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Research | Original Research| Volume 115, ISSUE 4, P528-536.e1, April 2015

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

Published:January 22, 2015DOI:https://doi.org/10.1016/j.jand.2014.11.017

Abstract

Background

Epidemiologic evidence is sparse on the effect of dietary behaviors and diet quality on body mass index (BMI; calculated as kg/m2), which can 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 including 2,696 men and women aged 40 to 59 years from the United States and the United Kingdom.

Design

The International Study on Macro/Micronutrients and Blood Pressure 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 Index 9.3. 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% CI. Multiple linear regression models were used to examine associations of eating occasions, ratio of evening/morning energy intake, dietary energy density, and Nutrient Rich Food Index 9.3 with BMI.

Results

Compared to participants with fewer than four eating occasions in 24 hours, those with six or more eating occasions in 24 hours had lower mean BMI (27.3 vs 29.0), total energy intake (2,129 vs 2,472 kcal/24 hours), dietary energy density (1.5 vs 2.1 kcal/g), and higher Nutrient Rich Food Index 9.3 (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.

Keywords

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References

    • Finucane M.
    • Stevens G.
    • Cowan M.
    • et al.
    National, regional, and global trends in body-mass index since 1980: Systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants.
    Lancet. 2011; 377: 557-567
    • Mesas A.
    • Guallar-Castillón P.
    • León-Muñoz L.
    • et al.
    Obesity-related eating behaviors are associated with low physical activity and poor diet quality in Spain.
    J Nutr. 2012; 142: 1321-1328
    • Prospective Studies Collaboration
    Body-mass index and cause-specific mortality in 900000 adults: Collaborative analyses of 57 prospective studies.
    Lancet. 2009; 373: 1083-1096
    • Reeves G.K.
    • Pirie K.
    • Beral V.
    • Green J.
    • Spencer E.
    • Bull D.
    Cancer incidence and mortality in relation to body mass index in the Million Women Study: Cohort study.
    BMJ. 2007; 335: 1134
    • Palmer M.
    • Capra S.
    • Baines S.
    Association between eating frequency, weight, and health.
    Nutr Rev. 2009; 67: 379-390
    • Stote K.
    • Baer D.
    • Spears K.
    • et al.
    A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults.
    Am J Clin Nutr. 2007; 85: 981-988
    • Franko D.
    • Striegel-Moore R.
    • Thompson D.
    • et al.
    The relationship between meal frequency and body mass index in black and white adolescent girls: More is less.
    Int J Obes. 2008; 32: 23-29
    • Ma Y.
    • Bertone E.
    • Stanek E.
    • et al.
    Association between eating patterns and obesity in a free-living US adult population.
    Am J Epidemiol. 2003; 158: 85-92
    • Ritchie L.
    Less frequent eating predicts greater BMI and waist circumference in female adolescents.
    Am J Clin Nutr. 2012; 95: 290-296
    • Andersson I.
    • Rossner S.
    Meal patterns in obese and normal weight men: The 'Gustaf' study.
    Eur J Clin Nutr. 1996; 50: 639-646
    • Summerbell C.
    • Moody R.
    • Shanks J.
    • Stock M.
    • Geissler C.
    Relationship between feeding pattern and body mass index in 220 free-living people in four age groups.
    Eur J Clin Nutr. 1996; 50: 513-519
    • Pan A.
    • Schernhammer E.
    • Sun Q.
    • Hu F.
    Rotating night shift work and risk of type 2 diabetes: Two prospective cohort studies in women.
    PLoS Med. 2011; 8: e1001141
    • Parkes K.
    Shift work and age as interactive predictors of body mass index among offshore workers.
    Scand J Work Environ Health. 2002; 28: 64-71
    • Hill B.
    • Rolls B.
    • Roe L.
    • De Souza M.
    • Williams N.
    Ghrelin and peptide YY increase with weight loss during a 12-month intervention to reduce dietary energy density in obese women.
    Peptides. 2013; 49: 138-144
    • Farmer B.
    • Larson B.T.
    • Fulgoni V.L.
    • Rainville A.J.
    • Liepa G.U.
    A vegetarian dietary pattern as a nutrient-dense approach to weight management: An analysis of the national health and nutrition examination survey 1999-2004.
    J Am Diet Assoc. 2011; 111: 819-827
    • Stamler J.
    • Elliott P.
    • Dennis B.
    • et al.
    INTERMAP: Background, aims, design, methods, and descriptive statistics (nondietary).
    J Hum Hypertens. 2003; 17: 591-608
    • Holmes E.
    • Loo R.
    • Stamler J.
    • et al.
    Human metabolic phenotype diversity and its association with diet and blood pressure.
    Nature. 2008; 453: 396-400
    • Schofield W.
    Predicting basal metabolic rate, new standards and review of previous work.
    Hum Nutr Clin Nutr. 1985; 39: 41
    • Mahan K.
    • Escott-Stump S.
    Krause's Food and Nutrition Therapy.
    12 ed. Saunders Elsevier, St Louis, MO2008: 33-35
    • Black A.
    The sensitivity and specificity of the Goldberg cut-off for EI: BMR for identifying diet reports of poor validity.
    Eur J Clin Nutr. 2000; 54: 395-404
    • Dennis B.
    • Stamler J.
    • Buzzard M.
    • et al.
    INTERMAP: The dietary data process and quality control.
    J Hum Hypertens. 2003; 17: 609-622
    • Schakel S.
    • Dennis B.
    • Wold A.
    • et al.
    Enhancing data on nutrient composition of foods eaten by participants in the INTERMAP study in China, Japan, the United Kingdom, and the United States.
    J Food Compost Anal. 2003; 16: 395-408
    • Ledikwe J.
    • Blanck H.
    • Khan L.
    • et al.
    Dietary energy density determined by eight calculation methods in a nationally representative United States population.
    J Nutr. 2005; 135: 273-278
    • Drewnowski A.
    Defining nutrient density: Development and validation of the nutrient rich foods index.
    J Am Coll Nutr. 2009; 28: 421S-426S
    • Fulgoni V.
    • Keast D.
    • Drewnowski A.
    Development and validation of the nutrient-rich foods index: A tool to measure nutritional quality of foods.
    J Nutr. 2009; 139: 1549-1554
  1. US Department of Agriculture. 2005 Dietary Guidelines for Americans. Washington, DC: US Department of Agriculture.

