Cited by 248Circadian rhythm and melatoninDietary Effects on HealthSleep and related disorders

Chronotype: Implications for Epidemiologic Studies on Chrono-Nutrition and Cardiometabolic Health

Open access
Almoosawi, Suzana, Vingeliene, Snieguole, Gachon, Frederic, Voortman, Trudy, Palla, Luigi, Johnston, Jonathan D, Van Dam, Rob Martinus, Darimont, Christian +1 more·2019·Advances in Nutrition

Abstract

Chrono-nutrition is an emerging research field in nutritional epidemiology that encompasses 3 dimensions of eating behavior: timing, frequency, and regularity. To date, few studies have investigated how an individual's circadian typology, i.e., one's chronotype, affects the association between chrono-nutrition and cardiometabolic health. This review sets the directions for future research by providing a narrative overview of recent epidemiologic research on chronotype, its determinants, and its association with dietary intake and cardiometabolic health. Limited research was found on the association between chronotype and dietary intake in infants, children, and older adults. Moreover, most of the evidence in adolescents and adults was restricted to cross-sectional surveys with few longitudinal cohorts simultaneously collecting data on chronotype and dietary intake. There was a gap in the research concerning the association between chronotype and the 3 dimensions of chrono-nutrition. Whether chronotype modifies the association between diet and cardiometabolic health outcomes remains to be elucidated. In conclusion, further research is required to understand the interplay between chronotype, chrono-nutrition, and cardiometabolic health outcomes.

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative review summarizes epidemiologic evidence on chronotype measurement, determinants, and associations with dietary intake, eating behavior, and cardiometabolic health. It concludes that evening chronotype is generally linked to less healthy dietary patterns and higher cardiometabolic risk, but causality and the role of chrono-nutrition remain unresolved.

Key findings

  • Evening chronotype was associated with lower fruit and vegetable intake and higher intake of energy drinks, alcoholic, sugary, and caffeinated beverages, and higher energy from fat. In UK Biobank, adults with a morning chronotype consumed a mean of 0.25 more servings of fruit and 0.13 more servings of vegetables/d than evening chronotypes.
  • In FINRISK 2007, evening types had 1.3-fold greater odds of arterial hypertension and 2.5-fold greater odds of type 2 diabetes than morning types. In the Korean Genome and Epidemiology Study, evening chronotype was associated with higher prevalence of diabetes and metabolic syndrome after adjustment, with diabetes in men and metabolic syndrome in women.
  • Chronotype shifts across the life course: >90% of 2-y-old children had a morning chronotype, declining to 58% by age 6 y. In 6631 Italian adolescents aged 14–18 y, eveningness was associated with later bedtime and wake-up time, shorter time in bed during the week, longer time in bed at the weekend, irregular sleep-wake schedule, and more frequent napping during school days.
  • Among 194 non–shift-working type 2 diabetes patients, 22 (11.3%) reported skipping breakfast; breakfast skippers had higher HbA1c, higher BMI, and later midpoint of sleep, and the relation between breakfast skipping and HbA1c was reported to be mediated by chronotype.

Methods

  • Narrative review/overview of recent epidemiologic research on chronotype, its measurement, nonmodifiable and modifiable determinants, and its association with dietary intake, eating behavior, and cardiometabolic health.
  • Evidence base: observational studies summarized in Tables 1 and 2, mostly cross-sectional surveys in adolescents and adults, with few longitudinal cohorts simultaneously collecting chronotype and dietary intake; populations included infants/children, adolescents, adults, older adults, and clinical groups such as type 2 diabetes.
  • Main analysis: narrative synthesis; no systematic search, meta-analysis, or formal risk-of-bias assessment is reported.

Limitations

  • The paper states that most evidence is cross-sectional, so cause and effect or temporality cannot be determined; studies were also limited by unrepresentative samples, small sample sizes, selection bias, and other observational-study biases.
  • The paper states that evidence is limited in infants, older adults, and those at risk of cardiovascular disease or type 2 diabetes; dietary assessment methods varied, with most using FFQs or 24-h recalls that either do not capture timing of consumption or do not permit assessment of day-to-day variability.
  • The paper states that no study assessed the context within which foods are consumed at different time points, and no study examined whether chronotype affects the association between diet and cardiometabolic health across life stages. It also states that the applicability of different chronotype assessment methods remains to be established, with inconsistent correlations between MCTQ or MEQ and DLMO. Evident from the text: as a narrative review, no systematic search or quality appraisal is described.

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Integrity signals

Registry

Crossref · 10.1093/advances/nmy070

Cites

138 of 138 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 167 cited sources checked · 0 supported · 0 flagged

  • Findingnone given

    In epidemiology, research on chrono-nutrition is hindered because few cross-sectional surveys or longitudinal cohorts assess chronotype or use dietary assessment methods that permit assessment of the timing of dietary intake.

    “In epidemiology, such research is currently hindered by the fact that few cross-sectional surveys or longitudinal cohorts assess chronotype or use dietary assessment methods that permit assessment of the timing of dietary intake.”
    Quote in the paperSubstantial claim
  • Findingreasoning

    There is a gap in research on the association between chronotype and the three dimensions of chrono-nutrition.

    “There was a gap in the research concerning the association between chronotype and the 3 dimensions of chrono-nutrition.”
    Quote in the paperSubstantial claim
  • Findingnone given

    Limited research exists on the association between chronotype and dietary intake in infants, children, and older adults.

