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Circadian rhythms and meal timing: impact on energy
balance and body weight
Hedda L Boege1, Mehreen Z Bhatti1 and Marie-Pierre St-Onge1,2
Available online at www.sciencedirect.com
ScienceDirect
Energy metabolism and appetite regulating hormones follow
circadian rhythms which, when disrupted, could lead to
adverse metabolic consequences. Such circadian
misalignment, a mismatch between endogenous circadian
rhythms and behavior, is most severely experienced by shift
workers, due to nighttime wake, daytime sleep, and eating at
night. However, circadian misalignment is not restricted to shift
workers; milder shifts in sleep and mealtimes, termed social
and eating jetlag, are highly prevalent in the general population.
Social and eating jetlag result in later mealtimes, which may
promote positive energy balance and weight gain. Earlier meal
timing, specific to individual endogenous circadian patterns,
could serve to reduce cardiometabolic disease burden and aid
in weight loss and interventions should be done to test this.
Addresses
1 Sleep Center of Excellence and Division of General Medicine, Depart-
ment of Medicine, Columbia University Irving Medical Center, New York,
NY, USA
2 Institute of Human Nutrition, Columbia University Irving Medical Center,
New York, NY, USA
Corresponding author:
St-Onge, Marie-Pierre (ms2554@cumc.columbia.edu)
Current Opinion in Biotechnology 2021, 70:xx–yy
This review comes from a themed issue on Food biotechnology
Edited by Anna E Thalacker-Mercer and Martha Field
https://doi.org/10.1016/j.copbio.2020.08.009
0958-1669/ã 2020 Elsevier Ltd. All rights reserved.
Introduction
Circadian rhythms are cyclic endogenous biological pat-
terns following an �24-hour cycle that regulate the timing
of physiology, metabolism, and behavior. They initiate
wake and sleep episodes at the appropriate biological
time as well as signal feeding and fasting. When behaviors
such as eating and sleeping fail to align with circadian
cues, misalignment can occur, compromising the integrity
of robust endogenous circadian rhythms [1]. Repeated
disruption through mismatched timing of eating and
sleeping has been shown to increase the risk of obesity,
type 2 diabetes and cardiovascular disease [1,2�]. Corre-
spondingly, shift workers, who experience chronic
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circadian misalignment due to complete reversal of feed-
ing-fasting and wake-sleep behavioral cycles, provide the
strongest evidence for these effects [3]. Milder desyn-
chronizing behavioral patterns, such as variability in sleep
and meal times throughout the week, are highly prevalent
in modern society and have been coined social [4] and
eating [5��] jetlag (differences in the midpoint of the
sleep or feeding episode on free days versus work days)
(Figure 1). The timing of food intake, particularly, has
come to the forefront of research efforts with studies
showing that consumption of food later in the day and
closer to bedtime is associated with higher weight status
[6,7].
While still in early stages, findings from this field of study
have broad applicability. The demands of modern life
result in many non-shift workers delaying morning meals,
adopting irregular eating patterns and extending eating
into the night [8–10]. Adjustment of meal timing in
accordance with individual endogenous circadian
rhythms could serve to reduce cardiometabolic disease
burden. Here we present evidence on the effect of meal
timing, as a disruptor of circadian rhythms, on energy
balance (energy intake and energy expenditure) and body
weight. Research to date has focused on leptin and
ghrelin as regulators of food intake, and resting energy
expenditure, all of which are known to exhibit circadian
rhythmicity [11–13].
Entrainment of circadian clocks and circadian
alignment
The endogenous circadian system is primarily controlled
by an autonomous master clock in the suprachiasmatic
nucleus (SCN) of the hypothalamus, which is synchro-
nized by ambient light and entrains secondary clocks in
the brain and most peripheral tissues of the body [2�].
Importantly, secondary clocks are also entrained by envi-
ronmental cues and behaviors, termed ‘zeitgebers,’ such
as eating and sleeping [1,2�]. When environmental and
behavioral factors are repeatedly misaligned from the
SCN-driven endogenous circadian cycle, such as when
food intake occurs during the night, integration of mis-
timed signals can disrupt the tightly controlled peripheral
system, resulting in a loss of homeostasis (circadian mis-
alignment) [2�]. Meanwhile, in conditions of circadian
alignment, behavioral cues feed into peripheral circadian
systems at the appropriate phase, facilitating the smooth
cycling of physiological processes (Figure 1). The circa-
dian rhythms of appetite regulating hormones, energy
expenditure and substrate utilization prepare the body for
Current Opinion in Biotechnology 2021, 70:1–6
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https://doi.org/10.1016/j.copbio.2020.08.009
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2 Food biotechnology
Figure 1
Current Opinion in Biotechnology
(a) (b)
An overview of how mistimed sleeping and eating result in circadian misalignment and the metabolic consequences.
