Despite observed ethnic differences in eating patterns and obesity, evidence in China is limited. This study examined ethnic differences in eating patterns and their associations with weight outcomes among multi-ethnic adults in West China. A cross-sectional survey collected self-reported data on demographics, eating behaviours, weight and height in 2021. Principal component analysis and multivariate regression were conducted to identify eating patterns and examine their associations with weight outcomes. In total, 4407 subjects aged ≥ 18 years were recruited across seven provinces in West China. Four eating patterns were identified: ‘meat-lover’ – characterised by frequent consumption of meat and dairy products, ‘indulgent’ – by frequent intakes of added salt, sugar, alcohol and pickled food, ‘diversified-eating’ – by frequently consuming food with diversified cooking methods and eating out and ‘nutri-health-concerned’ – by good food hygiene behaviours and reading food labels. Ethnic differences in eating patterns were observed. Compared with Han, Hui were less likely to exhibit meat-lover or diversified-eating patterns; Tibetans were less likely to have meat-lover or nutri-health-concerned patterns; Mongolians were more likely to have indulgent pattern. BMI was positively associated with meat-lover pattern in both genders (exp(β): 1·029; 95 % CI: 1·001, 1·058 for men; 1·018; 1·000, 1·036 for women) and negatively associated with nutri-health-concerned pattern in women (0·983; 0·966, 1·000). Mongolians were two times more likely to be overweight/obese than Han (OR: 3·126; 1·688, 5·790). Considerable ethnic differences existed in eating patterns in West China. Mongolians were more likely to be overweight/obese, which was associated with their indulgent eating patterns. Ethnic-specific healthy eating intervention programs are needed.

The association between time-restricted eating (TRE) and the risk of non-alcoholic fatty liver disease (NAFLD) is less studied. Moreover, whether the association is independent of physical exercise or diet quality or quantity is uncertain. In this nationwide cross-sectional study of 3813 participants, the timing of food intakes was recorded by 24-h recalls; NAFLD was defined through vibration-controlled transient elastography in the absence of other causes of chronic liver disease. OR and 95 % CI were estimated using logistic regression. Participants with daily eating window of ≤ 8 h had lower odds of NAFLD (OR = 0·70, 95 % CI: 0·52, 0·93), compared with those with ≥ 10 h window. Early (05.00–15.00) and late TRE (11.00–21.00) showed inverse associations with NAFLD prevalence without statistical heterogeneity (Pheterogeneity = 0·649) with OR of 0·73 (95 % CI: 0·36, 1·47) and 0·61 (95 % CI: 0·44, 0·84), respectively. Such inverse association seemed stronger in participants with lower energy intake (OR = 0·58, 95 % CI: 0·38, 0·89, Pinteraction = 0·020). There are no statistical differences in the TRE-NAFLD associations according to physical activity (Pinteraction = 0·390) or diet quality (Pinteraction = 0·110). TRE might be associated with lower likelihood of NAFLD. Such inverse association is independent of physical activity and diet quality and appears stronger in individuals consuming lower energy. Given the potential misclassification of TRE based on one- or two-day recall in the analysis, epidemiological studies with validated methods for measuring the habitual timing of dietary intake are warranted.

Accumulative evidence indicates that meal timing is associated with cardiometabolic risks by deteriorating circadian rhythms. However, evidence is unclear. This cross-sectional study aimed to investigate the relation between nightly fasting duration, meal timing and frequency and metabolic syndrome (MetS) among Iranian adults. Eight hundred fifty adults were recruited in this study. Dietary data were collected by 24-h dietary recalls. Time-related eating patterns were determined as nightly fasting duration, occasions of eating, time and energy proportion of first and last meal and meal frequency on a day. The MetS was recognised on the basis of the National Cholesterol Education Program Adult Treatment Panel III criteria. A binary logistic regression was applied to examine the relation between meal timing and MetS. A significant inverse relation between habitual nightly fasting duration with MetS (OR = 0·74, 95 % CI 0·55, 0·99, P = 0·04) and ‘increased TAG’ (OR = 0·73, 95 % CI 0·55, 0·98, P = 0·03) was found after confounder adjustment. Also, habitual first and last meal energy had no significant connection with MetS. However, the odds of ‘increased fasting blood glucose’ were lower in subjects who consumed ≥25% of habitual energy intake in the last meal (OR = 0·60, 95 % CI 0·42, 0·85, P = 0·005). Having longer nightly fasting duration may be useful for decreasing the risk of both MetS and ‘elevated TAG’. These findings introduce a new insight that time-related eating patterns, instead of nightly fasting duration alone, might be related to cardiometabolic risks in Iranian adults.

