You’ve probably heard a lot about circadian rhythms
in terms of sleep/wake patterns and eating patterns. But, did you know
that your circadian rhythms do much more than that? Our entire body is controlled
by diurnal oscillations, which is why some activities seem easier at
certain times of the day. This influence has the potential to impact
the best times to take medication, eat your meals, and take your nutritional
supplements.
Many complementary medicine traditions, such as
Ayurveda and Traditional Chinese Medicine, incorporate
circadian rhythms in their treatments. Western medicine is starting to
recognize the power of these rhythms to both facilitate treatments and contribute
to dysfunction when they are in disarray. Let’s learn more about the influence
of these powerful rhythms.
The Power and Importance of the Circadian Rhythm
Every process in your body, including reacting to
oxidative stress, the composition of your microbiome, and the levels of your
intracellular proteins, all have some type of oscillating
pattern that fits within a daily 24-hour rhythm. Your
body upregulates certain components of metabolism and mechanisms
required for self-defense during the hours it expects to need them and
down-regulates them during periods of rest.
There are several circadian transcription factors
that control positive and negative feedback loops in the cells to determine
functions of key organs and systems, including your heart, lungs, immune
system, and metabolism, as well as the intracellular processes, such
as cellular respiration and DNA repair. In fact, this internal clock
system regulates roughly one-third of your body’s entire gene
activity! Your genetic code regulating these systems affects your body’s
timing for peak performance, such as whether you are a morning person or
a night owl.
The central regulator of your circadian rhythms is
the suprachiasmatic nucleus, SCN, which is found in the hypothalamus in
your brain. It does this largely through controlling the secretion of
melatonin, which is the main circadian hormone.
– Allergies
– Asthma
– Cardiovascular disease
– Hypertension
– Insomnia
– Jet lag
– Metabolic disorders
– Neurological disorders
– Psychiatric disorders
– Social
jet lag
– Stroke
Disruptions in the circadian rhythm also reduce your
life expectancy. Furthermore, as you age, you become more sensitive to
disruptions in the circadian rhythms—and less sensitive to synchronization
techniques.
Metabolism, Dietary Enzymes, and Feeding Times
Circadian rhythms regulate your digestion
and metabolism. In the proper rhythm, gastric
emptying, thermogenesis, and motility rates reach their
peak in the morning. During the active phase of the day, bile acids and
nutrient transporters are regulated and more active, as is energy
metabolism. Conversely, detoxification becomes more
active during the rest phase.
– AMPK: a signal of low cellular energy
and one of the most important sensors of nutrient status
– PGC-1a: regulates energy metabolism
– PPARa: regulates genes involved in glucose and lipid metabolism
– REV-ERBa: involved in the differentiation of adipocytes
– RORa: regulates lipid storage in skeletal muscle and lipogenesis
– SIRT1: a histone deacetylase that helps to signal transcription and stability
of genes if dependent upon NAD+
For example, CLOCK-BMAL1 and
omega-3 fatty acids activate some nuclear
receptors involved in energy homeostasis, including
PPARs. Glycogen synthase functions during the active period
and glycogen phosphorylase during the resting
period. Polymorphisms and other variants in certain genes related to
circadian rhythms are associated with obesity and metabolic
disease, some of which are affected by certain diets, such as higher
carbohydrate intake or higher fat intake.
Blood glucose and lipid
regulation are dependent upon diurnal
rhythms as well. Consuming a high-fat meal raises triglycerides in the
blood more at night than the same meal consumed during the day. Important
adipokines, including leptin and adiponectin, also have diurnal rhythms.
– Adiponectin production
– Decreased synthesis of cholesterol
– Glycolytic metabolism
– Increased synthesis of bile acids and glycogen
– Increased uptake of fatty acids
– Lipogenesis
– Secretion of insulin
During night when you are fasting and sleeping, you
have:
– Biogenesis of mitochondria
– Catabolism of lipid
– Gluconeogenesis and glycogenolysis
– Leptin and glucagon secretion
– Oxidative metabolism
It is not just the human cells in your body that have
a daily rhythm; your microbiota impacts—and is impacted
by—circadian rhythms as well. Melatonin exists in
the gut in levels that are about 400 times the level in the pineal
gland in the brain where it acts as a modulator of bowel
function. One study found that melatonin might impact the microbiota in
the gut as well as regulate other components of the circadian rhythm, like
sleep.
