Eating patterns are increasingly varied. Typical breakfast, lunch, and dinner meals are difficult to distinguish because skipping meals and snacking have become more prevalent. Such eating styles can have various effects on cardiometabolic health markers, namely obesity, lipid profile, insulin resistance, and blood pressure. In this statement, we review the cardiometabolic health effects of specific eating patterns: skipping breakfast, intermittent fasting, meal frequency (number of daily eating occasions), and timing of eating occasions. Furthermore, we propose definitions for meals, snacks, and eating occasions for use in research. Finally, data suggest that irregular eating patterns appear less favorable for achieving a healthy cardiometabolic profile. Intentional eating with mindful attention to the timing and frequency of eating occasions could lead to healthier lifestyle and cardiometabolic risk factor management.T he patterns of meal and snack eating behavior in American adults have changed over the past 40 years. Based on NHANES (National Health and Nutrition Examination Survey) data from 1971 to 1974 to 2009 to 2010 (n=62 298), women 20 to 74 years of age reported a decrease in 24-hour meal-derived total energy intake (TEI) from 82% in the 1970s to 77% in 2009 to 2010 and an increase in the proportion of TEI consumed from snacks from 18% to 23%.1 Similar trends were reported among men. The proportion of men and women who reported consuming all 3 standard meals declined over this period (from 73% to 59% in men; from 75% to 63% in women), 1 reflecting changes in eating patterns rather than changes in eating frequency. Indeed, the traditional breakfast-lunch-dinner pattern was not observed in a population of healthy, non-shift-working adults. 2 In that study, the number of eating occasions, defined as consumption of any food or beverage providing at least 5 kcal, was ≈4.2 times a day in the lowest decile and 10.5 times a day for the top decile. There were only 5 hours during the 24-hour day when <1% of all eating occasions occurred: between 1 and 6 am. This study clearly demonstrated that adults in the United States eat around the clock. Because feeding and fasting entrain clock genes, which regulate all aspects of metabolism, meal timing can have serious implications for the development of cardiovascular disease (CVD), type 2 diabetes mellitus, and obesity. 3,4 The circadian rhythms of the body are controlled by the central clock located in the suprachiasmatic nucleus of the hypothalamus but also by clocks of peripheral organs. Although the master clock is strongly entrained by light, clocks of peripheral organs are additionally responsive to food supply, and temporal restriction of food can reset clock gene rhythms. In mice, food given in the normal sleeping period can uncouple peripheral clocks from the master clock. 5 In fact, time-restricted feeding CLINICAL STATEMENTS AND GUIDELINESin mice alters the robustness and coherence of rhythmic gene transcripts, 6 which may be relevant for cardiom...

Background The effects of smoking and smoking cessation on lipoproteins have not been studied in a large contemporary group of smokers. This study was designed to determine the effects of smoking cessation on lipoproteins. Methods One-year, prospective, double-blind, randomized, placebo-controlled clinical trial of the effects of 5 smoking cessation pharmacotherapies. Fasting nuclear magnetic resonance spectroscopy lipoprotein profiles were obtained before and 1-year after the target smoking cessation date. The effects of smoking cessation and predictors of changes in lipoproteins after one year were identified by multivariable regression. Results The 1,504 current smokers were mean (standard deviation) 45.4 (11.3) years old and smoked 21.4 (8.9) cigarettes/day at baseline. Of the 923 adult smokers who returned at 1 year, 334 (36.2%) had quit smoking. Despite gaining more weight (4.6 kg [5.7] vs. 0.7 kg [5.1], p<0.001], abstainers had increases in high-density lipoprotein cholesterol (HDL-C) (2.4 [8.3] vs. 0.1 [8.8] mg/dL, p<0.001], total HDL (1.0 [4.6] vs. −0.3 mcmol/L [5.0], p<0.001) and large HDL (0.6 [2.2] vs. 0.1 [2.1] mcmol/L, p=0.003) particles, compared with continuing smokers. Significant changes in low-density lipoprotein (LDL) cholesterol and particles were not observed. After adjustment, abstinence from smoking (p<0.001) was independently associated with increases in HDL-C and total HDL particles. These effects were stronger in women. Conclusions Despite weight gain, smoking cessation improved HDL-C, total HDL and large HDL particles, especially in women. Smoking cessation did not affect LDL or LDL size. Increases in HDL may mediate part of the reduced cardiovascular disease risk observed after smoking cessation.

Given rapid advancements in medical science, it is often challenging for the busy clinician to remain up-to-date on the fundamental and multifaceted aspects of preventive cardiology and maintain awareness of the latest guidelines applicable to cardiovascular disease (CVD) risk factors. The “American Society for Preventive Cardiology (ASPC) Top Ten CVD Risk Factors 2021 Update” is a summary document (updated yearly) regarding CVD risk factors. This “ASPC Top Ten CVD Risk Factors 2021 Update” summary document reflects the perspective of the section authors regarding ten things to know about ten sentinel CVD risk factors. It also includes quick access to sentinel references (applicable guidelines and select reviews) for each CVD risk factor section. The ten CVD risk factors include unhealthful nutrition, physical inactivity, dyslipidemia, hyperglycemia, high blood pressure, obesity, considerations of select populations (older age, race/ethnicity, and sex differences), thrombosis/smoking, kidney dysfunction and genetics/familial hypercholesterolemia. For the individual patient, other CVD risk factors may be relevant, beyond the CVD risk factors discussed here. However, it is the intent of the “ASPC Top Ten CVD Risk Factors 2021 Update” to provide a succinct overview of things to know about ten common CVD risk factors applicable to preventive cardiology.

Like most behavior, consumer behavior too is goal driven. In turn, goals constitute cognitive constructs that can be chronically active as well as primed by features of the environment. Goal systems theory outlines the principles that characterize the dynamics of goal pursuit and explores their implications for consumer behavior. In this vein, we discuss from a common, goal systemic, perspective a variety of well known phenomena in the realm of consumer behavior including brand loyalty, variety seeking, impulsive buying, preferences, choices and regret. The goal systemic perspective affords guidelines for subsequent research on the dynamic aspects of consummatory behavior as well as offering insights into practical matters in the area of marketing.