Exploring the Relationship between Chronotype and Waist Circumference: A Scoping Review

Abstract

Understanding the relationship between chronotype and waist circumference (WC) has implications for metabolic health management. The present article overviews the available literature, the knowledge gaps, and the insights for future research. We conducted a search on the Scopus, Web of Science, and PubMed electronic databases and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. A total of 33 articles were included in the review. The studies primarily identified that people with the evening chronotype presented a higher mean WC compared to those with the morning chronotype. However, the difference was not significant in all studies. A significant positive correlation of the WC with chronotype scores denoting eveningness was found in 88% of the studies. The cut-off values on the scales to categorize subjects into different chronotypes may need to be defined for communities living across the globe. We conclude that higher WC values are associated with eveningness. However, this finding should be validated using objective measures of chronotype assessment.

 

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Keywords

chronotype - obesity - abdominal - waist circumference

Introduction

The human body has an internal clock regulating various functions on a defined 24-hour rhythm called the circadian rhythm. For example, we often feel hungry or sleepy at a specific time of the day. The circadian rhythm differs in terms of timing for everyone, and this characterization is called the chronotype.[1] The chronotype is assessed on a continuum ranging from morningness, which refers to rising and going to bed earlier and performing better physically and mentally in the daytime, to eveningness, which refers to getting up and going to bed later and performing better physically and mentally in the evening or night.[2] Several validated scales are available to assess the chronotype of an individual; they collect information such as diurnal preferences, sleep-wake patterns, alertness, and mid-sleep time subjectively and/or objectively.[3] The score on these scales is used to assess the respondent's proneness towards morningness or eveningness. The scales have identified the cut-off points for the scores to categorize the individuals into morning-type person (MC), evening-type person (EC), or neither morning nor evening, that is, intermediate chronotype (IC).

Even though our activities should synchronize with our circadian rhythm to maintain good health conditions, sometimes we fail to do so due to work schedules, responsibilities, or other personal and social factors. This creates an imbalance between our internal clock and our activities that is called circadian disruption and can be described as a 'transient and chronic disturbance of the circadian system'.[4] Circadian disruption adversely impacts various hormonal and metabolic functions and may lead to obesity.[5] Several studies have identified that, compared to MCs, ECs present higher body mass index (BMI) and a greater tendency to follow unhealthy lifestyles, such as caffeine consumption at night, low intake of fruits and vegetables,[6] smoking, lack of adherence to physical activities,[7] delays in meal timing, skipping breakfast, lower consumption of proteins and vegetables, and increased consumption of sucrose, sweets, caffeine, and alcohol.[8] An association of eveningness with obesity has also been identified in studies exploring genetic predispositions. Ruiz-Lozano et al.[9] (2016) found a significant interaction between the 3111T/C single-nucleotide polymorphism (SNP) of the Circadian Locomotor Output Cycles Kaput (CLOCK) gene and chronotype for body weight. The ECs presented higher body weight than MCs among carriers of the risk allele C. However, it should be noted that some of the studies[10] have not found a significant association between evening chronotype and higher BMI.

Though BMI is a valid indicator of obesity, it has limitations in terms of assessing the distribution of fats in the body.[11] The significance of the accumulation of fats surrounding the visceral organs in obesity is crucial, since it is an independent indicator of metabolic disorders apart from BMI.[12] Researchers have often preferred anthropometric measurements over computed tomography (CT) or magnetic resonance imaging (MRI) scans to assess visceral fats, since the performance of these scans is costly. Waist circumference (WC) is one of the most widely used anthropometric indicators of abdominal obesity aside from the BMI. It is widely used to assess obesity-related health risks.[13]

Hence, it is crucial to examine the relationship between chronotype and abdominal obesity through simple and commonly used parameters such as the WC. Understanding this relationship may help researchers have new insights or find areas for interventions and future research to manage obesity. The present review article describes the statistical association and correlation identified between chronotype and WC in previous studies, as well as any factors influencing this relationship.

 

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Materials and Methods

 

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Search Strategy

We conducted a search for studies published between 2012 and 2023 on the relationship between chronotype and WC on the Scopus, Web of Science, and PubMed electronic databases using combinations of the keywords chronotype, eveningness, morningness, and waist circumference. The titles and abstracts of the articles identified were read and screened by two independent reviewers. We tried to obtain the full texts of the articles through the websites of the publishers, the Google Scholar database, or the Research Gate online portal.

