Meal Frequency and Timing Are Associated with Changes in Body Mass Index in Adventist Health Study 2

Abstract

Scientific evidence for the optimal number, timing, and size of meals is lacking. We investigated the relation between meal frequency and timing and changes in body mass index (BMI) in the Adventist Health Study 2 (AHS-2), a relatively healthy North American cohort. The analysis used data from 50,660 adult members aged ≥30 y of Seventh-day Adventist churches in the United States and Canada (mean ± SD follow-up: 7.42 ± 1.23 y). The number of meals per day, length of overnight fast, consumption of breakfast, and timing of the largest meal were exposure variables. The primary outcome was change in BMI per year. Linear regression analyses (stratified on baseline BMI) were adjusted for important demographic and lifestyle factors. Subjects who ate 1 or 2 meals/d had a reduction in BMI per year (in kg · m · y) (-0.035; 95% CI: -0.065, -0.004 and -0.029; 95% CI: -0.041, -0.017, respectively) compared with those who ate 3 meals/d. On the other hand, eating >3 meals/d (snacking) was associated with a relative increase in BMI ( < 0.001). Correspondingly, the BMI of subjects who had a long overnight fast (≥18 h) decreased compared with those who had a medium overnight fast (12-17 h) ( < 0.001). Breakfast eaters (-0.029; 95% CI: -0.047, -0.012; < 0.001) experienced a decreased BMI compared with breakfast skippers. Relative to subjects who ate their largest meal at dinner, those who consumed breakfast as the largest meal experienced a significant decrease in BMI (-0.038; 95% CI: -0.048, -0.028), and those who consumed a big lunch experienced a smaller but still significant decrease in BMI than did those who ate their largest meal at dinner. Our results suggest that in relatively healthy adults, eating less frequently, no snacking, consuming breakfast, and eating the largest meal in the morning may be effective methods for preventing long-term weight gain. Eating breakfast and lunch 5-6 h apart and making the overnight fast last 18-19 h may be a useful practical strategy.

The impact of a higher eating frequency on the diet quality and nutritional status of women with breast cancer undergoing chemotherapy

“…Similarly, Kim et al (18) found that Korean adults with an EF ≥ 5 daily eating episodes compared with <3 episodes had a lower BMI, WC and body fat percentage. However, the literature still presents contradictory results for the ideal number of daily eating episodes and their benefits in nutritional status (22)(23) , providing evidence for the necessity for further studies relating to these variables.…”

“…In addition to diet quality, inverse associations between the number of eating episodes and anthropometric variables were identified (10,17,18) . Studies show better control of body weight and healthy maintenance of biological markers when eating episodes are lower in energy intake and more frequent (19)(20)(21) , but the results are still inconsistent because of variations in methodological factors, especially for the optimal number of meals for anthropometric benefits (22,23) . It is known that negative anthropometric changes in BC patients are already commonly observed during CT (6,24) and are negatively related to the prognosis of the disease (25,26) .…”

Potential circadian and circannual rhythm contributions to the obesity epidemic in elementary school age children

“…Night Eating Syndrome, an eating disorder that involves eating 25% or more of one's daily calories after the evening meal, was associated with increased risk of obesity and changes in the timing and amplitude of metabolic hormones such as glucose, insulin, ghrelin, and leptin in adults [14,46,47]. Finally, an association between late meal timing and weight gain or obesity has been observed in observational studies among adults [48][49][50][51][52][53] and children [54][55][56]. In addition, late meal timing has been shown to affect weight loss outcomes in obesity treatment interventions [57][58][59].…”

Fast consumption increases the risk of overweight and obesity

“…In a review of 10 papers on the role of meal frequencies in weight management by healthy adults aged 20-70 Palmer et al did not show any significant dependence on weight loss or maintenance [21]. On the other hand, Kahleova et al analysing data from 50,660 adult members aged ≥30 y Seventh-day Adventist churches in the United States and Canada reports relative increase in BMI during a year in subjects who ate 3 meals/d compared with those who ate 1 or 2 meals/d [12]. It is worth to mention that such strategy worked for those who ate breakfast and lunch 5-6 h apart, consumed no snacks and made the overnight fast last 18-19 h. In studies performed by O'Connor et al in a group of 1,092 adults with a normal body weight, eating snacks between meals did not result in weight gain as well [20].…”