In this study, colonies of a specific commensal
bacterium, Enterobacter aerogenes, grew faster and
experienced increased swarming and motility when exposed to melatonin in a
dose-dependent relationship. The biggest response matched the levels of
melatonin typically found in the human gut. This finding provides
potential evidence that the microbiome might synchronize with the
human host, and that this might happen through
melatonin communication.
Another study found diurnal changes in 60 percent
of the microbial composition of a mouse model,
including Bacteroidales, Clostridiales, and Lactobacillales.
There were higher numbers during the resting phase compared to the active
phase. The diurnal fluctuations match the microbial
functions that the microbiota perform. For example, during the
active phase, the microbiota performing energy harvest, cell
growth, and DNA repair are more active, while bacteria dealing with
detoxification see a greater abundance during the resting phase. For these
rhythms to occur, there had to be a functional
circadian clock in the host. Food intake, feeding times, and sleep
disturbances impacted the diurnal patterns of the microbiome.
This change could contribute to dysbiosis and be one reason for the
link between dysbiosis and metabolic disease.
Treating dysbiosis might help with modulating the
circadian clock. One study postulated that the beneficial effects of
probiotics on patients with IBS was due to the impact on
melatonin. The randomized, double-blind, placebo-controlled trial gave one
group of IBS patients a particular probiotic, VSL#3, while the control
group had a placebo. The male treated patients experienced a significant
increase in their morning melatonin levels after taking VSL#3 (5.43 pg/ml
increased to 9.74 pg/ml), but females and the combined group did not have any
significant changes. This increase in melatonin levels correlated with increased satisfaction in
bowel habits. The group who had a normal circadian rhythm pre-treatment
also experienced an increase in morning melatonin and
better satisfaction of bowel habits. Thus, the researchers postulated that
the efficacy of the probiotics came from the impact on melatonin metabolism and
secretion.
Circadian rhythms might also impact the
severity of an allergic response to food. In a study in
an ovalbumin food allergy mouse model, the severity of symptoms was higher
in the group that was exposed in the light period (rest phase) rather
than the dark period (active phase). The light period group had a
higher absorption of the allergen and a higher intestinal permeability. Timing
and type of food also impacts the microbial makeup and its
circadian rhythms.
Diet, Meal Times, and Circadian Rhythm Disruption
High-fat diets might interrupt the feeding and
fasting cycles, which might negatively impact the circadian rhythms.
For example, a high-fat diet stopped the normal oscillation of NAD+
in a mouse model. Amino acids, including lysine, did not change their oscillation
patterns, while there was amplification in coenzyme A, which is involved in
beta-oxidation and the syntheses of fatty acids. It also caused a phase shift.
However, these changes were reversible through changing the diet. Another
mouse study found that time-restricted
feeding mitigates some of the negative metabolic changes that occur
with eating ad libitum, even on the same high-fat diet.
Studies have found that meal timing relates to
obesity and metabolic syndrome. In a systematic
review on the subject, researchers found that in observational
studies, participants who ate lunch after 3 PM were twice as likely
to have a reduced response to bariatric surgery, regardless of the actual
composition of the foods. In randomized control trials, participants lost more
weight when they had the bulk of their calories in the early part of the day
rather than at dinner. There was also an association between hyperglycemia
and diabetes with those who ate the bulk of their calories at the end of the
day. Feeding
times can also lead to a shift of the peripheral circadian genes,
which could disrupt the clock balance. It can also reset the phase through
timed feeding.
Certain nutrients also
impact your circadian rhythm. For example, adenosine, retinoic
acid, and caffeine can shift circadian rhythms, and
thiamine-deficiency might lead to a disruption. Alcohol alters
your natural rhythms in several ways, including through changes
in hormone secretion, body temperature, and the ability to
sleep. High-salt diets increase the amplitude of the normal
circadian rhythms. One study found oscillations in vitamin D,
calcium, and calcium-phosphorus ratio. In this study, diabetic patient and
healthy controls had their highest levels of vitamin D at noon, while their
lowest levels were at 6 AM. Diabetic patients experienced a phase shift in
these nutrients compared to the controls.
Proanthocyanidins,
which are one of the biggest classes of polyphenols, have the
potential to regulate the peripheral components of the circadian rhythms.