 

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Selection of Studies

Only original studies using primary data were considered. We excluded studies with no information relevant to the objectives of the present scoping review. Review articles, systematic reviews, and meta-analyses were also excluded. The selected abstracts were reviewed by a third independent reviewer. Any issues, difficulties, or conflicts regarding the selection of studies were resolved through a discussion among all the reviewers.

Documentation and data charting of all the studies were conducted using the Microsoft Excel 2016 (Microsoft Corp., Redmond, WA, United States) software. The present review was reported following the extension for scoping reviews of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.[14]

 

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Results

The database search resulted in 153 records. After removing duplicate studies (n = 75), the titles and abstracts of the remaining 78 studies were read, and 6 were excluded because they were review articles, systematic reviews, or meta-analyses. After excluding the abstracts and/or full texts of studies that did not contain relevant information, 33 articles were finally selected for analysis ([Figure 1]).

Fig. 1 Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) flow chart regarding stages of selection of articles.

 

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Baseline Information about the Selected Studies

The studies selected were published between 2013 and 2023, and [Table 1] presents brief details about them.[7] [15] [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] [26] [27] [28] [29] [30] [31] [32] [33] [34] [35] [36] [37] [38] [39] [40] [41] [42] [43] [44] [45] [46] In total, 22 (67%) studies were conducted on European populations, and 28 (85%) assess the chronotype of the participants through the Morningness-Eveningness Questionnaire (MEQ), which is a validated scale that collects subjective information about various aspects of an individual, such as sleep-wake preferences and alertness.[47] The full version of the MEQ was used in 16 (57%) studies, whereas the reduced version or selected items of the MEQ were used in 12 (43%) studies. Overall, 4 (12%) studies used the Munich Chronotype Questionnaire (MCTQ), another validated scale that assesses chronotype based on the objective measurement of mid-sleep time and subjective information such as sleep-wake preferences.[48] Only 1 study[49] determined the chronotype of the participants through actigraphy, a method used to record and analyze sleep parameters through small, computerized devices worn by the participants on their body.

Table 1 Brief details about the selected studies.

