Circadian Monique

variation

Romon,

of diet-induced

Jean-Louis

Edme,

ABSTRACT The objective cadian variation ofdiet-induced favor weight gain among night time

snack.

1 700,

Nine

young

or 0100.

men

Energy

metabolic

rate.

ternoon the

time

than

when

sponse J

and

0.04)

=

higher

DIT

given

KEY

WORDS

ation,

shift

mean

measured

a meal

(P

is consumed

DIT

(P

=

0.06).

Diet-induced

the

snack. above

higher

0.002).

=

We

affects in the

at 0900,

by indirect

significantly

night DIT

must be considered 1993:57:476-80.

C/in Nutr

the same

was

was

and night

Jean-Louis

the

DIT basal

than

af-

re-

Am

circadian

vari-

work

ules requiring These workers

a rotation are used

hours that comprises Despite the fact that

shown gain

a20% of their daily energy intake (1-3). their 24-h energy intake is no different than

is different

ofthem suggest

depending

in the same in humans

practice: however a7.3 million on permanent shifts or on sched-

of morning, evening, and night work. to eating a snack during their working

that ofday workers, some on night work (4-7). Some studies indirectly of a diet

subjects

when

food

do tend

to gain

that

metabolic

on

the

the

that

there

was

available

time

weight

when

efficiency

it is eaten:

intake

intake

but

(4). Because

have

body

was a relative

a higher

only

Circadian for a long

it is much

its

changes stimuli ation

476

neither

This induced

and

ofdiet-induced

(8)

than

in EE (13,

variation. during

the

14). Only

two

of energy

metabolism

food

thermogenesis

intake

(to mimic

of day,

Some day studies

in the have

in response

of many

other

data on 24-h energy have been interested

investigators absence

nocturnal

shift

ie, between

Subjects

DIT.

workers’

whether thermogenesis of the usual 24-h energy

eating

morning,

patterns)

afternoon,

varied

and

with

time

night.

and methods

Subjects Nine young nonobese men participated volunteers. Data concerning some physical presented in Table 1. ofthe subjects had a history

have

studied

of thermogenic

examined

diurnal

to thermogenic Am J C/in Nuir

and they or subjects

were who

in the study characteristics

ofendocrine

not taking had traveled

as paid and

or metabolic

any drugs. Shift or night across time zones within

the previous six mo were excluded. All potential volunteers answered a questionnaire concerning their daily routine and sleep and meal schedule; those with irregular habits were excluded. Each selected subject pose ofthe experiment ticipate Helsinki

was informed before giving

The

study

consisted and

night.

of three

randomized

Between

each

was

eaten

at 0900

the afternoon

I

subject

From

with

the

during

session, the

snack

the

the Laboratoire

de Physiologic, 2 Supported

March

a time 22 and

5 wk.

within

morning the

session,

during same

for

During

night

the

three

during

session.

For

sessions:

it

and the Laboratoire Re-

gional Nord-Pas-de-Calais, and Davigel SA. 3 Address reprint requests to M Romon, Laboratoire de Medecine Travail, Facult#{233} de M#{233}decine,59045 Lille C#{233}dex, France.

du

vari-

1993:57:476-80.

Received

March

Accepted

for publication

Printed

25,

in USA.

CRE

I 700

Conseil

stimuli

INSERM,

at

the

de M#{233}decinedu Travail,

Lille, France. by grants from

morning, was

for 1 h preceding and 6 h after daily energy intake. This snack

at 0100

was

there

between

experiment

the

and

sessions:

session

conducted

each session EE was measured a snack representing 20% ofusual

each

in accordance in 1983.

design

span 5 d. The study June 6, 1988. All subjects completed

was

about the nature and purhis written consent to par-

and the study was conducted Declaration of 1975 as revised

afternoon,

has been known (10), yet despite

the rhythm

Numerous authors have collected (EE) (1 1 , 12) but few studies

circadian

nocturnal

of body weight, we propose the DIT, which could favor weight

less documented

studied

study was designed to investigate by a snack consisting of 20%

Experimental

weight

in the evening

variation of energy metabolism time in humans (9) and in animals

functions. expenditure in

evening

the regulation

(DIT) is relevant to the control hypothesis of a lower nocturnal gain.

this,

and

it was

as compared with availability in the morning. In a former study we found that among shift workers, those who gain the most weight do not differ with regard to their 24h energy

16). However. they failed to find a difference between morning and afternoon DIT, but morning and afternoon tests varied in duration ofthe postabsorptive state in the second study

disorders workers

eating is not a frequent work at night either

Frimat

( 1 5,

age are None

Introduction Night Americans

Paul

that

balance.

thermogenesis,

and

Afternoon

conclude

thermogenic

energy

Lescroart,

no. 86.80.33,

1992.

