0252 Chronotype and Disordered Eating Behavior: A Systematic Review and Meta-Analysis

PurposeGlycemic response to the same meal depends on daytime and alignment of consumption with the inner clock, which has not been examined by individual chronotype yet. This study examined whether the 2-h postprandial and 24-h glycemic response to a meal with high glycemic index (GI) differ when consumed early or late in the day among students with early or late chronotype.MethodsFrom a screening of 327 students aged 18–25 years, those with early (n = 22) or late (n = 23) chronotype participated in a 7-day randomized controlled cross-over intervention study. After a 3-day observational phase, standardized meals were provided on run-in/washout (days 4 and 6) and intervention (days 5 and 7), on which participants received a high GI meal (GI = 72) in the morning (7 a.m.) or in the evening (8 p.m.). All other meals had a medium GI. Continuous glucose monitoring was used to measure 2-h postprandial and 24-h glycemic responses and their variability.ResultsAmong students with early chronotype 2-h postprandial glucose responses to the high GI meal were higher in the evening than in the morning (iAUC: 234 (± 92) vs. 195 (± 91) (mmol/L) × min, p = 0.042). Likewise, mean and lowest 2-h postprandial glucose values were higher when the high GI meal was consumed in the evening (p < 0.001; p = 0.017). 24-h glycemic responses were similar irrespective of meal time. Participants with late chronotype consuming a high GI meal in the morning or evening showed similar 2-h postprandial (iAUC: 211 (± 110) vs. 207 (± 95) (mmol/L) × min, p = 0.9) and 24-h glycemic responses at both daytimes.ConclusionsDiurnal differences in response to a high GI meal are confined to those young adults with early chronotype, whilst those with a late chronotype seem vulnerable to both very early and late high GI meals. Registered at clinicaltrials.gov (NCT04298645; 22/01/2020).

ABSTRACTIt is a common notion that phases-of-entrainment of circadian rhythms are adaptive, in that they enable organisms to time their behavior to specific times of the day to enhance their fitness. Therefore, understanding mechanisms that bring about such phases-of-entrainment is crucial to chronobiologists. Our previous studies have shown that selection for morning and evening phasing of adult emergence in Drosophila melanogaster populations leads to divergent coevolution of free-running periods of both adult emergence and activity/rest rhythms, such that early (morning) and late (evening) adult emergence chronotypes have shorter and longer circadian periods, respectively. However, there is little evidence to support the notion that phases-of-entrainment in these fly stocks is indeed driven by non-parametric mechanisms. Extending from a previous hypothesis based on anecdotal evidence for parametric mechanisms being in play, we explore the extent of non-parametric and parametric effects of light on circadian clocks of early and late chronotypes. We systematically tested predictions of the non-parametric model of entrainment, sketched the Circadian Integrated Response Characteristic (CIRC) of our stocks, assessed the effect of light pulses on amplitude of the behavior and the effect of duration of light pulse on phase-shifts of the clock. We demonstrate that, in addition to the differences in clock period, divergent CIRCs contribute to entrainment of the activity/rest rhythm. The differences in CIRC could be explained by differential transient amplitude responses and duration responses of the clock’s phase between the early and late chronotypes. Our study thus highlights the role of amplitude responses and phase-shifts due to long durations of light in entrainment of circadian rhythms of D. melanogaster.

Late chronotype, the individual’s aptitude to perform daily activities late in the day, has been associated with low adherence to the Mediterranean diet (MedDiet) and metabolic syndrome. The aim of this work was to investigate the potential association of chronotype and adherence to the MedDiet with the liver fibrosis risk in patients with non-alcoholic fatty liver disease (NAFLD). Liver stiffness was assessed in 126 patients by FibroScan®530. Significant (F ≥ 2) and advanced (F ≥ 3) hepatic fibrosis were defined according to liver stiffness values ≥7.1 kPa and ≥8.8 kPa, respectively. Chronotype (MSFsc) was defined by the Munich Chronotype Questionnaire, and adherence to the MedDiet was defined by the Mediterranean diet score (MDS). Overall, the median age was 55 (46–63) years, and 57.9% of participants were male. The principal comorbidities were type-2 diabetes mellitus (T2DM) (26.1%), arterial hypertension (53.1%), dyslipidaemia (63.4%), obstructive sleep apnoea (5.5%) and depression (5.5%). Most subjects (65.0%) had intermediate + late chronotype and showed higher mid-sleep on workdays (p < 0.001) and on work-free days (p < 0.001) compared to those with early chronotype. In the logistic regression model, intermediate + late chronotype (p = 0.024), MDS (p = 0.019) and T2DM (p = 0.004) were found to be significantly and independently associated with the risk of both F ≥ 2 And F ≥ 3. We observed that the intermediate + late chronotype and low adherence to the MedDiet were associated with both significant and advanced liver fibrosis in patients with NAFLD.

