The Impact of Eating Frequency and Time of Intake on Nutrient Quality and Body Mass Index: The INTERMAP Study, a Population-Based Study

Abstract

Background Epidemiologic evidence is sparse on the effect of dietary behaviors and diet quality on body mass index (BMI) that may be important drivers of the obesity epidemic. Objective This study investigated the relationships of frequency of eating and time of intake to energy density, nutrient quality and BMI using data from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) including 2,696 men and women aged 40-59 from the United States and the United Kingdom. Design INTERMAP is a cross-sectional investigation with four 24-hour dietary recalls and BMI measurements conducted between 1996 and 1999. Consumption of solid foods was aggregated into eating occasion. Nutrient density is expressed using the Nutrient Rich Food (NRF 9.3) index. The ratio of evening/morning energy intake was calculated; mean values of four visits were used. Statistical analyses performed Characteristics across eating occasion categories are presented as adjusted mean with corresponding 95% confidence interval. Multiple linear regression models were used to examine associations of eating occasions, ratio of evening/morning energy intake, dietary energy density, and NRF 9.3 index with BMI. Results Compared to participants with < 4 eating occasions/24-hours, those with ≥ 6 eating occasions/24-hours had lower mean: BMI: 27.3 vs. 29.0 kg/m2; total energy intake: 2,129 vs. 2,472 kcal/24-hours; dietary energy density: 1.5 vs. 2.1 kcal/g; and higher NRF 9.3 index: 34.3 vs. 28.1. In multiple regression analyses, higher evening intake relative to morning intake was directly associated with BMI; however this did not influence the relationship between eating frequency and BMI. Conclusions Our results suggest that a larger number of small meals may be associated with improved diet quality and lower BMI. This may have implications for behavioral approaches to controlling the obesity epidemic.

Temporal eating patterns: a latent class analysis approach

“…Total energy intake and the proportion of total energy intake from snacks was also higher. Previous research has shown that later timing of the last EO [34], consuming a higher proportion of total energy intake after 17:00 h [11, 12] or at the dinner meal [35] and having a higher evening to morning energy intake ratio [36] is positively associated with higher overall energy intakes. However, the metabolic implications of this later eating pattern are unclear, and future research should examine the relationship between temporal eating patterns and health.…”

Chrono-nutrition: a review of current evidence from observational studies on global trends in time-of-day of energy intake and its association with obesity

“…The number of dietary data days also varied from as few as 1-7 d. BMI was assessed as a continuous variable expressed as kg/m 2 or as z-scores in some studies (27,(37)(38)(39)(40) , whilst in others BMI was treated as a categorical variable (41,42) . One study selected subcutaneous and visceral fat as an outcome of interest (43) .…”

Temporal eating patterns: associations with nutrient intakes, diet quality, and measures of adiposity

“…Studies have reported a progressive lowering of insulin sensitivity and glucose tolerance into the evening, which explains how a later temporal eating pattern may promote weight gain (58)(59)(60). Two cross-sectional studies have found a positive association between evening EI and BMI (13,61). In addition, in a crossover trial in 6 healthy lean volunteers that controlled for total EI and macronutrient intake (59), higher glucose concentrations and diminished insulin sensitivity were observed in participants who consumed a large evening meal that was high in energy (w59% total EI) and carbohydrates, but low in fiber, compared with those who consumed that same meal in the TABLE 4 Associations between temporal eating patterns and BMI and overweight or obesity among Australian men and women TEMPORAL EATING PATTERNS AND ADIPOSITY morning.…”

“…The inconsistent findings among observational studies may be attributed to differences in how the timing and distribution of EI or EOs were assessed. For example, studies have examined the proportion of total EI across stratified time periods (e.g., morning, midday, or evening) (13), the proportion of EI consumed after 1700 (12), and the ratio of evening to morning EI (61). However, because individuals have multiple EOs across the day and the EIs at these EOs are likely correlated, novel approaches, such as the use of LCA or cluster analysis [e.g., the approaches used in this study and in the study by Eicher-Miller et al (17)] are needed to better understand the relation between temporal eating patterns and obesity.…”