October

6. 1992.

© 1993 American

Society

for Clinical

Nutrition

Downloaded from www.ajcn.org by guest on July 13, 2011

was

were

and during the 6 h after 3 h of energy expenditure

Morning

(P

DIT

DIT

Boulenguez,

of this study was to assess a cirthermogenesis (DIT) that could workers used to eating a night

expenditure

calorimetry 1 h before was calculated as the

Charles

thermogenesis13

CIRCADIAN TABLE 1 Physical characteristics of the test meal*

VARIATION

OF

All gas-exchange of the nine subjects

and energy

content

ventilated cart with

Value

61.8 171 21.1 2274 544

± 2.31 ±

3.45

±

0.63

was

158

±

air was

drawn

inhaled

from

performed

through

with

the

canopy on both

with

a blower. air

the

between samples

air

0.65

were

air

of a

Horizon

in a plastic fastenings

canopy

flowing

use

the

into flow

so that

the

with

is provided

the air flowing through the system and passed mixing chamber for analysis. The rate of air

adjusted

Gas

± 37

system

expired

maintained

entering

and

the

stream;

mixing

chamber

was

0.85%.

analyzed

every

3 mm

and

an

automatic

calibration sequence was introduced every 20 mm, which introduced first compressed pure nitrogen into the analyzers to check for zero drift and second a calibration gas (20.0% 02, 0.75%

SE.

±

subject

mixed with the Horizon

were

the canopy

subject’s head was enclosed seal at the neck and velcro

Room

The

28 ± 2

measurements

hood;

(1 7). The a flexible

sides. Age (i) Weight (kg) Height (cm) Body massindext Meal (kJ) (kcal) *

477

DIT

t In kg/m2.

CO2. and the balance, At the was composed Dieppe,

offrozen

France).

identical

dishes

The

for all individuals;

derived

from

ofknown

relative

protein,

composition

composition the

fat, and

fractions

of total

carbohydrate EE under

was intake

0. 15, 0.35,

the same

Three

nental fee)

hours

breakfast

before

the

(bread,jam,

representing

20%

Experimental

butter,

of usual

metabolic

the

preceding

registered

For the 6 h before

For day

con-

and

had

the up in-

decaffeinated

and

eat

conditions and to Ferrannini

EE (kcal/min) In this

spent evening woken

0530

and

the

subjects

night

in the

to

arrived

he was

then

and night and had

each sat

test subjects arrived their standardized

of the three sessions quietly in the ward

ward;

they

allowed

to

in the ward meal 4 h be-

and after reading

was

a

and

V02

+ 1.10

were

used

VCO2

-

dioxide pressure,

to calculate

3.34

N

study

DIT

was

rate

measured

the energy

calculated

as is usually in quotation

as the

between

done marks

additional

0530

classically. For is used instead

EE had reached the resting as the 3-h EE and expressed

content

of the test

EE above

and

0600

instead

this reason of DIT.

the

value after 3 h, DIT as a percentage of

meal.

at

meal at home at 1800. At and his basal metabolic rate 0600:

urea nitrogen ( 18),

3.91

=

metabolic

Because the was calculated

breakfast.

afternoon the snack After subjects

dry (STPD) EE according

basal

test

there

temperature,

The volume ofoxygen consumed (V02) and carbon produced (VCO2) corrected to standard temperature

cof-

intake.

morning

session

volume,

a conti-

session subjects were instructed and to refrain from moderate

the

and

to have an was gently between

get to void

forehand. a meal,

energy

each diet

activity.

were instructed 05 1 5 the subject was

milk,

they

of the for

Calculations

protocol

physical

2200

snack

procedure

analyzers.

of the RMR, term “DIT”

For the day preceding not to change their usual heavy

morning

calibration

and

ditions at the different times of the day, subjects were given same meal 4 h before the night and afternoon snacks, made of frozen dishes (Davigel) representing 30% of usual energy take.

