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Accepted manuscript

Circadian Rhythms, Feeding Patterns, and Metabolic Regulation: Implications for Critical Care

Published online by Cambridge University Press:  18 November 2024

Harry A. Smith*
Affiliation:
Department of Nutritional Sciences, King’s College London, London, UK. Centre for Nutrition, Exercise, and Metabolism, Department for Health, University of Bath, Bath, UK.
James A. Betts
Affiliation:
Centre for Nutrition, Exercise, and Metabolism, Department for Health, University of Bath, Bath, UK.
*
*Corresponding Author: Harry A. Smith PhD, [email protected], University of Bath, Bath, UK, BA2 7AY
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Abstract

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Endogenous biological rhythms synchronise human physiology with daily cycles of light-dark, wake-sleep, feeding-fasting. Proper circadian alignment is crucial for physiological function, reflected in the rhythmic expression of molecular clock genes in various tissues, especially in skeletal muscle. Circadian disruption, such as misaligned feeding, dysregulates metabolism and increases the risk of metabolic disorders like type 2 diabetes. Such disturbances are common in critically ill patients, especially those who rely on enteral nutrition. Whilst continuous provision of enteral nutrition is currently the most common practice in ciritical care, this is largely dictated by convenience rather than evidence. Conversely, some findings indicate that that intermittent provision of enteral nutrition aligned with daylight may better support physiological functions and improve clinical/metabolic outcomes. However, there is a critical need for studies of skeletal muscle responses to acutely divergent feeding patterns, in addition to complementary translational research to map tissue-level physiology to whole-body and clinical outcomes.

Type
Review Article
Copyright
© The Authors 2024. Published by Cambridge University Press on behalf of The Nutrition Society