Morning chronotype is associated with higher adherence to the Mediterranean diet in a sample of Italian adults

Abstract Background and aims: A growing body of evidence has associated subjects with an evening chronotype with worse eating behaviours and poorer diet quality. However, only few studies have investigated the relationship between chronotype and Mediterranean diet (MD). The aim of this study was to better understand the chronotype influence on dietary habits and MD adherence in a large sample of Italian adults. Methods and results: A total of 1247 participants (66.7% women) with a mean age of 36.1   14.6 years were included in the analysis. Chronotype was classified as morning in 35.6% of subjects, intermediate in 56.7%, and evening in 7.1%. Regarding meal frequency, evening subjects showed a significantly (p < 0.05) greater tendency to skip breakfast (20.5%) than morning (6.9%) and intermediate (12%) subjects. Similarly, evening subjects were found to skip mid-morning snack more often than morning subjects (59.1% vs. 47.1%; p Z 0.04), and lunch more often than intermediate subjects (8% vs. 2.8%; p Z 0.01). In addition, all meals were eaten by evening subjects at a significantly delayed time, except for lunch. As to MD adherence a significant (p < 0.001) higher adherence in morning subjects (10.1   2.2) compared to intermediate (9.5   2.1) and evening (9.5   2.2) subjects was observed. At a logistic regression analysis adjusted for possible confounding factors, morning subjects showed an increased probability (OR 1.54, 95%CI 1.19e1.99; p < 0.001) of being in the highest MD adherence tertile. Conclusion: Chronotype was associated with MD adherence. In particular, morning subjects showed higher MD adherence than intermediate and evening subjects.