Poor sleep habits are associated with increased risk of developing type 2 diabetes. In this review and meta-analysis, we aimed to investigate the effects of sleep manipulation on markers of insulin sensitivity from randomized, controlled trials. Sleep manipulation was defined as reduction in sleep duration, sleep quality, and circadian misalignment. A systematic literature search was conducted in three databases and resulted in 35 eligible articles. The studies included interventions on sleep restriction (26 studies), slow wave sleep suppression and rapid eye movement sleep disturbance (2 studies), sleep fragmentation (2 studies), and circadian misalignment (5 studies). The meta-analysis included 21 sleep restriction studies. Sleep restriction reduced insulin sensitivity assessed by oral or intravenous glucose tolerance test and homeostatic model assessment of insulin resistance. Whole-body insulin sensitivity was also reduced after short sleep when measured by the hyperinsulinemic euglycemic clamp, but peripheral insulin sensitivity was not affected. In addition, circadian misalignment and slow wave sleep suppression negatively affected insulin sensitivity, while rapid eye movement sleep disturbance and sleep fragmentation had no effect. In summary, the studies indicated that duration, quality, and timing of sleep are essential for metabolic function and risk of type 2 diabetes.

Summary: In parallel with an increased focus on climate changes and carbon footprint, the interest in plant‐based diets and its potential health effects have increased over the past decade. The objective of this systematic review and meta‐analysis was to examine the effect of vegan diets (≥12 weeks) on cardiometabolic risk factors in people with overweight or type 2 diabetes. We identified 11 trials (796 participants). In comparison with control diets, vegan diets reduced body weight (−4.1 kg, 95% confidence interval (CI) −5.9 to −2.4, p < 0.001), body mass index (BMI) (−1.38 kg/m², 95% CI −1.96 to −0.80, p < 0.001), glycated hemoglobin (HbA_1c) (−0.18% points, 95% CI −0.29 to −0.07, p = 0.002), total cholesterol (−0.30 mmol/L, 95% CI −0.52 to −0.08, p = 0.007), and low‐density lipoprotein cholesterol (−0.24 mmol/L, 95% CI −0.40 to −0.07, p = 0.005). We identified no effect on blood pressure, high‐density lipoprotein cholesterol, and triglycerides. We found that adhering to vegan diets for at least 12 weeks may be effective in individuals with overweight or type 2 diabetes to induce a meaningful decrease in body weight and improve glycemia. Some of this effect may be contributed to differences in the macronutrient composition and energy intake in the vegan versus control diets. Therefore, more research is needed regarding vegan diets and cardiometabolic health.

Early meal timing and chronotype are associated with lower BMI, but their impact on appetite is poorly understood. We examined the impact of meal timing and chronotype on appetite and food reward. Forty-four adults were divided into early (EC; Morningness–Eveningness Questionnaire (MEQ) score = 55 ± 5) or late chronotype (LC; MEQ score = 40 ± 6) and assessed for body mass index, habitual energy intake (EI; three-day online dietary record) and eating behavior traits from the Three-Factor Eating Questionnaire (TFEQ). Participants attended the laboratory after ≥3 h fast on two occasions for early (AM; 8–10 a.m.) and late (PM; 4–6 p.m.) counterbalanced testing sessions in a 2 × 2 design. Appetite ratings and food reward (validated diurnal Leeds Food Preference Questionnaire) were measured in response to a standardized test meal. LC was associated with higher BMI (p = 0.01), but not with EI or TFEQ. The composite appetite score was lower in AM than PM (M_Δ= −5 (95% CI −10, −0.2) mm, p = 0.040). Perceived test meal fillingness was higher in AM than PM and EC compared to LC (p ≤ 0.038). Liking and wanting high-fat food were lower in AM than PM (p ≤ 0.004). The late chronotype was associated with greater desire for high-fat food (p = 0.006). To conclude, early meal timing and early chronotype are independently associated with smaller appetite and lower desire for high-fat food.

Time-restricted eating (TRE) has been suggested to be a simple, feasible, and effective dietary strategy for individuals with overweight or obesity. We aimed to investigate the effects of 3 months of 10-h per-day TRE and 3 months of follow-up on bodyweight and cardiometabolic risk factors in individuals at high risk of type 2 diabetes. This was a single-centre, parallel, superiority, open-label randomised controlled clinical trial conducted at Steno Diabetes Center Copenhagen (Denmark). The inclusion criteria were age 30-70 years with either overweight (ie, BMI ≥25 kg/m²) and concomitant prediabetes (ie, glycated haemoglobin [HbA_1c] 39-47 mmol/mol) or obesity (ie, BMI ≥30 kg/m²) with or without prediabetes and a habitual self-reported eating window (eating and drinking [except for water]) of 12 h per day or more every day and of 14 h per day or more at least 1 day per week. Individuals were randomly assigned 1:1 to 3 months of habitual living (hereafter referred to as the control group) or TRE, which was a self-selected 10-h per-day eating window placed between 0600 h and 2000 h. Randomisation was done in blocks varying in size and was open for participants and research staff, but outcome assessors were masked during statistical analyses. The randomisation list was generated by an external statistician. The primary outcome was change in bodyweight, assessed after 3 months (12 weeks) of the intervention and after 3 months (13 weeks) of follow-up. Adverse events were reported and registered at study visits or if participants contacted study staff to report events between visits. This trial is registered on ClinicalTrials.gov (NCT03854656). Between March 12, 2019, and March 2, 2022, 100 participants (66 [66%] were female and 34 [34%] were male; median age 59 years [IQR 52-65]) were enrolled and randomly assigned (50 to each group). Of those 100, 46 (92%) in the TRE group and 46 (92%) in the control group completed the intervention period. After 3 months of the intervention, there was no difference in bodyweight between the TRE group and the control group (-0·8 kg, 95% CI -1·7 to 0·2; p=0·099). Being in the TRE group was not associated with a lower bodyweight compared with the control group after subsequent 3-month follow-up (-0·2 kg, -1·6 to 1·2). In the per-protocol analysis, participants who completed the intervention in the TRE group lost 1·0 kg (-1·9 to -0·0; p=0·040) bodyweight compared with the control group after 3 months of intervention, which was not maintained after the 3-month follow-up period (-0·4 kg, -1·8 to 1·0). During the trial and follow-up period, one participant in the TRE group reported a severe adverse event: development of a subcutaneous nodule and pain when the arm was in use. This side-effect was evaluated to be related to the trial procedures. 3 months of 10-h per-day TRE did not lead to clinically relevant effects on bodyweight in middle-aged to older individuals at high risk of type 2 diabetes. Novo Nordisk Foundation, Aalborg University, Helsefonden, and Innovation Fund Denmark.