Table 4 Association of meal timing, number of eating occasions and nighttime fasting duration with risk of cardiovascular disease by sex in the NutriNet-santé cohort, 2009-2021, N = 103,389

From: Dietary circadian rhythms and cardiovascular disease risk in the prospective NutriNet-Santé cohort

 

Women

Men

 

N cases/non-cases

HR (95% CI)a

p-valb

N cases/non-cases

HR (95% CI)a

p-valb

Overall cardiovascular diseases

Time of first meal (1 h incr.)

1106/80,603

1.06 (0.99–1.14)

0.08

930/20,750

1.06 (0.99–1.15)

0.09

 Before 8AM

538/35,161

Ref

0.05

502/10,105

Ref.

0.6

 Between 8 and 9AM

414/29,403

1.04 (0.91–1.19)

350/6814

1.09 (0.95–1.26)

 After 9AM

154/16,039

1.24 (1.02–1.51)

78/3831

0.98 (0.76–1.25)

Time of last meal (1 h incr.)

1106/80,603

1.07 (1.00–1.13)

0.05

930/20,750

0.97 (0.91–1.04)

0.4

 Before 8PM

387/16,039

Ref.

0.01

399/7040

Ref.

1.0

 Between 8 and 9PM

479/36,347

1.12 (0.97–1.29)

365/8419

1.04 (0.89–1.20)

 After 9PM

240/17,359

1.26 (1.05–1.51)

166/5291

0.99 (0.80–1.21)

Number of eating occasions (1 occasion incr.)

1106/80,603

0.99 (0.95 –1.03)

0.6

930/20,750

0.99 (0.95–1.03)

0.7

Nighttime fasting durationc (1 h incr.)

1106/80,603

0.94 (0.88–1.00)

0.05

930/20,750

1.03 (0.96–1.09)

0.4

Cerebrovascular diseasesd

Time of first meal (1 h incr.)

625/81,084

1.10 (1.01–1.21)

0.03

363/21,680

0.98 (0.87–1.11)

0.8

 Before 8AM

299/35,400

Ref.

0.02

209/10,398

Ref.

0.8

 Between 8 and 9AM

242/29,575

1.11 (0.94–1.33)

119/7045

0.86 (0.68–1.08)

 After 9AM

84/16,109

1.35 (1.04–1.75)

35/3874

1.00 (0.69–1.46)

Time of last meal (1 h incr.)

625/81,084

1.07 (0.98–1.16)

0.1

363/21,680

1.09 (0.99–1.21)

0.09

 Before 8PM

218/27,066

Ref.

0.02

145/7294

Ref.

1.0

 Between 8 and 9PM

275/36,551

1.18 (0.98–1.42)

151/8633

1.20 (0.94–1.52)

 After 9PM

132/17,467

1.31 (1.03–1.67)

67/5390

1.20 (0.87–1.67)

Number of eating occasions (1 occasion incr.)

625/81,084

0.98 (0.93–1.04)

0.6

363/21,680

0.94 (0.88–1.01)

0.09

Nighttime fasting duration (1 h incr.)

625/81,084

0.94 (0.86 − 1.02)

0.1

363/21,680

0.91 (0.82–1.01)

0.09

Coronary heart diseasese

Time of first meal (1 h incr.)

495/81,214

0.99 (0.90–1.10)

0.9

576/21,104

1.11 (1.01–1.22)

0.03

 Before 8AM

250/35,449

Ref.

1.0

300/10,307

Ref.

0.2

 Between 8 and 9AM

175/29,642

0.93 (0.76–1.13)

231/6933

1.23 (1.04–1.47)

 After 9AM

70/16,123

1.06 (0.79–1.42)

45/3864

0.97 (0.70–1.35)

Time of last meal (1 h incr.)

495/81,214

1.07 (0.97–1.18)

0.2

576/21,104

0.91 (0.84–0.99)

0.02

 Before 8PM

174/27,110

Ref.

0.2

258/7181

Ref.

0.2

 Between 8 and 9PM

212/36,614

1.06 (0.86–1.30)

217/8567

0.94 (0.78–1.14)

 After 9PM

109/17,490

1.18 (0.90–1.55)

101/5356

0.87 (0.67–1.12)

Number of eating occasions (1 occasion incr.)

495/81,214

0.99 (0.93–1.05)

0.6

576/21,104

1.03 (0.98–1.08)

0.3

Nighttime fasting duration (1 h incr.)

495/81,214

0.93 (0.85–1.03)

0.2

576/21,104

1.10 (1.01–1.19)

0.02

  1. HR hazard ratio, N sample size, CI confidence Interval.
  2. Interactions between time of first meal and sex for the association with overall CVD, cerebrovascular diseases and coronary heart diseases were p-value = 0.2, 0.1 and 0.8 respectively. Interaction between time of last meal and sex for the association with overall CVD, cerebrovascular diseases and coronary heart diseases were p-value = 0.01, 0.6 and 0.004, respectively. Interaction between number of eating occasions and sex for the association with overall CVD, cerebrovascular diseases and coronary heart diseases were p-value = 0.3, 0.2 and 0.8, respectively. Interaction between nighttime fasting duration and sex for the association with overall CVD, cerebrovascular diseases and coronary heart diseases were p-value = 0.2, 0.5 and 0.02, respectively.
  3. aMultivariable Cox proportional hazard models adjusted for age (timescale), educational level (less than high school degree, <2 years after high school degree, ≥2 years after high school degree), monthly income per unit of consumption (<900€, 900–1200€, 1200–1800€, 1800–2300€, 2300–3700€, more than 3700€, do not want to answer), BMI at baseline (continuous, kg/m2), family history of CVDs (no, yes), alcohol consumption (Non-consumers (0 g/day), low consumers (0.1–4.9 g/day), moderate consumers (5.0–14.9 g/day), high consumers (15.0–29.9 g/day) and very high consumers (>30.0 g/day)), episodes of binge drinking (None, one, more than one) alcohol intake (continuous, kcal/day), daily energy intake excluding alcohol (continuous, kcal/day), healthy and Western dietary patterns derived by factorial analysis (continuous), smoking (current regular (1 cigarette or more per day), current occasional, current, former, never), number of pack years (continuous, defined as the number of packs of cigarettes smoked per day by the number of years of smoking), physical activity (low, moderate, high) and number of dietary records (continuous). Circadian nutritional behaviours were mutually adjusted (except for nighttime fasting duration).
  4. bP-values for continuous variables and p-value for trend for categorical variables.
  5. cThe models for nighttime fasting duration were adjusted for the same variables as indicated in point 1 but excluding time of last meal of the day to avoid overadjustment.
  6. dStroke and transient ischemic attack.
  7. eMyocardial infarction acute coronary syndrome, angioplasty and angina pectoris.
  8. Source data are provided as a Source Data file.
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