    “Limited research was found on the association between chronotype and dietary intake in infants, children, and older adults.”
    Quote in the paperSubstantial claim
  • Findingnone given

    Few studies have investigated how an individual's chronotype affects the association between chrono-nutrition and cardiometabolic health.

    “To date, few studies have investigated how an individual's circadian typology, i.e., one's chronotype, affects the association between chrono-nutrition and cardiometabolic health.”
    Quote in the paperSubstantial claim
  • Findingcitation

    Correlations between MEQ and DLMO have not been investigated in larger samples of the population.

    “To our knowledge, such correlations have as yet not been investigated in larger samples of the population (26).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Kantermann, 2015, Comparing the Morningness-Eveningness Questionnaire and Munich ChronoType Questionnaire to the Dim Light Melatonin Onset, J Biol Rhythms source

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  • Classified as probably not a substantial claim. 15
  • May combine two claims. 55
  • Classified as probably not a substantial claim.

    Findingreasoning

    Whether chronotype modifies the association between diet and cardiometabolic health outcomes remains to be elucidated.

    “Whether chronotype modifies the association between diet and cardiometabolic health outcomes remains to be elucidated.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingnone given

    Most evidence on chronotype and dietary intake in adolescents and adults comes from cross-sectional surveys, with few longitudinal cohorts simultaneously collecting chronotype and dietary intake data.

    “Moreover, most of the evidence in adolescents and adults was restricted to cross-sectional surveys with few longitudinal cohorts simultaneously collecting data on chronotype and dietary intake.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingcitation

    Variations in chronotype between urban and rural areas within the same country have been observed in Japanese adolescents and in adults in Brazil, India, and elsewhere.

    “In addition to country-specific differences, variations in chronotype between urban and rural areas within the same country have been observed in Japanese adolescents (53, 59, 60) and in adults in Brazil, India, and elsewhere (61–63).”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [53] Takeuchi, 2001, Parental enforcement of bedtime during childhood modulates preference of Japanese junior high school students for eveningness chronotype, Chronobiol Int source

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    • cites [59] Louzada, 2003, Predissociated dimers and molten globule monomers in the equilibrium unfolding of yeast glutathione reductase, Biophys J source

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    • cites [60] Louzada, 2004, Exposure to light versus way of life: effects on sleep patterns of a teenager—case report, Chronobiol Int source

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    • cites [61] von Schantz, 2015, Distribution and heritability of diurnal preference (chronotype) in a rural Brazilian family-based cohort, the Baependi study, Sci Rep source

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    • cites [62] Nag, 2012, Impact of lifestyle on circadian orientation and sleep behaviour, Sleep Biol Rhythms source

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    • cites [63] Evans, 2011, Habitual sleep/wake patterns in the Old Order Amish: heritability and association with non-genetic factors, Sleep source

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    Findingcitation

    Some studies but not others found a greater prevalence of eveningness in men compared with women, who exhibit greater morningness.

    “Some studies (48, 49) but not others (9, 24) found a greater prevalence of eveningness in men compared with women, who exhibit greater morningness.”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [48] Lehnkering, 2007, Influence of chronotype, season, and sex of subject on sleep behavior of young adults, Chronobiol Int source

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    • cites [49] Leonhard, 2009, In sync with the family: children and partners influence the sleep-wake circadian rhythm and social habits of women, Chronobiol Int source

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    • cites [9] Levandovski, 2013, Chronotype: a review of the advances, limits and applicability of the main instruments used in the literature to assess human phenotype, Trends Psychiatry Psychother source

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    • cites [24] Wittmann, 2006, Social jetlag: misalignment of biological and social time, Chronobiol Int source

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    Findingcitation

    Most evidence on the impact of chronodisruption on gestational development is currently based on animal models, and few studies have investigated how variations in chronotype among mothers influence long-term offspring health in humans.

    “Most of the evidence on the impact of chronodisruption on gestational development is currently based on animal models, and few studies have investigated how variations in chronotype among mothers influence long-term offspring health in humans (87).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [87] Serón-Ferré, 2016, Circadian rhythms in the fetus and newborn: significance of interactions with maternal physiology and the environment

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  • Classified as probably not a substantial claim. May combine two claims.

    Findingnone given

    The literature on the link between chronotype and diet is currently emerging and we are far from understanding the link.

    “The literature on this topic is currently emerging and we are far from understanding the link between chronotype and diet.”
    Quote in the paperSubstantial claim
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    Premisecitation

    Individuals with an evening chronotype tend to consume fewer and larger meals and delay food intake due to later awakening time.

    “In particular, research indicates that individuals presenting with an evening chronotype have a tendency towards consuming fewer and larger meals and delaying food intake due to later awakening time (19, 22).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [19] Meule, 2012, Skipping breakfast: morningness-eveningness preference is differentially related to state and trait food cravings, Eat Weight Disord

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    • cites [22] Dashti, 2015, Short sleep duration and dietary intake: epidemiological evidence, mechanisms, and health implications, Adv Nutr source

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    Premisecitation

    Mounting evidence suggests an association between evening chronotype and increased risk of cardiovascular disease and metabolic disorders including type 2 diabetes.