N2). at the beginning

and

breakfast or or watching

Statistics The results were conducted

are

expressed with the

as mean ± SE. Statistical statistical system (19).

of variance with use of a model for a single-factor with repeated measurements (GLM procedure, ment) was used to test whether between morning, afternoon, was

then

and

“DIT”

performed

experiment repeated state-

EE and DIT varied systematically and night. Contrast transformation

to evaluate

between

analyses Analysis

SAS

morning,

differences afternoon,

in premeal and

RMR

night.

television. After a 30-mm rest on a bed the resting metabolic was measured 1 h before the test snack. Afterward, 20 mm

outside

measured the

the canopy

continudusly

postprandial

EE

and examining the night.

slides

Gas-exchange

oxygen (Liston

beginning

measurements, for errors

and

the snack.

subjects to keep

them

void.

were awake,

lying even

Results

EE was During down

The and

premeal

night

was kept at 22-25 #{176}C. After gas-exchange was collected to determine urea nitrogen.

showed

Figure

a Horizon

Anaheim a Beckman

CA), OM-Il

were

made

metabolic

by open-circuit

measurement

cart

and an infrared optical Beckman) for carbon

system dioxide

medical analyzer measurements.

given

for

the

separately

no significant

effect

morning,

in Table oftime

afternoon, 2. Analysis

ofthe

day

1 shows patterns of EE after ingestion with premeal RMR, EE was significantly

the

=

there

which includes a turbine volume analyzer with a polarographic

in subjects

are

(P

first

0.02)

and

second

(P

hour

of

on RMR.

of the meal. higher dur0.003)

=

for

the

morning session. It was significantly higher during the first hour (P = 0.05) and lower during the fifth (P = 0.04) and sixth hours

(P

measurements

by using

analyzer Becker-2;

ing

RMR

sessions

variance

during

measurement

Indirect-calorimetry respirometry

for 6 h after

meal

Compared

Room temperature measurements, urine

(Sensormedics, transducer,

to eat the test

rate (RMR) subjects spent

0.006) was

during

the afternoon

no difference

session.

at any

time

During

with

the

the night premeal

Because EE was no higher and was in fact initial value after 3 h during all three sessions, culated Table snack,

as the 2 gives expressed

3-h

EE above the

“DIT”

as a percent

basal calculated ofthe

metabolic

lower “DIT”

than was

the cal-

rate.

during energy

session

level.

the

content

3 h after ofthe

the meal.

Downloaded from www.ajcn.org by guest on July 13, 2011

0.50, respectively. To measure the postsnack

snack

energy

were

complete

(Davigel,

of the

end

478

ROMON

TABLE 2 Premeal resting metabolic rate (RMR) and diet-induced (DIT) in nine subjects at different times of the day*

ET

AL

day, thermogenesis

“

and RMR

6.06

±

of meal)

15.9

± I .6tt

6.10 13.5

±

0.29

of meal)

±

l.8

(kJ/min)

of energy

content

RMR (kJ/min) of energy content

0.33

*

any

different

Significantly

from

different

afternoon

from

value.

night

value,

P

P

=

=

0.002,

0.04.

have §P

in the During

the morning

session

“DIT”

was significantly

session

(P

0.002).

Afternoon

“DIT”

tended

night “DIT” (P = Mean respiratory

0.06). quotient

session

during (P

± 0.02 ± 0.02

=

the

before

in the morning. 0.83 at night (NS). During

during the first hour after ± 0.03, and 0.86 ± 0.03 night sessions, respectively.

higher

meal

variation

the meal, which was 0.89 ± 0.02, (NS) for the morning, afternoon,

0.87 and

and

gastric

it was

study meal.

consumed.

to each

series

ifa

ofthe

be rejected

unpublished This result

three a

P

communication, differed from

not find any significant noon DIT. However.

24-h

emptying.

ofO.Ol,

was

authors insulin shown

during

which

function

is fitted

ofchange

rhythm

can

assumption

see Appendix

1992). that of Westrate

and

than

bolus

suggested dose

a more

by the

measured

fasting

evening

consisting ofdigestion mainly

involved important

regulates

the

rate

of nutrient

by Tai load

flux

et al (23), of nutrients

compared

rapid

gastric

to be slower

the

meavariation

changes

state

and

may

not

ofan and

reflect

obligatory processing

mediated

by the sym-

with

absorption

in digestion and abfactor is the rate of of nutrients

into

the

absorption.