(a) The circadian system promotes wakefulness/feeding during the biological day and sleep/fasting during the biological night.
(b) Several behavioral patterns do not fit these endogenous preferences. Shift work: Awake/feeding at night and sleeping/fasting during the day,
causing severe circadian misalignment. Social Jetlag: A shift in the midpoint of sleep on workdays versus free days, causing mild circadian
misalignment. Eating jetlag: A shift in the midpoint of the feeding episode on workdays versus free days, causing mild circadian misalignment.
These behavioral patterns result in a mismatch between the timing of eating/sleeping and the endogenous circadian system (indicated in
magenta). Circadian misalignment is thought to disrupt energy balance, resulting in increased body weight and cardiometabolic risk.
specific biological responses at different times of day to
maintain energy balance. For example, ghrelin levels are
higher in the biological evening than the morning [12],
promoting greater evening hunger. In contrast, diet
induced thermogenesis (DIT), the rise in energy expen-
diture after a meal, is higher after a morning meal than
after an isocaloric evening meal [14,15], indicating more
calories burned after a morning meal. Respiratory quo-
tient (RQ), an index of macronutrient utilization, is high-
est in the biological morning, indicative of greater carbo-
hydrate oxidation, and lowest during the biological
evening, indicating greater lipid oxidation [11,16]. These
rhythms have implications for health and mismatched
behaviors in relation to these endogenous processes can
result in adverse health effects.
Severe circadian desynchronization
Studies in mice have shown that food intake during the
biological night, akin to night shift work in humans,
causes a 12-hour shift in peripheral clock, but not central
clock, activity [17]. Such mistimed feeding results in
higher body weight [18] and increased risk of metabolic
Current Opinion in Biotechnology 2021, 70:1–6 
syndrome and diabetes [17] relative to control mice fed
during the biological day.
Studies in humans have similarly shown phase shifts in
peripheral clock activity in response to inappropriate
timing of sleep and food intake, while the phase of the
SCN master clock remains unaffected [3,19]. Chronic
shift work has been associated with metabolic disruption
and positive energy balance, resulting in increased risk of
obesity, type 2 diabetes, heart disease and metabolic
syndrome [20]. The largest body of evidence for the
impact of circadian misalignment on human health stems
from clinical interventions approximating theconditions
of shift work in healthy, non-shift working volunteers.
Acute circadian misalignment is induced via simulated
night shift or forced desynchrony protocols, in which
either active and rest phases are reversed, or the day is
artificially shortened/extended. This effectively shifts the
behavioral patterns of sleep and eating out of phase with
the endogenous rhythm of the SCN master clock, sub-
stantially altering the input received by peripheral clocks
that regulate metabolism [3].
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Circadian rhythms, meal timing, and body weight 3
One proposed contributor to the increased risk of obesity
observed in shift workers is higher energy intake due to
altered levels of hunger and satiety hormones ghrelin and
leptin in response to circadian misalignment. Multiple
simulated shiftwork studies observed decreased leptin
levels [21–24,25��] and increased ghrelin levels
[12,21,25��,26] in circadian misalignment relative to cir-
cadian alignment conditions. According to a recent study
[25��], these effects may be sex-dependent. Indeed, night
shift work (circadian misalignment) induced a 7%
decrease in 24-hour leptin levels and an 8% increase in
wake period ghrelin levels in females whereas in males,
leptin levels were increased by 11% and ghrelin levels
were unchanged compared to the daytime work (circadian
aligned) condition [25��]. Increased hunger and decreased
satiety in response to circadian misalignment and
depending on time of eating could contribute to weight
gain in shift workers [20] and late eaters [27]. Meanwhile,
despite higher risk of obesity and chronic disorders,
studies have not reported significant differences in energy
intake between shift and non-shift workers by objective
measure [28] or self-report [29,30,31]. However, this
could reflect inherent biases in food intake measures [32].
Whereas the influence of circadian misalignment on food
intake regulation is more conclusive, evidence related to
energy expenditure is more equivocal. A simulated night
shift intervention showed a small but significant reduc-
tion in 24-hour resting energy expenditure (REE) after
circadian misalignment compared to alignment [24],
while similar protocols produced an increase [25��] or
no effect [11,23]. The discordance in results could be
explained by the finding that REE differs greatly
between individuals but is very stable within a person
[33]. These inter-individual differences may be in part
driven by sex: Qian et al. [25��] observed distinct sex-
specific differences, with REE increasing by 4.5% in
females after circadian misalignment, while there was
no change in males.
