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Background

Circadian dietary rhythms: secular trends and associations with cardiometabolic risk factors in the 1946 British birth cohort Al Moosawi S1, Prynne CJ1, Olson A1, Winter J1, Hardy R2, Stephen AM1. MRC Human Nutrition Research, Cambridge, UK

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  1. Circadian dietary rhythms: secular trends and associations with cardiometabolic risk factors in the 1946 British birth cohort Al Moosawi S1, Prynne CJ1, Olson A1, Winter J1, Hardy R2, Stephen AM1. MRC Human Nutrition Research, Cambridge, UK MRC Unit for Lifelong Health and Ageing, London, UK

  2. Background • Cohort studies • National Health and Nutrition Examination Survey • European Prospective Investigation into Cancer and Nutrition • Breakfast skipping • Shift workers • Animal studies

  3. Limitations • Cross-sectional design • Food frequency questionnaire • Small sample size

  4. Aim and objectives Using dietary data from the National Survey of Health and Development (British Birth Cohort 1946): To examine 17-year changes in energy and macronutrient intake across eating occasions in the 1946 British birth cohort. To investigate the association between longitudinal changes in distribution of macronutrient intakes through the day and long-term changes in BMI To investigate the association between longitudinal changes in distribution of energy and macronutrient intakes through the day and development: Hypertension Diabetes Metabolic syndrome

  5. Numbers of participants Follow-up selection of NSHD in 1948: single births to married women with husbands in non-manual and agricultural employment, and 1 in 4 in manual employment n = 5362 Number who completed all 3 time points = 1253

  6. 1950 1960 1970 1980 1990 2000 1940 MRC National Survey of Health and Development (NSHD) 1946 British Birth Cohort Clinic Visit Blood sample 1946 Birth 53 43 36 60-65 M BF 4 36 43 53 2007-11 = Dietary Assessment = BMI

  7. Adult dietary assessment in NSHD • 5 day diary • Photographs for portions since 1989 • Coded using DIDO (Diet In, Data Out) • McCance and Widdowson’s the Composition of Foods for nutrients

  8. Time slots through the day 1 = Before breakfast 2 = Breakfast 3 = Mid-morning 4 = Lunch 5 = Mid-afternoon 6 = Dinner 7 = Late evening 8 = Extras

  9. Statistical analyses Secular trends in energy and nutrient intake between 1982 and 1999 Dietary data 1982-1999 Longitudinal associations BMI Dietary data 1982-1999 BMI data 1982-1999 Diabetes Dietary data 1989 HbA1C 1999 Metabolic syndrome Dietary data 1989 Metabolic syndrome 1999 Hypertension Dietary data 1989 Metabolic syndrome 1999

  10. Statistical analyses Secular trends mixed between-within subjects analysis of variance Linear mixed models BMI Linear mixed models Diabetes/ Metabolic syndrome/ Hypertension Logistic regression

  11. Statistical analyses Multivariate Nutrient Density Models +

  12. Definitions BMI Weight in kilograms by height in meters squared Hypertension Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNCDET) systolic blood pressure ≥ 140 mmHg diastolic blood pressure ≥ 90 mmHg or anti-hypertension medication Diabetes HbA1c≥ 6.1% or diabetes medication Metabolic syndrome Adult Treatment Panel (ATPIII8) 2001 cut-offs. Definition modified to include glycosylated haemoglobin instead of fasting glucose

  13. Results: Changes in secular trends of energy and nutrient distribution

  14. Energy (% daily intake) Figure 1 Secular changes in proportion of energy at breakfast, mid-morning, lunch, mid-afternoon, evening and extra time slots in NSHD cohort (n=1253).

  15. Protein (% daily intake) Figure 2 Secular changes in proportion of protein at breakfast, mid-morning, lunch, mid-afternoon, evening and extra time slots in NSHD cohort (n=1253). 1982 ( ),1989 ( ),1999 ( )

  16. Fat (% daily intake) Figure 3 Secular changes in proportion of fat at breakfast, mid-morning, lunch, mid-afternoon, evening and extra time slots in NSHD cohort (n=1253). 1982 ( ),1989 ( ),1999 ( )

  17. Carbohydrates (% daily intake) Figure 4 Secular changes in proportion of carbohydrate at breakfast, mid-morning, lunch, mid-afternoon, evening and extra time slots in NSHD cohort (n=1253). 1982 ( ),1989 ( ),1999 ( )

  18. Results: Longitudinal associations

  19. BMI: Fat substitution model Figure 1 Longitudinal association between nutrient intake at different time slots and BMI in 1999. Model 1 estimates the effect of substituting 5% of energy from carbohydrate ( ) or protein ( ) for 5% of energy from fat. (n=1253)

  20. BMI: Carbohydrate substitution model Figure 5 Longitudinal association between nutrient intake at different time slots and BMI in 1999. Model 2 estimates the effect of substituting 5% of energy from fat ( ) or protein ( ) for 5% of energy from carbohydrate.(n=1253)

  21. BMI: Protein substitution model Figure 6 Longitudinal association between nutrient intake at different time slots and BMI in 1999. Model 3 estimates the effect of substituting 5% of energy from fat ( ) or carbohydrate ( ) for 5% of energy from protein. (n=1253)

  22. Diabetes

  23. Metabolic syndrome

  24. Hypertension

  25. Conclusions • Timing of energy and nutrient intake is associated with several cardiometabolic risk factors. • Breakfast and evening meals have the strongest association with cardiometabolic risk factors. • Repeating analyses in Avon Longitudinal Study of Parents and Children

  26. suzana.almoosawi@mrc-hnr.cam.ac.uk MRC Human Nutrition Research Cambridge, UK

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