Poster Presentation 2025 National Cancer Survivorship Conference

Eating frequency, timing of meals, sleep duration, and chronotype with biomarkers of inflammation and insulin resistance in breast cancer survivors (#155)

Kelly D'cunha 1 , Louise Marquart-Wilson 1 , Yikyung Park 2 , Melinda Protani 1 , Ingrid Hickman 3 , Marina Reeves 1
  1. School of Public Health, The University of Queensland, Herston, QLD, Australia
  2. Division of Public Health Sciences, Department of Surgery, Washington University at St Louis, St Louis, MO, USA
  3. ULTRA team Clinical Trial Capability, UQ Centre for Clinical Research, The University of Queensland, Herston, QLD, Australia

Background: Eating behaviours and sleep – behaviours associated with circadian rhythm disruption – may influence breast cancer prognosis via altered inflammatory and metabolic biomarker pathways. Our exploratory study aimed to cross-sectionally and prospectively examine the associations between eating frequency, proportion of daily calories after 5 PM, eating after 8 PM, nightly fasting duration, sleep duration, and chronotype with inflammation (high-sensitivity C-reactive protein; hs-CRP) and insulin resistance (HOMA2-IR) in breast cancer survivors.

Methods: Data were collected on eating behaviours (via 2x24-hour dietary recalls), sleep duration and chronotype (via 7-day sleep logs), and hs-CRP and HOMA2-IR (fasting blood samples) from female breast cancer survivors (n=159; 55±9 years; 31.4±5.0 kg/m2; stage I-III) who participated in a randomised controlled trial. Different definitions of eating frequency were examined. Linear regression models examined health behaviours at baseline with mechanistic biomarkers at baseline (cross-sectional) and 12-months (prospective).

Results: Cross-sectionally, eating less frequently (<5 vs 5-8 times/day; definition: ≥1kJ) was associated with higher hs-CRP (β=0.53[95%CI: 0.16, 0.95]). Prospectively, eating more frequently (>8 vs 5-8 times/day) at baseline was associated with increases in hs-CRP (0.34 [-0.09, 0.85]), while eating less (0.33[-0.09, 0.76]) and more frequently (0.41[-0.05, 0.88]) were associated with increases in HOMA2-IR at 12-months. Using an alternate definition (≥210 kJ + 15 mins between), more frequent eating showed trends with higher hs-CRP prospectively. Non-significant trends suggested eating after 8 PM (vs not) and late chronotype (vs early) were prospectively associated with increases in hs-CRP, while sleeping longer (>9 h versus ≥7 to ≤9 hours) was prospectively associated with increases in HOMA2-IR; however, except for eating after 8 PM, these associations were attenuated following adjustments. 

Conclusions: Eating behaviours, sleep duration, and chronotype may be important to consider following a breast cancer diagnosis. Our findings may inform practical strategies to improve survivorship if confirmed by large, diverse, longitudinal prospective cohort studies and intervention trials.