    “Accordingly, mounting evidence suggests a potential association between an evening chronotype and increased risk of cardiovascular disease (12, 13) and metabolic disorders including type 2 diabetes (11, 13).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [12] Kantermann, 2014, Changes in chronotype after stroke: a pilot study, Front Neurol

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    • cites [13] Merikanto, 2013, Associations of chronotype and sleep with cardiovascular diseases and type 2 diabetes, Chronobiol Int source

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    • cites [11] Yu, 2015, Evening chronotype is associated with metabolic disorders and body composition in middle-aged adults, J Clin Endocrinol Metab source

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    Premisecitation

    The MEQ measures psychological preference for behavior but has been shown to correlate less with DLMO than measures of sleep timing obtained with the MCTQ in one study but not in another.

    “The MEQ specifically measures the psychological preference for behavior but has been shown to correlate less with DLMO than measures of sleep timing obtained with the MCTQ in one study (34) but not in another (26).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [34] Kitamura, 2014, Validity of the Japanese version of the Munich ChronoType Questionnaire, Chronobiol Int source

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    • cites [26] Kantermann, 2015, Comparing the Morningness-Eveningness Questionnaire and Munich ChronoType Questionnaire to the Dim Light Melatonin Onset, J Biol Rhythms source

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    Premisecitation

    Use of urine samples to measure melatonin metabolites is widely reported in epidemiologic studies but is limited by poorer urine sample resolution, which affects accuracy of measurement.

    “In contrast, the use of urine samples to measure melatonin metabolites is widely reported in epidemiologic studies (27) but is limited because of the poorer urine sample resolution which affects the accuracy of measurement (28).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [27] Mirick, 2008, Melatonin as a biomarker of circadian dysregulation, Cancer Epidemiol Biomarkers Prev source

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    • cites [28] Benloucif, 2008, Measuring melatonin in humans, J Clin Sleep Med source

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    Premisecitation

    Food can regulate various peripheral body clocks and metabolic rhythms and is often referred to as a zeitgeber.

    “Food is often referred to as a zeitgeber (14) because of its ability to regulate various peripheral body clocks and metabolic rhythms (2, 15, 16).”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [14] Stephan, 2002, The “other” circadian system: food as a Zeitgeber, J Biol Rhythms source

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    • cites [2] Johnston, 2016, Circadian rhythms, metabolism, and chrononutrition in rodents and humans, Adv Nutr source

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    • cites [15] Wehrens, 2017, Meal timing regulates the human circadian system, Curr Biol source

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    • cites [16] Oike, 2017, Modulation of circadian clocks by nutrients and food factors, Biosci Biotechnol Biochem source

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    Premisenone given

    Environmental cues such as light, social interactions, and study/work schedules are each thought to entrain the circadian system.

    “Environmental cues such as light, social interactions, and study/work schedules are each thought to entrain the circadian system (Figure 1).”
    Quote in the paperNot a substantial claim
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    Premisecitation

    A shift towards morningness is seen at approximately 50 years of age, indicating that aging influences chronotype.

    “By contrast, a shift towards morningness is seen at ∼50 y of age (52), indicating that aging influences chronotype (51).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [52] Carrier, 1997, Sleep and morningness-eveningness in the ‘middle' years of life (20-59 y), J Sleep Res source

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    • cites [51] Jankowski, 2015, Composite Scale of Morningness: psychometric properties, validity with Munich ChronoType Questionnaire and age/sex differences in Poland, Eur Psychiatry source

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    Interpretationreasoning

    Social conditions may influence timing and duration of exposure to artificial or dim light compared with outdoor daylight, which would then entrain the circadian clock system.

    “For instance, it could be argued that social conditions may influence timing and duration of exposure to artificial or dim light compared with outdoor daylight, which would then entrain the circadian clock system.”
    Quote in the paperNot a substantial claim
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    Premisecitation

    The higher morning chronotype prevalence in British black ethnicity was argued to be due to the shorter τ reported previously in individuals with black ethnicity.

    “This was argued to be due to the shorter τ reported previously in individuals with black ethnicity (45)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45] Smith, 2009, Racial differences in the human endogenous circadian period, PLoS One source

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    Premisecitation

    In children, morning chronotype is more prevalent, with a shift towards eveningness during puberty.

    “In children, the morning chronotype is more prevalent, with a shift towards eveningness being observed during puberty (51).”
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    • cites [51] Jankowski, 2015, Composite Scale of Morningness: psychometric properties, validity with Munich ChronoType Questionnaire and age/sex differences in Poland, Eur Psychiatry source

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    Premisecitation

    Light is believed to be the strongest synchronizer of the master clock, and variations in the light-dark cycle across latitudes and time zones are thought to influence the circadian system, leading to differences in chronotype across the globe.

    “Light is believed to be the strongest synchronizer of the master clock, and variations in the light-dark cycle across different latitudes and time zones are thought to influence the circadian system, leading to differences in chronotype across the globe (55).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [55] Miguel, 2014, Detecting chronotype differences associated to latitude: a comparison between Horne–Östberg and Munich Chronotype questionnaires, Ann Hum Biol source

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    Premisecitation

    Rare cases of familial extreme chronotype disorders, such as advanced sleep-phase syndrome, have been described.