Serial number	Author and year of publication	Country	Study population	Chronotype considered as a categorical or continuous variable	Findings	Type of chronotype assessment	Type of data analyzed	Type of analysis
1	Molina-Montes et al.,[15] 2022	Spain	Participants of the EPIC study	Categorical	Mean WC higher in ECs than MCs at baseline (not Significant)	MCTQ	Cross-sectional	Mean difference
				Categorical	Mean gain in WC higher in EC than MC over 3 years (Significant)	MCTQ	Longitudinal	Mean difference
2	Zeraattalab-Motlagh et al.,[16] 2023	Iran	General population	Categorical	Mean WC higher in ECs and ICs than in MCs (among men; not significant)	MEQ	Cross-sectional	Mean difference
				Categorical	Mean WC higher in MCs than in ECs and ICs (among women; not significant)	MEQ	Cross-sectional	Logistic regression
3	Vetrani et al.,[17] 2022	Italy	Obese individuals	Categorical	Mean WC higher in ECs than MCs (significant)	MEQ	Cross-sectional	Mean difference
4	Rahati et al.,[18] 2022	Iran	Overweight and obese individuals	Categorical	Mean WC higher in EC- and IC-related genotypes than in MC-related genotypes (significant)	MEQ	Cross-sectional	Mean difference
5	Di Somma et al.,[19] 2021	Italy	Craniopharyngioma patients and controls	Categorical	Mean WC higher in ECs than MCs (significant)	MEQ	Cross-sectional	Mean difference
				Continuous	Positive correlation between eveningness and WC (significant)	MEQ	Cross-sectional	Correlation
6	Barrea et al.,[20] 2021	Italy	Patients with GEP-NET	Categorical	Mean WC higher in ECs than MCs (significant)	MEQ	Cross-sectional	Mean difference
				Continuous	Positive correlation between eveningness and WC (significant even after adjustment for BMI)	MEQ	Cross-sectional	Correlation
7	Marqueze et al.,[21] 2021	Turkey	Overweight night shift workers	Categorical	Mean WC at baseline higher than after melatonin supplementation (among MCs; significant)	MCTQ (MSFsc was calculated)	Interventional	Mean difference
8	Barrea et al.,[22] 2021	Italy	Mixed group of patients, volunteers, and hospital employees	Categorical	Mean WC higher in ECs than MCs (significant)	MEQ	Cross-sectional	Mean difference
				Continuous	Positive correlation between eveningness and WC (significant)	MEQ	Cross-sectional	Correlation
9	Suikki et al.,[23] 2021	Finland	Participants of the FINRISK and DILGOM studies	Categorical	Mean WC lower in MCs with sleep-corrected SJ < 1 hour as compared to MCs with sleep-corrected SJL ≤ 1 hour to < 2 hours (significant)	sMEQ	Cross-sectional	Mean difference
				Categorical	Mean WC lower in ICs with sleep-corrected SJL < 1 hour as compared to ICs with sleep-corrected SJL ≤ 1 hour to < 2 hours (not dignificant)	sMEQ	Cross-sectional	Mean difference
				Categorical	Mean WC higher in ECs with sleep-corrected SJL < 1 hour as compared to ECs with sleep-corrected SJL ≤ 1 hour to < 2 hours (not significant)	sMEQ	Cross-sectional	Mean difference
10	De Amicis et al.,[24] 2020	Italy	European general population	Categorical	Mean WC higher in ECs than in MCs (not significant)	rMEQ	Cross-sectional	Mean difference
				Continuous	Positive correlation between eveningness and WC (significant)	rMEQ	Cross-sectional	Correlation
11	Cespedes Feliciano et al.,[25] 2019	United States	Adolescents	Continuous	Positive correlation between eveningness and WC (in girls; significant)	MEQ for children	Cross-sectional	Correlation
				Continuous	Positive correlation between eveningness and WC (in boys; not significant)	MEQ for children	Cross-sectional	Correlation
12	Ritonja et al.,[26] 2019	Canada	Female hospital employees	Categorical	Mean WC higher in ECs with current rotating night work compared to ECs working in day shifts (significant)	MCTQ (MSF was calculated)	Cross-sectional	Mean difference
				Categorical	Mean WC higher in ICs with current rotating night work compared to ICs working in day shifts (significant)	MCTQ (MSF was calculated)	Cross-sectional	Mean difference
				Categorical	Mean WC higher in ECs with ≥ 10 years of night work than in ECs with < 10 years of night work (significant)	MCTQ (MSF was calculated)	Cross-sectional	Mean difference
				Categorical	Mean WC higher in ECs with < 3 consecutive night shifts in the week prior to data collection than in ECs with > 3 consecutive night shifts (significant)	MCTQ (MSF was calculated)	Cross-sectional	Mean difference
				Categorical	Mean WC higher in ICs with < 3 consecutive night shifts in the week prior to data collection than in ICs with > 3 consecutive night shifts (significant)	MCTQ (MSF was calculated)	Cross-sectional	Mean difference
13	Loef et al.,[27] 2019	Netherlands	Healthcare workers	Categorical	Effect estimate of shift work: WC higher in ECs working in shifts than in ECs who are not shift workers (not significant)	Single-item question from the MEQ	Cross-sectional	Effect estimate
				Categorical	Effect estimate of shift work: WC higher in MCs who are not shift workers than in MCs who are shift workers (not significant)	Single-item question from the MEQ	Cross-sectional	Effect estimate
				Categorical	Effect estimate of shift work: WC higher in ICs who are not shift workers than ICs who are shift workers (not significant)	Single-item question from the MEQ	Cross-sectional	Effect estimate
