The big breakfast study: chrono-nutrition influence on energy expenditure and body weight

Lead Research Organisation: University of Aberdeen
Department Name: Sch of Medicine, Medical Sci & Nutrition

Abstract

During the past three decades, the prevalence of obesity has increased worldwide to epidemic proportions and is considered to be a major health problem because of its association with non-communicable diseases, such as cardiovascular disease, stroke and some cancers. Approaches to manage overweight and obesity are likely to be focused around diet and lifestyle solutions to achieve negative energy balance for weight loss, as clinical pharmaceutical and surgical approaches are targeted for morbid obesity. Current dietary advice for weight management is broadly based on the assumption that a 'calorie is a calorie' and it does not matter when these calories are consumed throughout the day. Recent evidence has challenged this assumption, suggesting that we may utilize or expend calories consumed in the morning more efficiently than in the evening, which is a beneficial strategy for weight control. This would mean in practical terms that you would consume more calories at breakfast time as the main meal of the day, and less during the evening meal. In the UK, the main meal of the day is most often in the evening, which pre-disposes to weight gain. These studies suggest that calories are not metabolized equally at all times during the day, and that the process of digestion, absorption and utilization are influenced by the time of day. Studies have not rigorously investigated how time of eating of the main meal of the day influences energy balance. It may be that eating a larger meal at breakfast time leads to being more physically active, or indeed, a larger meal at the evening leads to inactivity. Or, that the natural biological rhythms in the human body are more responsive to calorie ingestion in the morning. After eating, there is an increase in energy expenditure, this is termed, 'thermic effect of food' (TEF). We will explore the mechanisms and time-course of adaption for enhanced morning (breakfast) TEF response as a means to dissipate extra calories, driven by the natural circadian variation in the human (related to light-dark cycle), which can be maximized in the morning for increased energy utilization. An enhanced morning TEF after breakfast could contribute to increased 24-h energy expenditure and, if food intake remained stable, weight loss would thus ensue over time. Numerous authors have studied 24hr energy expenditure particularly in the context of lean-obese differences, but few have considered circadian rhythms and none have studied the interaction with gastric emptying in overweight/obese subjects.

Our hypothesis is that timing of eating influences energy balance and body weight, because morning energy expenditure is amplified in comparison to evening. The cause of the increased energy expenditure in the morning is unclear, whether this is linked to natural biological circadian rhythm or behavioral adaption. This hypothesis will be addressed through conduct of two controlled dietary intervention studies that will examine,

(i) the impact of the time of the main meal of the day (breakfast Vs evening) on metabolic and behavioral regulation during weight loss to establish the biological mechanisms that drive elevated energy expenditure when eating in the morning, in overweight men and women

(ii) whether time of meal consumption effects on energy balance are modulated though the normal biological circadian rhythm

The proposed work aims to show that our current meal consumption pattern in the UK, of having a small breakfast and large evening meal is working against our internal biological clock and this exacerbates the difficulties in successful weight management. From a public health perspective, this chrono-nutrition study offers an opportunity to provide evidence-based data for translational studies on when to eat to promote weight loss. These studies can potentially support the public health message of the importance of a breakfast meal and offers an alternative strategy to promote body weight control.

Technical Summary

Energy balance may be influenced by timing of eating, such that weight loss is greater when consuming a relatively larger morning meal than a comparable evening meal. The mechanisms for this are not understood, but likely to be linked to either behavioral adaption in physical activity in response to time of eating, or, driven by biological circadian rhythms. After eating, a cascade of metabolites and hormones are released, which can influence energy expenditure through thermic effect of food. Neuronal and hormonal systems that are likely involved in driving the circadian rhythm in energy expenditure or TEF are the endocrine hormones (insulin) and metabolites (glucose); with diurnal variation also reported in a gastric emptying. Our hypothesis is that timing of eating influences energy balance, because morning energy expenditure is amplified in comparison to evening. The cause of the increased energy expenditure in the morning is unclear, whether this is linked to natural biological circadian rhythm in response to eating or behavioral adaption. Key objectives will be addressed through a research study program that involves two key experiments in overweight/obese subjects, to explore potential behavioral and circadian influences on energy expenditure and energy balance. Our first diet trial will examine the impact of calorie distribution as morning and evening eating on metabolic and behavioral regulation during weight loss. Finally, we will test whether meal consumption effects on energy balance are modulated though the normal circadian rhythms, by applying a phase delay protocol in a controlled environment. Together, these studies will elucidate how energy balance can be modulated by timing of eating.

