentials Pregnancy (per daily packet):  50 mcg.
    • Prenatal (six capsules daily): 50 mcg.

    The target daily dose for Folic Acid was 169–720 mcg dietary folate equivalents (DFE) of folic acid:

    •  Everyday Essentials Pregnancy (per daily packet): 1,700 mcg DFE (as calcium L-5-methyltetrahydrofolate)
    • Prenatal (six capsules daily): 1,700 mcg DFE (as calcium L-5-methyltetrahydrofolate)

    The target daily dose for Calcium was  383–943 mg. 

    •  Everyday Essentials Pregnancy (per daily packet): 400 mg. (as calcium citrate)
    • Prenatal (six capsules daily): 400 mg. (as calcium citrate)

    The target daily dose for Iron was 13–22 mg.

    •  Everyday Essentials Pregnancy (per daily packet): 30 mg. (as ferrous bisglycinate chelate) (Ferrochel™) 
    • Prenatal (six capsules daily): 30 mg. (as ferrous bisglycinate chelate) (Ferrochel™) 

    The target daily dose for Omega-3 Fatty Acids was ≥59 mg ω-3 FAs:

    •  Everyday Essentials Pregnancy (per daily packet): Total Omega-3 Fatty Acids - 1.6 grams (1600 mg.) - (860 mg. of EPA, 580 mg. of DHA and 160 mg. of Additional Omega-3 Fatty Acids)  
    • Prenatal (six capsules daily): None


    NOTE: Other than the Prenatal (R714), NOT containing Omega-3 Fatty Acids, BOTH NutriDyn prenatal formulas met or exceeded the research determined target dose for vitamin A, vitamin D, folate, calcium, iron, and in the case of Everyday Essentials Pregnancy, the omega-3 fatty acids.

    Also, our retail price for a month supply is $67.25 for Everyday Essentials Pregnancy (R275P), and $42.25 for the Prenatal (R714)… NOT $200.00 a month!


    Original article:Dietary supplements and requirements in pregnancy 

    Most pregnant women in the United States (US) are at risk of inadequate intake of key nutrients during pregnancy from foods alone. Current dietary supplement practices reduce risk of inadequacy for only some nutrients and induce excessive intake of other nutrients.

    Objectives

    Our study aimed to estimate the doses of supplementation needed to help most pregnant women achieve the recommended intake without exceeding upper limits for key prenatal nutrients and to identify US dietary supplements providing these doses.

    Monday, May 1, 2023

    Going deeper and why?

    When listening to motivational speakers including Tony Robbins, the common theme is mastering our emotions and healing childhood traumas. There is also a lot of research linking our emotions and its impact on our physiology, which impacts our overall health. Our emotions and beliefs also impact our epigenetics whichs impact how our genes express themselves. (positively or negatively)

    Our emotions impacts how we navigate life. Basically how you feel about things and situations creates the beliefs you form and these beliefs also form habits. Habitual behavior, for example: You feel inadequate (sometimes this is a deeply ingrained and sometimes hidden emotion) When you are challenged during interactions about your ability at work or personally, you may become very defensive. You may be seen as aggressive, temperamental or on the other side of that emotional belief, you may never voice your opinion or truths in fear of being "found out" or focused on.

    What happens to us as children creates pain/emotions within us and then we make it mean something, which creates a belief system within us and we live the rest of our lives as if this lie we have come to believe (the meaning you attached at time of emotional hurt) is true and it truly impact all aspects of our journey, until we recognize and deal with that internal and initial wound/pain/emotion. 

    How do we find these underlying beliefs and their emotions? We ask many questions by checking in with our bodies. Our body never lies. The tension and pain in the body signifies blockages. If you are doing all the right things and you are still not healing, you may wish to consider the possibility of an emotional connection. 

    There are many different outcomes from the traumas we experience as children and young adults and addictions (food, alcohol, drugs, exercise etc.) are usually related to that.

    Gabor Maté CM (born January 6, 1944) is a Hungarian-born Canadian physician. He has a background in family practice and a special interest in childhood development and trauma, and in their potential lifelong impacts on physical and mental health, including on autoimmune disease, cancer, ADHD, addictions, and a wide range of other conditions. Now retired from clinical practice, he travels and speaks extensively on these and related topics, both in North America and abroad. His books have been published internationally in over twenty-five languages. Maté's approach to addiction focuses on the trauma his patients have suffered and looks to address this in their recovery, with special regard to indigenous populations around the world.

    How childhood trauma leads to addiction

    It is certainly one of my passions to work with clearing some of these traumas through Energy Medicine, so that people can experience the fullness of life and the love that resides deep within us all.

    And I feel privileged to be able to serve in such a manner. I have had so much help in my life through energy medicine and healing modalities. I come from a very abusive and traumatic childhood. This has helped me cultivate a deeper understanding and compassion in life.