Circadian misalignment may also affect substrate utiliza-
tion. Compared to circadian alignment, misalignment
results in reduced RQ [11,16,25��], with concomitant
lower carbohydrate oxidation [16,24] and higher lipid
oxidation [16,24]. There is some evidence that this effect
may also be sex-specific, with reduced RQ being
observed in females but not in males [25��]. In general,
the circadian system favors carbohydrate utilization in the
biological morning and lipid utilization in the biological
evening [11,16]. Circadian misalignment may cause a
potentially unfavorable shift in these patterns when con-
sidered in conjunction with other circadian-controlled
metabolic processes, such as glucose regulation. Indeed,
multiple clinical interventions have demonstrated dis-
rupted glucose-insulin metabolism in response to acute
circadian misalignment. Postprandial glucose levels are
raised in response to misaligned mealtimes and insulin
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sensitivity is reduced [16,22,23], which may increase risk
of type 2 diabetes.
Milder circadian desynchronization
Epidemiological studies show that individuals with
greater social jetlag (difference in midpoint of the sleep
period between work and free days) have higher BMI,
adiposity and odds of obesity, metabolic syndrome and
type 2 diabetes [34,35]. In a study population with obe-
sity-related chronic diseases, greater social jetlag was
associated with consumption of more calories, saturated
fat and cholesterol at dinner, of more protein, total fat,
saturated fat and cholesterol at lunch, as well as more total
fat and saturated fat consumed at morning snack [36�].
Because of later waking times, social jetlag was also
associated with later mealtimes for breakfast, early after-
noon snack and dinner [36�]. These later consumption
patterns, at odds with endogenous preference, could
contribute to the observed risk of obesity in those with
greater social jetlag.
Few clinical intervention studies have explored the met-
abolic effects of mild circadian misalignment. One obser-
vational study showed that those with later midpoint of
sleep, but not necessarily social jetlag, had higher energy
intakes at dinner and after 8 PM, behaviors that were
associated with higher BMI, as well as higher intakes of
fast food, sugar-sweetened beverages, and lower fruits
and vegetables [6]. However, this study was confounded
by differences in sleep duration, whereby those with later
sleep times also had shorter sleep duration than those
with earlier sleep times. We and others have shown that
short sleep duration increases food intake [37,38].
Another study showed that sleep restriction for two nights
followed by two nights of sleep recovery and another two
nights of sleep restriction, effectively shifting midpoint of
sleep by 2.5 hours between sleep restriction and sleep
recovery, increases food intake relative to baseline, pre-
study sleep [39]. Both periods of sleep restriction
increased energy intakes by �1000 kcal whereas recovery
sleep increased intakes by �500 kcal relative to baseline.
Sex differences were observed whereby intakes were
increased similarly in the two sleep restriction periods
in both men and women, but intakes during recovery
sleep returned to baseline levels in women only. How-
ever, this study too, was confounded by differences in
sleep duration throughout the sleep conditions [39].
Our lab attempted to address this research gap via a 4-
phase randomized crossover pilot study with constant
sleep duration [40]. Six men and women underwent four
inpatient phases in which the timing, but not duration, of
sleep and meals was manipulated: Normal sleep/normal
meals, normal sleep/late meals, late sleep/normal meals
and late sleep/late meals. Sleep and mealtimes were
delayed by 3.5 hours in the late conditions relative to
those with normal times. Glucagon-like peptide
Current Opinion in Biotechnology 2021, 70:1–6
4 Food biotechnology
1 concentrations in response to a meal were higher with
early sleep and mealtimes, suggesting improved satiety
compared with the late meal condition [40]. In contrast,
earlier sleep and mealtimes were associated with higher
ghrelin concentrations and did not influence leptin con-
centrations. The combination of normal sleep and meal-
times had a reducing effect on food intakes [40]. Although
limited, these studies suggest a potential influence of
small shifts in sleep and meal timing on regulation of
energy balance. We are not aware of any study that has
assessed the influence of social jetlag on REE.
Meal timing and weight status
Outside of the laboratory, several recent epidemiological
studies have examined the association between timing of
eating and obesity risk. Eating jetlag, the difference in
midpoint of the eating period between work and free
days, has been associated with higher BMI [5��]. In this
epidemiological sample, eating jetlag was driven primar-
ily by a delay in breakfast time on weekends relative to
weekdays. Later meal timing in general has been associ-
ated with higher daily caloric intakes [27] and higher
BMI, independent of sleep timing and duration [6]. Xiao
et al. [7] associated a higher percentage of dietary intake in
the morning with 50% lower odds of overweight or
obesity, while a higherpercentage of dietary intake in
the evening was associated with 80% higher odds of
overweight or obesity.