14	Maukonen et al.,[28] 2019	Finland	Participants of the DILGOM baseline and follow-up study, and the Findiet 2007 study	Categorical	Mean WC higher in ECs (at baseline; not significant)	sMEQ	Cross-sectional	Mean difference
				Categorical	Mean WC higher in ECs than in MCs (at follow-up after 7 years; not Significant)	sMEQ	Cross-sectional	Mean difference
				Categorical	Proportion of individuals whose WC had increased (≥ 5%) over the follow-up period was higher in ECs than in MCs (not significant)	sMEQ	Longitudinal	Mean difference
15	Celis-Morales et al.,[29] 2017	United Kingdom	Participants of the United Kingdom Biobank study	Categorical	WC-based central obesity was higher in evening-related genetic predisposition than morning-related genetic predisposition (significant)	Single-item question from the MEQ	Cross-sectional	Logistic regression
16	Maukonen et al.,[7] 2016	Finland	Participants of the FINRISK and DILGOM studies	Categorical	Mean WC higher in ECs than in MCs (not significant)	sMEQ	Cross-sectional	Mean difference
17	Lee et al.,[30] 2015	Norway	HIV-AIDS patients	Categorical based on actigraphy	WC higher in circadian quotients related to eveningness	Actigraphy	Cross-sectional	Mean difference
18	Merikanto et al.,[31] 2015	Finland	Participants of the 2007 and 2012 FINRISK studies	Categorical	Mean WC higher in MCs than in ECs (significant)	sMEQ	Cross-sectional	Mean difference
				Categorical	Mean WC lower in ECs with no depressive symptoms than in ECs with two depressive symptoms (not significant)	sMEQ	Cross-sectional	linear regression
19	Merikanto et al.,[32] 2013	Finland	Participants of the 2007 FINRISK study	Categorical	Mean WC higher in MCs than in ECs (not significant among boys or girls: sex-stratified analysis)	sMEQ	Cross-sectional	Mean difference
				Categorical	Mean WC lower in ECs with no depressive symptoms than in ECs with two depressive symptoms (significant)	sMEQ	Cross-sectional	Analyses of covariance
20	Johnsen et al.,[33] 2013	Norway	Participants of the Tromsø study	Continuous	Positive correlation between eveningness and WC (significant)	MCTQ (MSFsc was calculated)	Cross-sectional	Correlation
21	Yilmaz and Yangılar,[34] 2022	Turkey	General population	Categorical	Mean WC higher in MCs than in ECs (not significant)	MEQ	Cross-sectional	Mean difference
22	Merikanto et al.,[35] 2013	Finland	Participants of the 2007 FINRISK and DILGOM studies	Categorical	Mean WC higher in MCs than ECs (significant)	sMEQ	Cross-sectional	Mean difference
				Continuous	Positive correlation between eveningness and WC (significant)	sMEQ	Cross-sectional	Linear regression
23	Basnet et al.,[36] 2018	Finland	Participants of the FINRISK study	Categorical	Mean WC higher in ECs than in MCs (19th question of the MEQ; not significant)	Six items selected from the MEQ	Cross-sectional	Mean difference
24	Malin et al.,[37] 2022	United States	Participants of a clinical trial	Categorical	Mean WC higher in ECs than in MCs (not Significant)	MEQ	Cross-sectional	Mean difference
25	Sadeghzadeh et al.,[38] 2022	Iran	General population	Categorical	Mean WC higher in ECs than in MCs (not significant)	MEQ	Cross-sectional	Mean difference
26	Rabiei et al.,[39] 2022	Iran	General population	Categorical	Mean WC higher in ECs than in MCs (not significant)	MEQ	Cross-sectional	Mean difference
27	Ngo-Nkondjock et al.,[40] 2021	United States	Participants of the 2015 NHANES study	Categorical	Mean WC higher in extreme-morning type participants than in the rest of the participants (significant)	sMEQ and sleep-onset and wake-up-offset timing	Cross-sectional	Mean difference
28	Muscogiuri et al.,[41] 2020	Italy	Participants of the OPERA Prevention Project	Categorical	Mean WC higher in ECs than in MCs (not significant)	MEQ	Cross-sectional	Mean difference
				Continuous	Positive Correlation between eveningness and WC (not significant)	MEQ	Cross-sectional	Correlation
29	Melo et al.,[42] 2020	Brazil	Bipolar disorder patients	Categorical	Participants with abnormal WC had scores denoting evening chronotype on the MEQ (not significant)	MEQ	Cross-sectional	Mean difference
30	Yazdinezhad et al.,[43] 2019	Iran	Housewives	Categorical	Mean WC higher in MCs with normal weight than in overweight/obese MCs (not significant)	MEQ	Cross-sectional	Mean difference
				Categorical	Mean WC higher in overweight /obese ECs than in ECs with normal weight (not significant)	MEQ	Cross-sectional	Mean difference
31	Vetrani et al.,[44] 2023	Italy	Obese individuals	Categorical	Mean WC higher in ECs than in MCs (significant)	MEQ	Cross-sectional	Mean difference
32	Verde et al.,[45] 2023	Italy	Overweight/Obese women	Categorical	Weight loss was lower in ECs than in MCs after 31 days of intervention (significant)	MEQ	Cross-sectional	Mean difference
				Continuous	Negative correlation between eveningness and percentage changes in WC after 31 days of intervention (significant)	MEQ	Interventional	Correlation
33	Remchak et al.,[46] 2022	United States	Adults with metabolic syndrome	Categorical	Mean WC higher in ECs than in MCs (not significant)	MEQ	Cross-sectional	Mean difference