This

ex-

who

a higher

found

was

six small

administered doses.

of nutrients

emptying after

a night

(24).

Gastric

meal

than

For

induced

response and enhanced nutrient storage. that morning gastric emptying is significantly

found

is

to explain

be due to circadian variation the thermic response to flu-

one.

the

an isoenergetic

after

be

(22).

which hence

DIT in the EE response

the extent

no circadian

state to the

ofprocesses known. One

planation

stage

cosine

values,

The

with

difference

on the circadian

quantitatively.

can then

a clear

Furthermore

ofthe

be assessed

showed

depending

system

and

not

of EE.

Circadian variation sorption is not well

a single present

fasting

a facultative

nervous

could

enough

be confounded

trients. It is an intricate mechanism component. which is the energy cost pathetic

a rhythm

0.633: see Appendix during the night DIT

however,

may

0.84

Discussion The

ofthe

ofnutrients,

other

(2 1 ). In fact, the premeal

the metabolic-rate

cases

than

± 0.02 in the afternoon, and 0.81 the three sessions it reached a peak

EE (20)

difficulty:

this

to be higher was

of

=

is not

Circadian variation of DIT might of the different factors underlying

ingestion

are

fail to

object that the use of a no meal is given, would

by an adaptation

duodenum

to the same

which

They

authors

period between

and

night

and

cir-

found. One might test. ie. a test when

in these

circadian

than

1% (20),

fed.

in resting

sessions,

the

0.04)

=

rhythm

the three

duration

and

a greater It has more

emptying after

as these been rapid

was

a morning

also meal

A (F. Halberg,

et al ( 16) who

did

difference between morning and afterin his study the subjects had a shorter

-

Morning

-

-

fasting

period

in the

so the

subjects

were

ditions.

afternoon not

tests

exactly

than

under

et al ( 1 5) compared

Capani

in the

the

same

oxygen

morning

tests

metabolic

con-

consumption

-

- .-

Night

-

after

the morning or evening meal with each meal being given after the same period offasting (I 2 h). He found a significantly higher oxygen consumption when the protein meal was given in the morning but no difference for the carbohydrate or fat meal. The response The

to a night circadian

observed of resting the this

meal

has

differences

can be explained EE and

not

variation

of the

factors

circadian

Circadian

variation

of resting

study

we chose

variation

we took

measure

EE should “DIT”

as the

test.

Because

as a reference

we were the same

we

involved

be discussed

metabolic rate although most EE above RMR measured

control

that variation

rhythmic

to nutrients.

a nonenergy

before. of response

factors:

response

above the basal DIT as additional

studied

pattern

by different

thermic

to

been

in the

in

first.

additional

studies premeal

In EE

calculated or during

interested

in circadian

metabolic

point

of the

50

0

1 Time

2 after

3 meal

4

5

6

(br)

FIG 1 . Patterns of energy expenditure after ingestion of a meal at different times ofthe day for a 60-mm period of measurement. . ± SE. Significantly different from premeal value: *J) < 0.05. P < 0.01.

Downloaded from www.ajcn.org by guest on July 13, 2011

afternoon

seen

are

for rhythm rejection it has been stated that

overcome

our

DIT

( I 3. 14).

subjects

(P

that we control

surements

0.06.

=

of feeding when

of circadian

by

Therefore,

true

observed in the overnight any significant difference

underestimated

± 2.2

et al (20).

phenomena:

EE. In humans it has been suggested of resting EE occur during the day

and

EE during

demonstrated A). However,

± 0.25

two

independent

evidence

be induced that

are

amplitude

difference nonenergy

t Significantly

:

find

Pullicino

account

of resting oscillations

they

little

resting

SE.

±

.