Frequent nightmares can pose a serious clinical problem, especially in association with sleep and psychological disturbances, in the general population. However, this association has not been investigated in inpatients with cardiovascular (CV) diseases. Furthermore, whether CV medications could induce iatrogenic nightmares remains unknown. In a cross-sectional designed study, we evaluated the prevalence and determinants of frequent nightmares and its association with sleep and psychological disturbances among hospitalized CV patients. A total of 1233 patients (mean age, 64 ± 15 years; 25.1% female) hospitalized for various CV diseases in a single university hospital were enrolled. We assessed nightmares and sleep characteristics using the Pittsburgh Sleep Quality Index (PSQI), sleep-disordered breathing (SDB) using nocturnal pulse oximetry, and psychological disturbances using Hospital Anxiety and Depression Scale (HADS). Overall, 14.8% and 3.6% of the patients had at least one nightmare per month and per week (frequent nightmares), respectively. In this cohort, 45.9% had insomnia (modified PSQI > 5), 28.0% had SDB (3% oxygen desaturation index > 15), 18.5% had depression (HADS-depression ≥ 8), and 16.9% had anxiety (HADS-anxiety ≥ 8). Frequent nightmares were not associated with CV medications and SDB but were associated with depression [odds ratio (OR) = 4.61, 95% confidence interval (CI) = 2.03-10.48], anxiety (OR = 5.32, 95% CI = 2.36-12.01), and insomnia (OR = 7.15, 95% CI = 2.41-21.22). Frequent nightmares were not uncommon in patients hospitalized for CV diseases. Although the cause-effect relationship is unclear, frequent nightmares were associated with psychological disturbances and insomnia, but not iatrogenic factors, among hospitalized CV patients. Cardiologists should be more conscientious to nightmare complaints with respect to screening for psychological disturbances and insomnia.

The present study aimed to explore the influence of the chronotype on mental rotation performance in university students. Using the Morningness-Eveningness Questionnaire (MEQ), 24 healthy volunteers were categorized as either early chronotype (ECT) or late chronotype (LCT). Participants completed a chronometric mental rotation task with three-dimensional stimuli at different times of day (8 AM and 8 PM). ECT participants showed a shorter reaction time in the morning trial than in the evening (p = 0.003), whereas LCT participants showed a shorter reaction time (p = 0.001) and increased accuracy (p = 0.031) in the evening compared to the morning session. Additionally, the MEQ score was positively correlated with the difference in reaction time between morning and evening trials (r = −0.589, p = 0.002). Two-way analysis of variance revealed an interaction between time and chronotype for the parameter reaction time in the evening trials (F(1, 22) = 28.27, p < 0.001). LCT participants showed higher speed and increased accuracy during their optimal time compared to ECT participants. This study explored diurnal alterations of visual-spatial abilities assessed as mental rotation performance, and the possible implications for certain life skills such as sports, car driving, and manual labor are discussed.

Individuals are different ‘chronotypes’ with early ‘larks’ and late ‘owls’ forming the limits of a normal distribution in the population. We recently described that late chronotypes who suffer from a conflict between internal and external time (‘social jetlag’) suffer from more mental distress and are more likely to smoke than early chronotypes (Wittmann, Dinich, Merrow, and Roenneberg, . Social jetlag: mis-alignment of biological and social time. Chronobiology International, 23:497–509.). We performed a detailed analysis of the same database collected in 2002 comprising 134 daily smokers and 366 nonsmokers, scrutinizing the relationships between chronotype, smoking, and alcohol consumption as well as psychological well-being using a multiple mediation analysis. On average, smokers tend to be later chronotypes, report more sleep-associated psychosomatic symptoms, are more depressed, less balanced, and less vigilant. The mediation analysis suggests that only those late chronotypes who smoke and those who drink more suffer from increased psychological distress. We suggest that ‘chronotype’ is introduced as an additional factor in substance use, that is, when considering motives for smoking and drinking.