Polyphenols are found in a variety of plant-based foods, including fruits, cocoa,
nuts, vegetables, red wine, and tea. In a mouse model study, both healthy
and obese rats were given chow supplemented with different doses of
grape seed proanthocyanidin extract (GSPE). The obese group
was fed a diet comprised of higher-fat diet (comprised of 23.4
percent fat, 35.2 percent carbohydrates, and 11.7 percent protein),
and one group was given 25 mg of the GSPE per kg body weight.
The rats given GSPE had an increased expression of
two important circadian genes in the liver: Clock and Per2 in a dose-dependent
fashion. The increase became significant at 25 and 50 mg GSPE/kg/body weight.
In the mWAT, all of the circadian genes studied were modulated by GSPE,
with Clock, BMal1, and Per2 increased at 50 mg, while the genes that Clock
and Bmal1 regulate, such as Rora, Rev-erba, and Nampt, were
repressed. HmgCoAR were not modulated. In the intestines, Bmal1
and HmgCoAR were modulated, with all doses increased Bmal1
and 25 mg/kg body weight increased HmgCoAR. They found that these
modulations in the main and periphery circadian genes occurred in the
obese mice as well, demonstrating that the polyphenols were able to
counteract disruption in the rhythm that occurs with
obesity. Another study confirmed this, but that the timing of
administration might impact the efficacy. This is just another
reason why eating a colorful diet rich in a variety of phytochemicals
is so important.
Liver, Metabolism, Detox Capabilities, and
Diurnal Oscillation
There are three PARbZip transcription
factors controlled by Clock and Bmal1 in the liver that regulate
detoxification: D-site binding protein, thyrotrophic embryonic
factor, and hepatic leukemia factor. Studies have found that knockout mice
without these genes are unable to metabolize xenobiotics. This is because these
genes activate cytochrome P450 oxidoreductase. They also power the daily
oscillations of these pathways, especially those controlled by the CYP systems.
– Metabolism of carbohydrates: PEPCK, PKLR,
KLF10
– Metabolism of lipids: PPAR, PGC1, LXR
– Metabolism of amino acids: KLF15, OCD
– Detoxification: TEF, HLF, DBD
– Plasma protein synthesis: TFPI
– Metabolism of bile acids: SREBP, INSIG
Diet and expected function determines some of
this effect. For example, some enzymes used
to metabolize cholesterol, such as HMG-CoA reductase peaks at times
where the body does not expect to consume cholesterol.
Bile acids play
an important role in the digestion and absorption of dietary fat, fat-soluble
vitamins, steroids, and certain drugs. They also play an important role as
signaling molecules for metabolism and immune modulation. Bile
acids also follow a circadian rhythm, controlled by the central
clock. CYP7A1, the gene that regulates the synthesis of bile acids, peaks
in the middle of the active period and sees its minimum in the middle of the
rest period. In humans, there are two peaks:
1:00 PM and 9:00 PM. Most bile acid synthesis occurs right after
you eat.
There are three phases of detox, and each one
has its own regular schedule. Phase I of detoxification requires
the CYP
genes, of which there are 18 different families. Humans have a total of 57
CYP genes, with different families responsible for the metabolism of different
molecules. CYP1 genes handle the majority of xenobiotics and drugs. CYP enzymes increase
their activity during the active phase. Conversely, phase II and
III enzymes reach their peak during the rest phase. This impacts the
ability to metabolize drugs, and it also might impact your ability to
detoxify other xenobiotics. For many drugs, morning consumption makes
it easier to absorb the drug, since it is the time at which bile
acid synthesis hits a peak, which helps to facilitate the absorption
and transportation of the drug.
Matching medication usage with the natural circadian
rhythms has a major impact on its efficacy and safety. A meta-analysis found
that taking medications on a schedule that matches circadian cycles led to
a 5-fold enhanced tolerance of the drug, as well as
twice the efficacy of the drug, compared to the same treatment not on a
schedule. Similar instances occur with metabolism and the detoxification
of other xenobiotics.
Maximizing Supplement Use Through Circadian
Rhythms
Certain medications have been shown to be more
effective and less toxic when given at different times of the day, such
as iummunomodulators, glucocorticoid
steroids, insulin for type-1 diabetics, cancer drugs, and more.
