Time-of-day and Meal Size Effects on Clinical Lipid Markers

一天中不同时间及餐量对临床血脂指标的影响

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Abstract

CONTEXT: Dyslipidemia and cardiovascular disease are common in shift workers and eating at night may contribute to this pathophysiology. OBJECTIVE: To examine the effects of eating at different times of day on lipid profiles. DESIGN: Two 24-hour baseline days with 8 hours of sleep, 3 meals (breakfast, lunch, dinner) and a snack, followed by a 40-hour constant routine (CR) with hourly isocaloric meals. SETTING: Intensive Physiological Monitoring Unit, Brigham and Women's Hospital. PARTICIPANTS: Twenty-one healthy adults [23.4 ± 2.7 years, 5F]. INTERVENTION: Forty-hour CR. MAIN OUTCOME MEASURES: A standard clinical lipid panel, consisting of total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), was assayed in blood samples collected 4-hourly across ~4 days. RESULTS: When participants ate at night, levels of TG were similar to eating during the day, however, these levels at night were reached with consuming approximately half the calories. Additionally, 24-hour levels of TG were 10% higher when meals were consumed hourly across 24 hours compared to consuming a typical 3-meal schedule while awake during the day and sleeping at night. The endogenous circadian rhythms of TG, which peaked at night, were shifted earlier by ~10 hours under baseline conditions, whereas the rhythms in total cholesterol, HDL-C, and LDL-C remained unchanged and peaked in the afternoon. CONCLUSIONS: The time-of-day dependency on postprandial lipid metabolism, which leads to hypersensitivity in TG responses when eating at night, may underlie the dyslipidemia and elevated cardiovascular disease risk observed in shift workers.

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