Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Clinical Studies and Practice

Circadian timing and alignment in healthy adults: associations with BMI, body fat, caloric intake and physical activity

International Journal of Obesity volume 41, pages 203–209 (2017)Cite this article

Subjects

Abstract

Introduction:

Disruption of circadian rhythms is one of the proposed mechanisms linking late sleep timing to obesity risk but few studies have evaluated biological markers outside of the laboratory. The goal of this study was to determine the relationship between the timing and alignment of melatonin and sleep onset (phase angle) with body mass index (BMI), body fat and obesity-related behaviors. We hypothesized that circadian alignment (relationship of melatonin to sleep timing) rather than circadian (melatonin) timing would be associated with higher BMI, body fat, dietary intake and lower physical activity.

Subjects/Methods:

Adults with sleep duration ⩾6.5 h completed 7 days of wrist actigraphy, food diaries and SenseWear arm band monitoring. Circadian timing, measured by dim light melatonin onset was measured in the clinical research unit. Circadian alignment was calculated as the duration between dim light melatonin onset and average sleep onset time in the prior week (phase angle). Body fat was evaluated using dual-energy X-ray absorptiometry. Data were analyzed using bivariate correlations and multivariable regression analyses controlling for age, sex, sleep duration and evening light exposure.

Results:

Participants included 97 adults (61 F, age 26.8±7.3 years) with average sleep duration 443.7 (s.d.=50.4) minutes. Average phase angle was 2.2 h (s.d.=1.5). Circadian alignment was associated with circadian timing (P<0.001) and sleep duration (P=0.005). In multivariable analyses, later circadian timing was associated with lower BMI (P=0.04). Among males only, circadian alignment was associated with percent body fat (P=0.02) and higher android/gynoid fat ratio (P=0.04). Circadian alignment was associated with caloric intake (P=0.049) carbohydrate intake (P=0.04) and meal frequency (P=0.03) among both males and females.

Conclusion:

Circadian timing and alignment were not associated with increased BMI or body fat, among healthy adults with ⩾6.5 h of sleep, but circadian alignment was associated with dietary intake. There may be sex differences in the relationship between circadian alignment and body fat.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Arble DM, Ramsey KM, Bass J, Turek FW . Circadian disruption and metabolic disease: findings from animal models. Best Pract Res Clin Endocrinol Metab 2010; 24: 785–800.

    Article  CAS  Google Scholar 

  2. Wong PM, Hasler BP, Kamarck TW, Muldoon MF, Manuck SB . Social Jetlag, Chronotype, and Cardiometabolic Risk. J Clin Endocrinol Metab 2015; 100: 4612–4620.

    Article  CAS  Google Scholar 

  3. Merikanto I, Lahti T, Puolijoki H, Vanhala M, Peltonen M, Laatikainen T et al. Associations of chronotype and sleep with cardiovascular diseases and type 2 diabetes. Chronobiol Int 2013; 30: 470–477.

    Article  Google Scholar 

  4. Baron KG, Reid KJ, Kern AS, Zee PC . Role of sleep timing in caloric intake and BMI. Obesity 2011; 19: 1374–1381.

    Article  Google Scholar 

  5. Lucassen EA, Zhao X, Rother KI, Mattingly MS, Courville AB, de Jonge L et al. Evening chronotype is associated with changes in eating behavior, more sleep apnea, and increased stress hormones in short sleeping obese individuals. PLoS One 2013; 8: e56519.

    Article  CAS  Google Scholar 

  6. Arora T, Taheri S . Associations among late chronotype, body mass index and dietary behaviors in young adolescents. Int J Obes 2015; 39: 39–44.

    Article  CAS  Google Scholar 

  7. Sato-Mito N, Shibata S, Sasaki S, Sato K . Dietary intake is associated with human chronotype as assessed by both morningness-eveningness score and preferred midpoint of sleep in young Japanese women. Int J Food Sci Nutr 2011; 62: 525–532.

    Article  CAS  Google Scholar 

  8. Baron KG, Reid K . Circadian misalignment and heatlh. Int Rev Psychiatry 2014; 26: 139–154.

    Article  Google Scholar 

  9. Antunes LC, Levandovski R, Dantas G, Caumo W, Hidalgo MP . Obesity and shift work: chronobiological aspects. Nutr Res Rev 2010; 23: 155–168.