Sleep timing, chronotype and social jetlag: Impact on cognitive abilities and psychiatric disorders

To compare the efficacy, safety and perioperative outcomes of robotic-assisted sacrocolpopexy (RASC) versus laparoscopic sacrocolpopexy (LSC) for the surgical management of apical or multicompartment pelvic organ prolapse (POP). Systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies (PROSPERO CRD42025111099), conducted according to PRISMA guidelines. Secondary and tertiary care centres. Women undergoing sacrocolpopexy for POP. Medical databases (PubMed, Scopus, ISI Web of Science, Embase, Cochrane) were searched from inception to April 2025 for studies comparing RASC versus LSC. Risk-of-bias was assessed using the Cochrane tool for RCTs and Joanna Briggs Institute checklists for observational studies. Data were meta-analysed separately by study design using odds ratios (ORs) and standardised mean differences with 95% confidence intervals (CIs), applying fixed- or random-effects models according to heterogeneity. Operative time, anatomical outcomes, complications, conversion to laparotomy, recurrence and patient-reported outcomes. Five RCTs and twenty-four observational studies were included. In RCTs, no significant differences between RASC and LSC in operative time, anatomical outcomes or patient-reported outcomes were found, with similar intraoperative and post-operative complication rates. In observational studies, perioperative outcomes, complications, mesh exposure, readmissions and recurrence were comparable, but RASC ensured lower conversion to laparotomy (OR 0.2, 95% CI 0.1-0.3). RASC and LSC provide equivalent anatomical and clinical outcomes with similar morbidity. RASC may be particularly useful in complex or technically demanding cases.

The purpose of the present study was to determine whether elevated dietary Na intake could be associated with CVD mortality. We performed a systematic review and meta-analysis of prospective studies representing the general population. The adjusted relative risks and their 95 % confidence intervals were pooled by the inverse variance method using random-effects models. Heterogeneity, publication bias, subgroup and meta-regression analyses were performed. Settings MEDLINE (since 1973), Embase (since 1975), the Cochrane Library (since 1976), ISI Web of Science, Google Scholar (until September 2013) and secondary referencing were searched for inclusion in the study. Subject Eleven prospective studies with 229 785 participants and average follow-up period of 13.37 years (range 5.5-19 years). Higher Na intake was significantly associated with higher CVD mortality (relative risk=1.12; 95 % CI 1.06, 1.19). In the sensitivity analysis, the exclusion of studies with important relative weights did not significantly affect the results (relative risk=1.08; 95 % CI 1.01, 1.15). The meta-regression analysis showed that for every increase of 10 mmol/d in Na intake, CVD mortality increased significantly by 1 % (P=0.016). Age, hypertensive status and length of follow-up were also associated with increased CVD mortality. Higher Na intake was associated with higher CVD mortality in the general population; this result suggests a reduction in Na intake to prevent CVD mortality from any cause.

Vitamin D Status and Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis of Observational Studies

Social jetlag and dietary intake: A systematic review

The association between belonging to a disadvantaged socio-economic status or social class and health outcomes has been consistently documented during recent decades. However, a meta-analysis quantifying the association between belonging to a lower social class and the risk of dementia has yet to be performed. In the present work, we sought to summarise the results of prospective, longitudinal studies on this topic. We conducted a systematic review and meta-analysis of prospective, longitudinal studies measuring the association between indicators of social class and the risk of all-cause/Alzheimer's dementia. The search was conducted in four databases (Medline, Embase, Web of Science and PsychInfo). Inclusion criteria for this systematic review and meta-analysis were: (a) longitudinal prospective study, (b) aged ⩾60 years at baseline, (c) issued from the general population, (d) no dementia at baseline and (e) mention of social class as exposure. Exclusion criteria were: (a) study of rare dementia types (e.g. frontotemporal dementia), (b) abstract-only papers and (c) articles without full text available. The Newcastle-Ottawa scale was used to assess the risk of bias in individual studies. We calculated the overall pooled relative risk of dementia for different social class indicators, both crude and adjusted for sex, age and the year of the cohort start. Out of 4548 screened abstracts, 15 were included in the final analysis (76,561 participants, mean follow-up 6.7 years (2.4-25 years), mean age at baseline 75.1 years (70.6-82.1 years), mean percentage of women 58%). Social class was operationalised as levels of education, occupational class, income level, neighbourhood disadvantage and wealth. Education (relative risk (RR)=2.48; confidence interval (CI) 1.71-3.59) and occupational class (RR=2.09; CI 1.18-3.69) but not income (RR=1.28; CI 0.81-2.04) were significantly associated with the risk of dementia in the adjusted model. Some of the limitations of this study are the inclusion of studies predominantly conducted in high-income countries and the exclusion of social mobility in our analysis. We conclude that there is a significant association between belonging to a social class and the risk of dementia, with education and occupation being the most relevant indicators of social class regarding this risk. Studying the relationship between belonging to a disadvantaged social class and dementia risk might be a fruitful path to diminishing the incidence of dementia over time. However, a narrow operationalisation of social class that only includes education, occupation and income may reduce the potential for such studies to inform social policies.

