Recommending Small, Frequent Meals in the Clinical Care of Adults: A Review of the Evidence and Important Considerations

Dashti, Hassan S.; Mogensen, Kris M.

doi:10.1177/0884533616662995

Cited by 15 publications

(8 citation statements)

References 99 publications

(155 reference statements)

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“…The recommendations of the ideal number of daily eating episodes for cancer patients are not available yet. However, there are medical indications for frequent and small meals throughout the day to relieve transient symptoms of a variety of diseases, including cancer (53) . In addition, the American Dietetics Association recommends the daily energetic distribution in four to five meals (including breakfast) in order to avoid the development of diseases (54) .…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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The present study investigated the association between eating frequency (EF), diet quality and nutritional status of fifty-five women with breast cancer (BC) undergoing chemotherapy (CT), with three follow-ups, before the first cycle (T0), after the intermediate cycle (T1) and after the last cycle of CT (T2). Dietary data were obtained by nine 24-h dietary recalls (24HR), and the Brazilian Healthy Eating Index Revised (BHEI-R) was used for qualitative analysis of diet. The average EF was established by adding the number of daily eating episodes in the three 24HR of each time. Anthropometric variables were obtained at three times. Women who reported higher EF (equal to or above median value (T0 and T1: 4·67; T2: 4·33 eating episodes)) presented better anthropometric parameters, in T0 and T1, as well as higher scores for BHEI-R specific groups and BHEI-R Total score in T1 and T2. In generalised linear models, the continuous variable EF was negatively associated with all the anthropometric variables in T0 and with the waist:height ratio in T1. There were positive associations for the BHEI-R groups at the three times: Total Fruit; Whole Fruit; Total Vegetables; Dark Green and Orange Vegetables and Legumes. At T1 and T2 the EF was positively associated with the BHEI-R Total score, and also with Whole Grains in T1. The results suggest that a higher EF was associated with a better diet quality during CT in women with BC. In contrast, an inverse association was observed between EF and anthropometric parameters before the first cycle of treatment.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…While skeletal MPS is unlikely to be further enhanced by more frequent eating occasions, smaller more frequent eating occasions (5–6+) are advocated when attempting to increase muscle mass, presumably because gastrointestinal tract tolerance is higher with more frequent eating occasions compared to merely increasing the size of existing eating occasions (31). Indeed, smaller, more frequent meals are advocated clinically in the management of early satiety, anorexia and gastrointestinal symptoms (137). Emerging evidence supports this notion, with significantly stronger hunger and desire to eat when following a smaller, more frequent eating pattern (138).…”

Section: Energy Surplus… Nutrient Timingmentioning

confidence: 99%

Is an Energy Surplus Required to Maximize Skeletal Muscle Hypertrophy Associated With Resistance Training

et al. 2019

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Resistance training is commonly prescribed to enhance strength/power qualities and is achieved via improved neuromuscular recruitment, fiber type transition, and/ or skeletal muscle hypertrophy. The rate and amount of muscle hypertrophy associated with resistance training is influenced by a wide array of variables including the training program, plus training experience, gender, genetic predisposition, and nutritional status of the individual. Various dietary interventions have been proposed to influence muscle hypertrophy, including manipulation of protein intake, specific supplement prescription, and creation of an energy surplus. While recent research has provided significant insight into optimization of dietary protein intake and application of evidence based supplements, the specific energy surplus required to facilitate muscle hypertrophy is unknown. However, there is clear evidence of an anabolic stimulus possible from an energy surplus, even independent of resistance training. Common textbook recommendations are often based solely on the assumed energy stored within the tissue being assimilated. Unfortunately, such guidance likely fails to account for other energetically expensive processes associated with muscle hypertrophy, the acute metabolic adjustments that occur in response to an energy surplus, or individual nuances like training experience and energy status of the individual. Given the ambiguous nature of these calculations, it is not surprising to see broad ranging guidance on energy needs. These estimates have never been validated in a resistance training population to confirm the “sweet spot” for an energy surplus that facilitates optimal rates of muscle gain relative to fat mass. This review not only addresses the influence of an energy surplus on resistance training outcomes, but also explores other pertinent issues, including “how much should energy intake be increased,” “where should this extra energy come from,” and “when should this extra energy be consumed.” Several gaps in the literature are identified, with the hope this will stimulate further research interest in this area. Having a broader appreciation of these issues will assist practitioners in the establishment of dietary strategies that facilitate resistance training adaptations while also addressing other important nutrition related issues such as optimization of fuelling and recovery goals. Practical issues like the management of satiety when attempting to increase energy intake are also addressed.

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“…There is no consensus regarding which of the many proposed diet and fasting schemes is optimal for each person: some restrict fat while allowing for high carbohydrates (HCLF); some do the opposite, i.e. restrict carbohydrates and allow fat (LCHF); some advocate fasting two days a week (5:2); some 16 hours each day (intermediate fasting, IF); and some suggest small, frequent meals (SFM) [1][2][3][4][5][6][7][8]. The reason for this lack of consensus from long-term studies may partially be due to a variety of confounding factors that are hard to monitor in large-scale long-term studies.…”

Section: Introductionmentioning

confidence: 99%

Digital twin predicting diet response before and after long-term fasting

Silfvergren

Simonsson²,

Ekstedt³

et al. 2022

PLoS Comput Biol

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Today, there is great interest in diets proposing new combinations of macronutrient compositions and fasting schedules. Unfortunately, there is little consensus regarding the impact of these different diets, since available studies measure different sets of variables in different populations, thus only providing partial, non-connected insights. We lack an approach for integrating all such partial insights into a useful and interconnected big picture. Herein, we present such an integrating tool. The tool uses a novel mathematical model that describes mechanisms regulating diet response and fasting metabolic fluxes, both for organ-organ crosstalk, and inside the liver. The tool can mechanistically explain and integrate data from several clinical studies, and correctly predict new independent data, including data from a new study. Using this model, we can predict non-measured variables, e.g. hepatic glycogen and gluconeogenesis, in response to fasting and different diets. Furthermore, we exemplify how such metabolic responses can be successfully adapted to a specific individual’s sex, weight, height, as well as to the individual’s historical data on metabolite dynamics. This tool enables an offline digital twin technology.

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Recommending Small, Frequent Meals in the Clinical Care of Adults: A Review of the Evidence and Important Considerations

Cited by 15 publications

References 99 publications

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

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

Is an Energy Surplus Required to Maximize Skeletal Muscle Hypertrophy Associated With Resistance Training

Digital twin predicting diet response before and after long-term fasting

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