    “Concerning the influence of nonmodifiable determinants, rare cases of familial extreme chronotype disorders, such as advanced sleep-phase syndrome, have been described (36, 37).”
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    • cites [36] von Schantz, 2008, Phenotypic effects of genetic variability in human clock genes on circadian and sleep parameters, J Genet source

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    • cites [37] Jones, 1999, Familial advanced sleep-phase syndrome: a short-period circadian rhythm variant in humans, Nat Med source

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    Interpretationcitation

    Having children may be a more important social factor influencing a woman's chronotype compared with their partner, and potentially an effect modifier in analyses of nutritional surveys or cohorts.

    “This may imply that having children is a more important social factor influencing a woman's chronotype compared with their partner (49), and potentially an effect modifier that needs to be considered in the analysis of nutritional surveys or cohorts.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [49] Leonhard, 2009, In sync with the family: children and partners influence the sleep-wake circadian rhythm and social habits of women, Chronobiol Int source

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    Premisecitation

    The authors of one study concluded that photoperiod might not be the major driver behind determining the distribution of chronotype within a population, but rather social conditions imposed by different cultures or lifestyles may more likely determine the prevalence of one chronotype over another within a specific population.

    “This led the authors to conclude that the photoperiod might not be the major driver behind determining the distribution of chronotype within a population, but rather social conditions imposed by different cultures or lifestyles (rural or urban) may more likely determine the prevalence of one chronotype over another within a specific population (61).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61] von Schantz, 2015, Distribution and heritability of diurnal preference (chronotype) in a rural Brazilian family-based cohort, the Baependi study, Sci Rep source

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    Premisecitation

    Specific mutations in circadian clock regulators affect human circadian behavior and the period of the underlying clock.

    “Herein, specific mutations in circadian clock regulators that affect human circadian behavior and the period of the underlying clock have been identified (38, 39).”
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    • cites [38] Toh, 2001, An hPer2 phosphorylation site mutation in familial advanced sleep phase syndrome, Science source

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    • cites [39] Xu, 2005, Functional consequences of a CKIdelta mutation causing familial advanced sleep phase syndrome, Nature source

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    Premisecitation

    An observational study in Japan found that consumption of a breakfast high in tryptophan is associated with greater morningness, as assessed through a morningness-eveningness questionnaire, in infants and elementary school children (0-8 years old) but not in adolescents (>8 years old).

    “An observational study in Japan found that consumption of a breakfast high in tryptophan is associated with greater morningness, as assessed through the use of a morningness-eveningness questionnaire, in infants and elementary school children (0–8 y old) but not in adolescents (>8 y old) (98).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [98] Harada, 2007, Correlation between breakfast tryptophan content and morningness-eveningness in Japanese infants and students aged 0–15 yrs, J Physiol Anthropol source

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    Premisecitation

    In a study of 5000 adults aged 30-49 years from New Zealand, after controlling for ethnicity, sex, and socioeconomic status, work schedules predicted chronotype, with night workers being more likely to be definitely evening-type and the unemployed less likely to be moderately morning-type compared with other workers.

    “After controlling for ethnicity, sex, and socioeconomic status, work schedules were found to predict chronotype, with night workers being more likely to be “definitely evening-type” and the unemployed less likely to be “moderately morning-type” compared with other workers (71).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Paine, 2006, The epidemiology of morningness/eveningness: influence of age, gender, ethnicity, and socioeconomic factors in adults (30-49 years), J Biol Rhythms source

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    Premisecitation

    A recent review concluded that, as early as during fetal development, disruption of circadian rhythms in the mother may adversely affect fetal development and growth.

    “A recent review concluded that, as early as during fetal development, disruption of circadian rhythms in the mother may adversely affect fetal development and growth (87).”
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    • cites [87] Serón-Ferré, 2016, Circadian rhythms in the fetus and newborn: significance of interactions with maternal physiology and the environment

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    Premisecitation

    In a large-scale cross-sectional study of 3304 female dietetics students from 53 institutions in Japan, a late midpoint of sleep was associated with a lower percentage of energy from protein and carbohydrates and a lower intake of rice, vegetables, pulses, eggs, and milk products.

    “A late midpoint of sleep was associated with a lower percentage of energy from protein and carbohydrates and a lower intake of rice, vegetables, pulses, eggs, and milk products (81).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [81] Sato-Mito, 2011, The midpoint of sleep is associated with dietary intake and dietary behavior among young Japanese women, Sleep Med source

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    Premisecitation

    One feature of circadian misalignment is altered timing of nutrient supply to the fetus, which may potentially play a role that is yet to be fully elucidated.

    “One feature of circadian misalignment is the altered timing of nutrient supply to the fetus, which may potentially play a role that is yet to be fully elucidated (87).”
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    • cites [87] Serón-Ferré, 2016, Circadian rhythms in the fetus and newborn: significance of interactions with maternal physiology and the environment

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    Premisecitation

    In a representative sample in Italy of 6631 adolescents aged 14-18 years, eveningness was associated with later bedtime and wake-up time, shorter time in bed during the week, longer time in bed at the weekend, irregular sleep-wake schedule, and more frequent napping during school days.

    “For instance, in a representative sample in Italy of 6631 adolescents aged 14–18 y, eveningness was associated with later bedtime and wake-up time (especially on weekends), shorter time in bed during the week, longer time in bed at the weekend, irregular sleep-wake schedule, and more frequent napping during school days (70).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [70] Giannotti, 2002, Circadian preference, sleep and daytime behaviour in adolescence, J Sleep Res source

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    Premisecitation

    Wickersham found that more than 90% of 2-year-old children exhibit a morning chronotype, a proportion that declines to 58% by the time children reach 6 years of age.

