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Associations of subjective sleep patterns and social jet lag with weight loss and dietary intake in bariatric surgery patients: a 1-year follow-up study

Published online by Cambridge University Press:  24 February 2025

Aline Cunha Carvalho Open the ORCID record for Aline Cunha Carvalho [Opens in a new window] ,
Luisa Pereira Marot ,
Luis Augusto Mattar ,
José Américo Gomides de Sousa ,
Ana Cristina Tomaz Araújo ,
Camila Thais da Costa Assis ,
Maria Carliana Mota  and
Cibele Aparecida Crispim
Aline Cunha Carvalho*
Affiliation:
Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlandia, Uberlandia, MG, Brazil LEV Clinic – Treatment of Obesity, Uberlandia, Brazil
Luisa Pereira Marot
Affiliation:
Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlandia, Uberlandia, MG, Brazil Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309-0354, USA
Luis Augusto Mattar
Affiliation:
LEV Clinic – Treatment of Obesity, Uberlandia, Brazil
José Américo Gomides de Sousa
Affiliation:
LEV Clinic – Treatment of Obesity, Uberlandia, Brazil
Ana Cristina Tomaz Araújo
Affiliation:
LEV Clinic – Treatment of Obesity, Uberlandia, Brazil
Camila Thais da Costa Assis
Affiliation:
University Center of Uberlandia (UNITRI), Uberlândia, Brazil
Maria Carliana Mota
Affiliation:
Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlandia, Uberlandia, MG, Brazil
Cibele Aparecida Crispim*
Affiliation:
Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlandia, Uberlandia, MG, Brazil
*
Corresponding authors: Aline Cunha Carvalho; Email: [email protected] and Cibele Aparecida Crispim; Email: [email protected]
Corresponding authors: Aline Cunha Carvalho; Email: [email protected] and Cibele Aparecida Crispim; Email: [email protected]
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Abstract

Current literature has shown that poor sleep patterns and social jet lag (SJL) are associated with obesity and weight gain. However, this area remains underexplored in patients who have undergone bariatric surgery. We hypothesised that higher levels of SJL and poorer sleep patterns are associated with lower weight loss, greater caloric/nutrient intake and poorer metabolic outcomes following surgery. This study aims to assess the associations of SJL and subjective sleep with anthropometric, metabolic and dietary parameters during the first year following bariatric surgery. SJL, sleep quality and daytime sleepiness were measured in 122 patients (77 % women; median age 33·0 [28·0 – 41·7]). SJL was estimated by the absolute difference between the midpoint of sleep and wake times on weekdays and weekends. Daytime sleepiness and sleep quality were evaluated using the Epworth Sleepiness Scale (Epworth) and the Pittsburgh Sleep Quality Index, respectively. Multiple linear regressions were employed to evaluate the associations of SJL, sleep quality and daytime sleepiness with weight loss, metabolic and dietary outcomes. Independent variables were negatively associated with weight loss after surgery: SJL at 6 months and 1 year; sleep quality at all time points and sleepiness after one year (P < 0·05). SJL was positively associated with calorie and protein intake after 1-year post-surgery (P < 0·05). Our results show that higher SJL and poorer sleep patterns are associated with worse anthropometric, metabolic and dietary outcomes after bariatric surgery. These findings reinforce the importance of addressing variables related to biological rhythms to optimise post-surgical outcomes in bariatric patients.

Keywords

Bariatric SurgerySocial jetlagWeight lossSleep patterns
Type
Research Article
Information
British Journal of Nutrition , First View , pp. 1 - 10
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