Abbreviations: BMI, body mass index; DILGOM, Dietary Lifestyle and Genetic Determinants of Obesity and Metabolic Syndrome; EC, evening chronotype; EPIC, European Prospective Investigation into Cancer and Nutrition; FinDiet, The Finnish National Dietary Survey in Adults; FINRISK, Finnish population survey on risk factors of chronic, noncommunicable diseases; GEP-NET, gastroenteropancreatic neuroendocrine tumors; IC, intermediate chronotype; MC, morning Chronotype; MCTQ, Munich Chronotype Questionnaire; MEQ, Morningness-Eveningness Questionnaire; MSF, midsleep on free days; MSFsc: sleep-correct midsleep on free days; NHANES: National Health and Nutrition Examination Survey; OPERA, Obesity, Programs of Nutrition, Education, Research and Assessment of the Best Treatment; rMEQ, reduced version of the Morningness-Eveningness Questionnaire; SJL, social Jet lag; sMEQ, short version of the Morningness-Eveningness Questionnaire; WC, waist circumference.

 

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Differences in WC Values according to the Chronotype

In 22 (67%) studies, the mean WC values of participants of different chronotypes were compared: 18 (77%) out of 22 studies identified that ECs presented higher mean WC than MCs. This finding was primarily obtained from the demographic characteristics of the participants. The difference was significant in 5 (28%) out of 18 studies.

Similar findings were also observed in genetic predisposition-related studies. Rahati et al.¹⁸ (2022) and Lee et al.³⁰ (2015) found that the mean WC was significantly higher among the participants with genotypes denoting evening preference compared to those with genotypes denoting preferences other than eveningness. Rahati et al.¹⁸ identified that the difference was significant after adjustments for age, sex, energy intake, and physical activity. Celis-Morales et al.²⁹ (2017) found that WC-based central obesity was higher in participants with an evening-related genetic predisposition than in participants with a morning-related genetic predisposition.

Contrary to these findings, only 5 (23%) out of 22 studies identified higher mean WCs in MCs than in ECs. The difference was significant in two of these studies. Interestingly, Merikanto et al.³¹ (2015) identified the same thing in their cross-sectional analysis, but the difference became insignificant when linear regression analysis was performed.

Apart from these studies, few explored the effect of various factors on the relationship or other aspects, such as differences in weight gain. Molina-Montes et al.[15] (2022) prospectively compared gain in WC among ECs and MCs over 3 years in a European cohort: ECs presented a significantly higher gain than MCs. Maukonen et al.[28] (2019) found a higher gain in WC in a Finnish population throughout 7 years, but the increase was not significant. Melatonin is a hormone naturally produced by the body that responds to darkness. External melatonin supplementation has been found to be useful in regulating circadian disruption in the body.[50] Marqueze et al.[21] (2021) conducted an interventional study to check the effect of melatonin supplementation on circadian misalignment and body weight, and they identified a significant reduction in WC among the MC participants before and after the melatonin supplementation. However, such a difference was not identified in the IC or EC groups. Social jet lag (SJL) can be described as a discrepancy between the biological time determined by the internal body clock and social time, mainly dictated by social obligations such as school or work.[51] The circadian misalignment caused by SJL is associated with disrupted metabolism and related morbidities like obesity[51]. Since people of different chronotypes present different biological wake-up and sleep times, it is essential to explore the magnitude of the metabolic effects of SJL in these subjects. The sleep-corrected SJL (SJLsc) is a modified measure of SJL that was developed to remove the possible effect of sleep debt while calculating the SJL.[52] Suikki et al.[23] (2021) compared the differences in WC among participants of different chronotypes and experiencing different amounts of SJLsc. The mean WC was lower among the group of MCs with SJLsc < 1 hour compared to the group of MCs with SJLsc ≥ 2 hours. However, a similar finding was not observed among ECs experiencing different amounts of SJLsc. Shift work is a circadian disruptor, as it can cause misalignment of biological and actual sleep-wake times due to work schedules. Ritonja et al.[26] (2019) compared the differences in WC among female hospital employees: the WC was significantly higher among ECs working in night shifts than among ECs working in day shifts. The WC was also significantly higher among ECs working in night shifts > 10 years compared to ECs working in night shifts < 10 years, as well as among ECs working < 3 consecutive night shifts compared to ECs working in daytime shifts and ECs working for > 3 consecutive night shifts. No significant differences in WC were found[26] among MCs concerning the time or duration of their shifts. Loef et al.[27] (2019) compared the effect estimates of night shift work on metabolic aspects in a cohort of hospital employees; they found no significant differences in WC among shift and non-shift workers of any chronotype concerning the frequency and duration of the shift work. Merikanto et al.[32] (2013) found that ECs with 2 depressive symptoms had significantly higher WC than ECs with no depressive symptoms, even after adjustments for gender, age, level of schooling, and smoking status. A study on Iranian housewives[43] identified that WC in overweight and obese participants was higher as compared to participants with normal BMIs, regardless of their chronotype. In the normal BMI group, the absolute value for WC in MCs was higher than in ECs, but this difference was not statistically significant. In the overweight and obese groups, the absolute value for WC was higher in ECs, but neither was this difference statistically significant.

