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Sleep, Dietary Patterns and Metabolic Health in UK Adults Gregory David

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Sleep, Dietary Patterns and Metabolic Health in UK Adults Gregory David Sleep, dietary patterns and metabolic health in UK adults Gregory David Maxwell Potter Submitted in accordance with the requirements for the degree of Doctor of Philosophy The University of Leeds Faculty of Medicine and Health March 2018 1 1 Declaration The candidate confirms that the work submitted is his own, except where work which has formed part of jointly authored publications has been included. The contribution of the candidate and the other authors to this work has been explicitly indicated below. The candidate confirms that appropriate credit has been given within the thesis where reference has been made to the work of others. The literature review in Chapter 1 incorporates much of the work of two jointly authored publications: Potter GDM, Cade JE, Grant PJ, Hardie LJ. Nutrition and the circadian system. Br J Nutr. 2016;116(3):434-42. Potter GDM, Skene DJ, Arendt J, Cade JE, Grant PJ, Hardie LJ. Circadian Rhythm and Sleep Disruption: Causes, Metabolic Consequences, and Countermeasures. Endocr Rev. 2016;37(6):584-608. The candidate was responsible for reviewing the literature and writing all drafts of both of these manuscripts. The contribution of the other authors was providing comprehensive feedback throughout preparation of the publications. Chapter 2 incorporates much of the work of another jointly authored publication: Wark PA, Hardie LJ, Frost GS, Alwan NA, Carter M, Elliott P, et al. Validity of an online 24-hour recall tool (myfood24) for dietary assessment in population studies: comparison with biomarkers and standard interviews. BMC Med (In press) 2018. ISSN 1741-7015. The candidate was responsible for completing the urinary nitrogen and sugars laboratory analyses. The contribution of the other authors was as follows: Nisreen helped design the study. Janet conceived the project, oversaw the project, contributed to study design, and helped develop myfood24. Michelle Carter managed the project in Leeds for two years and helped develop myfood24. Paul helped design the study. Heather led participant recruitment and collection of biological samples. Gary helped design the study and oversaw the participant recruitment process. Darren helped design the study and completed the statistical analyses. Neil contributed to the study design, helped develop myfood24, and continues to manage the myfood24 database. Laura helped design the study and developed the biomarker methods. Michelle Morris contributed to management of the project in Leeds for one year and helped develop myfood24. Umme and Katerina managed the project in London, also helping with participant recruitment and biological sample collection. David did the plasma β-carotene, α-tocopherol, and vitamin C biomarker laboratory analyses. Essra also contributed to the vitamin C 2 biomarker laboratory analysis. Elio helped design the study. Petra jointly conceived the project, oversaw the project in London, and helped design the study. Chapter 4 incorporates much of the work of another jointly authored publication: Potter GDM, Cade JE, Hardie LJ. Longer sleep is associated with lower BMI and favorable metabolic profiles in UK adults: Findings from the National Diet and Nutrition Survey. PLoS One. 2017;12(7):e0182195. Chapter 4 is based on a secondary analysis of a publicly available dataset (the National Diet and Nutrition Survey). The candidate was not involved in the design, data collection, or primary data processing of the National Diet and Nutrition Survey. Credit for these data is detailed in the Acknowledgements. The candidate was responsible for designing and completing the data analysis in Chapter 4. The candidate was also responsible for data cleaning and formatting, data interpretation, and writing all drafts of the manuscript. The contribution of the other authors was helping design the analysis and providing comprehensive feedback throughout preparation of the publication. This copy has been supplied on the understanding that it is copyright material and that no quotation from the thesis may be published without proper acknowledgement. 3 Acknowledgements I thank the team that has contributed to the myfood24 validation work of Chapter 2. (Please note that I also did a separate analysis of myfood24 data for the work presented in Chapter 3.) myfood24 validation research has been carried out by a team which has included Nisreen Alwan, Janet Cade, Michelle Carter, Paul Elliott, Heather Ford, Gary Frost, Darren Greenwood, Neil Hancock, Laura Hardie, Michelle Morris, Umme Mulla, David Murphy, Essra Noorwali, Katerina Petropoulou, Elio Riboli, and Petra Wark. My own contributions, fully and explicitly indicated in the thesis, have been completion of the urinary nitrogen and urinary sugars biomarkers laboratory analyses used in myfood24 validation. The other members of the group and their contributions have been as follows: Nisreen helped design the study. Janet conceived the project, oversaw the project, contributed to study design, and