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References

Chaput, JP, Mc Hill, AW, Cox, RC, et al. (2023) The role of insufficient sleep and circadian misalignment in obesity. Nat Rev Endocrinol 19, 82–97.CrossRefGoogle ScholarPubMed
Reinke, H & Asher, G (2016) Circadian clock control of liver metabolic functions. Gastroenterology 150, 574–580.CrossRefGoogle ScholarPubMed
Voigt, RM, Forsyth, CB & Keshavarzian, A (2019) Circadian rhythms: a regulator of gastrointestinal health and dysfunction. Expert Rev Gastroenterol Hepatol 13, 411–424.CrossRefGoogle ScholarPubMed
Stenvers, DJ, Scher, FAJL, Schrauwen, P, et al. (2019) Circadian clocks and insulin resistance. Nat Rev Endocrinol 15, 75–89.CrossRefGoogle ScholarPubMed
Froy, O & Garaulet, M (2018) The circadian clock in white and brown adipose tissue: mechanistic, endocrine and clinical aspects. Endocr Rev 39, 261–273.CrossRefGoogle Scholar
Morris, CJ, Purvis, TE, Hu, K, et al. (2016) Circadian misalignment increases cardiovascular disease risk factors in humans. Proc Natl Acad Sci 113, 1402–1411.CrossRefGoogle Scholar
Astiz, M, Heyde, I & Oster, H (2019) Mechanisms of communication in the mammalian circadian timing system. Int J Mol Sci 20, 343.CrossRefGoogle ScholarPubMed
Wittmann, M, Dinich, J, Merrow, M, et al. (2006) Social jetlag: misalignment of biological and social time. Chronobiol Int 23, 497–509.CrossRefGoogle ScholarPubMed
Roenneberg, T, Allebrandt, KV, Merrow, M, et al. (2012) Social jetlag and obesity. Curr Biol 22, 939–943.CrossRefGoogle ScholarPubMed
Zerón-Rugerio, MF, Cambras, T & Izquierdo-Pulido, M (2019) Social jet lag associates negatively with the adherence to the Mediterranean Diet and Body Mass Index among young adults. Nutrients 11, 1756.CrossRefGoogle Scholar
Mota, MC, Silva, CM, Balieiro, LCT, et al. (2019) Association between social jetlag food consumption and meal times in patients with obesity-related chronic diseases. Plos one 14, e0212126.CrossRefGoogle ScholarPubMed
Jang, SJ, Son, YJ & Lee, H (2022) Associations among social jetlag, sleep-related characteristics, premenstrual symptoms, depression, and body mass index of female nursing students. Perspect Psychiatr Care 58, 1642–1650.CrossRefGoogle ScholarPubMed
Bouman, EJ, Beulens, JWJ, Groeneveld, L, et al. (2023) The association between social jetlag and parameters of metabolic syndrome and type 2 diabetes: a systematic review and meta-analysis. J Sleep Res 32, e13770.CrossRefGoogle ScholarPubMed
Sládek, M, Klusáček, J, Hamplová, D, et al. (2023) Population-representative study reveals cardiovascular and metabolic disease biomarkers associated with misaligned sleep schedules. Sleep 46, zsad037.CrossRefGoogle Scholar
Haynie, DL, Lewin, D, Luk, JW, et al. (2017) Beyond sleep duration: bidirectional associations among chronotype, social jetlag, and drinking behaviors in a longitudinal sample of US high school students. Sleep 41, zsx202.Google Scholar
Ho, C-Y, Lin, S-H, Tsai, M-C, et al. (2020) Impact of cumulative unhealthy sleep practices in adolescence on substance use in young adulthood estimated using marginal structural modeling. Front Neurosci 14, 339.CrossRefGoogle Scholar
Krueger, B, Stutz, B, Jankovic, N, et al. (2023) The association of chronotype and social jet lag with body composition in German students: the role of physical activity behaviour and the impact of the pandemic lockdown. Plos One 18, e0279620.CrossRefGoogle ScholarPubMed
Imes, CC, Bizhanova, Z, Kline, CE, et al. (2021) Bidirectional relationship between sleep and sedentary behavior in adults with overweight or obesity: a secondary analysis. Sleep Adv 2, zpab004.CrossRefGoogle Scholar
