Chrono-Cardiology and Chrononutrition: Integrating Circadian Biology Into Cardiometabolic Care

By Vijay Kumar MalesuReviewed by Benedette Cuffari, M.Sc.

Introduction
The body’s circadian clock and cardiometabolic health
Optimal nutrition strategies
Time-restricted eating and cardiometabolic health
Chrononutrition for blood pressure regulation
Practical daily strategies
Conclusions
References
Further reading

How, when you eat, not just what you eat, shapes circadian blood pressure rhythms, metabolic health, and the future of non-pharmacological cardiovascular prevention.

Image Credit: BilahDesign / Shutterstock.com

Introduction

This article examines how aligning meal timing with circadian biology influences blood pressure regulation, glucose metabolism, and vascular function. It synthesizes current evidence indicating that earlier, consistent eating windows may support cardiometabolic health, while highlighting the limitations of existing clinical data.^1,2

The body’s circadian clock and cardiometabolic health

The internal circadian clock regulates 24-hour rhythms across metabolic pathways ranging from blood pressure control and insulin sensitivity to glucose and lipid metabolism. Interference with circadian timing, which may involve irregular meals, late-night snacking, or shift work, can disrupt coordination between the central suprachiasmatic nucleus and peripheral clocks in organs such as the liver, kidney, heart, and vasculature, contributing to cardiometabolic dysfunction through internal circadian misalignment.^1,2,5

Chrono‐cardiology examines how blood pressure, heart rate, glucose metabolism, and vascular tone rely on the synchronization of central and peripheral circadian clocks to follow a daily pattern. Feeding time acts as a dominant zeitgeber for peripheral clocks, particularly those regulating renal sodium handling and endothelial function, making meal timing and food composition important signals for maintaining cardiovascular health, even though light remains the primary entrainer of the central clock.^1,2

Optimal nutrition strategies

Breakfast

Growing evidence indicates that eating breakfast, compared with skipping it, leads to better glycemic and insulin responses after consuming challenging foods later in the day. A well-balanced breakfast with sufficient protein, fiber from whole grains, and healthy unsaturated fats can decrease blood sugar surges, sustain energy levels, and reduce prolonged elevations in free fatty acids that impair insulin sensitivity later in the day.⁴ Eating breakfast during the biological morning coincides with peak insulin sensitivity and diet-induced thermogenesis, an effect that has been consistently observed in controlled metabolic studies and is anticipated to benefit long-term cardiometabolic health.^4,5

Midday meals and nutrient timing

Lunch is important to stabilize metabolic reactions when the body is actively utilizing nutrients and energy. Chrononutrition studies suggest that midday meal timing supports lipid clearance and limits postprandial glycemic excursions during the active circadian phase, although direct cardiovascular outcome data remain limited.⁵

A lunch consisting of lean protein, whole grains, and a variety of plant foods can also support cardiovascular health by improving postprandial endothelial function and reducing oxidative stress⁵. In contrast, consuming large quantities of refined carbohydrates at lunch may result in significant fluctuations in blood glucose levels.⁴

Dinner and evening eating patterns

Evening consumption patterns are crucial for maintaining optimal cardiometabolic health, as glucose tolerance and insulin sensitivity naturally decline later in the day. Large or late dinners are associated with poor glucose handling and adverse lipid metabolism, likely due to circadian misalignment between feeding time and reduced peripheral insulin responsiveness, as demonstrated primarily in experimental and short-term intervention studies.^1,5

A small meal consumed earlier in the evening can support overnight metabolic recovery by ensuring an adequate fasting period and preserving the normal nocturnal blood pressure ‘dipping’ pattern.^2,3 Food-timing approaches such as early time-restricted eating have been associated with improvements in blood pressure, insulin sensitivity, and other cardiometabolic markers, with most evidence derived from mechanistic and short-duration trials rather than long-term outcome studies.^1,2,5

Time-restricted eating and cardiometabolic health

Time-restricted eating confines daily food intake to a fixed window, typically 8-10 hours, to better align feeding–fasting cycles with circadian rhythms. Evidence suggests that time-restricted eating can improve body weight regulation, insulin sensitivity, and blood pressure by enhancing coordination between central and peripheral clocks, though most human studies remain short-term and heterogeneous in design.^1,5

