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Doctor’s Tip: When you eat matters

Obesity and its associated health problems have become a major problem in the U.S. — and worldwide as we export our diet. This is another column in a series based on Dr. Greger’s 2020 book “How Not to Diet.”

What you eat is the most important factor in causing and reversing obesity. However, it also matters when you eat. This has to do with circadian rhythms — our bodies’ daily natural biorhythms, which recur repetitively over each 24 hours. They affect digestion, body temperature, blood pressure, hormone levels, immune activity, the most effective time to take blood pressure pills (bedtime), and the most effective time for chemotherapy. Amazingly, our gut microbiome has circadian rhythms as well, and when our microbiome is made up of health-promoting microbes, it is in sync with our bodies’ biorhythms.

According to Dr. Greger, circadian rhythms account for the fact that “morning calories don’t appear to count as much as evening calories.” The Blue Zones are five areas in the world where people live particularly long, healthy lives. One of the take-home messages from studying these populations is that we should “eat breakfast like a king, lunch like a prince and dinner like a pauper.”



Breakfast skippers have higher rates of being overweight or obese. This seems counterintuitive, because If you skip breakfast, you would expect to lose weight due to intake of fewer total calories per day. However, Dr. Greger reviews studies showing that “morning calories don’t appear to count as much as evening calories.” Not only should you eat breakfast every day, but for optimal weight and health it should be the largest meal — caloriewise — of the day.

In an Israeli study of overweight and obese women, half of the subjects ate according to the king-prince-pauper principle, and the other half ate the same number of calories but in a pauper-prince-king sequence, with the most calories late in the day. At the end of the 12-week study, the king-prince-pauper group lost 19 pounds, and the pauper-prince-king group 11 pounds.



In another study, U.S. Army researchers had half of study participants eat dinner only, and the other half only breakfast— with each half eating the same number of calories. The breakfast-only participants lost 2 pounds a week compared to the dinner-only group. One explanation for this phenomenon is that due to circadian rhythms, our bodies use 50% more calories to digest food in the morning compared to evening.

Working the night shift disrupts our circadian rhythms. And guess what? Nightshift workers have significantly higher rates of being overweight or obese compared to day-shift workers. They also have higher rates of diabetes, heart disease and cancer.

Following are Dr. Greger’s nine tips for losing weight by getting in sync with your body’s circadian rhythms:

• Never skip breakfast.

• Eat the bulk of your daily calories for breakfast, less for lunch and even less for dinner.

• Sleep during the night and be active during the day.

• Sleep 7-8 hours.

• Go to bed by 10 and get up at 6 or 7.

• Avoid bright light exposure at night.

• Sleep in total darkness.

• Eat dinner at least two and a half hours prior to bed.

• Avoid eating at night.

Greg Feinsinger, M.D., is a retired family physician with a special interest in heart disease and diabetes prevention and reversal, ideally though lifestyle changes. He’s available for free, one-hour consultations — call 970-379-5718.


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