Eisenberg, D, Shikora, SA, Aarts, E, et al. (2022) American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery. Surg Obes Relat Dis 18, 1345–1356.CrossRefGoogle ScholarPubMed
Lodewijks, Y, Schonck, F & Nienhuijs, S (2023) Sleep quality before and after bariatric surgery. Obes Surg 33, 279–283.CrossRefGoogle ScholarPubMed
Carvalho, AC, Mota, MC, Marot, LP, et al. (2020) Circadian misalignment is negatively associated with the anthropometric, metabolic and food intake outcomes of bariatric patients 6 months after surgery. Obes Surg 31, 159–169.CrossRefGoogle ScholarPubMed
Bertolazi, AN, Fagondes, SC, Hoff, LS, et al. (2011) Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Med 12, 70– 75.CrossRefGoogle ScholarPubMed
Mota, MC, Waterhouse, J, De-Souza, DA, et al. (2014) Sleep pattern is associated with adipokine levels and nutritional markers in resident physicians. Chronobiol Int 31, 1130–1138.CrossRefGoogle ScholarPubMed
Bertolazi, AN, Fagondes, SC; Hoff, LS, et al. (2009). Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil. Braz J Pulmonol 35, 877–883.Google ScholarPubMed
WHO (2000) Obesity: Preventing and Managing the Global Epidemic. Report of a WHO consultation. World Health Organization Technical Report Series no. 894, i-xii, 1–253. Geneva: WHO.Google Scholar
Friedwald, WT, Levy, RI & Fredrickson, DS (1972) Estimation of the concentration of low density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18, 499–502.CrossRefGoogle Scholar
Matthews, DR, Hosker, JP, Rudenski, AS, et al. (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28, 412–419.CrossRefGoogle ScholarPubMed
Moshfegh, AJ, Rhodes, DG, Baer, DJ, et al. (2008) The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr 88, 324–432.CrossRefGoogle ScholarPubMed
Voigt, RM, Forsyth, CB, Green, SJ, et al. (2014) Circadian disorganization alters intestinal microbiota. Plos one 9, e97500.CrossRefGoogle ScholarPubMed
Senesi, P, Ferrulli, A, Luzi, L, et al. (2022) Chrono-communication and cardiometabolic health: the intrinsic relationship and therapeutic nutritional promises. Front Endocrinol 13, 975509.CrossRefGoogle ScholarPubMed
Brum, MCB, Senger, MB, Schnorr, CC, et al. (2022) Effect of night-shift work on cortisol circadian rhythm and melatonin levels. Sleep Sci 15, 143–148.Google ScholarPubMed
Vieira, RPO, Nehme, PXSA, Marqueze, EC, et al. (2021) High social jetlag is correlated with nocturnal inhibition of melatonin production among night workers. Chronobiol Int 38, 1170–1176.CrossRefGoogle ScholarPubMed
Mota, MC, Silva, CM, Balieiro, LCT, et al. (2021) Social jetlag is associated with impaired metabolic control during a 1-year follow-up. Front Physiol 12, 702769.CrossRefGoogle ScholarPubMed
Cespedes Feliciano, EM, Rifas-Shiman, SL, Quante, M, et al. (2019) Chronotype, social jet lag, and cardiometabolic risk factors in early adolescence. JAMA Pediatr 173, 1049–1057.CrossRefGoogle ScholarPubMed
Suikki, T, Maukonen, M, Partonen, T, et al. (2021) Association between social jet lag, quality of diet and obesity by diurnal preference in Finnish adult population. Chronobiol Int 38, 720–731.CrossRefGoogle ScholarPubMed
Mokhlesi, B, Temple, KA, Tjaden, AH, et al. (2019) Association of self-reported sleep and circadian measures with glycemia in adults with pre diabetes or recently diagnosed untreated type 2 diabetes. Diabetes Care 42, 1326–1332.CrossRefGoogle ScholarPubMed
Liu, JL, Wang, CY, Cheng, TY, et al. (2021) Circadian clock disruption suppresses PDL1+ intraepithelial B cells in experimental colitis and colitis-associated colorectal cancer. Cell Mol Gastroenterol Hepatol 12, 251–276.CrossRefGoogle ScholarPubMed
