Evening Chronotype Is Associated with Poorer Habitual Diet in US Women, with Dietary Energy Density Mediating a Relation of Chronotype with Cardiovascular Health
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Background An innate preference for later timing of sleep and activity, termed evening chronotype, is linked to poorer cardiovascular health (CVH). However, associations of chronotype with specific health behaviors in US women are not well characterized. Of particular interest is habitual diet, because <1% of US adults meet recommendations for a healthful diet.Objectives We aimed to evaluate cross-sectional and prospective associations of chronotype with diet quantity and quality in US women, and to assess whether dietary energy density (ED), a robust predictor of cardiometabolic outcomes, mediates an established chronotype-CVH relation.Methods Data were collected from participants in the AHA Go Red for Women Strategically Focused Research Network cohort (aged 20-76 y; 61% racial/ethnic minority) at baseline (n = 487) and 1-y follow-up (n = 432). Chronotype (evening compared with morning/intermediate) and habitual diet were ascertained from the Morningness-Eveningness Questionnaire and an FFQ, respectively. Multivariable-adjusted linear regression models evaluated cross-sectional and prospective associations of chronotype with diet. Causal mediation analyses assessed whether dietary ED mediated a relation between chronotype and CVH, quantified using AHA Life's Simple 7 score, derived from clinical measurements and validated assessments of CVH components.Results Evening compared with morning/intermediate chronotype was associated with poorer diet quality, including lower intakes of plant protein (cross-sectional: β = -0.63 ± 0.24, P < 0.01; prospective: β = -0.62 ± 0.26, P = 0.01), fiber (cross-sectional: β = -2.19 ± 0.65, P < 0.001; prospective: β = -2.39 ± 0.66, P < 0.001), and fruits and vegetables (cross-sectional: β = -1.24 ± 0.33, P < 0.001; prospective: β = -1.15 ± 0.36, P = 0.001). Evening chronotype was also associated with higher dietary ED at baseline (β = 0.20 ± 0.05, P = 0.001) and 1 y (β = 0.19 ± 0.06, P = 0.001). Dietary ED was a partial mediator of the association between evening chronotype and poorer CVH (24.6 ± 9.1%, P < 0.01).Conclusions Evening chronotype could contribute to unhealthful dietary patterns in US women, with higher dietary ED partially mediating the relation between eveningness and poorer CVH. Behavioral interventions to reduce dietary ED might mitigate cardiovascular disease risk in women with evening chronotype.
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The evening chronotype has been linked to greater risk of depression and anxiety, greater dietary energy density, reduced physical activity, and lower cardiorespiratory fitness.
“Importantly, the evening chronotype has been linked to greater risk of depression and anxiety, 25 greater dietary energy density, 26 as well as reduced physical activity and lower cardiorespiratory fitness, 27”
From The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review (2024) · cites this paper as [26]
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- Authors
- Zuraikat, F. M., St-Onge, M.-P., Makarem, N., Boege, H. L., Xi, H., & Aggarwal, B.
- Affiliations
- Columbia University Irving Medical Center (US)
- Corresponding author
- Aggarwal, Brooke
- Venue
- The Journal of Nutrition
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 151
- Issue
- 5
- Pages
- 1150-1158
- ISSN
- 0022-3166 (ISSN-L)
- PMC
- PMC8112764
- OpenAlex
- W3138806923
- Cited by
- 38
- References
- 64
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 6 · 2023: 10 · 2022: 5 · 2021: 2
- FWCI
- 3.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- AHA Go Red for Women Strategically Focused Research Network (16SFRN27960011)
- BA (16SFRN27950012)
- AHA Research Goes Red (811531)
- National Institutes of Health (R01 HL128226, R01 HL142648, T32 HL007343)
- FMZ (K99 HL148511)
- NM
- Berrie Diabetes Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- evening chronotype, chronotype, habitual diet, dietary energy density, cardiovascular health, diet quality, plant protein intake, dietary fiber, fruit and vegetable intake, mediation, women, sleep timing, cardiometabolic health, racial and ethnic minorities
- MeSH terms
- Adult, Aged, Energy Intake, Cardiovascular Diseases, Circadian Rhythm, Cross-Sectional Studies, Diet, Female, Humans, Middle Aged, Prospective Studies, Cohort Studies, Young Adult
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