ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
This article is part of the Research TopicInteractions Between Diet, Sleep and Musculoskeletal Health: Beyond a Disease-Specific PerspectiveView all 6 articles
Development and Validation of an Osteoporosis Risk Prediction Model Incorporating Nighttime Eating Exposure
Provisionally accepted
- 1Luoyang Orthopedic Traumatological Hospital, Luoyang, China
- 2Fujian University of Traditional Chinese Medicine, Fuzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background:Osteoporosis (OP) is a global bone metabolic disease, and its incidence continues to rise with the intensifying aging of the population. In recent years, chrono-nutrition research has uncovered the significant impact of dietary timing patterns on health, but the relationship between nighttime eating exposure (NEE) and OP remains unclear. Objective: This study aimed to confirm through multi-dimensional methodologies that NEE is an independent risk factor for OP. Methods: A clinical cross-sectional study (n=186) employed LASSO regression, logistic regression, and random forest to screen for OP predictors, constructing and validating a nomogram model. Analysis of the US NHANES database (n=15,46) assessed the association between NEE and OP and explored non-linear relationships using weighted logistic regression. Multivariable Mendelian randomization (MR) analysis inferred causal associations using genetic instruments for dietary patterns, BMI, and sleep duration. Results:NEE was identified as an independent risk factor for OP. In the clinical prediction model, the combination model including NEE (NEE + bone mineral density + age, etc.) demonstrated optimal predictive performance (training set AUC=0.808). NHANES validation showed a significantly increased OP risk when NEE >25% (OR=1.83, 95% CI: 1.27–2.64), with a dose-effect threshold identified (steep risk increase at NEE=10–25%). Subgroup analysis revealed that the effect size of NEE was significantly higher in individuals with osteopenia (OR=1.12) compared to those with normal bone mass (OR=1.06, interaction P=0.0297), and the protective effect of bone mineral density was weakened in the osteopenic group. Multivariable MR results indicated that a genetic predisposition representing dietary disturbance was positively associated with OP risk (β=0.0228, P=0.0033), reflecting the potential causal role of NEE-related behavioral patterns. Conclusion: NEE is a novel behavioral risk factor for OP, posing a significant hazard particularly for osteopenic individuals. Its mechanism may be related to circadian rhythm disruption, metabolic dysregulation, and melatonin suppression. This research provides a new direction for precision OP prevention strategies based on "chrono-nutrition".
Keywords: Chrono-nutrition1, Nighttime Eating Exposure2, Osteoporosis (OP), MendelianRandomization (MR)4, Bone Mineral Density (BMD)5
Received: 05 Jul 2025; Accepted: 04 Nov 2025.
Copyright: © 2025 Liu, Tong, Pan, Li, Yang, Wang and Xing. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yanlei Wang, 15116992692@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.