For example, P-glycoprotein or P-gp mRNA
expression in the liver and intestines, which plays a role in
the detoxification of a certain cancer medication known as
irinotecan, was found to have changes dependent upon time of day. The
efficacy and tolerance of the drug related to the diurnal changes,
with the timing of highest expression of the mRNA corresponding to the best
tolerability and effectiveness of the drug. This finding has led
to the development of chronopharmacology,
or taking medication at appropriate times in the circadian
rhythm. Chronopharmacology takes into account the daily timing of
important components of drug metabolism like:
– Absorption: timing of blood flow, gut motility,
emptying of the gut, transporters of the medication, and pH
– Metabolism: cytochrome P450 enzyme activity, conjugating enzyme
activity, ATP-binding cassette transporters
– Genes targeted by drugs: neural receptors, HMG-CoA reductase
– Distribution: lipophilicity, affinity for binding with albumin,
concentration
– Excretion: glomerular filtration rate, renal blood
flow, function of the kidneys
These known body timings might also impact at
what times you should take certain nutritional supplementation. For
example, the timing of a calcium
supplement might impact its effect on bone resorption. In one
study on 18 premenopausal women, the patients took
calcium supplements at either 8:00 AM or 11:00 PM.
After 14 days, urine collections were studied to review markers of bone
resorption. They found that the time of day had a significant effect,
with evening calcium intake suppressing the usual nightly increase in
parathyroid hormone and markers of the bone resorption.
Morning supplementation had no impact. Therefore, they found that
taking calcium in the evening could suppress bone resorption.
Although research into timing of supplement dosage
is not as rich as that reviewing the impact on medication, the diurnal rhythms
of your digestion, metabolism, and detoxification systems will impact the
efficacy of any substances you take, including your nutritional supplements. As
such, it is beneficial to bear this in mind, and ensure you maintain a balanced
and functional circadian rhythm.
What You Can Do
The most important action to take is to ensure
you take care to keep your circadian rhythms functional. You can test for
markers, such as cortisol, melatonin, and body temperature, to determine if
you are out of balance.
A few simple actions to take to maintain a balanced
rhythm include:
- Avoid exercising late in the day
- Avoid foods that can induce a phase shift
(i.e. soybean oil and cornstarch)
- Consume lots of antioxidant-rich fruits and vegetables,
especially those rich in polyphenols
- Do not eat late at night
- Eat your biggest meals early in the
day
- Follow a regular
meal schedule within a restricted period of time (around
8 hours), as timed restricted feeding of the same high-fat meal was
shown to produce better metabolic outcomes than eating throughout the day
and a 5-hour shift in meal timing has led to a similar
shift in circadian rhythms
- Get a good night’s sleep and avoid night shift
work when possible
- Limit caffeine,
which has been shown to shift circadian rhythms
- Make sure to expose yourself to sunlight during
the day
- Minimize your light exposure at night
Certain foods can influence your melatonin levels,
which in turn might help to regulate your circadian rhythms. For example, tart cherry
juice, which contains melatonin, may lead to better
sleep quality. In a double-blind, placebo-controlled study, 20 subjects drank
two servings of either tart cherry juice concentrate or a placebo for a week,
served within 30 minutes of waking and prior to their evening
meal. Those who consumed the cherry juice had a significantly higher melatonin
level, as well as significant increase in sleep efficiency, total sleep time,
and time in bed. The timing of the melatonin circadian rhythm did not show a
difference, but there were a higher mesor and amplitude. Although
the researchers found the cherries did not regulate the circadian rhythms in
the healthy population, they do postulate that it might help others, such as
those with disturbed sleep, and that
it deserves further study.
In addition to generally maintaining a functional circadian
rhythm, you can also consider the impact of your enzymes, digestion and
absorption, and metabolism when deciding at what time to take certain
supplements (and medication if you take any). For example, you
most likely want to take your calcium supplements in the evening,
based on the study above. As always, discuss with a doctor before
proceeding with any changes.
Rainbow Foods & Supplement Course
Did this pique your interest to learn more about the
best timing for food and supplements? If so, please join me this
January for the Rainbow
Foods & Supplements Course, where I’ll teach you even more the
emerging, trending health findings and scientific research in the food, eating,
and supplement fields!
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