    Article  CAS  Google Scholar 

  10. Suwazono Y, Dochi M, Sakata K, Okubo Y, Oishi M, Tanaka K et al. A longitudinal study on the effect of shift work on weight gain in male Japanese workers. Obesity (Silver Spring) 2008; 16: 1887–1893.

    Article  Google Scholar 

  11. Ruger M, Scheer FA . Effects of circadian disruption on the cardiometabolic system. Rev Endocr Metab Disord 2009; 10: 245–260.

    Article  Google Scholar 

  12. Sack RL, Auckley D, Auger RR, Carskadon MA, Wright Jr KP, Vitiello MV et al. Circadian rhythm sleep disorders: part I, basic principles, shift work and jet lag disorders. An American Academy of Sleep Medicine review. Sleep 2007; 30: 1460–1483.

    Article  Google Scholar 

  13. Morris CJ, Yang JN, Garcia JI, Myers S, Bozzi I, Wang W et al. Endogenous circadian system and circadian misalignment impact glucose tolerance via separate mechanisms in humans. Proc Natl Acad Sci USA 2015; 112: E2225–E2234.

    Article  CAS  Google Scholar 

  14. Scheer FA, Hilton MF, Mantzoros CS, Shea SA . Adverse metabolic and cardiovascular consequences of circadian misalignment. Proc Natl Acad Sci USA 2009; 106: 4453–4458.

    Article  CAS  Google Scholar 

  15. Buxton OM, Cain SW, O'Connor SP, Porter JH, Duffy JF, Wang W et al. Adverse metabolic consequences in humans of prolonged sleep restriction combined with circadian disruption. Sci Transl Med 2012; 4: 129ra43.

    Article  Google Scholar 

  16. Gronfier C, Wright Jr KP, Kronauer RE, Czeisler CA . Entrainment of the human circadian pacemaker to longer-than-24-h days. Proc Natl Acad Sci USA 2007; 104: 9081–9086.

    Article  CAS  Google Scholar 

  17. Eckel RH, Depner CM, Perreault L, Markwald RR, Smith MR, McHill AW et al. Morning circadian misalignment during short sleep duration impacts insulin sensitivity. Curr Biol 2015; 25: 3004–3010.

    Article  CAS  Google Scholar 

  18. Benloucif S, Burgess HJ, Klerman EB, Lewy AJ, Middleton B, Murphy PJ et al. Measuring melatonin in humans. J Clin Sleep Med 2008; 4: 66–69.

    PubMed  PubMed Central  Google Scholar 

  19. Burgess HJ, Eastman CI . The dim light melatonin onset following fixed and free sleep schedules. J Sleep Res 2005; 14: 229–237.

    Article  Google Scholar 

  20. Burgess HJ, Savic N, Sletten T, Roach G, Gilbert SS, Dawson D . The relationship between the dim light melatonin onset and sleep on a regular schedule in young healthy adults. Behav Sleep Med 2003; 1: 102–114.

    Article  Google Scholar 

  21. Cain SW, Dennison CF, Zeitzer JM, Guzik AM, Khalsa SB, Santhi N et al. Sex differences in phase angle of entrainment and melatonin amplitude in humans. J Biol Rhythms 2010; 25: 288–296.

    Article  CAS  Google Scholar 

  22. Van Reen E, Sharkey KM, Roane BM, Barker D, Seifer R, Raffray T et al. Sex of college students moderates associations among bedtime, time in bed, and circadian phase angle. J Biol Rhythms 2013; 28: 425–431.

    Article  Google Scholar 

  23. Duffy JF, Dijk DJ, Klerman EB, Czeisler CA . Later endogenous circadian temperature nadir relative to an earlier wake time in older people. Am J Physiol 1998; 275: R1478–R1487.

    CAS  PubMed  Google Scholar 

  24. Duffy JF, Zeitzer JM, Rimmer DW, Klerman EB, Dijk DJ, Czeisler CA . Peak of circadian melatonin rhythm occurs later within the sleep of older subjects. Am J Physiol Endocrinol Metab 2002; 282: E297–E303.