Early time-restricted eating, characterized by earlier meal times and longer overnight fasting, is more consistently associated with improvements in glycemic control, lipid metabolism, and blood pressure regulation than later eating windows.^1,2,5 However, responses vary by age, sex, cardiometabolic status, and work schedules, and causality cannot be inferred from observational studies alone, underscoring the need for individualized approaches.¹

Image Credit: DROBOT VIKTORIIA / Shutterstock.com

Chrononutrition for blood pressure regulation

Blood pressure follows a circadian pattern characterized by a morning surge, sustained daytime levels, and a nocturnal decline. Disruption of this rhythm, particularly reduced nighttime dipping, is associated with hypertension and increased cardiovascular risk.²

The timing of nutrient intake contributes to blood pressure regulation by influencing renal sodium excretion, vascular tone, and autonomic nervous system activity. Consistent and earlier eating windows may promote healthier blood pressure profiles by supporting circadian regulation of the renin–angiotensin–aldosterone system and endothelial nitric oxide signaling.^2,3 However, evidence from randomized controlled trials using 24-hour ambulatory blood pressure monitoring remains limited, and current findings should be interpreted as hypothesis-generating rather than definitive. Diets rich in fiber and anti-inflammatory bioactive compounds further improve endothelial function and vascular resilience.⁵

Practical daily strategies

Morning eating aligns with peak insulin sensitivity, thermogenesis, and metabolic flexibility. A balanced breakfast that includes protein, fiber, and whole grains enhances satiety and reduces postprandial glucose spikes, thereby supporting stable energy metabolism.^4,5

In contrast, heavy nighttime meals impair glucose tolerance and lipid metabolism. Restricting food intake to an earlier, consistent daily window may reinforce circadian rhythms, reduce metabolic stress, and support long-term cardiometabolic health, particularly among individuals at risk of circadian disruption, such as shift workers.^1,5

Conclusions

The timing and regularity of food intake influence circadian blood pressure rhythms, glucose regulation, insulin sensitivity, and vascular function. Eating earlier in the day, avoiding late-night meals, and maintaining consistent eating windows promote circadian alignment, supporting cardiovascular and metabolic health. Integrating meal timing with nutrient-rich dietary patterns represents a practical, non-pharmacological strategy to improve cardiometabolic outcomes, although long-term randomized trials are still needed to establish clinical efficacy and population-specific guidelines.

References

1. Dashti, H. S., Jansen, E. C., Zuraikat, F. M., et al. (2025). Advancing Chrononutrition for Cardiometabolic Health: A 2023 National Heart, Lung, and Blood Institute Workshop Report. Journal of the American Heart Association 14(9). DOI: 10.1161/JAHA.124.039373. https://www.ahajournals.org/doi/10.1161/JAHA.124.039373
2. Bohmke, N. J., Dixon, D. L., & Kirkman, D. L. (2024). Chrono‐nutrition for hypertension. Diabetes/Metabolism Research and Reviews 40(1). DOI: 10.1002/dmrr.3760. https://onlinelibrary.wiley.com/doi/full/10.1002%2Fdmrr.3760
3. Keiser, T., Katz, S., Robson, S. M., et al. (2024). Association between time-of-day for eating, exercise, and sleep with blood pressure in adults with elevated blood pressure or hypertension: a systematic review. Journal of Hypertension 42(6); 951-960. DOI: 10.1097/HJH.0000000000003732. https://journals.lww.com/10.1097/HJH.0000000000003732
4. Maki, K. C., Phillips-Eakley, A. K., & Smith, K. N. (2016). The effects of breakfast consumption and composition on metabolic wellness with a focus on carbohydrate metabolism. Advances in Nutrition 7(3); 613S-621S. DOI:10.3945/an.115.010314. https://www.sciencedirect.com/science/article/pii/S2161831322007487 
5. Reytor-González, C., Simancas-Racines, D., Román-Galeano, N. M., et al. (2025). Chrononutrition and Energy Balance: How Meal Timing and Circadian Rhythms Shape Weight Regulation and Metabolic Health. Nutrients 17(13). DOI: 10.3390/nu17132135. https://www.mdpi.com/2072-6643/17/13/2135

Further Reading

• All Circadian Rhythm Content
• How Does the Suprachiasmatic Nucleus (SCN) Control Circadian Rhythm?
• Circadian Rhythm
• Circadian Rhythm and Weight Loss
• Artificial Light Exposure and Circadian Rhythm

Last Updated: Feb 9, 2026