A study by Bandı́n et al. [41] in which mealtimes were
delayed by 3.5 hours while sleep was kept constant,
showed decreased pre-meal REE, decreased fasting
RQ and decreased carbohydrate oxidation compared to
the control condition. Other studies have shown that diet-
induced thermogenesis (DIT), the rise in energy expen-
diture in response to food intake, is consistently lower in
response to an evening meal compared with a morning
meal [14,15,24]. In fact, one study reported 44% lower
DIT following an evening meal compared to a morning
meal [15]. These findings suggest that energy homeosta-
sis is favored when greater caloric intakes occur in the
morning/early afternoon versus the evening/night due to
higher energy costs of processing foods consumed at an
earlier time.
Importantly, meal timing patterns may not follow a ‘one-
size-fits-all’ approach. Recent findings suggest that timing
of meals relative to individual circadian clock timing,
marked by evening melatonin onset, is a better predictor
of body composition and weight status than clock time
[42,43��]. Indeed, individuals consuming a greater pro-
portion of their daily energy intakes closer to melatonin
onset (circadian clock) had higher BMI and percentage
body fat than those who consumed food earlier in their
biological day [42]. The same study showed that individ-
uals with higher percentage body fat ate 8% more of their
total daily calories in the biological evening, and 13%
Current Opinion in Biotechnology 2021, 70:1–6 
more carbohydrates in the biological afternoon, irrespec-
tive of clock hour, than individuals with lower percentage
body fat [43��]. Given the circadian rhythmicity of DIT
and substrate oxidation highlighted above, food con-
sumption later in the day could result in fewer calories
burned and greater carbohydrates remaining in circula-
tion, increasing the risk of weight gain and type 2 diabetes
in susceptible individuals.
Meal timing and weight loss
Given the associations between timing of food intake and
circadian alignment, it is plausible that shifting mealtimes
could influence weight management. Indeed, behavioral
weight loss programs have shown that greater weight loss
occurs in those who consume their main daily meal earlier
in the day compared to those who consume that meal later
in the day [44] and in those who consume the greatest
percentage of daily calories during a morning meal [45–
48]. A six-year follow-up study of bariatric surgery simi-
larly associated earlier consumption of the main meal with
greater weight loss success compared to a later main meal,
an observation that could not be explained by differences
in energy intake, diet composition or sleep duration [49].
These results indicate that the timing of meals and
distribution of caloric intake throughout the day may
be important considerations for weight management,
along with traditional dietary characteristics such as
energy intake and diet composition.
Conclusion
Circadian misalignment is increasingly recognized as a
risk factor for obesity and cardiometabolic disease. While
shift workers are most affected, there is a growing under-
standing that milder shifts in eating and sleeping patterns,
such as social jetlag and eating jetlag, can also have
adverse health consequences. Both social and eating jet-
lags result in later meal consumption patterns, which may
result in eating at biologically unfavorable times for
energy and macronutrient metabolism. Clinical interven-
tion studies assessing the effects of these subtle shifts in
sleep and meal timing are needed to uncover the mecha-
nism by which mild forms of circadian misalignment lead
to higher body weight and cardiometabolic risk. Finally,
due to inter-individual differences in circadian timing, it
may be important to personalize meal timing recommen-
dations. Meal timing in relation to chronotype, a measure
of innate individual preference for morning or evening
shown to modulate the risk associated with late eating
[50], could be considered to alleviate burden in those at
high risk. An understanding of circadian rhythms and
differential metabolic responses to food intake at differ-
ent circadian phases can inform recommendations for
temporally healthier eating patterns and should be the
subject of clinical investigations.
Conflict of interest statement
Nothing declared.
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Circadian rhythms, meal timing, and body weight 5
Acknowledgements
This was funded in part by the National Institutes of Health [grant numbers
R01 HL142648, R01 HL128226] and the American Heart Association [grant
number 16SFRN27950012] (St-Onge).
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	Circadian rhythms and meal timing: impact on energy balance and body weight
	Introduction
	Entrainment of circadian clocks and circadian alignment
	Severe circadian desynchronization
	Milder circadian desynchronization
	Meal timing and weight status
	Meal timing and weight loss
	Conclusion
	Conflict of interest statement
	References and recommended reading
	Acknowledgements