Planned Impact

The research team have a very strong track record to deliver impact, drawing on existing strengths. This project will provide impact in many key areas identified by the MRC;

Knowledge and knowledge economy. The Food industry will be a main beneficiary from the evidence-basis on the role of breakfast eating on energy balance. Key food ingredient and retail sectors related to breakfast eating can translate these data with immediate effect to influence health and wellbeing with a simple behavioral approach, also creating innovation and wealth creation for these sectors. The Pharmaceutical industry could benefit for innovation and wealth creation by using the data generated to investigate novel approaches for weight management, based on modulation of gastric emptying influencing thermic effect of feeding and energy balance. Additionally, circadian dysregulation in shift workers has a detrimental impact on health and workforce productivity. Our study will provide novel knowledge that has the potential to improve worker performance and therefore produce great economic benefit applied in the Occupation Health arena.

Training and delivering highly skilled people. A postdoctoral researcher will be linked to this application and will spend time in Aberdeen and Surrey labs. The individual will greatly expand their theoretical understanding of dietary approaches influencing energy balance and circadian biology and also learn new practical skills. They will be a highly trained and experienced researcher at the end of the project.

Policy development. The impact of this work will be to provide clear evidence to policy makers that weight management initiatives and policies must take account of the importance of time of day, work patterns (shift work) and lifestyle in tackling the obesity problem. There can be societal gains from the project in the development of new dietary based strategies to manage body weight. These would enhance quality of life, health and wellbeing in the UK population. PJM's role with policy advisors allows opportunity for key messages to be explored with influential stakeholders.

Public engagement, public health and societal issues. It is anticipated that the current application will be of great interest to the media and public, so providing excellent opportunity for public engagement. All of the applicants already have experience of public engagement, ranging from newspaper interviews to television appearances, and are willing to continue this work. As well as providing an interesting scientific story, the research also relates to public health and contemporary societal issues, including nutrition and energy balance. This area of research is of interest to the media and excellent opportunities exist to highlight the research findings.

International development. As many of the issues mentioned above (e.g. energy balance, shift work and scientific advancement) are relevant internationally, the research should have wide-reaching impact both within and outside the UK.

Publications

10 25 50
 
Description Royal Society of Medicine
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact In recent years, there has been considerable public, media and commercial interest in the potential benefits of various forms of intermittent fasting. These include time-restricted eating, '5:2' diet or alternate-day fasting-mimicking regimes. There appears to be significant hype in the media concerning the health and weight-loss benefits of such regimes, but does the evidence support such hype? Are some regimes clearly more effective and beneficial than others? Could there be negative consequences to these approaches to intermittent fasting? To address these important questions, this webinar brings together diverse experts including dieticians, nutritionists, sports physiologists, psychologists, neuroscientists and physicians to present and discuss recent scientific evidence on intermittent fasting. During this session, participants will be able to: Know the extent to which evidence supports intermittent fasting as an alternative to continuous caloric restriction for weight loss and other health benefits Understand how different forms of intermittent fasting such as time-restricted eating or alternate day differ in their effects and outcomes Be aware of the evidence for metabolic changes, including interactions with exercise, and impacts on appetite, that may occur when undertaking intermittent fasting Understand who may be more likely to adhere to intermittent fasting regimes Be aware of any potential negative consequences of forms of intermittent fasting
URL https://www.rsm.ac.uk/events/food-health/2021-22/fhq51/
 
Description Aberdeen Science Centre workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact The research team organised a workshop for general public at science day activity at Aberdeen Science Centre.
Year(s) Of Engagement Activity 2017
 
Description BBC Food web article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Response to a media request for expert opinion on meal timing
Year(s) Of Engagement Activity 2022
URL https://www.bbc.co.uk/food/articles/eating_times
 
Description BBC Radio Surrey interview 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact REsponse to a media request to do a live radio interview about meal timing
Year(s) Of Engagement Activity 2021
 
Description BBC online article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Online news article By James Gallagher, Health and science correspondent, to highlight study findings
Year(s) Of Engagement Activity 2022
URL https://www.bbc.co.uk/food/articles/eating_times
 
Description BBC online article, Have we got our meal times all wrong? 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Online article with BBC which quotes the MRC funded project and Alexandra Johnstone and Jonathan Johnston as experts.
Year(s) Of Engagement Activity 2022
URL https://www.bbc.co.uk/food/articles/eating_times
 
Description BDA webinar 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact A live webinar for the British Dietetics Association (BDA) to cover aspects of chrono-nutrition and timed eating. There were questions afterwards and the BDA organisers were very happy with the response of their members.
Year(s) Of Engagement Activity 2022
URL https://www.bda.uk.com/events/webinars.html
 
Description BeWell Faryre - Public Engagement Event at University of Aberdeen (AJ) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Running stall and providing information on health and wellbeing
Year(s) Of Engagement Activity 2020
 
Description Blog published on MRC webpage about meal timing and the big breakfast study. 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact A blog was published on the MRC website in relation to Meal Timing and linking to the Big Breakfast Study. This was in response to the recently published article in Nutrition Bulletin about the study.
Year(s) Of Engagement Activity 2018
URL https://www.insight.mrc.ac.uk/2018/06/19/do-meal-timings-matter/
 