5.89 10.9

of meal)

that

very

as did

into

than a reduction we did not find

Night

Premeal RMR (kJ/min) DIT ( of energy content

rate,

takes

cadian variation that significant

Value Morning Premeal DIT (% Afternoon Premeal DIT (%

ie, basal

DIT”

CIRCADIAN (25),

but

have

to be confirmed

subjects

A blunted sistance

were

thermic

(26).

infusion,

Cauter that

they

ditions a nocturnal rise 50% for insulin secretion identical

meal

glucose ing

and

meal

of

relationship

secretion

and

the magnitude to a meal

times

evening.

by a night

of glucagon

on

difference

the

termines

liver

energy The

cost (33). facultative

by circadian

daily

cortisol an inverse

ofglucose in insulin

to be clarified.

counterregulatory

response

glucose

metabolism,

component

could of DIT

rhythmicity. protein

lead

also

substrate

cycling,

are under all ofthe

the influence of sympathetic control facultative response can be suppressed

receptor blockade (22). Among is modulated by true circadian

or sodium

catecholamines rhythmicity

the night importance

explain could, (26).

this

as the

study

evening

the phenomenon as in obesity, lead Other

A (36) scribed about

metabolic

and

suggested to eat.”

shift

is nocturnal to a reduced

as futile which

workers. utilization

years

ago,

Despite

these

of nutrients “more

response

work

to

resistance, which effect of glucose

as increased

hemoglobin

38)

have

been

facts

little

is known

and

as Halberg

is needed

on

de-

aspects

(in

German).

of the

V. Frimat

E, Burnond

chronobiology

18.

of nutrition:

20.

more

Chem Fed

J#{233}quier E. Twenty-four

hour

and resting metabolic rate in obese, moderately subjects. Am J Clin Nutr 1982:35:566-73.

Schutz

T, J#{233}quierE. Diet-induced

G.

Bessard

sured

over a whole

Nutr

I 984:40:542-52.

Apfelbaum

M,

day in obese

Reinberg

Bailey

D,

Johnson

A,

Capani

HRE.

of man

thermogenesis

and nonobese

Lacatis

D,

Kupprat

at rest. J AppI

F, Consoli

A, Del

Ferrannini

E. The

women.

Abulker

C,

I. Oscillations

Physiol

Ponte

theoretical

Pullicino

E, Goldberg

GR,

metabolism measured receiving cyclic and 199 1:80:57 1-82. 21.

Goldberg

and

mea-

Am J Clin Bostsarron

J,

in oxygen

con-

1973:34:467-70.

A, Ferrara

D, Guagnono

T, Sensi

basis

GR,

basal

Prentice

Elia

calorimetry:

statistics,

M. Energy

version

a review.

5 edition.

expenditure

and

by 24-h whole body calorimetry continuous parenteral nutrition. AM,

metabolic

ofindirect

rates

Davies

HL,

Murgatroyd

in men

and

women.

substrate

in patients Clin Sci

PR.

Eur

Cary.

Overnight

J Clin

Nutr

1988:42:137-44. 22.

23.

work on eating behavior of et travail. Paris: Masson,

Y,

in a 1 (in

energy expenditure obese, and control

Metabolism I 988:37:287-301. 19. SAS Institute Inc. SAS user’s guide: NC: SAS Institute Inc. 1985.

when 13

References

B, Schutz

P.

of shift workers working Mal Prof 1985:46:257-6

S. Morning-afternoon variation of specific dynamic action of nutrients. In: Haus E, Kobot H, eds. Chronobiology 1982-83. Basel. Switzerland: Karger, 1984:480-3. 16. Westrate JA, Weys PJM. Poortvliet LI, Deurenberg P. Hautvast JG. Diurnal variation in postabsorptive resting metabolic rate and dietinduced thermogenesis. Am J Clin Nutr 1989:50:908-14. 1 7. Segal KR. Comparison of indirect calorimetric measurements of resting energy expenditure with a ventilated hood. face mask, and mouth piece. Am J Clin Nutr 1987:45:1420-3.

(8)

We thank Franz Halberg for his helpful criticisms, suggestions, and calculations in Appendix A. We thank Bernadette Hennache for the urea nitrogen assay.

1. Debry G, Bleyer R. Influence of shift workers. In: Debry G, ed. Alimentation 1972:153-72 (in French).

1984:38:30-5 C, Demarcq-Leignel

Riou F. Circadian rhythm ofoxygen consumption and of respiratory quotient ofyoung adult women with spontaneous food intake and after energy restriction. Rev Eur Etud Clin Biol 197 I : I 6: 1 35-43 (in French).

15.

is parare higher

hypotheses

Wissenschatt M, Declercq

F. Some

sumption

is of physio-

of the

(37,

13.

