Metabolic and Endocrine Responses to Nocturnal Eating

Sammanfattning: An increasing amount of people have their work hours displaced to the night and there are indications that shift work and other irregular working schedules are associated with an increased risk of developing the metabolic syndrome and other pathological conditions. It is therefore important to address the consequences of eating at irregular hours, especially nighttime. Papers I-III refer to a study in which 7 males were given a high-carbohydrate diet (HC) or a high-fat diet (HF), using a cross-over design. Subjects were kept awake for 24 h and food was provided as 6 equally spaced isocaloric meals. Higher energy expenditure and non-esterified fatty acids (NEFA) concentration, as well as lower glucose and triacylglycerol (TAG) concentrations were observed with the HF-diet, compared to the HC-diet. With the HF-diet, fat oxidation, heat release, heart rate, glucose, NEFA and TAG concentrations differed depending on time of day. The highest postprandial TAG concentrations were seen after the 04.00 meal with both diets. Insulin and leptin responses to meal intake differed with respect to diet and time of day. Time of day affected glucagon, thyroid stimulating hormone, free thyroxin, total triiodothyronine (tT3), cortisol, chromogranin A and pancreatic polypeptide (PP) concentrations. PP’s postprandial increase was greater during 08.00 – 16.00 compared to 20.00 – 08.00. Furthermore, the subjects felt less irritated when eating the HF-diet but hunger was not related to macronutrient composition. Hunger and thirst decreased throughout the 24 h period despite constant activity and energy intake; and were correlated with several endocrine and metabolic variables. In paper IV 7 males were studied twice during 24-h either given 6 isocaloric meals throughout the 24-h period, or 4 isocaloric meals from 08.00 to 20.00, followed by a nocturnal fast. Energy expenditure, glucose, TAG, insulin and glucagon concentrations were lower; and NEFA concentrations were higher during the nocturnal fast compared to nocturnal eating; although no 24 h differences between the protocols were apparent. The subjects were more passive during the fasting period compared to when food was given. Stepwise regression showed that correlations between metabolic variables and hormones differed between daytime and nighttime. The decreased evening/nocturnal responses of cortisol and PP to meal intake suggest that nocturnal eating might have health implications and that the body reacts unfavorably to nocturnal eating. Smaller meals around the clock, however, showed marginally better effects on postprandial TAG concentrations and mental energy compared to larger meals during daytime. Further studies (long term) are needed before dietary guidelines can be given to shift workers, especially regarding the impact of nocturnal eating on gastrointestinal response and cortisol.