Description Deeside Food Festival 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact A one day festival to bring people together to celebrate local food and the theme was focussed around 'Health. The research team was there to promote the new research grant as part of one of the stalls, to meet general public. Also, one team member gave public presentations throughout the afternoon with a local chef to discuss the role of timing of eating and food choice on energy balance.
Year(s) Of Engagement Activity 2017
URL https://www.deesidefoodfestival.co.uk
 
Description Deeside Food Festival, Public Engagement Event (AJ) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Prof. A Johnstone engaged in a discussion about food and nutrition with chef (Craig Wilson (kilted Chef) on stage at a regional food festival.
Year(s) Of Engagement Activity 2019
 
Description Diet and Health Public Lecture Event at AKR Gym (A.Johnstone) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Prof Alex Johnstone gave a public lecture to members of the gym and other general public on diets and health.
Year(s) Of Engagement Activity 2019
 
Description Engagement public lecture at Aberdeen Mayfest (LRC) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Dr. Leonie Ruddick-Collins gave a one hour interactive talk at the Aberdeen Mayfest event. The talk discussed energy balance and what factors can change energy expenditure.
Year(s) Of Engagement Activity 2019
 
Description Filming for TV program: The Secret Lives of Slim People 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact This was filmed as part of a series entitled The Secret Lives of Slim People series which broadcast on Channel 4 on Monday 11th February 2019. The purpose was to what is chrononutrition and how meal timing could impact on energy balance and body weight.
Year(s) Of Engagement Activity 2019
URL https://www.channel4.com/programmes/the-secret-lives-of-slim-people/episode-guide/
 
Description Health day event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact The research team supported a health day at a local private sector company.
Year(s) Of Engagement Activity 2018
 
Description Internal staff talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Staff talk from Prof Alex Johnstone to highlight recent grant awards, including the MRC-funded time of eating study.
Year(s) Of Engagement Activity 2017
 
Description Interview for science focus magazine (LRC) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact LRC answered questions for an article in Cience Focus magazine regarding the importance of breakfast.
Year(s) Of Engagement Activity 2019
URL https://www.sciencefocus.com/the-human-body/a-scientists-guide-to-life-how-to-eat-a-good-breakfast/
 
Description Invited Lecture to International Federation for the Surgery of Obesity Integrated Health Webinar 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact AJ Invited Online Lecture to International Federation for the Surgery of Obesity Integrated Health Webinar, Sleep, Chrono-Nutriton and Obesity , 500 clinical attendees, 14th Jan 2021 with discussion
Year(s) Of Engagement Activity 2021
 
Description Invited lecture for Association for Nutrition (UK) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact AJ Talk to Scottish section for Association for Nutrition
Year(s) Of Engagement Activity 2020,2021
 
Description Invited speaker for Osteoperosis Group 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Invited speaker Prof Alex Johnstone to talk about Fat Matters at the Rowett Institute to highlight current research to local Osteoporosis Patient Group. Informal discussions.
Year(s) Of Engagement Activity 2018
 
Description New Scientist article 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Invited interview to discuss study findings with New Scientist
Year(s) Of Engagement Activity 2022
URL https://www.newscientist.com/article/2337329-altering-when-you-consume-your-calories-doesnt-change-w...
 
Description News article quoting Dr J. Johnston and A. Johnstone and reference to the MRC studies. News Article title: Are we eating at the wrong time for our body clocks? 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Dr J. Johnston and A. Johnstone were interviewed by BBC news to publish an article about timing of eating and body clocks. The article quotes J. Johnston and A. Johnstone about the current work in the field and the need for further research. The article highlights that work is currently being undertaken by our research team to address how meal timing may impact weight loss and health and address the underlying factors which may contribute to different health and weight outcomes.
Year(s) Of Engagement Activity 2018
URL http://www.bbc.co.uk/news/health-44174043
 
Description Online blog with The Conversation 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Online blog about the study results
Year(s) Of Engagement Activity 2022
URL https://theconversation.com/weight-loss-the-time-of-day-you-eat-your-biggest-meal-has-little-effect-...
 