    Article  CAS  Google Scholar 

  25. Baehr EK, Revelle W, Eastman CI . Individual differences in the phase and amplitude of the human circadian temperature rhythm: with an emphasis on morningness-eveningness. J Sleep Res 2000; 9: 117–127.

    Article  CAS  Google Scholar 

  26. Wright Jr KP, Gronfier C, Duffy JF, Czeisler CA . Intrinsic period and light intensity determine the phase relationship between melatonin and sleep in humans. J Biol Rhythms 2005; 20: 168–177.

    Article  Google Scholar 

  27. Wittmann M, Dinich J, Merrow M, Roenneberg T . Social jetlag: misalignment of biological and social time. Chronobiol Int 2006; 23: 497–509.

    Article  Google Scholar 

  28. Lewy AJ, Emens JS, Songer JB, Sims N, Laurie AL, Fiala SC et al. Winter depression: integrating mood, circadian rhythms, and the sleep/wake and light/dark cycles into a bio-psycho-social-environmental model. Sleep Med Clin 2009; 4: 285–299.

    Article  Google Scholar 

  29. Emens J, Lewy A, Kinzie JM, Arntz D, Rough J . Circadian misalignment in major depressive disorder. Psychiatry Res 2009; 168: 259–261.

    Article  Google Scholar 

  30. Hasler BP, Buysse DJ, Kupfer DJ, Germain A . Phase relationships between core body temperature, melatonin, and sleep are associated with depression severity: further evidence for circadian misalignment in non-seasonal depression. Psychiatry Res 2010; 178: 205–207.

    Article  CAS  Google Scholar 

  31. Roenneberg T, Allebrandt KV, Merrow M, Vetter C . Social jetlag and obesity. Curr Biol 2012; 22: 939–943.

    Article  CAS  Google Scholar 

  32. Radloff LS . The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measure 1977; 1: 385–401.

    Article  Google Scholar 

  33. Ng SS, Chan TO, To KW, Ngai J, Tung A, Ko FW et al. Validation of a portable recording device (ApneaLink) for identifying patients with suspected obstructive sleep apnoea syndrome. Intern Med J 2009; 39: 757–762.

    Article  CAS  Google Scholar 

  34. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193–213.

    Article  CAS  Google Scholar 

  35. Voultsios A, Kennaway DJ, Dawson D . Salivary melatonin as a circadian phase marker: validation and comparison to plasma melatonin. J Biol Rhythms 1997; 12: 457–466.

    Article  CAS  Google Scholar 

  36. Johannsen DL, Calabro MA, Stewart J, Franke W, Rood JC, Welk GJ . Accuracy of armband monitors for measuring daily energy expenditure in healthy adults. Med Sci Sports Exerc 2010; 42: 2134–2140.

    Article  Google Scholar 

  37. Fruin ML, Rankin JW . Validity of a multi-sensor armband in estimating rest and exercise energy expenditure. Med Sci Sports Exerc 2004; 36: 1063–1069.

    Article  Google Scholar 

  38. Drenowatz C, Eisenmann JC . Validation of the SenseWear Armband at high intensity exercise. Eur J Appl Physiol 2011; 111: 883–887.

    Article  Google Scholar 

  39. Li C, Ford ES, Zhao G, Balluz LS, Giles WH . Estimates of body composition with dual-energy X-ray absorptiometry in adults. Am J Clin Nutr 2009; 90: 1457–1465.

    Article  CAS  Google Scholar 

  40. Kanaley JA, Heden TD, Liu Y, Fairchild TJ . Alteration of postprandial glucose and insulin concentrations with meal frequency and composition. Br J Nutr 2014; 112: 1484–1493.

    Article  CAS  Google Scholar 

  41. Heden TD, Liu Y, Sims LJ, Whaley-Connell AT, Chockalingam A, Dellsperger KC et al. Meal frequency differentially alters postprandial triacylglycerol and insulin concentrations in obese women. Obesity (Silver Spring) 2013; 21: 123–129.