14.

because almost by 3-adrenegic

only epinephrine (34), with a trough

insulin thermic

such

in

such

thermogenic

concentrations

nocturnal a few

that One

disturbances

triglyceride

among the

shows

progresses.

a de-

pumping,

(35). Whether this phenomenon remains to be demonstrated.

In conclusion, declines

12.

be modulated

occurring at 0320. Epinephrine-induced thermogenesis tially inhibited by basal insulin concentrations, which during logical

(32), which

Halberg

1 1. Ravussin

vs the

to a difference

mechanisms

turnover,

subshown insulin

the effect

insulin,

may

It includes

and how-

is unclear

and

Z Arbeit

work is needed on “when to eat.” J Nutr 1989:1 19:333-43. 9. Benedict FG. Factors affecting basal metabolism. J Biol I915:20:263-95. 10. AschoffJ, Pohl H. Rhytmic variations in energy metabolism. Proc I 970:29:1541-52.

hormones

Although

to glucose

ofglucagon

8.

to eve-

morning

work.

Romon-Rousseaux

Furon D. Survey of eating behavior glass factory in Pas-de-Calais. Arch French).

response

been done in night-fasting the day and it has been between glucagon and in the

shift 7.

insulin

(29). Glucagon variation (30);

is eaten

AS, Wahlquist MC. Effect of shiftwork on canteen food purchase. J Occup Med l985;27:552-4. 4. Romon M, Beuscart R, Frimat P. Debry G, Furon D. Energy intake and weight gain according to rotation schedules in shift workers. Rev Epidemiol Sante Publique 1986:34:324-31 (in French). 5. Rutenfranz J, Colquhoun WP, Knauth P. Ghata JM. Biomedical and psychosocial aspects ofshiftwork. A review. Scand J Work Environ Health 1977:3:165-82. 6. Cervinka R, Kundi M, Koller M, Arnhog J. Eating behavior and

Moreover,

of a morning

and

ratio

and

(28).

increase

meal molar

a higher to a mornbe mod-

magnitude

meal

need

found could

in insulin thermic

in the

con-

concentrations: variation, and

cortisol concentration do not undergo circadian

Changes

induced

night.

same

than

been observed

to evening with

the single

1979:5:33-41. 3. Stewart

24.

Acheson

KS,

Ravussin

E, Wahren

J, Jequier

E. Thermic

effect

glucose in man: obligatory and facultative thermogenesis. Invest I 984:74:1572-80. Tai MM, Castello P. Pi Sunyer FX. Meal size and frequency: on the thermic effect offood. Am J Clin Nutr 199 l;54:783-7. Goo

RH,

in gastric 5 15-8.

Moore emptying

JG,

Greenberg of meals

E, Alazraki in humans.

HP.

Circadian

Gastroenterology

of

J Clin effect

variation 1987:93:

Downloaded from www.ajcn.org by guest on July 13, 2011

when

they meal

the patterns have

ever, most circadian studies have jects who ate their meals during (3 1 ) that internal time relations differ

the

resistance

hormone circadian

between

in

of the day insulin

ofmorning

ning decrease growth hormone

ofthe

under

479

DIT

A. Migraine C, Apfelbaum M, Brigant L. Circadian and rhythms in the feeding behaviour and nutrient intakes of oil refinery operators with shift-work every 3-4 days. Diabete Metab

re-

glucose as evening

the middle

to an evening

cortisol

is correlated

to insulin

OF

2. Reinberg ultradian

results

a constant

deteriorates

around

nocturnal

plasma

and

be due

using

tolerance

ulated by counterregulatory concentration displays a clear temporal

night,

17% for plasma glucose and almost (28). More recently, when giving an

response

The

also

demonstrated

at different

insulin

(29).

could

a minimum study

the

state.

et al (27),

glucose

reaching

In a subsequent

during

wakeful

response

Van

showed

progresses,

sleeping in the

VARIATION

480

ROMON

25. Coupe AJ, Davis 55, Evans DS, Wilding imaging to investigate the gastrointestinal Controlled Release 1992:20:155-62. 26.

Ravussin

E, Acheson

of glucose

Clin Endocrinol 28.

Van

Cauter

Metab

JD,

lonsky KS. Modulation 29.

Van

Cauter

rhythm. 30.

Van

and

E, Shapiro and

D, Spire

regulation

infusion.

