INTRODUCTION

Obesity is a rapidly growing worldwide epidemic; its prevalence has nearly doubled in more than 70 countries since 1980¹. 75% of the world population lives in countries where overweight and obesity are responsible for higher mortality compared to underweight¹; this is due to its negative impact on health which is associated with an increased risk of developing chronic diseases, such as type II diabetes, cardiovascular diseases, musculoskeletal disorders and some cancers².

In Peru, the Report “Peru: Non-communicable and communicable diseases”, where the Body Mass Index (BMI) was assessed in people aged 15 years and older, showed that in 2019, the prevalence of overweight and obesity was 37.8% and 22.3%, respectively³. Comparing these figures with 2013, an increase of 4.0 percentage points is observed in both conditions.

Before that, within the proposed strategies to reduce energy intake (diets, drugs, and bariatric surgery) and increase energy production (exercise and movement without exercise), the schedule and frequency of meals could exert a significant influence on the control and weight loss^1,4.

Interestingly, the relationship between feeding frequency and changes in BMI is still controversial. In some research, eating one or two meals daily was associated with a relatively lower BMI compared with three meals daily; while in others a negative relationship was found between feeding episodes and the prevalence of abdominal obesity^1,5.

On the other hand, regarding the timing of meals, it has been suggested that eating later in the evening may negatively influence the success of a weight loss therapy⁶. It has also been observed that regular ingesting food in the morning can protect against weight gain by reducing absolute energy intake during the day⁽⁷⁾. This difference between early versus late feeding has been related to the internal circadian clock^1,7-9.

Precisely, through the circadian clock system, it is explained why the feeding schedule has an impact on body weight regulation; since it is involved in metabolic rhythms, including glucose and lipids⁹. According to research, the organism's capacity to assimilate carbohydrates is highest in the morning, and the activity of adipocytes in lipid metabolism decreases in the evening^10,11. This leads to our body processing food more slowly and converting it into fats more easily during the night than in the morning.

For this reason, the present research seeks to contribute knowledge about the topic in the concrete reality of the adult Trujillo population to avoid the potential increase in overweight and obesity due to the negative health consequences they bring.

METHODS

Procedures

The data collection took place between December 2021 and January 2022. For obtaining the data an online survey was used by the Google Forms platform, which was sent through the institutional mails of the students of the National University of Trujillo. A total of 172 responses were obtained, of which 12 were excluded for not completing the survey, for presenting underweight (BMI < 18.5) or for having a BMI equal to or greater than 25 and performing intense physical activity a minimum of 5 days a week; remaining a total of 160 participants.

Subsequently, the 160 participants were classified into a normal weight group established by a BMI between 18.5-24.9 and an overweight-obesity group established by a BMI greater than or equal to 25. In the normal weight group, a total of was obtained 60 participants

Figure 1 Flow chart for participant selection 

RESULTS

The participants were classified according to sex and age group (Table 1), 99 were females and 61 males. A similar proportion of females and males was observed in both groups. Participants between 30 - 39 years old represented a higher percentage in the normal weight group and in the overweight-obesity one.

Overweight-obesity persons had a higher frequency of low-moderate physical activity (Table 2), statistically significant.

The number of sleep hours were similar in both groups (Table 2). , is from 5 to 8 hours of daily sleep most common.

The frequency of food consumption presented no significant difference (Table 3), the usual number of daily meals both in the normal weight and the overweight-obese group was 3 meals or less.

The normal weight and the overweight-obese group consumed breakfast most frequently in the 8:00-9:59 am schedule; and lunch, from 12:00-1:59 p.m. The overweight-obesity group consumed dinner and late-evening interludes on a later schedule than the normal weight group, with significant differences (Table 4).

DISCUSSION

In the present research a significant relationship was found between the consumption of late dinner during the n oche (after 8:00 pm) with overweight and obesity, these findings are similar to those found by Ha K, et al.⁶where they observed an increase in the prevalence of obesity and metabolic syndrome associated with eating after 9:00 pm in Korean adults. Also, it was found that the consumption of intermediates during the late evening in the overweight and obese group was significantly later than that of normal weight, which was not evidenced with the intermediates during the morning. These findings are consistent with Barrington W, et al.¹², who found an association between intermediate evening consumption with obesogenic behavior but not with morning or midday intermediates.

Based on this, it is deduced that overweight or obese people consume food during the night at a later schedule than normal weight people. This coincides with that reported by Xiao, et al.⁷; Yoshida, et al.¹³; Kutsuma, et al.,¹⁴and Berg, et al.¹⁵; who pointed out that people with nocturnal eating habits such as eating dinner immediately before bedtime or consuming “snacks” after dinner, have higher odds of developing obesity than those who don’t present these habits.

No significant difference in breakfast schedule was found between the normal weight and overweight or obese groups, as well as between those who did eat breakfast and those who did not. However, studies indicate that not consuming breakfast has been associated with an increased risk of overweight and obesity; as reported by Guinter M, et al.¹⁶, where women who ate breakfast 7 days a week presented a decreased risk of overweight and obesity, compared with women who ate breakfast 3 to 4 days a week. Odegaard A, et al.¹⁷found that people who ate breakfast 3 days a week or less had a risk of obesity 1.33 times higher than people who ate breakfast 4 to 6 days a week and 1.75 times higher than those who ate breakfast 7 days to the week. Goto M, et al.¹⁸evidenced that it was 1.34 times more likely a >5 % increase in BMI value in men who did not eat breakfast 2 or more days a week compared to those who did not eat breakfast only 1 day a week or less than.

The frequency of food consumption in normal weight and overweight-obese individuals did not evidence significant differences, being in both groups habitual consumption of 4 to less meals daily. This contrasts with the findings of Ha K, et al.⁶and Holmbäck I, et al.¹⁹that indicate an association between a higher number of feeding episodes with a lower prevalence of abdominal obesity. Similarly, Aljuraiban G, et al.²⁰found that participants who ate 6 or more meals a day compared to those who ate less than 4 meals had a lower BMI. However, Van der Heijden A, et al.²¹observed that an increase in feeding frequency beyond 3 daily meals was associated with an increased risk of weight gain of 5 kg at 10 years. Additional studies are needed to better understand the role of meal frequency in overweight and obesity risk.

Also, physical activity and hours of daily sleep were considered as intervening variables. Regarding low-moderate physical activity, this predominated in overweight or obese participants than in those with a normal weight. This finding was significant and similar to the work of Xiao, et al.⁷who found a lower level of physical activity determined by the number of steps per day in overweight-obese participants.

Sleep hours can influence people’s weight, as noted by Canuto R, et al.²²who found obesity prevalence ratios of 1.4 and 4.4 in workers with sleep deprivation at levels I (<5 h of continuous sleep/day with some additional rest) and II (<5 h of sleep continuous/day without additional rest), respectively. This effect was not found in the present study.

Within the limitations of the paper, it can be pointed out that the number could be higher to obtain significant results. The weight and height data were self-reported, due to reasons virtuality could not be done face-to-face. In addition, the study is cross-sectional analytic so causality cannot be assessed; likewise, the sampling was non-probabilistic, which causes a loss of representativeness.

CONCLUSION

In accordance with the aim of the study, it is concluded that consumption of food during the evening at a time later than 8:00 pm is significantly related to the risk of overweight and obesity in the Trujilloan adult population; while the feed frequency no.