Effects of circadian-restricted feeding and low energy intake, on risk of cardiovascular disease and type 2 diabetes mellitus

Background: Cardiometabolic risk has been reported to be significantly high among South Asian immigrants to developed countries, compared to people living in South Asian countries. This may be due to disruption of metabolic cycles. Halberg proposed that restricted feeding at a particular time of the day and low calorie intake have independent effects on body weight. This study examines the association of circadian restricted feeding in conjunction with low calorie diet in patients with risk of CVDs and type 2 diabetes mellitus. Subjects and Methods: This study included 32 volunteers, 25-67 years of age, receiving low caloric diet with circadian restricted feeding. All volunteers had an available medical record of overweight (n = 2), obesity (n = 5), hypertension (n = 12), type 2 diabetes mellitus (n = 9) or angina pectoris (n = 4). We randomly selected age- and gender-matched urban patients (n = 500) with known type 2 diabetes and/or hypertension and/or coronary artery disease (CAD) for comparison with volunteers on low caloric diets. Multivariate logistic regression analysis was applied to seek associations of protective or risk factors relative to CVDs and type 2 diabetes. Results: Mean body weight, body mass index, and systolic and diastolic blood pressure were significantly lower in the study group, compared to high-risk urban participants. Fasting blood glucose, triglycerides and total cholesterol, and HDL cholesterol were significantly lower in the study group, compared to high-risk urban subjects. Multivariate logistic regression analysis after adjustment of age and body mass index revealed that the relative risk (RR) and confidence interval of difference (CI) for restricted feeding (male: 0.63 [0.59-0.68], P < 0.001; female: 0.65 [0.62-0.69], P < 0.001) and low-calorie intake (male: 0.64 [0.61-0.67], P < 0.001); female: 0.66 [0.63-0.69], P < 0.001) were inversely associated with the risk of CVDs and type 2 diabetes. Total energy intake (male: 0.67 [0.61-0.74], P < 0.05; female: 0.69 [0.62-0.76], P < 0.05), total cholesterol (male: 0.68 [0.59-0.78], P < 0.05; female: 0.71 [0.61-0.78], P < 0.05), triglycerides (male: 0.68 [0.60-0.75],P < 0.002; female: 0.64 [0.58-0.71], P < 0.001), and fasting blood glucose (male: 0.68 [0.61-0.77], P < 0.05; female: 0.69 [0.62-0.78], P < 0.05) were positively associated with the risk of CVDs and type 2 diabetes. Conclusions: This study revealed that restriction of feeding and low caloric diet are important protective factors, whereas total cholesterol, triglycerides and fasting blood glucose are risk factors of CVDs and type 2 diabetes. Eating usual dinner and lower per day total energy intake, despite no breakfast and nominal lunch, may be associated with better health.