    “Wickersham (96), in particular, found that >90% of 2-y-old children exhibit a morning chronotype, a proportion that declines to 58% by the time children reach 6 y of age.”
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    • cites [96] Wickersham, 2006, Time-of-day preference for preschool-aged children, Chrestomathy

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    Premisecitation

    The development of the 24-h circadian rest-activity rhythm is observed in infants as young as 3 weeks old and is potentially influenced by a mother's rest-activity cycle and maternal melatonin rhythm.

    “After birth, the development of the 24-h circadian rest-activity rhythm is observed in infants as young as 3 wk old and is potentially influenced by a mother's rest-activity cycle (88) and maternal melatonin rhythm (89).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [88] Nishihara, 2002, The development of infants' circadian rest–activity rhythm and mothers' rhythm, Physiol Behav source

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    • cites [89] Davis, 1997, Melatonin: role in development, J Biol Rhythms source

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    Premisecitation

    Adolescents with an evening chronotype experience greater shifts in timing of breakfast consumption between weekdays and weekends, with later awakening times during weekends corresponding to later breakfast consumption.

    “Adolescents with an evening chronotype experience greater shifts in timing of breakfast consumption between weekdays and weekends, with later awakening times during weekends corresponding to later breakfast consumption (20).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Randler, 2010, Morningness-eveningness, habitual sleep-wake variables and cortisol level, Biol Psychol source

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    Premisecitation

    In a study involving students and professionals, individuals with an evening chronotype consumed more alcohol, coffee, and cola, whereas morning types consumed more tea.

    “In another study involving students and professionals, individuals with an evening chronotype were found to consume more alcohol, coffee, and cola, whereas morning types consumed more tea (86).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [86] Adan, 1994, Chronotype and personality factors in the daily consumption of alcohol and psychostimulants, Addiction source

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    Premisecitation

    Factors such as noise, ambient light, and crowding within an urban environment may underlie some of the ethnic differences in sleep duration.

    “Hale and Do (67) similarly reported that factors such as noise, ambient light, and crowding within an urban environment may underlie some of the ethnic differences in sleep duration.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [67] Hale, 2007, Racial differences in self-reports of sleep duration in a population-based study, Sleep source

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    Premisecitation

    In that Japanese study of female dietetics students, a late midpoint of sleep was associated with a higher percentage of energy from alcohol and fat and higher intake of noodles, confectionery, fats and oils, and meat.

    “It was, however, associated with a higher percentage of energy from alcohol and fat and higher intake of noodles, confectionery, fats and oils, and meat.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [81] Sato-Mito, 2011, The midpoint of sleep is associated with dietary intake and dietary behavior among young Japanese women, Sleep Med source

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    Premisecitation

    Extreme morning types show a smaller shift in sleep times between work and free days, although they do accumulate sleep debt during weekends in an attempt to keep up with social norms.

    “By contrast, extreme morning types show a smaller shift in sleep times between work and free days, although they do accumulate sleep debt during weekends in an attempt to keep up with social norms (66).”
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    • cites [66] Roenneberg, 2003, Life between clocks: daily temporal patterns of human chronotypes, J Biol Rhythms source

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    Premisecitation

    Social schedules may directly interfere with individual sleep preferences, subsequently affecting health.

    “Social schedules may also directly interfere with individual sleep preferences, subsequently affecting health (24).”
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    • cites [24] Wittmann, 2006, Social jetlag: misalignment of biological and social time, Chronobiol Int source

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    Interpretationcitation

    It may be that chronotype is a consequence of the entraining effect of food constituents or eating patterns on peripheral clocks.

    “Furthermore, it may be that chronotype is a consequence of (caused by) the entraining effect of food constituents (16) or eating patterns on the peripheral clocks (15) (Figure 1).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [16] Oike, 2017, Modulation of circadian clocks by nutrients and food factors, Biosci Biotechnol Biochem source

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    • cites [15] Wehrens, 2017, Meal timing regulates the human circadian system, Curr Biol source

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    Premisecitation

    Breast milk is believed to play an important role in determining the circadian phase in infants, evident by circadian variation in nutrient composition of breast milk and cytokine concentrations.

    “Breast milk is also believed to play an important role in determining the circadian phase in infants, which is evident by the circadian variation in nutrient composition of breast milk (90–93) and cytokine concentrations (93).”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [90] Sánchez, 2013, Evolution of the circadian profile of human milk amino acids during breastfeeding, J Appl Biomed source

      Not checked in the free run.

    • cites [91] Lubetzky, 2006, Circadian variations in fat content of expressed breast milk from mothers of preterm infants, J Am Coll Nutr source

      Not checked in the free run.

    • cites [92] Schneider, 2018, Diet and nutrients in the modulation of infant sleep: a review of the literature, Nutr Neurosci source

      Not checked in the free run.

    • cites [93] Morais, 2015, Temporal fluctuations of cytokine concentrations in human milk, Biol Rhythm Res source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The timing of exposure to strong outdoor daylight determines the phase of sleep, and every additional hour spent outdoors is associated with 30 minutes of advance sleep.

