Night Owls Beware: Evening Preference Linked to 72% Higher Diabetes Risk

Evening preference, or "definite evening" chronotype, was linked to both unhealthy lifestyle choices like poor diet and lack of exercise and a 72% higher risk of developing type 2 diabetes compared to morning types. While accounting for these behaviours and other factors like family history did explain some of the increased risk, evening types still faced a 19% higher chance of diabetes. This suggests that, even beyond lifestyle habits, something about being an evening person is independently connected to diabetes risk. This study published in the journal Annals of Internal Medicine points towards personalized interventions for evening types, focusing on healthy lifestyle changes and potentially investigating the biological mechanisms beyond lifestyle that drive this association. This study investigates the impact of chronotype (natural sleep-wake preference) on diabetes risk, examining how lifestyle behaviours mediate this association. It focuses on middle-aged nurses (45–62 years old) and follows them for eight years in the Nurses' Health Study II.

Key Findings

• Having an evening chronotype (preference for late sleep/wake) is linked to a higher type 2 diabetes risk.

• The reason for this association is unclear.

Objective:

• Investigate if modifiable lifestyle factors mediate the link between chronotype and diabetes risk.

Design:

• A prospective cohort study using data from Nurses' Health Study II.

• Participants: 63,676 middle-aged female nurses.

Methods:

• Participants self-reported chronotype, lifestyle factors (diet, activity, etc.), and medical history.

• Diabetes diagnoses were tracked over 8 years.

Results:

• Evening chronotype was associated with unhealthier lifestyles (less activity, worse diet).

• Compared to morning chronotypes, evening types had:

  • 54% higher chance of an unhealthy lifestyle.

  • 72% higher risk of diabetes (after basic adjustments).

• Adjusting for BMI, physical activity, and diet quality:

  • Reduced diabetes risk increases for evening types (59% higher).

  • Still, a significant association remained (19% higher risk).

Limitations:

• The single question for chronotype assessment.

• Self-reported data.

• Homogeneous population (mostly white nurses).

Conclusion:

• Evening chronotype is linked to both unhealthier lifestyles and higher diabetes risk.

• Modifiable lifestyle factors partially explain the increased diabetes risk in evening types.

• Further research is needed to understand the remaining associations and explore interventions.

Unraveling the Association: Evening Chronotype and Diabetes Risk

Research has uncovered a significant association between having an evening chronotype and an increased risk of developing type 2 diabetes. Approximately 8% of the population falls into this category, and understanding the reasons behind this observed connection has become a critical focus for scientists.

Circadian Misalignment: A Key Player

One plausible explanation for the heightened diabetes risk in individuals with an evening chronotype is circadian misalignment. This phenomenon occurs when biological rhythms, including sleep-wake cycles, hormone secretion, body temperature regulation, and metabolism, are not synchronized with the physical and social environment. Factors contributing to circadian misalignment include social jetlag, irregular sleep schedules, and night shift work, with the latter being particularly common among individuals with an evening chronotype.

Understanding Chronotype

Chronotype refers to an individual's biological predisposition towards being a morning or evening person, influencing their sleep-wake cycle and peak periods of alertness. While morning chronotypes prefer early bed and rise times, evening chronotypes exhibit a preference for later sleep onset and waking times.

Association with Unhealthy Lifestyle Behaviors

Research indicates that individuals with an evening chronotype are more likely to engage in unhealthy lifestyle behaviors compared to morning chronotypes. These behaviors include smoking, inadequate sleep duration, low diet quality, physical inactivity, and excessive alcohol consumption.

Smoking and Sleep Duration

Evening chronotype has been strongly associated with smoking habits and extremes of sleep duration, including both short and long sleep patterns. This relationship underscores the importance of addressing sleep habits in individuals with varying chronotypes to mitigate associated health risks.

Diet Quality and Physical Activity

Moreover, individuals with an evening chronotype tend to exhibit poorer diet quality and lower levels of physical activity. These factors contribute significantly to the development of metabolic disorders such as obesity and type 2 diabetes.

