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Title:	The feasibility of integrated chrono-nutrition weight reduction program among overweight and obese non-shift workers in Putrajaya
Authors:	Fatin Hanani Mazri (P90592)
Supervisor:	Zahara Abdul Manaf, Assoc. Prof. Dr.
Keywords:	Weight Loss Circadian Rhythm Overweight Universiti Kebangsaan Malaysia -- Dissertations Dissertations, Academic -- Malaysia
Issue Date:	28-Jul-2022
Description:	Chrono-nutrition is the interaction of food timing-related practice with circadian rhythm. The disruption in chrono-nutrition has been linked with obesity, thus chrononutrition is a potentially modifiable factor in weight management. This study aims to develop and evaluate the feasibility of an integrated chrono-nutrition weight reduction program among overweight and obese non-shift workers with morning and evening chronotypes. This study consisted of two phases; Phase 1 was the program development, and Phase 2 was the implementation and evaluation of the integrated chrono-nutrition weight reduction program. Phase 1 was started with needs assessment through scoping review of the chronotype's dietary patterns. The outcomes indicated that evening chronotypes was associated with greater energy intake towards the later part of the day and delayed meal timing than morning chronotypes. These dietary practices were associated with an increased risk of obesity and hampered weight loss intervention. The next step of Phase 1 was the validation study of the instrument to measure chronotype - Munich Chronotypes Questionnaire (MCTQ). Based on pilot test, 20% of the sample populations displayed a split-sleep pattern due to religious obligation. Thus, a modified MCTQ for split-sleep was developed and validated among 161 non-shift workers. Subsequently, a cross-sectional study involving 299 overweight and obese non-shift workers was conducted to examine the association between chronotype, metabolic health status, and chrono-nutrition. It was discovered that individuals with metabolically unhealthy obesity (n=126) consumed less energy during earlier part of the day (59.0 vs 63.0 %, p=0.008) coupled with more energy intake during later part of the day (41.0 vs 37.0 %, p=0.008) compared to those with metabolically healthy obesity (n=173). The final step in Phase 1 was the development and integration of identified chrono-nutrition domains with the existing workplace weight reduction module. The original SLIMSHAPE™ module focused on balanced & hypocaloric diet, physical activity and behavioural modification. While the chrono-nutrition domains consisted of recommendations on (i) temporal energy distribution tailored to morning and evening chronotypes (ii) meal timing and (iii) sleep duration. Phase 2 was a quasiexperimental feasibility study of the integrated program, involving a sub-sample of 91 participants, overweight and obese non-shift workers of Putrajaya (74.7% women, 39.6±6.3 years old, BMI: 31.2±4.5 kg/m2). After 12-weeks of intervention, both chronotypes had significant improvement in chrono-nutrition practice with greater % energy intake in the early eating window (mean difference (MD): +2.8%, 95%CI: 0.3, 5.1, p=0.028) and smaller intake in the late eating window and earlier midpoint of eating (MD: -0.5 h, 95% CI: -0.8, -0.1, p=0.005) and had a reduced night eating syndrome score (MD: -1.5, 95%CI: -2.5, -0.5, p=0.004). Both chronotypes also had significant reduction in body weight (MD: -4.0 kg, 95% CI: -4.9, -3.1, p<0.001), body mass index (MD: -1.5 kg/m2, 95% CI: -1.9, -1.2, p<0.001), body fat percent (MD: -2.0%, 95% CI: -2.5, -1.4, p<0.001), insulin resistance (MD: -0.7, 95% CI: -1.1, -0.4, p<0.001), systolic (MD: -8.5 mmHg, 95% CI: -10.7, -6.2, p<0.001) and diastolic (MD: -4.3 mmHg, 95% CI: -6.7, -2.0, p<0.001) blood pressure. In conclusion, an integrated weight reduction program that incorporates dietary, physical activity, behaviour modification, and chrono-nutrition is feasible among overweight and obese non-shift workers. The positive outcomes show a promising role in weight management.,Ijazah Doktor Falsafah
Notes:	e-thesis
Pages:	289
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Health Sciences / Fakulti Sains Kesihatan

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