Meal frequency and incidence of type 2 diabetes: a prospective study

Abstract

Dietary habits play an important role in the development of obesity and type 2 diabetes. However, evidence on association between diet frequency and type 2 diabetes was limited and inconclusive. We aimed to examine the association between meal frequency and risk of type 2 diabetes. The cohort study used data from China Health and Retirement Longitudinal Study of 8874 community-dwelling people aged over 45 years. Participants were classified as eating 2 meals/d, 3 meals/d and 4 meals/d. Multiple Poisson regression models were used to examine risk of 4-year incident type 2 diabetes among people who ate more or less than 3 meals/d compared with people who ate 3 meals/d. We documented 706 type 2 diabetes cases during follow-up. After adjustment for known risk factors for type 2 diabetes, except for body mass index (BMI), participants who ate 4 meals/d were at a lower risk of type 2 diabetes than those who ate 3 meals/d (RR = 0.73 [0.58, 0.92]). After further adjustment for baseline BMI, the association was slightly attenuated but remained statistically significant (RR = 0.76 [0.60, 0.97]). Subgroup analysis showed that the fully-adjusted RRs of type 2 diabetes for people eating 4 meals/day were 0.66 (0.48, 0.91) and 0.93 (0.65, 1.34) among those had a BMI < 25 and ≥ 25 kg/m2, respectively. Eating 4 meals/day, compared with eating 3 meals/day, was associated with lower risk of developing type 2 diabetes in a Chinese population, particularly in those with a BMI < 25 kg/m2.

Association between Meal Frequency and Type 2 Diabetes Mellitus in Rural Adults: A Large-Scale Cross-Sectional Study

“…A follow-up study of American health professional men showed that lower eating frequency was associated with a higher risk of T2DM [ 8 ]. Besides, another study conducted on Chinese community residents showed that eating four meals a day was related to a lower risk of T2DM compared to eating three meals a day, while eating two meals a day showed no relationship with T2DM [ 7 ]. In addition, there was a randomized trial focusing on prediabetes patients, suggesting that increasing the frequency of eating under isocaloric conditions can provide a variety of metabolic benefits, including improved glucose metabolism [ 9 ].…”

“…Nevertheless, research on this topic has produced inconclusive results. A prospective study conducted on Chinese community residents showed that increasing diet frequency may reduce the risk of T2DM [ 7 ]. Another study of American health professional subjects indicated that lower eating frequency was associated with a higher risk of T2DM [ 8 ].…”

Meal Frequency and Multi-Morbidity in a Cypriot Population: A Cross-Sectional Study

“…Several dietary habits, such as meal frequency, seem to have potential effects on human health and metabolism, especially on diet-related diseases [ 11 , 12 ]. Previous studies indicated that increased meal frequency is associated with a lower risk of obesity [ 13 ] and improved lipid profiles [ 14 , 15 ]. In regard to lipid metabolism, a previous meta-analysis of randomized controlled trials (RCTs) suggested that higher meal frequency improves lipid profile [ 16 ].…”

Dietary habits are associated with the prevalence of type 2 diabetes: a study among a middle eastern population

“…In contrast, Mekary et al ( 10 ) showed both high- and low-frequency eating patterns were linked to T2D in 46 289 US women as part of the Nurses’ Health Study. Wang et al ( 11 ) showed eating 4 meals/d, compared to three meals was associated with lower risk of developing T2D (RR 0⋅76; 95 % CI 0⋅60, 0⋅97) in a Chinese population of 8874 adults over 45. In addition to meal frequency, unhealthy dietary habits such as high salt and fried food intakes have been shown to impact risk of hypertension, overweight and obesity ( 12 , 13 ) alongside T2D.…”

“…Increased sodium intake was shown to significantly ( P < 0⋅05) decrease healthy lifestyle scores across the four quartiles. Further research is needed to evaluate the combined associations between meal frequency ( 11 ) , high salt intakes ( 16 ) , frequency of fried/grilled-food consumption ( 13 ) with the prevalence of T2D.…”