NNND 6423

Current Topics in Clinical Nutrition (Sem 2)

Lee Jie Yee

P119892
MCL 22/23
 1. Compare meal time, eating patterns, BMI, alertness time, physical
activity level of one morning person with one evening person.

Chronotype Morning: Score 72 Evening: Score 24 (Me)

Category

Meal timing Breakfast: 7.00 am Breakfast: -

Morning tea: - Morning tea: -
Lunch: 1.00 pm Lunch: 2.00 pm
Afternoon tea: 5.00 pm Afternoon tea: -
Dinner: 8.00 pm Dinner: 8.00 pm
Supper: - Supper: 2.00 am

Eating Four times a day, average 4.3 hours Three times a day, average 6.5 hours
frequency of meal interval of meal interval

Meal skipping No meal skipping for main meals Usually skips breakfast

Hunger Usually starts at 12.00 pm and 7.30 Usually starts at 6.00 pm and 12.00
feeling pm. The rating of hunger is 5 out of am. The rating of hunger is 6 out of
10. 10.

Binge eating Never Sometimes, usually happens at late

night after 12 am

Eating Finish one meal within 15 minutes Finish one meal within 15 minutes
duration

Food group ● Grain: 11 exchanges ● Grain: 9 exchanges

intake/day ● Legumes: -
● Meat: 2 exchanges
● Fish: 2 exchanges
● Dairy: 2 exchanges
● Fruits: 1 exchange
● Vegetables: 3 exchanges
● Caffeinated drink: 1
exchange
● Sweetened drink: -
● Sweetened food: -
● Fast food: -
● Alcohol: -
● Legumes: -
● Meat: 3 exchanges
● Fish: -
● Dairy: 1 exchange
● Fruits: 1 exchange
● Vegetables: 2 exchanges
● Caffeinated drink: -
● Sweetened drink: 1 exchange
● Sweetened food: -
● Fast food: 1 exchange
● Alcohol: -

Daily calorie 1500 kcal 1550 kcal

intake

BMI 21 kg/m2 24.6 kg/m2

Waist 68 cm 73 cm
circumference

Physical Lightly active: Go walking during Sedentary

activity level evening for 4 times a week

Alertness 7am to 9pm 6pm to 5am

time

2. Discuss on the findings

Chronotype refers to an individual’s sleep-wake timing and preference for
functioning at different times of day. They are categorized into morning,
intermediate and evening types. The morning-type has an earlier sleep-wake timing
and circadian function compared to the evening-type. Besides, the difference
between morning- and evening-type is not only limited to the circadian rhythm, but
also several physiological outcomes. For example, evening-types showed a greater
prevalence of mental health problems and mood disorders compared to morning-
and intermediate-types (Hasan et al. 2022). Hence, would different chronotypes
have different impacts in terms of diet and other aspects? Are the factors related to
each other? This will be further discussed in the following paragraphs.

From the table above, we can observe that the meal timing of the morning
chronotype is earlier, with the first meal starting at 7.00 am and the last meal at
8.00 pm. On the other hand, the evening chronotype has their meal timing shifted
towards afternoon and late night, with the first meal starting at 2.00 pm and the last
meal at 2.00 am. The later chronotype is usually associated with delayed meal
timing as suggested in a scoping review by Mazri et al. (2019). For the hunger
feeling, morning chronotype usually experiences before lunchtime and dinnertime
while evening chronotype experiences before dinnertime and suppertime. The
hunger rating score of the morning chronotype is lower compared to the evening
chronotype. The reason could be due to the association between meal timing and
appetite. A lower overall appetite in A.M. compared to P.M. is reported in a study.
This could be due to a greater metabolic response to meals in the morning, such as
the thermic effect of food, glucose tolerance and gastric emptying, which
eventually will promote greater satiety response (Beaulieu et al. 2020).

Besides, morning chronotype people are more likely to favor a morning

loaded meal, which means they consume more energy in the morning (Merwe et al.
2022). In a randomized controlled trial study, it suggested that participants with
morning loaded calorie intake (45%:35%:20% calories at breakfast:lunch:dinner)
have a significantly lower hunger score and high mean satiety as compared to
evening loaded calorie intake (20%:35%:45% calories at breakfast:lunch:dinner).
Therefore, morning chronotype could possibly have a greater suppression of
appetite. The mechanism behind it could be due to the relationship between
circadian variation and the secretion of many appetite hormones. For instance,
postprandial ghrelin, which is also the “hunger hormone”, is suppressed to a
greater extent in the morning in response to a breakfast meal. Moreover, a greater
appetite suppression in morning loaded meals could also be because of extended
duration of gastric emptying time due to the larger meal size and calorie load
(Ruddick-Collins et al. 2022).

