Effects of Chrononutritional Patterns on Weight Loss After Bariatric Surgery in Patients With Severe Obesity

Introduction: Obesity is a chronic, relapsing disease which increases the risk of many non-communicable diseases. Until now the main focus has been on what and how much to eat but the timing of eating is as important for metabolism. Chrono-nutrition is an emerging field that explains how circadian rhythms, nutrition, and health interact. Aim of the study: The aim of this study was to observe how different chrono-nutritional patterns affect weight loss and comorbidity remission in patients who underwent bariatric surgery. Materials and methods: This retrospective study included 75 patients who underwent bariatric surgery at the University Hospital of Padova 36 ±11 months ago. Data were collected from the patient’s medical records in the hospital’s database and from telephone interviews. R software (v4.4.0; R Core Team, 2024) was used in order to handle data, build clusters and check for correlations. Results: The most frequent clusters are Cluster 2 and Cluster 4, with 33 patients each, together accounting for 88% of the population (44% each). Statistical analysis showed that there is a significant weight loss from baseline at follow-up for all clusters, but there was not a significant difference in weight loss among clusters. However, Cluster 3 had a lower weight loss compared to other Clusters. There was a significant remission of comorbidities from baseline to follow-up. Patients in Cluster 3 had a higher prevalence of diabetes, hypertension and OSA, while patients belonging to cluster 1 had the highest prevalence for dyslipidemia and MACE. There was a significant difference in Epworth values between Cluster 2 (regular eating pattern) and Cluster 4 (irregular eating pattern). Age and alcohol were the only variable that had a statistically significant effect, with age increasing the risk for hypertension and dyslipidemia and alcohol reducing the risk for dyslipidemia. Conclusions: This study highlights the importance of chrono-nutritional patterns in patients with severe obesity following bariatric surgery. The lower weight loss in Cluster 3, characterized by irregular eating patterns, suggests that chrono-nutrition may play a role in weight regulation. On the other hand, the significant difference in Epworth scores between Cluster 2 characterized by a regular eating pattern and Cluster 4 characterized by an irregular eating pattern demonstrates the important impact of chrono-nutritional analysis in patients with obesity. Key words: obesity, chrono-nutrition, metabolic effects, bariatric surgery