Background: This study protocol outlines the planned, systematic review and dose-response meta-analysis of nuts intake with cancer risk and its mortality.&#x0D; Methods: This meta-analysis will be done based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). A systematic literature search will be conducted using online databases, including PubMed/Medline, ISI Web of Science, and Scopus with no limitation in language or time of publication to identify observational studies investigating the association of nuts intake with cancer risk and its mortality. The target population will be adults (≥18 years of age). Random-effects models will be used to calculate pooled effect sizes (ESs) for the risk of cancer and its mortality based on the comparison between the highest and lowest categories of nut intake and to incorporate variation between studies. Linear and non-linear dose-response analyses will be done to evaluate the dose-response associations between nut intake and risk of cancer and its mortality. The Newcastle-Ottawa Scale (NOS) will be used to assess the risk of bias or quality of included studies.&#x0D; Conclusion: The findings of this systematic review and dose-response meta-analysis will summarize all available evidence on the association between nut intake and risk of cancer and its mortality.

Chronotype is a measure of an individual's timing of sleep and wakefulness. It describes the relationship between an external time and a person's internal biological time. The chronotype has been used to characterize human circadian trait. Differences in chronotypes are believed to be related to genetic variation, location, geographic and cultural factors. Determination of chronotype using quantitative approaches has been done in Europe for more than a decade now through the Munich Chronotype Questionnaire (MCTQ). In this approach, the chronotype is quantified by the midpoint time between the start and end of sleep during free days, corrected for sleep duration on work days. The calculated time classifies whether an individual has an early or late chronotype. In the Philippines, there is no existing data for chronotypes as well as social jetlag - the discrepancy between an individual's internal time and social clock. In this study, we provide a quantitative description of chronotypes and social jetlag among Filipinos. We present preliminary results based on the 895 non-shift worker respondents of the PhilMCTQ, a language variant of the MCTQ for the Philippine population. Using this set of data, we determined the association of chronotype and social jetlag against certain factors, i.e., age, gender, self- assessed exposure to natural light, type of location (whether living in the urban or rural area), travel time to/from work, sleep duration, and body mass index. Observations concerning the relationship of chronotype and gender, age and social jetlag that have been previously reported in other populations are also seen in our data. Increased social jetlag has been observed among people with late chronotypes among our respondents. There were also some differences in chronotypes between genders, age groups, dwelling locations and consumers of stimulants (i.e., beer, liquor and cigarettes). Both Metro City and Non-Metro City residents similarly experience social jetlag. The data show that as commuting time becomes longer, social jetlag slightly increases. Differences in social jetlag have been observed between age groups and certain stimulants (e.g., smoking, coffee drinking) have been shown to be associated with social jetlag. Other factors such as gender, dwelling location, time spent outdoors and body mass index did not show sufficient evidence of association or correlation with social jetlag among the study participants.

Background:This systematic review was conducted to review the studies investigating the role of dietary approach to stop hypertension (DASH) diet in prevalence and progression of the metabolic syndrome (MetS) in children, adolescents, and adults.Methods:Electronic searches for included studies were performed in MEDLINE, SCOPUS, EMBASE, Cochrane Trial Register, and ISI Web of Science until 30 March 2020. Study selection, data extraction, and quality assessment were fulfilled independently by two reviewers using predefined criteria. Studies were included if they assessed the role of adherence to DASH diet in risk of incidence, prevalence, and development of MetS.Results:Twelve eligible studies (eight observational studies and four clinical trials) were identified. Despite methodological heterogeneity, limited statistical power, and the cross-sectional nature of most of observational studies, greater adherence to DASH diet was associated with reduced risk of MetS. However, results for change in metabolic characteristics based on dietary intervention with DASH diet in some interventional studies were somewhat controversial.Conclusions:The current study demonstrates that, based on observational studies, greater adherence to a DASH diet is inversely associated with MetS presence and progression. However, more interventional studies are needed in this regard to clarify the exact effect of DASH diet on MetS.