Circadian distribution of carbohydrate intake during adolescence and association with risk markers of type 2 diabetes in adulthood—the role of chronotype

Abstract

Adolescence is a critical phase characterized by temporary insulin resistance and a tendency for a later chronotype, potentially influencing the risk of developing type 2 diabetes (T2D) later in life. This study explores how morning and evening carbohydrate (CHO) intake during adolescence are prospectively related to T2D risk factors—such as insulin resistance (HOMA2-IR), liver fat indices, and subclinical inflammation— in adulthood while considering the role of chronotype. This analysis utilizes data from 224 DONALD study participants (58% female) who provided 3-day weighed dietary records during adolescence (median age = 12 years) and a blood sample in adulthood (median age = 22 years). Owing to detected interactions between the timing of CHO intake i.e. CHOevening(E%)–CHOmorning(E%), (eveningness in CHO intake) and chronotype, analyses were stratified accordingly. An inverse relationship was found between morning CHO intake (before 11 a.m.) and adult HOMA2-IR levels (beta and 95% CI for high (T3) vs. low (T1): −0.12 (−0.21; −0.04), ptrend = 0.01). For individuals with an earlier chronotype, a higher "eveningness in CHO intake" was linked to higher HOMA2-IR (ptrend = 0.03). Conversely, those with a later chronotype exhibited the lowest HOMA2-IR in the median "eveningness in CHO intake" category (T2). No significant associations were observed between evening CHO intake and other risk markers. Consuming CHOs in the morning during adolescence is associated with lower HOMA2-IR in adulthood, irrespective of chronotype. However, the favorable morning CHO intake amount appears to vary by chronotype, indicating a personalized approach may be beneficial.