helped develop myfood24. Michelle Carter managed the project in Leeds for two years and helped develop myfood24. Paul helped design the study. Heather led participant recruitment and collection of biological samples. Gary helped design the study and oversaw the participant recruitment process. Darren helped design the study and completed the statistical analyses. Neil contributed to the study design, helped develop myfood24, and continues to manage the myfood24 database. Laura helped design the study and developed the biomarker methods. Michelle Morris contributed to management of the project in Leeds for one year and helped develop myfood24. Umme and Katerina managed the project in London, also helping with participant recruitment and biological sample collection. David did the plasma β-carotene, α-tocopherol, and vitamin C biomarker laboratory analyses. Essra also contributed to the vitamin C biomarker laboratory analysis. Elio helped design the study. Petra jointly conceived the project, oversaw the project in London, and helped design the study. Now that I have made compulsory acknowledgements, the following words are from my heart. I first thank my supervisors for all they have done for me during this project. I don’t think I can capture the many ways in which they have supported me in a few sentences without omissions or sounding glib, but I will try. I am exceptionally fortunate to have such a supportive primary supervisor as Laura. She has been understanding during troubling times, patient of my pedantry, and her door has always been open whenever I have needed her counsel. She has invested a lot of time and effort in me, for which I am hugely grateful (and baffled). Despite juggling so many projects and protégés, Janet has produced a wealth of ideas and useful feedback throughout the project, always delivered with a smile and a spring in the step. And Peter, of course, strongly supported the EuRhythDia work. He has encouraged me to play my golf hole backwards, and I will miss our off-topic musings. 4 In addition to my supervisory triumvirate, I am particularly appreciative of Darren’s statistical wizardry and Eleanor Scott’s encouragement and enthusiasm to engage me in other projects. Acknowledging the contributions of all of my other colleagues at the University of Leeds could result in a tome, so I will just say a single big thank you: You know who you are, and I hope you realise how much your help means to me. Beyond Leeds, I thank all of those who have shared ideas with me during this time, particularly Debra Skene and Josephine Arendt for their generosity and considerable expertise. I am also indebted to the Medical Research Council, without which my project might not have been possible. I am privileged to have been able to analyse data that others have kindly made open access. In Chapter 4 I used National Diet and Nutrition Survey (NDNS) data held by the UK Data Archive. I acknowledge and thank the survey creators, depositors, and funders, including the National Centre for Social Research, the Northern Ireland Statistics and Research Agency, the Medical Research Council, University College London Medical School, the Food Standards Agency, the Department of Health, and the UK Data Archive. The original data creators, depositors and copyright holders of the NDNS and the UK Data Archive bear no responsibility for further analysis or interpretation. Crown copyright for the NDNS is held jointly with the National Centre for Social Research, and material is reproduced with the permission of the Controller of HMSO and the Queen’s Printer for Scotland. Finally, I thank my friends and family. I have met many special people in Leeds, among whom Laura and Ted stand out. Outside Leeds, Dan has been a profoundly positive influence on my life recently. Mo, you always have been too - you are the man. Many claim to have the best parents in the world. History has shown that many are wrong. In this instance, however, I am certain of this: You are the best, Mr and Mrs P. It has been a turbulent spell, throughout which you have been at least as loving as ever. Anna, Kip and Marcus, you lot are alright too. 5 Abstract The causes of the ongoing metabolic disease pandemic are complex. Changes in human population genetics proceed slowly, so the recent increase in metabolic disease prevalence likely reflects environmental and behavioural changes. Our circadian (~ 24- hour) systems optimise our biology according to time of day. Artificial stimuli like electric lighting and around-the-clock food access enable waking behaviours, such as eating, at times at which our circadian systems prime us to sleep. Such mistimed behaviours may contribute to metabolic disease, as exemplified by increased risk of diabetes in shift workers. However, few researchers have concurrently explored associations between sleep, diet composition and timing, and metabolic health. Furthermore, many dietary analysis methods used have not been validated, precluding accurate inferences about diet-disease relationships. And few studies have assessed the metabolic effects of interventions to resynchronise the circadian system each day.
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