Qi Wang

Background/Objectives: Circadian misalignment, including mistimed sleep or eating, is associated with altered glucose metabolism. The importance of eating window timing for time-restricted eating (TRE) is increasingly recognized. This secondary analysis examined associations between meal to sleep timing intervals and glycemic parameters in individuals with obesity across three dietary interventions [TRE, CR: caloric restriction, and UE: unrestricted eating]. Methods: Participants aged 18–65 years with obesity were randomized to a 12-week intervention: TRE (8 h eating window), CR (15% reduction in daily caloric intake), or UE (usual eating habits). CGM and actigraphy were assessed over two weeks at baseline and end-intervention. Mixed effects models examined associations between continuous glucose monitoring (CGM) outcomes and two intervals: last meal to sleep onset (PM meal-Sleep) and awakening to first meal (Awake-AM meal). Results: Each hour increase in the Awake-AM meal interval was associated with lower overnight (1 AM–5 AM) average glucose, lower glycemic variability, lower %time > 180 mg/dL, and greater %time < 70 mg/dL. Each hour increase in the PM meal-Sleep interval was associated with lower overnight (1 AM–5 AM) average glucose. Both associations persisted after adjustment for baseline sleep duration, HbA1c, and randomization assignment. Conclusions: In individuals with obesity, morning (Awake-AM meal interval) and evening (PM meal-Sleep interval) fasting relative to sleep were differentially associated with glycemic control. These findings highlight the relevance of eating and sleep timing to glycemic parameters and may inform eating window selection for individuals practicing TRE.

Background: Little is known about the prevalence and experiences of intermittent caloric restriction (ICR) among individuals with Type 1 diabetes mellitus (T1DM), despite its growing popularity. Methods and Results: From September to October 2023, patients diagnosed with T1DM aged 18–89 in Minnesota were invited via the M Health Fairview′s electronic health record (EHR) to complete a 10‐min online survey. The survey gathered patient‐provided data on demographics, clinical data, and questions centered on weight and use of ICR. Out of 124 respondents, 39 reported participating in ICR and completed the survey. These participants, with a mean age of 42.8 years (SD = 12.0) and a mean BMI of 28.2 kg/m ² (SD = 5.5), included 22 females and 17 males. Among them, 34 reported practicing time‐restricted eating (TRE), whereas 5 reported practicing intermittent fasting (IF). TRE participants reported an average weight loss of 6.0 kg, whereas IF participants reported an average weight loss of 3.5 kg. Hypoglycemia was reported by five TRE participants and one IF participant, with no episodes of diabetic ketoacidosis (DKA) reported. Only six participants reported that their healthcare providers were aware of their fasting program. Conclusions: Individuals with T1DM do engage in ICR, mainly TRE, with rare hypoglycemia and no DKA. Further research is needed on long‐term ICR safety in T1DM patients.

Partially hydrolyzed guar gum (PHGG) is a water-soluble, prebiotic fiber that is used in foods and supplements. The effects of PHGG and its role in gut health are still being studied. The purpose of this study was to evaluate changes in the gut microbiome composition of healthy individuals in response to low-dose PHGG supplementation compared with a low fiber diet. A randomized, double-blind, placebo-controlled crossover study was performed on 33 healthy subjects (17 males, 16 females). Each subject completed three 14-day treatment periods with a 2-week washout between each period. Treatments included supplementation with 3 g PHGG, 6 g PHGG, or a placebo. During all periods, the participants followed a low fiber diet (≤14 g/day). Stools were collected on days 0 and 14 of each period. Gut microbiome profiling was performed using 16S rRNA sequencing. Stools were assessed by investigators with the Bristol Stool Form Scale as a secondary outcome. Saliva cortisol was also measured as a secondary outcome. Supplementation of 3 g and 6 g PHGG significantly increased Verrucomicrobia on day 14 when compared to the placebo (p = 0.0066 and p = 0.0068, respectively). On the genus level, Akkermansia was significantly increased on day 14 with both the 3 g and 6 g PHGG doses (p = 0.0081 and p = 0.0083). Faecalibacterium was significantly decreased on day 14 with 3 g PHGG (p = 0.0054). Supplementing with low doses of PHGG has the potential to cause shifts in the gut microbiome composition. By increasing beneficial microbes, PHGG can improve the microbiome composition of healthy individuals and may play a role in the treatment of inflammatory gastrointestinal diseases.

Background: Partially hydrolyzed guar gum (PHGG) is a water-soluble, prebiotic fiber that is used in foods and supplements. The effects of PHGG and its role in gut health are still being studied. The purpose of this study was to evaluate changes in the gut microbiome composition of healthy individuals in response to low-dose PHGG supplementation compared with a low fiber diet. Methods: A randomized, double-blind, placebo-controlled crossover study was performed on 33 healthy subjects (17 male, 16 female). Each subject completed three 14-day treatment periods with a 2-week washout between each period. Treatments included supplementation with 3 g PHGG, 6 g PHGG, or placebo. During all periods, the participants followed a low fiber diet (<14 g/day). Stools were collected on days 0 and 14 of each period. Gut microbiome profiling was performed using 16S rRNA sequencing. Results: Supplementation of 3 g and 6 g PHGG significantly increased Verrucomicrobia on day 14 when compared to the placebo (p=0.0066 and p= 0.0068, respectively). On the genus level, Akkermansia was significantly increased on day 14 with both the 3 g and 6 g PHGG doses (p=0.0081 and p=0.0083). Faecalibacterium was significantly decreased on day 14 with 3 g PHGG (p=0.0054). Conclusion: Supplementing with low doses of PHGG has the potential to cause shifts in gut microbiome composition. By increasing beneficial microbes, PHGG can improve the microbiome composition of healthy individuals and may play a role in the treatment of inflammatory gastrointestinal diseases.

This retrospective study utilized the National Electronic Injury Surveillance System (NEISS) database to identify pediatric emergency department (ED) patients with playground-associated craniofacial injuries between January 2012 and December 2021. A total of 25 414 patients were identified. The majority of injuries occurred in preschool and elementary school–age children (90.3%) and patients were more commonly boys (59.3%). Injuries most often involved the head/scalp (52.4%), face (30.4%), and mouth (11.9%). Infant (32.7%) and teen (40.0%) injuries most commonly involved swings, whereas preschool (23.1%) and elementary school (28.1%) injuries were mostly associated with slides and climbers, respectively. Most patients were treated in the ED and discharged to home (96.5%), a small portion required hospitalization (1.6%), and one death was reported. Although the majority of the injuries were relatively minor and resulted in same-day discharges, these injuries can result in serious physical harm, emotional stress, and unexpected financial burdens. Proper education and supervision regarding safe play is important to prevent these injuries.