***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The timing of energy intake is a modifiable behaviour that may influence energy regulation and the risk of obesity . We examined the associations of energy intake in the morning , midday and evening with  body mass index ( BMI ) ( n = 239 ) . METHODS Cross-sectional analyses were performed using data from the University of California , Los Angeles Energetics Study .  Energy  intake was assessed using three 24-h dietary recalls and stratified by time-of-day : morning ( 00.00 h to 11.00 h ) , midday ( 11.00 h to 17.00 h ) and evening ( 17.00 h to 00.00 h ) . Sensitivity analysis was conducted among ' true-reporters ' , whose self-reported energy intake was ±25 % of total energy expenditure measured by doubly-labelled water ( n = 99 ) . Logistic regression models were performed adjusting for age , sex , race , education , total daily energy intake and physical activity . RESULTS Energy intake in the morning was not associated with BMI  . Participants who consumed ≥33 % ( versus < 33 % ) of their daily energy intake at 12.00 h were ( nonsignificantly ) less likely to be overweight/obese [ odds ratio ( OR ) = 0.68 ; 95 % confidence interval ( CI ) = 0.37 - 1.24 ] and this association was stronger and statistically significant among true-reporters ( OR = 0.34 ; 95 % CI = 0.12 - 0.95 ) . Those who consumed ≥33 % of daily energy intake in the evening were two-fold more likely overweight/obese ( OR = 2.00 ; 95 % CI = 1.03 - 3.89 ) , although this association was not significant among true-reporters ( OR = 2.10 ; 95 % CI = 0.60 - 7.29 ) . CONCLUSIONS These data indicate that eating more of the day 's total energy intake at midday is associated with a lower risk of being overweight/obese , whereas consuming more in the evening is associated with a higher risk . R and omised trials are needed to test whether shifting energy intake earlier in the day could have a regulatory effect with respect to reducing intake in the evening , thereby promoting weight loss and maintenance Abstract Aims /hypothesisWe investigated whether therapy with the entire daily dose of ≥1 hypertension medications at bedtime exerts greater reduction in the risk of new-onset diabetes than therapy with all medications upon awakening . Methods We conducted a prospect i ve , r and omised , open-label , blinded endpoint trial of 2,012 hypertensive patients without diabetes , 976 men and 1,036 women , 52.7 ± 13.6 years of age . Patients were r and omised , using a computer-generated allocation table , to ingest all their prescribed hypertension medications upon awakening or the entire daily dose of ≥1 of them at bedtime . Investigators blinded to the hypertension treatment scheme of the patients assessed the development of new-onset diabetes . Results During a 5.9-year median follow-up , 171 participants developed type 2 diabetes . Patients of the bedtime , compared with the morning-treatment group , showed : ( 1 ) significantly lower asleep BP mean , greater sleep-time relative BP decline and attenuated prevalence of non-dipping at the final evaluation ( 32 % vs 52 % , p < 0.001 ) ; and ( 2 ) significantly lower HR of new-onset diabetes after adjustment for the significant influential characteristics of fasting glucose , waist circumference , asleep systolic BP mean , dipping classification and chronic kidney disease ( CKD ) ( unadjusted HR 0.41 [ 95 % CI 0.29 , 0.58 ] ; adjusted HR 0.43 [ 0.31 , 0.61 ] ; event-rate 4.8 % vs 12.1 % with bedtime and morning treatment , respectively ; p < 0.001 ) . Greater benefit was observed for bedtime compared with awakening treatment with angiotensin receptor blockers ( ARBs ) ( HR 0.39 [ 0.22 , 0.69 ] ; p < 0.001 ) , ACE inhibitors ( 0.31 [ 0.12 , 0.79 ] , p = 0.015 ) and β-blockers ( 0.35 [ 0.14 , 0.85 ] , p = 0.021 ) . Conclusions /interpretationIn hypertensive patients without diabetes , ingestion of ≥1 BP-lowering medications at bedtime , mainly those modulating or blocking the effects of angiotensin II , compared with ingestion of all such medications upon awakening , results in improved ambulatory BP ( ABP ) control ( significant further decrease of asleep BP ) and reduced risk of new-onset diabetes . Trial registration : Clinical Trials.gov NCT00295542 Funding : This independent investigator-promoted research was supported by unrestricted grants from Ministerio de Ciencia e Innovación ( SAF2006 - 6254-FEDER ; SAF2009 - 7028-FEDER ) ; Xunta de Galicia ( PGIDIT03-PXIB-32201PR ; INCITE07-PXI-322003ES ; INCITE08-E1R-322063ES ; INCITE09-E2R-322099ES ; 09CSA018322PR ) ; and Vicerrectorado de Investigación , University of Vigo Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE Few studies examined the association between time-of-day of nutrient intake and the metabolic syndrome . Our goal was to compare a weight loss diet with high caloric intake during breakfast to an isocaloric diet with high caloric intake at dinner . DESIGN AND METHODS Overweight and obese women ( BMI 32.4 ± 1.8 kg/m(2 ) ) with metabolic syndrome were r and omized into two isocaloric ( ~1400 kcal ) weight loss groups , a breakfast ( BF ) ( 700 kcal breakfast , 500 kcal lunch , 200 kcal dinner ) or a dinner ( D ) group ( 200 kcal breakfast , 500 kcal lunch , 700 kcal dinner ) for 12 weeks . RESULTS The BF group showed greater weight loss and waist circumference reduction . Although fasting glucose , insulin , and ghrelin were reduced in both groups , fasting glucose , insulin , and HOMA-IR decreased significantly to a greater extent in the BF group . Mean triglyceride levels decreased by 33.6 % in the BF group , but increased by 14.6 % in the D group . Oral glucose tolerance test led to a greater decrease of glucose and insulin in the BF group . In response to meal challenges , the overall daily glucose , insulin , ghrelin , and mean hunger scores were significantly lower , whereas mean satiety scores were significantly higher in the BF group . CONCLUSIONS High-calorie breakfast with reduced intake at dinner is beneficial and might be a useful alternative for the management of obesity and metabolic syndrome Background / Objectives : Timing of food intake associates with body weight regulation , insulin sensitivity and glucose tolerance . However , the mechanism is unknown . The aim of this study was to investigate the effects of changes in meal timing on energy-expenditure , glucose-tolerance and circadian-related variables . Subjects/ Methods : Thirty-two women ( aged 24±4 years and body mass index 22.9±2.6 kg m−2 ) completed two r and omized , crossover protocol s : one protocol ( P1 ) including assessment of resting-energy expenditure ( indirect-calorimetry ) and glucose tolerance ( mixed-meal test ) ( n=10 ) , the other ( P2 ) including circadian-related measurements based on profiles in salivary cortisol and wrist temperature ( Twrist ) ( n=22 ) . In each protocol , participants were provided with st and ardized meals ( breakfast , lunch and dinner ) during the two meal intervention weeks and were studied under two lunch-eating conditions : Early Eating ( EE ; lunch at 13:00 ) and Late Eating ( LE ; lunch 16:30 ) . Results : LE , as compared with EE , result ed in decreased pre-meal resting-energy expenditure ( P=0.048 ) , a lower pre-meal protein-corrected respiratory quotient ( CRQ ) and a changed post-meal profile of CRQ ( P=0.019 ) . These changes reflected a significantly lower pre-meal utilization of carbohydrates in LE versus EE ( P=0.006 ) . LE also increased glucose area under curve above baseline by 46 % , demonstrating decreased glucose tolerance ( P=0.002 ) . Changes in the daily profile of cortisol and Twrist were also found with LE blunting the cortisol profile , with lower morning and afternoon values , and suppressing the postpr and ial Twrist peak ( P<0.05 ) . Conclusions : Eating late is associated with decreased resting-energy expenditure , decreased fasting carbohydrate oxidation , decreased glucose tolerance , blunted daily profile in free cortisol concentrations and decreased thermal effect of food on Twrist . These results may be implicated in the differential effects of meal timing on metabolic health Shiftworkers have a higher risk of CHD and type 2 diabetes . They consume a large proportion of their daily energy and carbohydrate intake in the late evening or night-time , a factor which could be linked to their increase in disease risk . We compared the metabolic effects of varying both dietary glycaemic index ( GI ) and the time at which most daily energy intake was consumed . We hypothesised that glucose control would be optimal with a low-GI diet , consumed predominantly early in the day . A total of six healthy lean volunteers consumed isoenergetic meals on four occasions , comprising either high- or low-GI foods , with 60 % energy consumed predominantly early ( breakfast ) or late ( supper ) .  Interstitial glucose was measured continuously for 20 h. Insulin , TAG and non-esterified fatty acids were measured for 2 h following every meal . Highest glucose values were observed when large 5021 kJ ( 1200 kcal ) high-GI suppers were consumed . Glucose levels were also significantly higher in predominantly late high- v. low-GI meals ( P<0·01 ) . Using an estimate of postpr and ial insulin sensitivity throughout the day , we demonstrate that this follows the same trend , with insulin sensitivity being significantly worse in high energy consumed in the evening meal pattern . Both meal timing and GI affected glucose tolerance and insulin secretion . Avoidance of large , high-GI meals in the evening may be particularly beneficial in improving postpr and ial glucose profiles and may play a role in reducing the risk of type 2 diabetes ; however , longer-term studies are needed to confirm this In women with PCOS ( polycystic ovary syndrome ) , hyperinsulinaemia stimulates ovarian cytochrome P450c17α activity that , in turn , stimulates ovarian and rogen production . Our objective was to compare whether timed caloric intake differentially influences insulin resistance and hyper and rogenism in lean PCOS women . A total of 60 lean PCOS women [ BMI ( body mass index ) , 23.7±0.2 kg/m² ] were r and omized into two isocaloric ( ~1800 kcal ; where 1 kcal≈4.184 J ) maintenance diets with different meal timing distribution : a BF ( breakfast diet ) ( 980 kcal breakfast , 640 kcal lunch and 190 kcal dinner ) or a D ( dinner diet ) group ( 190 kcal breakfast , 640 kcal lunch and 980 kcal dinner ) for 90 days . In the BF group , a significant decrease was observed in both AUC(glucose ) ( glucose area under the curve ) and AUC(insulin ) ( insulin area under the curve ) by 7 and 54 % respectively . In the BF group , free testosterone decreased by 50 % and SHBG ( sex hormone-binding globulin ) increased by 105 % . GnRH ( gonadotropin-releasing hormone)-stimulated peak serum 17OHP ( 17α-hydroxyprogesterone ) decreased by 39 % . No change in these parameters was observed in the D group . In addition , women in the BF group had an increased ovulation rate . In lean PCOS women , a high caloric intake at breakfast with reduced intake at dinner results in improved insulin sensitivity indices and reduced cytochrome P450c17α activity , which ameliorates hyper and rogenism and improves ovulation rate . Meal timing and distribution should be considered as a therapeutic option for women with PCOS The increase in obesity and lipid disorders in industrialized countries may be due to irregular eating patterns . Few studies have investigated the effects of nighttime snacking on energy metabolism . We 
    Output:
    
Results confirm that eating time is relevant for obesity and metabolism : observational and experimental studies found an association between meal timing , weight gain , hyperglycemia and diabetes mellitus with benefits deriving from an early intake of food in the day in a wide range of individuals .