Jin Dai

The favorable meal timing for glycemic control in individuals with diabetes remains unclear. The primary aim of this study was to evaluate the prospective association of meal timing with hemoglobin A1C (HbA1c) in individuals with diabetes. The secondary aim was to evaluate associations of meal timing with other cardiovascular disease (CVD) risk factors, including triglycerides, low-density and high-density lipoprotein cholesterol (LDL-C, HDL-C), and systolic and diastolic blood pressure (SBP, DBP). This cohort study included participants with diabetes at baseline (2008-2011) and attending visit 2 examination (2014-2017). Baseline dietary intakes were assessed using two 24-hour dietary recalls. Linear regression was performed to estimate prospective associations of energy intake (EI) and glycemic load (GL) at each meal timing with HbA1c and other CVD risk factors at visit 2. This study included 1,740 participants (mean age: 52.8 years; 59.2% female). Meal timings were associated with HbA1c and CVD risk factors, but in different directions and varied by sex and antidiabetic medication use. For HbA1c, there were generally inverse associations with morning meals, particular early-morning meal (6:00-8:59 AM) in males [EI: percent change, -2.86 (95% CI, -5.48 to -0.17)] and late-morning meal (9:00-11:59 AM) in individuals without antidiabetic medication use [EI: -2.83 (-5.49 to -0.09); GL: -3.31 (-6.46 to -0.05)]. For triglyceride, inverse associations were found for early-morning meals, whereas positive associations were found for afternoon meals (12:00-5:59 PM) in females and individuals without antidiabetic medication use. For LDL-C, positive associations were found for evening meals (6:00-11:59 PM) in individuals without antidiabetic medication use. There were overall positive associations of afternoon meal with SBP and DBP. A greater proportion of daily energy intake or glycemic load consumed during morning meals was associated with lower HbA1c levels and more favorable cardiovascular risk factor profiles in individuals with diabetes. Medication use and sex should be considered when discussing potential meal-timing recommendations.

Excessive gestational weight gain (GWG) is associated with adverse pregnancy outcomes. This metabolome-wide association study aimed to identify metabolomic markers for GWG. This longitudinal study included 39 Black and White pregnant women with a prepregnancy body mass index (BMI) of ≥ 25 kg/m². Untargeted metabolomic profiling was performed using fasting plasma samples collected at baseline (mean: 12.1 weeks) and 32 weeks of gestation. The associations of metabolites at each time point and changes between the two time points with GWG were examined by linear and least absolute shrinkage and selection operator (LASSO) regression analyses. Pearson correlations between the identified metabolites and cardiometabolic biomarkers were examined. Of the 769 annotated metabolites, 88 metabolites at 32 weeks were individually associated with GWG, with four (phosphatidylcholine (PC) 34:4, triacylglycerol (TAG) 52:6, arachidonic acid, isoleucine) jointly associated with GWG (area under the receiver operating characteristic curve (AUC) for excessive GWG: 0.80, 95% CI: 0.67, 0.93). No correlations were observed between the 88 metabolites and insulin, C-peptide, and high-sensitivity C-reactive protein at 32 weeks. Twelve metabolites at baseline (AUC for excessive GWG: 0.80, 95% CI: 0.62, 0.99) and three metabolite changes (AUC for excessive GWG: 0.73, 95% CI: 0.44, 1.00) were jointly associated with GWG. We identified novel metabolites in the first and third trimesters associated with GWG, which may shed light on the pathophysiology of GWG.