Eating architecture in adults at increased risk of type 2 diabetes: associations with body fat and glycaemic control

Abstract

Eating architecture is a term that describes meal frequency, meal timing, and meal size and the daily variation in each of these. The aim of this study was to determine the relationship between components of eating architecture on body fat and markers of glycaemic control in healthy adults at increased risk of type 2 diabetes (T2DM). Participants (N=73, 39 males, age 58.8 [8.1] years, BMI 33.4 [4.4] kg/m²) recorded food intake and wore accelerometers and continuous glucose monitors (CGM) for 7-14 days under free-living conditions. Body fat and glycated haemoglobin (HbA1c) were also measured. The mean and day-to-day variation (calculated as the standard deviation during the monitoring period) of each component of eating architecture were calculated. Multivariable linear regression models were constructed for three separate outcome variables (body fat mass, mean CGM glucose, and HbA1c) for each component of eating architecture before and after adjustment for confounders. Higher variability in the time of first meal consumption was associated with increased body fat mass after adjusting for confounders (β=0.227, 95% CI: 0.019, 0.434, p=0.033). Increased variability in the time lag from waking to first meal consumption was also positively associated with increased HbA1c after adjustment (β=0.285, 95%CI: 0.040, 0.530, p=0.023). Low day-to-day variability in first meal consumption was associated with lower body fat and improved glucose control in adults at increased risk of T2DM. Routine consumption of meals may optimise temporal regulation to anticipate and respond appropriately to a glucose challenge.