    “Consistent with the latter, Roenneberg et al. (66) observed that the timing of exposure to strong outdoor daylight determines the phase of sleep and that every additional hour spent outdoors is associated with 30 min of advance sleep.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66] Roenneberg, 2003, Life between clocks: daily temporal patterns of human chronotypes, J Biol Rhythms source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Later bed- and rise times are associated with increased likelihood of caffeinated drink and fast-food consumption and lower likelihood of dairy product consumption in a small-scale cross-sectional survey of adolescents.

    “Later bed- and rise times have been found to be associated with increased likelihood of caffeinated drink and fast-food consumption and a lower likelihood of dairy product consumption in a small-scale cross-sectional survey of adolescents (83).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [83] Fleig, 2009, Association between chronotype and diet in adolescents based on food logs, Eat Behav source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In that Finnish study, differences were more pronounced on weekends and evening types reported eating more frequently and irregularly than morning types.

    “These differences were more pronounced in the weekends and evening types reported eating more frequently and irregularly than morning types (72).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [72] Mirkka, 2017, Chronotype differences in timing of energy and macronutrient intakes: a population‐based study in adults, Obesity source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a study of 72 physicians, greater morningness was associated with lower consumption of sweets and vegetables as assessed via a 3-d food record and greater leisure-time physical activity.

    “A further study involving 72 physicians reported that greater morningness was associated with lower consumption of sweets and vegetables as assessed via a 3-d food record and greater leisure-time physical activity (74).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [74] Mota, 2016, Association between chronotype, food intake and physical activity in medical residents, Chronobiol Int source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Older adults with an evening chronotype consume more caffeinated beverages at night, eat heavier meals before bedtime, have irregular sleep-wake schedules, and nap more frequently.

    “Consistent with the findings in adolescents, young adults, and adults, older adults with an evening chronotype have been found to consume more caffeinated beverages at night, eat heavier meals before bedtime, have irregular sleep-wake schedules, and nap more frequently (77).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [77] Suh, 2016, Chronotype differences in health behaviors and health-related quality of life: a population-based study among aged and older adults, Behav Sleep Med

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In that Finnish sample, lower morning-to-evening scores were associated with higher alcohol (as percentage of total energy) and sucrose intakes and lower intakes of carbohydrates, protein, fiber, folic acid, and sodium.

    “Intakes of alcohol (as a percentage of total energy intake) and sucrose were also higher, whereas intakes of carbohydrates, protein, fiber, folic acid, and sodium were lower with lower morning-to-evening scores (80).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [80] Kanerva, 2012, Tendency toward eveningness is associated with unhealthy dietary habits, Chronobiol Int source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In FINRISK 2007, evening types had lower adherence to the Baltic Sea dietary pattern and were more likely to be smokers, physically inactive, and have lower perceived health than other chronotypes.

    “Evening types were found to have a lower adherence to the Baltic Sea dietary pattern and were more likely to be smokers, physically inactive, and have lower perceived health than other chronotypes (73).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [73] Maukonen, 2016, The associations between chronotype, a healthy diet and obesity, Chronobiol Int source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In FINRISK 2007 (n = 6258), individuals with an evening type had 1.3-fold greater odds of arterial hypertension, a faster resting heart rate, and lower systolic blood pressure, serum total cholesterol, and LDL cholesterol than morning types.

    “In a larger cross-sectional analysis of the national FINRISK 2007 study, which included a representative sample of the Finnish population aged 25–74 y (n = 6258), individuals with an evening type had 1.3-fold greater odds of arterial hypertension, a faster resting heart rate, and a lower systolic blood pressure, serum total cholesterol, and LDL cholesterol than morning types (13).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Merikanto, 2013, Associations of chronotype and sleep with cardiovascular diseases and type 2 diabetes, Chronobiol Int source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a small-scale study (n = 56), no association between chronotype and stroke incidence was observed, although alterations in chronotype were reported after stroke.

    “In relation to cerebrovascular events, only 1 small-scale study (n = 56) has been conducted so far on stroke, wherein no association between chronotype and stroke incidence was observed, although alterations in chronotype were reported after stroke (12).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Kantermann, 2014, Changes in chronotype after stroke: a pilot study, Front Neurol

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Different forms of shift work induce multiple forms of circadian misalignment, which are believed to underlie raised postprandial glucose and insulin concentrations in shift workers, increased risk of impaired glucose tolerance, and type 2 diabetes.

    “Different forms of shift work are reported to induce multiple forms of circadian misalignment, which are believed to underlie the observed raised postprandial glucose (120) and insulin concentrations in shift workers (121), as well as the increased risk of impaired glucose tolerance (122) and type 2 diabetes observed in epidemiologic studies (81).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [120] Hampton, 1996, Postprandial hormone and metabolic responses in simulated shift work, J Endocrinol source

      Not checked in the free run.

    • cites [121] Lund, 2001, Postprandial hormone and metabolic responses amongst shift workers in Antarctica, J Endocrinol source

      Not checked in the free run.

    • cites [122] Suwazono, 2009, Shiftwork and impaired glucose metabolism: a 14-year cohort study on 7104 male workers, Chronobiol Int source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a random sample of the Finnish population, greater eveningness (lower morning-to-evening score) was associated with lower intake of whole grains, rye, potatoes, and vegetables and roots, whereas intake of wine and chocolate was higher.