J Clin

JP,

Refataff

Invest

Knuttsson

G. Ferrario

A. Relationships

transferase

among

shift

Romon

M, Nuttens

in shift

J

workers.

MC, Am

F, Bishop

influences cyclic

relations

AMP

K. Circadian relationship

meals;

J. Endocrine

and

other

APPENDIX

hemic

to

G,

glucagon

Van

as

human

circadian

glucagon,

induced

Gaal

L, Van

a determinant

insulin

thermogenesis

Acker of

in obese

rhythms.

WB Saunders,

1989:

of single

meal

daily

rhythms and

in urinary

iron.

Experientia

K, De

resting

Leew

metabolic

women.

I. Importance rate

and

Metabolism

of glucose

199 1:40:672-

5. 33.

Flatt

JP.

Recent 1978:21 34.

The

biochemistry

advances

of energy

in obesity

research

expenditure.

II. London:

In:

Newman

Bray

G,

ed.

Publisher,

1-28.

Linsell

CR,

Lightman

cadian

rhythms

SL,

ofepinephrine

Mullen

PE, and

Brown

norepinephrine

MJ,

Causon in man.

RC.

CirJ Clin

Endocrinol Metab 1985:60:1210-5. 35. MUller MJ. Acheson KJ, Piolino V. Jeanpr#{234}treN, Burger AG, JCquier E. Thermic effect of epinephrine, a role for endogenous insulin. Metabolism

1992:41:582-7.

Fievet

C, et al. Increased

triglyceride

levels

1992:93:259-62.

vs night

in the are

presnack neglected

meal

between

for a first

morning

and

approximation

cosinor a cosine

analysis, function

which is based of the form f(t)

=

least-squared

a

three using

regression

of

M + A#{149}cos(wt + 0)

where

flt) is the

cients; halfthe

M is the mean level, termed mesor: A is the amplitude, range ofoscillation: w the angular frequency, 360/r where

r is the

period

value

on

af-

and

at time

so that

of the

function

360#{176} represents

regression

one

complete

coeffi-

cycle.

in

our case 24 h: and 0 is the time of the maximum, termed the acrophase (for each individual subject). For thermogenesis. the zero-amplitude or no circadian rhythm assumption can then be rejected with a PofO.OlO. Around the mesor of 1 3.44% there

is a double

change) 2.74%

(ie,

of5.65% to 8.56%.

1 108)

with

amplitude

of energy

(a measure

with a 95% confidence The acrophase is at a 95%

to - 193#{176} from midnight. cannot be demonstrated

confidence

content

ofthe

extent

interval -

interval

For metabolic (P for rhythm

167#{176}from

extending

of the

meal,

of predictable extending local

from midnight

from

-

133

rate as such, a rhythm rejection = 0.633).

Downloaded from www.ajcn.org by guest on July 13, 2011

Vansant

triglycerides and glutamyl J Intern Med 1989:226:

24-h cosine function is fitted to each of the series of the values, the extent ofchange can be assessed quantitatively

cortisol

1976:32:1081-4. 32.

A.

J Occup

A

Ifdifferences ternoon

modulation

biological

Philadelphia: F, et al. Timing

among

and

M. Griece

parameter?

secretion

l992;262:E467-75.

J, Halberg

R, Arnoldi

be a job stress

between serum and day workers.

J Med

2658-705. 3 1. Goetz

M. Zanettini

337-9. 38.

199 1:88:934-42.

to

ed. Endocrinology.

G. Panza

Can glycosilated hemoglobin Med 1985:27:357-60. 37.

5, Po-

and insulin

H, Pollonski

response

E, Aschoff

In: Dc Groote,

glucose

Cesana

1.

sleep.

T, Tillil

insulin

Am J Physiol

Cauter

constant

Roland

of glucose

rhythmicity

of glucose

during

1989:69:604-1

E. Blackman

by circadian

36.

Vernet 0, Danforth E, Jequier E. Evidence is responsible for the decreased thermic effect obesity. J Clin Invest 1985:76:1268-73. D, Decoster C, Fery F, Balasse EG. Nocturnal tolerance

AL

J

KJ,

that insulin resistance ofglucose in human 27. Van Cauter E, Desir decrease

IR. Nocturnal scintigraphic transit ofdosage forms.

ET