Obesity remains a major public health concern and intermittent fasting is a popular strategy for weight loss, which may present independent health benefits. However, the number of diet books advising how fasting can be incorporated into our daily lives is several orders of magnitude greater than the number of trials examining whether fasting should be encouraged at all. This review will consider the state of current understanding regarding various forms of intermittent fasting (e.g. 5:2, time-restricted feeding and alternate-day fasting). The efficacy of these temporally defined approaches appears broadly equivalent to that of standard daily energy restriction, although many of these models of intermittent fasting do not involve fed-fasted cycles every other 24 h sleep–wake cycle and/or permit some limited energy intake outside of prescribed feeding times. Accordingly, the intervention period therefore may not regularly alternate, may not span all or even most of any given day, and may not even involve absolute fasting. This is important because potentially advantageous physiological mechanisms may only be initiated if a post-absorptive state is sustained by uninterrupted fasting for a more prolonged duration than applied in many trials. Indeed, promising effects on fat mass and insulin sensitivity have been reported when fasting duration is routinely extended beyond sixteen consecutive hours. Further progress will require such models to be tested with appropriate controls to isolate whether any possible health effects of intermittent fasting are primarily attributable to regularly protracted post-absorptive periods, or simply to the net negative energy balance indirectly elicited by any form of dietary restriction.

Numerous health benefits have been attributed to the ‘Mediterranean diet’ over the last decades. Selecting foods that were common in the Mediterranean regions (especially Crete) in the 1970s, with a frequent and abundant intake of fruit, vegetables, fish, olive oil and perhaps wine, has been reported to be associated with wide-ranging benefits including improved glucose metabolism and decreased risk of type 2 diabetes, obesity and CVD. While the respective contributions of various types of food have been widely investigated, less attention has been paid to other factors, also characteristic of the Mediterranean lifestyle, which may contribute to the health benefits perhaps as much as specific food choices. Traditionally, the Mediterranean diet was consumed in the context of a particular lifestyle, with a fixed number of daily meals, generally consumed at later hours (compared to North of Europe), and some specific meal-related behaviours such as the post-lunch siesta. In addition, the Mediterranean diet and lifestyle that were so beneficial to health, 40 years ago, were considerably different from present-day practices. The changes are particularly clear in younger individuals and countries of the Mediterranean region presently have the highest child overweight rates in Europe. The present paper will address research about meal and satiety patterns and examine how the recent changes from traditional practices are likely to have an impact on health risks and benefits in Mediterranean populations.

Effects of time of supplementation on forage intake, nutrient apparent digestibility and rumen fermentation were studied with 12 mature castrated male sheep (wethers) offered grass hay from 16.30 h to 09.30 h and supplemented with a cereal-based concentrate given at either 09.30 or 16.00 h. Voluntary intake of hay organic matter (OM) was decreased by feeding the concentrate (P < 0·01). Offering concentrate at 09.30 h after hay was available, increased intake of hay and total OM compared with offering it at 16.00 h before hay was available (P < 0·05). Daily pattern of hay intake was not changed when concentrate was offered at 09.30 h compared with feeding hay alone, but concentrate given at 16.00 h resulted in a lower hay intake between 16.30 and 18.00 h. Sheep offered concentrate at 09.30 h had higher rumen ammonia levels than those offered concentrate at 16.00 h, but there were no differences in the apparent digestibility of the nutrients, rumen pH and molar proportions of the main volatile fatty acids. There were also no differences between groups in the blood plasma concentrations of 3-hydroxybutyrate (30HB), nonesterified fatty acids (NEFA) and glucose. It is concluded that feeding supplement after rather than before a period of intake of forage or a bout of grazing may offer a means of minimizing reduction of forage intake as a consequence of feeding concentrate.