CHRONONUTRITION AND CIRCADIAN RHYTHMICITY: EXPLORING THE TEMPORAL DYNAMICS OF NUTRIENT INTAKE IN THE REGULATION OF GLUCOSE HOMEOSTASIS AND THE THERAPEUTIC MANAGEMENT OF TYPE 2 DIABETES MELLITUS

Abstract

Circadian rhythms are 24-hour cycles, which are controlled by internal molecular oscillators collectively known as the circadian clock. Nutritional factors on circadian rhythmicity are associated with a correlation of the timing of eating the food and the food content, which is referred to as chrononutrition. These aspects are regulated by personal chronotype attributes, in that evening or late chronotype individuals have a biological tendency to eat late in the day. Empirical evidence reveals that the effect of the time of day on the postprandial (PP) glucose response is enormous, and thus the time of day has a significant influence on the pathophysiology of type 2 diabetes (T2D). Both cross-sectional and experimental studies have shown that eating in the morning and not in the evening is beneficial in terms of PP glycaemia. The addition of protein and fat in the macronutrient content of night meals has been an easy approach to mitigate PP glycaemic excursion. Foods with low glycaemic index taken in the morning has been found to give a better response in terms of glycaemic response compared to those taken at night. The combination of fats and proteins with carbohydrate sources like bread and rice has also been demonstrated to lower glycaemic response. Moreover, the order of food service has a significant potential in lowering the PP blood glucose, as vegetables should be eaten at the start, then meat, and finally rice. These empirical suggestions can thus be considered measures to improve glycaemic control as opposed to merely measuring the nutritional content of individual meals, and they may play a role in the optimisation of dietary patterns in patients with diabetes. More clarification of this intriguing field of study is necessary to gain more knowledge about the circadian system and its nutritional implications that can eventually reduce the burden of T2D.