    “Greater eveningness, as demonstrated by lower morning-to-evening score, was associated with a lower intake of whole grains, rye, potatoes, and vegetables and roots, whereas intake of wine and chocolate was higher.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [80] Kanerva, 2012, Tendency toward eveningness is associated with unhealthy dietary habits, Chronobiol Int source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a small-scale German study (n = 55), individuals with an evening chronotype had lower heart rate variability but higher systolic blood pressure than morning types.

    “These findings are partially consistent with findings from another small-scale German study (n = 55), wherein individuals with an evening chronotype had lower heart rate variability but higher systolic blood pressure than did morning types (117).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [117] Roeser, 2012, Of larks and hearts—morningness/eveningness, heart rate variability and cardiovascular stress response at different times of day, Physiol Behav source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a randomized crossover study of 67 adolescents, during healthy sleep (10 h in bed induced by earlier sleep), adolescents with a morning chronotype reduced their evening energy intake, whereas no changes in evening energy intake were seen in adolescents with an evening chronotype.

    “During the intervention involving healthy sleep, adolescents with a morning chronotype were found to reduce their evening energy intake, whereas no changes in evening energy intake were seen in adolescents with an evening chronotype.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [104] Beebe, 2015, The impact of early bedtimes on adolescent caloric intake varies by chronotype, J Adolesc Health source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In experimental studies, a combination of circadian misalignment and sleep restriction reduces insulin sensitivity, increases inflammation, and impairs glucose tolerance.

    “In experimental studies, a combination of circadian misalignment and sleep restriction has been shown to reduce insulin sensitivity (124), increase inflammation (112), and impair glucose tolerance (125).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [124] Morris, 2015, Endogenous circadian system and circadian misalignment impact glucose tolerance via separate mechanisms in humans, Proc Natl Acad Sci USA source

      Not checked in the free run.

    • cites [112] Leproult, 2014, Circadian misalignment augments markers of insulin resistance and inflammation, independently of sleep loss, Diabetes source

      Not checked in the free run.

    • cites [125] Nedeltcheva, 2014, Metabolic effects of sleep disruption, links to obesity and diabetes, Curr Opin Endocrinol Diabetes Obes source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Elderly individuals with an evening chronotype were more likely to be current smokers, have more sleep disturbances, engage in more sleep-interfering behaviors, and have lower physical activity.

    “In particular, elderly individuals with an evening chronotype were more likely to be current smokers, have more sleep disturbances, engage in more sleep-interfering behaviors (i.e., evening caffeine or alcohol consumption, heavy meals before bedtime), and to have lower physical activity (77), emphasizing once more the need to understand the clustering of different lifestyle behaviors.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [77] Suh, 2016, Chronotype differences in health behaviors and health-related quality of life: a population-based study among aged and older adults, Behav Sleep Med

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a Japanese study, adults with an evening chronotype are more likely to skip meals more frequently and to have a higher probability of watching television at breakfast, lunch, and dinner.

    “Consistent with the Finnish study, one study in Japan found that adults with an evening chronotype are more likely to skip meals more frequently and to have a higher probability of watching television at breakfast, lunch, and dinner (81).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [81] Sato-Mito, 2011, The midpoint of sleep is associated with dietary intake and dietary behavior among young Japanese women, Sleep Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    The use of subjective questionnaires is a common practice in epidemiologic studies.

    “It was evident that the use of subjective questionnaires is a common practice in epidemiologic studies.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    In the Korean Genome and Epidemiology Study, evening chronotype was related to diabetes in men and to metabolic syndrome in women.

    “Interestingly, in the latter study, sex differences in the association were evident, wherein evening chronotype was related to diabetes in men and to metabolic syndrome in women (11).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] Yu, 2015, Evening chronotype is associated with metabolic disorders and body composition in middle-aged adults, J Clin Endocrinol Metab source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Overall, cross-sectional studies suggest that evening chronotype is associated with lower intake of fruits and vegetables and higher intake of energy drinks, alcoholic, sugary, and caffeinated beverages, as well as higher energy intake from fat.

    “Overall, cross-sectional studies suggest that evening chronotype is associated with lower intake of fruits and vegetables and higher intake of energy drinks, alcoholic, sugary, and caffeinated beverages, as well as higher energy intake from fat.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    In a study of 194 non-shift-working type 2 diabetes patients, 22 (11.3%) reported skipping breakfast; those individuals had significantly higher HbA1c concentrations, higher BMI, and later midpoint of sleep than breakfast eaters.

    “Overall, 22 (11.3%) type 2 diabetes patients reported skipping breakfast. Those individuals were found to have significantly higher HbA1c concentrations, higher BMI, and later midpoint of sleep than breakfast eaters.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Reutrakul, 2014, The relationship between breakfast skipping, chronotype, and glycemic control in type 2 diabetes, Chronobiol Int source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Experimental sleep loss, such as induced by circadian misalignment and social jet lag, reduces insulin sensitivity and induces inflammation.

    “For instance, experimental sleep loss, such as induced by circadian misalignment and social jet lag, reduces insulin sensitivity and induces inflammation (127), which may, in turn, modulate insulin sensitivity (128) and is a risk factor for cardiometabolic disturbance (129).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [127] Rangaraj, 2016, Association between sleep deficiency and cardiometabolic disease: implications for health disparities, Sleep Med source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In an earlier study, later chronotype and having a large dinner were associated with poorer glycemic control independently of sleep disturbances.