Both morning and evening chronotype have minimal difference in energy

intake. The morning chronotype distributed the energy into four meals while the
evening chronotype distributed into three meals. Although energy intake in both
chronotypes is similar, the food group intake differs a lot. As shown in the table
above, the morning chronotype tends to consume a healthier and balanced diet than
the evening type. The evening type has lower intake of grain, protein, and
vegetables. Mazri et al. (2019) observed a similar finding in several studies, which
is that the evening chronotype has lower intake in grain, fish and vegetables. This
study also reported a higher caffeine intake in evening chronotype. However, this
could be affected by personal preference since the participant doesn’t drink
caffeinated drinks. Furthermore, the difference in food group intake could be
affected by several reasons, for example, the morning-type participant has most of
his meal at home, which could be healthier, while the evening-type consumed
mostly outside food.

The evening chronotype has posed an unhealthy diet pattern by consuming

fast food and sweetened drinks. Studies have shown an overall unhealthier food
choices and nutrient intakes in evening chronotype, such as soft drinks and fatty
food. The reason behind the unhealthy food choices could be because our
self-control tends to reduce as the day wears on (Maukonen et al. 2017). When it
comes to meal skipping, the evening chronotype has reported breakfast skipping.
The possible mechanism could be due to the delayed sleep-wake time of evening
chronotype, causing them to start their day later and omit breakfast (Mazri et al.
2019). These findings could be linked to the binge eating behavior, which could be
observed in the evening chronotype. The factors mentioned above, including meal
skipping, infrequent food intake, snacking during night could result in binge eating
(Romo-Nava et al. 2022). Personally, I also craved and binged for unhealthy
energy-dense food more frequently during night time when I was undergoing an
evening circadian rhythm.

Lastly, the evening chronotype has a sedentary lifestyle while morning

chronotype has a lightly active lifestyle. This could be interrelated with their
alertness time, with evening chronotype starting from 6pm. Normally, exercise is
done during the daytime. Moreover, exercise areas like gyms and recreational
parks are open during the daytime. Both chronotypes have normal BMI and waist
circumference. However, the evening chronotype is on the upper limit of normal
BMI. The evening chronotype participant reported that she has been to the
overweight category before, and she has lost weight and back to the normal
category. This could be related to poor dietary habits that are mentioned above,
such as meal skipping, consumption of unhealthy food, and binge eating (Arora et
al. 2014).

3. Conclusion
Studies have shown a prevalence of poorer dietary choices and habits in evening
chronotype. These unfavorable diet patterns could put them at higher risk of
obesity and metabolic disturbances.

References
Arora, T., & Taheri, S. (2015). Associations among late chronotype, body mass
index and dietary behaviors in young adolescents. International Journal of Obesity,
39(1), 39–44.

Beaulieu, K., Oustric, P., Alkahtani, S., Alhussain, M., Pedersen, H., Quist, J. S.,
Færch, K., & Finlayson, G. 2020. Impact of Meal Timing and Chronotype on Food
Reward and Appetite Control in Young Adults. Nutrients, 12(5), 1506.

Hasan, M. M., Jankowski, K. S., & Khan, M. H. A. 2022.

Morningness-eveningness preference and shift in chronotype during COVID-19 as
predictors of mood and well-being in university students. Personality and
Individual Differences, 191, 111581.
Maukonen, M., Kanerva, N., Partonen, T., Kronholm, E., Tapanainen, H., Kontto,
J., & Männistö, S. (2017). Chronotype differences in timing of energy and
macronutrient intakes: A population-based study in adults: Energy/Macronutrient
Intake Timing of Chronotypes. Obesity, 25(3), 608–615.

Mazri, F. H., Manaf, Z. A., Shahar, S., & Mat Ludin, A. F. 2019. The Association
between Chronotype and Dietary Pattern among Adults: A Scoping Review.
International Journal of Environmental Research and Public Health, 17(1), 68.

Romo-Nava, F., Guerdjikova, A. I., Mori, N. N., Scheer, F. A. J. L., Burgess, H. J.,
McNamara, R. K., Welge, J. A., Grilo, C. M., & McElroy, S. L. 2022. A matter of
time: A systematic scoping review on a potential role of the circadian system in
binge eating behavior. Frontiers in Nutrition, 9, 978412.

Ruddick-Collins, L. C., Morgan, P. J., Fyfe, C. L., Filipe, J. A. N., Horgan, G. W.,
Westerterp, K. R., Johnston, J. D., & Johnstone, A. M. 2022. Timing of daily
calorie loading affects appetite and hunger responses without changes in energy
metabolism in healthy subjects with obesity. Cell Metabolism, 34(10),
1472-1485.e6.

Van Der Merwe, C., Münch, M., & Kruger, R. (2022). Chronotype Differences in
Body Composition, Dietary Intake and Eating Behavior Outcomes: A Scoping
Systematic Review. Advances in Nutrition, 13(6), 2357–2405.