देर रात का भोजन स्वास्थ्य का दुश्मन Toll on Health : Late-Night Meals

Author : Dr. P. D.GUPTA

Former Director Grade Scientist, Centre for Cellular and Molecular Biology, Hyderabad, India


“You are what you eat”, as it is in Hindi also ”Jaisa anna vaisa Man”. But a growing body of evidence indicates that it's not just what and how much you eat that influence your health. How fast and when you eat also play a crucial role in keeping good health.

Research now indicates that these two factors may affect the risk for gastrointestinal problems, obesity, and type 2 diabetes  (T2D). Because meal timing and speed of consumption are modifiable, they present new opportunities to change patient behavior to help prevent and perhaps address these conditions.

Not So Fast

Most people are well acquainted with the short-term gastrointestinal effects of eating too quickly, which include indigestion, gas, bloating, and nausea. But regularly eating too fast can cause long-term consequences.

Obtaining a sense of fullness is key to keep away overeating and excess caloric intake. However, it takes approximately 20 minutes for the stomach to alert the brain to feelings of fullness. Eat too quickly and the fullness signaling might not set in until you've consumed more calories than intended. It is observed that this habit results in excess body weight.

The practice also can lead to gastrointestinal diseases over the long term because overeating causes food to remain in the stomach longer, thus prolonging the time that the stomach lining is exposed to gastric acids for more time.

Korea are the fastest eating (speed < 5 min/meal) persons and had a 1.7 times greater likelihood  of  gastroenteritis than those with the slowest times (≥ 15 min/meal). Faster eating also was linked to increased risk for functional dyspepsia.

On the extreme end of the spectrum, researchers who performed an assessment of a competitive speed eater speculated that the observed physiological accommodation required for the role (expanding the stomach to form a large flaccid sac) makes speed eaters vulnerable to stomach and intestinal diseases and the need for gastrectomy.

The risk for metabolic changes and eventual development of T2D also appear to be linked to how quickly food is consumed. Metabolic syndrome, especially diabetes, has gained global attention over the past few decades and became one of the major public health concerns. Alongside known and well-established risk factors, eating behaviors, mainly eating speed has shown the potential as one of the novel risk factors that could supplement the development of diabetes.

Various dangers to explain why fast eating may upset metabolic processes, including a delayed sense of fullness contributing to spiking   glucose levels, lack of time for mastication causing higher glucose concentrations, and the triggering of specific chemicals   that lead to insulin resistance. It is also possible that the association is the result of people who eat quickly having relatively higher body weights, which translates to a higher risk for T2D.

However, there's an opportunity in the association of rapid meal consumption with gastrointestinal and metabolic diseases, as people can slow the speed at which they eat so they feel full before they overeat.

This approach may not work for all persons, however. There's evidence to suggest that tactics to slow down eating may not limit the energy intake of those who are already overweight or obese. Patients with obesity may physiologically differ in their processing of food.  About 20%-25% of people with obesity actually have rapid gastric emptying," "As a result, they don't feel full after they eat a meal and that might impact the total volume of food that they eat before they really feel full."

The Ideal Time to Eat

It's not only the speed at which individuals eat that may influence outcomes but when they take their meals. Research indicates that eating earlier in the day to align meals with the body's circadian rhythms in metabolism offers health benefits.

"The focus would be to eat a meal that synchronise during those daytime hours, as earlier most Indians used to do.it is also suggested that typically persons have their largest meal in the morning, whether that's a large or medium-sized breakfast, or a big lunch, and light in the evening

 Time-restricted eating (TRE), a form of intermittent fasting, also can improve metabolic health depending on the time of day.  TRE was more effective at reducing fasting glucose levels in participants who were overweight and obese, if done earlier rather than later in the day. Similarly, data on persons without diabetes or obesity found that early TRE was more effective than mid-day TRE at improving insulin sensitivity and that it improved fasting glucose and reduced total body mass and adiposity, while mid-day TRE did not.

A study that analyzed the effects of TRE in eight adult men with overweight and prediabetes found "better insulin resistance when the window of food consumption was earlier in the day," noted endocrinologist Beverly Tchang, MD, an assistant professor of clinical medicine at Weill Cornell Medicine with a focus on obesity medication.

Persons Benefit From Behavioral Interventions

Persons potentially negatively affected by eating too quickly or at late hours may benefit from adopting behavioral interventions to address these tendencies. "When I first meet patients, I always ask them to describe to me a typical day for how they eat — when they're eating, what they're eating, the food quality, who are they with — to see if there's social aspects to it. Then try and make the recommendations based on that," said Popp, whose work focuses on biobehavioral interventions for the treatment and prevention of obesity, T2D, and other cardio-metabolic outcomes. "Eat if you're hungry; don't force yourself to eat if you're not hungry". "If you're not sure whether you're hungry or not, do not load your stomach unnecessary.  

 "For example, we know that a high-fiber diet or a diet that has a large amount of fat in it tends to empty from the stomach slower,"   "That might give a sensation of fullness that lasts longer and that might prevent, for instance, the ingestion of the next meal. Those trying to eat more slowly are advised to seek out foods that are hard in texture and minimally processed.

Hard foods are consumed more slowly than soft foods and that energy intake is lowest with hard, minimally processed foods. Combining hard-textured foods with explicit instructions to reduce eating speed has also been shown to be an effective strategy.

Although the evidence is mounting that the timing and duration of meals have an impact on certain chronic diseases, clinicians should remember that these two factors are far from the most important contributors, as said in Ayurveda.

Total caloric intake, food quality, sleep, alcohol use, smoking, and physical activity, along with meal timing should be considered as under the umbrella of health. (The author has his own study and views)