Hunger associations with meal timing and adherence to meal timing recommendations for weight loss
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Those who practice poor meal timing habits such as irregular day-to-day eating, eating late at night, and have a short overnight fast are more at risk for weight gain, reduced weight loss with weight loss attempts, and increased risk for developing and/or worsening health conditions such as type 2 diabetes mellitus and cardiovascular disease and/or risk factors for said conditions. Recent studies have identified possible factors that influence meal timing, one of which is hunger. Hunger is defined as a physiologic need to eat, and can be triggered by a rise in the hormone ghrelin. Hunger in general, or greater hunger at certain times of day, may lead to poor meal timing and/or difficulty adhering to meal timing recommendations made in behavioral interventions. The goal of our study was to determine if the overall hunger level and time of onset of greatest hunger were associated with poor meal timing cross-sectionally and lower adherence to meal timing recommendations. The meal timing behaviors we examined were eating late at night, having a longer overnight fast, and an earlier ingestive period midpoint based on published evidence suggesting these are important for weight control. We hypothesized that a greater overall hunger level and later onset of greatest hunger would be inversely associated with poor meal timing cross-sectionally and a lower adherence to potential meal timing recommendations to be applied to future interventions. Our cross-sectional study was a secondary analysis of data from a previous study on diet and energy regulation in 116 healthy adults (mean BMI 24.3 kg/m2; SD 3.8, mean age 29.4 years; SD 11.9). Both continuous and categorical meal timing outcomes were examined. The continuous outcomes were eating late at night (defined as eating past 20:00 h), length of overnight fast (defined as the length of time between the last meal consumed before bedtime and first eating occasion after waking), and timing of the largest meal, which we measured using the midpoint of the ingestive period. Categorical outcomes, which had cutoff values determined based on evidence from published research, were: not eating after 20:00, achieving an overnight fast of ≥13 hours, and having the midpoint of the ingestive period before 15:00. Associations of hunger variables with continuous meal timing outcomes were examined in three separate models using analysis of covariance, with hunger variables as the independent variables and the meal timing patterns as the dependent variables. Associations of hunger variables with categorical (bivariate) outcomes had the same independent variables but were examined with logistic regression analysis. Covariates included in both continuous and categorical models were age, sex, race, physical activity level, weighted average bedtime on weekdays and weekends, dietary restraint score, dietary disinhibition score, sleep duration, and sleep quality. After inclusion of all covariates, a higher hunger score was associated with having an overnight fast lasting ≥13 hours (p=0.026), suggesting that participants were able to achieve a longer overnight fast despite being hungrier. There was no significant association between hunger variables and eating late at night or midpoint of ingestive period (p>0.05), although the p-value was marginally non-significant with eating late at night (p=0.080). Time of greatest hunger was not associated with any of the meal timing variables (p>0.05). As previous studies have shown that a longer overnight fast improves weight loss, a possible application of our findings, namely the length of overnight fast, is for individuals who aim to achieve an overnight fast of ≥13 hours to lose weight by consuming a greater proportion energy in the morning/afternoon as opposed to dinner/later at night.. This suggestion is based on previous studies showing eating a larger breakfast decreases feelings of hunger at night. Additionally, including more protein and fiber in the diet can increase satiety at any time of day. Future studies are needed to examine relationships between hunger score and a longer overnight fast, in larger, more diverse populations and with randomized controlled designs, as our study was cross-sectional and was unable to determine causality.
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