    “In an earlier study, later chronotype and having a large dinner were associated with poorer glycemic control independently of sleep disturbances (133).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [133] Reutrakul, 2013, Chronotype is independently associated with glycemic control in type 2 diabetes, Diabetes Care source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a study of 210 non-shift-working patients with type 2 diabetes, later bedtime on weekends was related to both shorter sleep duration and poorer glycemic control.

    “Later bedtime on weekends was related to both shorter sleep duration and poorer glycemic control (126).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [126] Reutrakul, 2015, Relationships among sleep timing, sleep duration and glycemic control in type 2 diabetes in Thailand, Chronobiol Int source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Study design and conductnone given

    No study has examined whether chronotype could affect the association between diet and cardiometabolic health across various stages of the life course.

    “This is particularly true considering that no study has examined whether chronotype could affect the association between diet and cardiometabolic health across various stages of the life course.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    The MCTQ is known to provide data on social jet lag and has been reported to correlate better than the MEQ with biological measures such as DLMO in one study but not in another.

    “To this end, the MCTQ is known to provide data on social jet lag and has been reported to correlate better than the MEQ with biological measures such as DLMO in one study (34) but not in another (26).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [34] Kitamura, 2014, Validity of the Japanese version of the Munich ChronoType Questionnaire, Chronobiol Int source

      Not checked in the free run.

    • cites [26] Kantermann, 2015, Comparing the Morningness-Eveningness Questionnaire and Munich ChronoType Questionnaire to the Dim Light Melatonin Onset, J Biol Rhythms source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    Most studies used either FFQs or 24-h food recalls, which either do not capture the timing of consumption or do not permit assessment of variability in intake between different days.

    “Dietary assessment methods varied, with most studies using either FFQs or 24-h food recalls, which either do not capture the timing of consumption or do not permit assessment of the variability in intake between different days.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Timing of macronutrient intake has been shown to affect the circadian clock in rodent models, with little data from human studies.

    “The latter are key issues considering that timing of macronutrient intake has been shown to affect the circadian clock in rodent models, with little data from human studies (16, 134).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [16] Oike, 2017, Modulation of circadian clocks by nutrients and food factors, Biosci Biotechnol Biochem source

      Not checked in the free run.

    • cites [134] Oosterman, 2015, Impact of nutrients on circadian rhythmicity, Am J Physiol Regul Integr Comp Physiol source

      Not checked in the free run.

64 of 64
  • The paper relies on this without support.

    Chronotype is a determinant of the bimodality of sleep-awake and fasting-feeding cycles.

    “Because chronotype is a determinant of the bimodality of sleep-awake and fasting-feeding cycles, researchers hypothesized that chronotype may correlate with cerebrovascular and cardiovascular disease risk (12, 13).”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Chronic sleep loss or shift work results in misalignment between the sleep-awake, fasting-feeding cycles, and the light-dark cycle.

    “Almoosawi and her colleagues suggest these situations result in misalignment between the sleep–awake, fasting–feeding cycles, and the light–dark cycle 97.”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Chronotype claim cites a yeast-enzyme study

    Minor

    The text cites reference 59 for urban-rural differences in chronotype among Japanese adolescents, but reference 59 is titled as a study of yeast glutathione reductase.

  • Opposite direction reported for sweets and vegetable intake

    Minor

    Table 2 associates greater eveningness with lower sweet and vegetable intake, whereas the text associates greater morningness with lower consumption of both.

2 of 2

Cites

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1 of the 139 references couldn’t be matched to a known paper.

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Authors
Almoosawi, S., Vingeliene, S., Gachon, F., Voortman, T., Palla, L., Johnston, J. D., Van Dam, R. M., Darimont, C., & Karagounis, L. G.
Affiliations
  • Northumbria University (GB)
  • Örebro University (SE)
  • Erasmus MC (NL)
  • London School of Hygiene & Tropical Medicine (GB)
  • University of Surrey (GB)
  • Nestlé (Switzerland) (CH)
Corresponding author
Karagounis, Leonidas G
Venue
Advances in Nutrition
Publisher
Elsevier BV
Published
2019-01
Volume
10
Issue
1
Pages
30-42
ISSN
  • 2156-5376 (ISSN-L)
  • 2161-8313
OpenAlex
W2898419548
Cited by
247
References
139
Citations by year
2026: 33 · 2025: 42 · 2024: 40 · 2023: 42 · 2022: 31 · 2021: 31 · 2020: 17 · 2019: 10 · 2018: 1
FWCI
2.06
Type
journal article
Language
en
Open access
Locations
  • Advances in Nutrition (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
  • Northumbria Research Link (Northumbria University) (acceptedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by-nc)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
  • RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
  • Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
  • RePub (Erasmus University Rotterdam) (submittedVersion)
Funders
Biotechnology and Biological Sciences Research Council (1267831, BB/I008470/1, 1309667)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
chronotype, chrononutrition, circadian rhythm, dietary habits, meal timing, meal frequency, meal regularity, dietary intake, cardiometabolic health, infants and children, older adults, adolescents
MeSH terms
Adolescent, Adult, Aged, Cardiovascular Diseases, Child, Child, Preschool, Circadian Rhythm, Diet, Feeding Behavior, Female, Humans, Infant, Male, Metabolic Diseases, Middle Aged, Epidemiologic Studies, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

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