 

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Correlation between WC and Chronotype Scores

In 8 (24%) out of 33 studies, the chronotype scores of the participants were analyzed as a continuous variable, to find out their correlation with the WC values. All of these studies found a positive correlation between WC and scores denoting eveningness. The correlation was significant in 7 (88%) out of 8 studies even after adjustment for various factors, such as sex, BMI, age, physical activity, and adherence to the Mediterranean diet. Cespedes Feliciano et al.[25] (2019) found the same correlation only among adolescent girls, and it was significant even after adjustments for sleep duration, age, pubertal status, race/ethnicity, season of measurement, maternal level of schooling, and household income; the correlation was not identified in adolescent boys. In a study by Johnsen et al.[33] (2013), the correlation was significant in the univariate analysis. However, it was not significant in the multivariate analysis when adjusted for various sleep, socioeconomic, lifestyle, health, and biological variables. A prospective study by Verde et al.[45] (2023) identified that lower levels of weight loss were significantly correlated with eveningness compared to morningness when a low-calorie ketogenic diet intervention was conducted for approximately 1 month.

 

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Discussion

We found that ECs are more prone to present higher WC than MCs, which is in line with previous studies[7] [8] reporting the association between ECs and unhealthier lifestyles. Considering the fact that generalized and abdominal obesity are complementary, it is also crucial to understand whether this relationship is independent of the BMI. However, this was only explored in one study[20] in which the relationship was independent of the BMI.

The scales developed to assess chronotype are primarily dependent on subjective information. The cut-off scores of these scales to differentiate subjects into EC and MC were established when the scales were developed. Though the translated versions of these scales have been found reliable and valid[16] [18] [24] [25] [34] [38] [39], it is not well known whether there is a need to revisit and validate them for different populations residing in other regions of the world. This was highlighted since we found that the fact that ECs present higher WCs than MCs was more noticeable when the chronotype was assessed as a continuous rather than a categorical variable.

The studies included in the present review were primarily conducted in European countries. We identified a dearth of research in other regions of the globe. An in-depth exploration of this relationship could be particularly important for South Asian populations who are more susceptible to abdominal obesity as compared to others.[53]

Since the chronotype denotes the circadian typology of an individual, the role of several factors, such as shift work, social jet lag, and sleep disorders, needs to be identified in the relationship between chronotype and WC. However, few studies[7] [21] [23] [25] [26] [27] addressed these factors, and their findings were inconsistent.

The current review has some limitations: most of the studies included were cross-sectional in design. Hence, the findings must be validated through prospective and/or experimental studies. More than 80% of the selected studies used the MEQ scale, which is based on subjective information. Researchers have translated the original scales to their local languages using scientific methods and assessing the reliability/validity of those versions. However, objective assessments are more reliable and valid than subjective ones. Hence, using objective measures to assess the chronotype, such as the Dim Light Melatonin Test may provide a better idea about the relationship in question. Additionally, clinical assessment methods like the CT and MRI, or blood lipid profiles, can be incorporated in addition to WC measurement.

 

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Conclusion

According to the findings of the present study, we conclude that eveningness is associated with higher WC values. However, this relationship needs to be explored and validated through prospective study designs and objective measures to assess the chronotype. It is not yet clear whether the relationship is independent of BMI. Chronotype can be a crucial factor in understanding the pathophysiology of abdominal obesity, and it may yield applicable insights for the future.

 

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Conflict of Interests

The authors have no conflict of interests to declare.

Authors' Contributions

SB, SJ, and PD: conception and design of the study, analysis and/or interpretation of data; drafting the article or critical review for important intellectual content; final approval of the version to be published; and agreement to be accountable for all aspects of the work by ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Publikationsverlauf

Eingereicht: 15. April 2024

Angenommen: 17. Oktober 2024

Artikel online veröffentlicht:
12. Juni 2025