    Article  CAS  Google Scholar 

  42. Mills JP, Perry CD, Reicks M . Eating frequency is associated with energy intake but not obesity in midlife women. Obesity (Silver Spring) 2011; 19: 552–559.

    Article  Google Scholar 

  43. Reid KJ, Baron KG, Zee PC . Meal timing influences daily caloric intake in healthy adults. Nutr Res 2014; 34: 930–935.

    Article  CAS  Google Scholar 

  44. McHill AW, Melanson EL, Higgins J, Connick E, Moehlman TM, Stothard ER et al. Impact of circadian misalignment on energy metabolism during simulated nightshift work. Proc Natl Acad Sci USA 2014; 111: 17302–17307.

    Article  CAS  Google Scholar 

  45. Carskadon MA, Acebo C, Jenni OG . Regulation of adolescent sleep: implications for behavior. Ann N Y Acad Sci 2004; 1021: 276–291.

    Article  Google Scholar 

  46. Boivin DB, Czeisler CA, Dijk DJ, Duffy JF, Folkard S, Minors DS et al. Complex interaction of the sleep-wake cycle and circadian phase modulates mood in healthy subjects. Arch Gen Psychiatry 1997; 54: 145–152.

    Article  CAS  Google Scholar 

  47. Borbely AA . A two process model of sleep regulation. Hum Neurobiol 1982; 1: 195–204.

    CAS  PubMed  Google Scholar 

  48. Baker FC, Driver HS . Circadian rhythms, sleep, and the menstrual cycle. Sleep Med 2007; 8: 613–622.

    Article  Google Scholar 

  49. Heo M, Faith MS, Pietrobelli A, Heymsfield SB . Percentage of body fat cutoffs by sex, age, and race-ethnicity in the US adult population from NHANES 1999–2004. Am J Clin Nutr 2012; 95: 594–602.

    Article  CAS  Google Scholar 

  50. Benloucif S, Guico MJ, Reid KJ, Wolfe LF, L'Hermite-Baleriaux M, Zee PC . Stability of melatonin and temperature as circadian phase markers and their relation to sleep times in humans. J Biol Rhythms 2005; 20: 178–188.

    Article  CAS  Google Scholar 

  51. Wyatt JK, Stepanski EJ, Kirkby J . Circadian phase in delayed sleep phase syndrome: predictors and temporal stability across multiple assessments. Sleep 2006; 29: 1075–1080.

    Article  Google Scholar 

  52. Sletten TL, Vincenzi S, Redman JR, Lockley SW, Rajaratnam SM . Timing of sleep and its relationship with the endogenous melatonin rhythm. Front Neurol 2010; 1: 137.

    Article  CAS  Google Scholar 

  53. Fonken LK, Nelson RJ . The effects of light at night on circadian clocks and metabolism. Endocr Rev 2014; 35: 648–670.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Leland Bardsley, Leah Hecht, David Clough and Lori Koch for their assistance with data collection and analyses. Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR000150 and by the National Institute of Health’s Heart Lung Blood and Sleep Institute Grant Number 1K23HL109110-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Support: grants 1K23HL109110-01, UL1TR000150.

Author information

Authors and Affiliations

  1. Department of Behavioral Sciences, Section of Sleep Disorders and Sleep Research, Rush University Medical Center, Chicago, IL, USA,

    K G Baron

  2. Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,

    K J Reid, T Kim, H Attarian, L Wolfe, G Santostasi & P C Zee

  3. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,

    L Van Horn & J Siddique

Authors
  1. K G Baron
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K J Reid
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L Van Horn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H Attarian
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L Wolfe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J Siddique
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G Santostasi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. P C Zee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K G Baron.

Ethics declarations

Competing interests

Dr Zee reports she is a consultant for Merck, Philips, Research grants to Northwestern University from Jazz Pharmaceuticals and stock ownership in Teva Pharmaceuticals. The remaining authors declare no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baron, K., Reid, K., Kim, T. et al. Circadian timing and alignment in healthy adults: associations with BMI, body fat, caloric intake and physical activity. Int J Obes 41, 203–209 (2017). https://doi.org/10.1038/ijo.2016.194

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2016.194

This article is cited by

Search

Advanced search

Quick links