Alcohol Consumption

While not directly linked to overall alcohol consumption, the evening chronotype has been correlated with unhealthy patterns of alcohol intake, particularly binge drinking. This underscores the need for targeted interventions to address alcohol-related health risks in individuals with varying chronotypes.

Diabetes Risk and Chronotype

Recent studies have provided compelling evidence linking the evening chronotype with an increased risk of developing type 2 diabetes. Longitudinal analyses have shown a significant association between eveningness and diabetes incidence, independent of other risk factors such as BMI and physical activity.

Prospective Studies

Prospective cohort studies have reported a 72% higher incidence of diabetes among individuals with a definite evening chronotype compared to morning chronotypes. This highlights the importance of considering chronotype as a predictive factor for diabetes risk assessment.

Role of Lifestyle Factors

Adjustment for lifestyle factors, including BMI, physical activity, and diet quality, has been shown to attenuate the relationship between chronotype and diabetes risk. This suggests that unhealthy lifestyle behaviours mediate the association between eveningness and metabolic disorders.

Subgroup Analysis

Subgroup analyses have revealed variations in the strength of association between chronotype and diabetes risk based on factors such as gender and night shift work history. These findings underscore the complexity of the relationship between chronotype, lifestyle factors, and disease outcomes.

Implications for Public Health

The clustering of unhealthy lifestyle behaviors among individuals with an evening chronotype presents challenges for public health interventions aimed at diabetes prevention. Targeted strategies focusing on improving sleep habits, dietary choices, and physical activity levels are warranted to mitigate the elevated risk associated with eveningness.

Lifestyle Modification

Given the modifiable nature of lifestyle factors, interventions targeting behavior change hold promise in reducing diabetes risk among individuals with varying chronotypes. Comprehensive lifestyle modification programs encompassing sleep hygiene, dietary counseling, and exercise promotion are essential components of diabetes prevention efforts.

Shift Scheduling Considerations

Furthermore, personalized shift scheduling tailored to individuals' chronotypes may help mitigate the adverse effects of circadian misalignment associated with night shift work. Employers and policymakers should consider integrating chronotype-based scheduling practices to promote employee health and well-being.

Results

• Evening chronotypes were 54% more likely to have unhealthy lifestyles compared to "morning people," including factors like diet quality, physical activity, and body mass index (BMI).

• Evening chronotypes had a higher risk of developing diabetes:

  Without considering lifestyle factors:

  • "Intermediate" evening types were 21% more likely to get diabetes than morning types.

  • "Definite" evening types were 72% more likely to get diabetes than morning types.

• After considering lifestyle factors: (like diet, exercise, and weight),

  • The risk for "definite" evening types went down, but they were still 31% more likely to get diabetes than morning types.

• Even after considering everything they measured: (lifestyle and other factors),

  • There was still a 19% higher risk of diabetes for "definite" evening types compared to morning types.

Overall, the study highlights the intriguing connection between sleep preference and diabetes, with potential implications for managing diabetes risk through lifestyle interventions and understanding the role of circadian rhythms.

Conclusion: Implications for Future Research and Health Interventions

In conclusion, this study contributes significantly to our understanding of the complex interplay between chronotype, lifestyle behaviors, and diabetes risk. Future research endeavors should explore the effectiveness of lifestyle interventions and personalized shift scheduling in mitigating the adverse effects of evening chronotype on diabetes risk.

Reference Article

Sina Kianersi, DVM, PhD, Yue Liu, MD, Marta Guasch-Ferré, PhD, Susan Redline, MD, MPH, Eva Schernhammer, MD, DrPH, Qi Sun, MD, ScD, and Tianyi Huang, ScD, MSc. Chronotype, Unhealthy Lifestyle, and Diabetes Risk in Middle-Aged U.S. Women: A Prospective Cohort Study. Annals of Internal Medicine. 2023;176(10):748-758. doi:10.7326/M23-0728
https://www.acpjournals.org/doi/10.7326/M23-0728

Related

https://healthnewstrend.com/conquering-type-2-diabetes-with-exercise-a-guide-to-the-best-workouts

Medical Disclaimer

The information on this website is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.