Description Organised an online conference for Association for the Study of Obesity on Meal Timing 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact An international expert panel will present their latest research around the influence of time-restricted food intake on weight loss and metabolic health. In addition to comparing time restriction with calorie restriction for weight loss, in this webinar evidence will be presented on synchronising eating patterns with the biological clock, the safety of time-restricted feeding and how meal timing impacts on physical activity and energy expenditure. Scientific research will be put into perspective by our representative for people living with obesity who will present a patient perspective on the challenges and opportunities to change meal timing.
Speakers and Panellists

Dr Abd Tahrani (University of Birmingham)
Dr Anne Martin (University of Glasgow)
Dr Emma Baldry (Senior Clinical Research Dietitian)
Prof. Krista Varady (Department of Kinesiology and Nutrition, University of Illinois Chicago)
Prof. Alex Johnstone (The Rowett Institute, University of Aberdeen)
Dr Leonie Ruddick Collins (The Rowett Institute, University of Aberdeen)
Prof. James Betts (University of Bath)
Andrew Healing
This webinar has been accredited with 0.5 SCOPE Points, which count towards SCOPE Certification. SCOPE Certification is conferred by the World Obesity Federation and is the internationally recognised standard of excellence in obesity management. SCOPE Certification is awarded to health professionals with obesity management experience who have earned 12 SCOPE points
Year(s) Of Engagement Activity 2021
URL https://www.aso.org.uk/events/does-meal-timing-influence-weight-loss-or-metabolic-health-aso-webinar...
 
Description Pint of Science Public Engagement Lecture (AJ) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Public event to engage the general public in matters of nutrition, health and weight loss in a friendly setting. Prof A. Johnstone provided a talk 'Fat matters - myths and reality of obesity and weight loss'
Year(s) Of Engagement Activity 2019
URL https://pintofscience.co.uk/event/debunking-myths-in-nutrition
 
Description Presentation at Aberdeen's Tech fest Sept 2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Presentation at Tech fest: Breakfast like a King, Dine like a Pauper: Debunking common breakfast myths
The presentation discussed the importance of breakfast, common fallacies and the current research about how meal timing may effect health and metabolism.
Year(s) Of Engagement Activity 2018
URL https://www.aberdeenperformingarts.com/whats-on/all-shows/techfest-breakfast-like-a-king-dine-like-a...
 
Description Presentation at knowledge exchange event, 'Hungry Histories' organised by University of Aberdeen 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Prof Alex Johnstone presented a talk on From stone age to obese age and highlighted this new research to look at time of eating. This event was run by the University of Aberdeen's Public Engagement with Research Unit where Hungry Histories is a project to explore archaeology, food and diet in historic Aberdeen, funded by the Heritage Lottery Fund.
Year(s) Of Engagement Activity 2017
URL https://www.facebook.com/hungryhistories
 
Description Presentation by Alex Johnstone for Cafe Scientific. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Alex Johnstone gave a talk entitled: You are when you eat: How time of eating influences body weight. This was for a local cafe scientific event in Spet 2018. 150 people from the general public attended.
Year(s) Of Engagement Activity 2018
 
Description Press Release detailing research initiation 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Press release to local and national radio and newspapers (July 2017) which led to radio interviews and newspaper press coverage.
Year(s) Of Engagement Activity 2017
URL https://www.abdn.ac.uk/news/10993/
 
Description Public Engagement Lecture at Health and Wellbeing Festival at Robert Gordon University (AJ) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Prof Alex Johnstone provided a public engagement lecture at the Health and Wellbeing Festival at Robert Gordon University. The talk addressed current research on diet.
Year(s) Of Engagement Activity 2020
 
Description Public Engagement Lecture to local Women's Group (AJ) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Prof A. Johnstone gave a public Lecture to a local women's Group 'Deen Divas' about current research on diet.
Year(s) Of Engagement Activity 2020
 
Description Radio interview 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Radio interview
Year(s) Of Engagement Activity 2022
URL https://www.thenakedscientists.com/articles/interviews/do-large-breakfasts-really-help-weight-loss
 
Description Sigma Nutrition podcast interview with Danny Lennon (AJ) 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact A.Johnstone undertook an interview of a nutrition podcast regarding how protein intake and distribution may impact on appetite and other questions related to making healthy choices and methods to implement changes in dietary intake in the population.
Year(s) Of Engagement Activity 2019
URL https://sigmanutrition.com/podcasts/
 
Description Techfest Science festival - organised a knowledge exchange event called Science Bites 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact A drop in session - find out about how the Rowett research influences the food we eat and a chance to taste some of these foods. Also a unique opportunity to speak with Nutrition Scientists in the Human Nutrition Unit. The research team organised a tour of the building and highlighted the research and some of the foods produced in the human nutrition unit.
Year(s) Of Engagement Activity 2017
URL https://www.abdn.ac.uk/news/11109/
 
Description Wellness Public Engagement Lecture at University of Aberdeen (AJ) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Prof Alex Johnstone provided a lecture 'Diet matters' to University of Aberdeen Alumni.
Year(s) Of Engagement Activity 2019
 
Description You and your hormones podcast 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Response to a request to provide expert opinion on the subject of meal timing in a highly regarded professional podcast series
Year(s) Of Engagement Activity 2021
URL https://www.yourhormones.info/resources/digital-library/podcasts/does-when-i-eat-affect-my-weight/