Kettner, NM, Voicu, H, Finegold, MJ, et al. (2016) Circadian homeostasis of liver metabolism suppresses hepatocarcinogenesis. Cancer Cell 30, 909–924.CrossRefGoogle ScholarPubMed
Malaguarnera, R, Ledda, C, Filippello, A, et al. (2020) Thyroid cancer and circadian clock disruption. Cancers 12, 3109.CrossRefGoogle ScholarPubMed
El Ansari, W & Elhag, W (2021) Weight regain and insufficient weight loss after bariatric surgery: definitions, prevalence, mechanisms, predictors, prevention and management strategies, and knowledge gaps-a scoping review. Obes Surg 31, 1755–1766.CrossRefGoogle ScholarPubMed
Jin, CX, Sutherland, K, Gislason, T, et al. (2022) Influence of social jetlag on daytime sleepiness in obstructive sleep apnea. J Sleep Res 32, e13772.CrossRefGoogle ScholarPubMed
Creasy, SA, Ostendorf, DM, Blankenship, JM, et al. (2022) Effect of sleep on weight loss and adherence to diet and physical activity recommendations during an 18-month behavioral weight loss intervention. Int J Obes 46, 1510–1517.CrossRefGoogle ScholarPubMed
Spiegel, K, Tasali, E, Penev, P, et al. (2004) Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 141, 846–850.CrossRefGoogle ScholarPubMed
Knutson, KL & Van Cauter, E (2008) Associations between sleep loss and increased risk of obesity and diabetes. Ann N Y Acad Sci 1129, 287–304.CrossRefGoogle ScholarPubMed
Zuraikat, FM, Thomas, E, Roeshot, D, et al. (2019) Can healthy sleep improve long-term bariatric surgery outcomes? Results of a pilot study and call for further research. Obesity 27, 1769–1771.CrossRefGoogle ScholarPubMed
Antza, C, Kostopoulos, G, Mostafa, S, et al. (2021) The links between sleep duration, obesity and type 2 diabetes mellitus. J Endocrinol 252, 125–141.CrossRefGoogle ScholarPubMed
Ackel-D’Elia, C, da Silva, AC, Silva, RS, et al. (2012) Effects of exercise training associated with continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome. Sleep Breath 16, 723–735.CrossRefGoogle Scholar
Carneiro-Barrera, A, Díaz-Román, A, Guillén-Riquelme, A, et al. (2019) Weight loss and lifestyle interventions for obstructive sleep apnea in adults: systematic review and meta-analysis. Obes Rev 20, 750–762.CrossRefGoogle ScholarPubMed
Mendoza, J (2019) Food intake and addictive-like eating behaviors: time to think about the circadian clock(s). Neurosci Biobehav Rev 106, 122–132.CrossRefGoogle ScholarPubMed
Shaw, E, Dorrian, J, Coates, AM, et al. (2019) Temporal pattern of eating in night shift workers. Chronobiol Int 36, 1613–1625.CrossRefGoogle ScholarPubMed
Chen, C, Valizadeh Aslani, T, Rosen, GL, et al. (2020) Healthcare shift workers’ temporal habits for eating, sleeping, and light exposure: a multi-instrument pilot study. J Circadian Rhythm 18, 6.CrossRefGoogle Scholar
Hemmer, A, Mareschal, J, Dibner, C, et al. (2021) The effects of shift work on cardio-metabolic diseases and eating patterns. Nutrients 13, 4178.CrossRefGoogle ScholarPubMed
Mota, MC, Silva, CM, Balieiro, LCT, et al. (2017) Social jetlag and metabolic control in non-communicable chronic diseases: a study addressing different obesity statuses. Sci Rep 7, 6358.CrossRefGoogle ScholarPubMed
Tuna, MK, Işık, AC, Madenci, ÖÇ, et al. (2022) Obesity effects on sleep quality with anthropometric and metabolic changes. Rev Assoc Med Bras 68, 574–578.CrossRefGoogle ScholarPubMed
Huang, JF, Chen, LD, Lin, QC, et al. (2016) The relationship between excessive daytime sleepiness and metabolic syndrome in severe obstructive sleep apnea syndrome. Clin Respir J 10, 714–721.CrossRefGoogle ScholarPubMed
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