    • US Department of Agriculture
    MyPyramid.
    US Department of Agriculture, Washington, DC2005
    • Dyer A.
    • Shipley M.
    • Elliott P.
    Urinary electrolyte excretion in 24 hours and blood pressure in the INTERSALT study. I. Estimates of reliability. The INTERSALT cooperative research group.
    Am J Epidemiol. 1994; 139: 927-939
    • Jenkins D.
    • Wolever T.
    • Vuksan V.
    • et al.
    Nibbling versus gorging: Metabolic advantages of increased meal frequency.
    N Engl J Med. 1989; 321: 929-934
    • Mekary R.
    • Giovannucci E.
    • Cahill L.
    • Willett W.
    • Van Dam R.
    • Hu F.
    Eating patterns and type 2 diabetes risk in older women: Breakfast consumption and eating frequency.
    Am J Clin Nutr. 2013; 98: 436-443
    • Zhao I.
    • Bogossian F.
    • Song S.
    • Turner C.
    The association between shift work and unhealthy weight: A cross-sectional analysis from the nurses and midwives’ e-cohort study.
    J Occup Environ Med. 2011; 53: 153-158
    • Di Lorenzo L.
    • De Pergola G.
    • Zocchetti C.
    • et al.
    Effect of shift work on body mass index: Results of a study performed in 319 glucose-tolerant men working in a Southern Italian industry.
    Int J Obes Relat Metab Disord. 2003; 27: 1353-1358
    • Waterhouse J.
    • Buckley P.
    • Edwards B.
    • Reilly T.
    Measurement of, and some reasons for, differences in eating habits between night and day workers.
    Chronobiol Int. 2003; 20: 1075-1092
    • Esquirol Y.
    • Bongard V.
    • Mabile L.
    • Jonnier B.
    • Soulat J.
    • Perret B.
    Shift work and metabolic syndrome: Respective impacts of job strain, physical activity, and dietary rhythms.
    Chronobiol Int. 2009; 26: 544-559
    • Smeets A.
    • Westerterp-Plantenga M.
    Acute effects on metabolism and appetite profile of one meal difference in the lower range of meal frequency.
    Br J Nutr. 2008; 99: 1316-1321
    • Speechly D.
    • Buffenstein R.
    Greater appetite control associated with an increased frequency of eating in lean males.
    Appetite. 1999; 33: 285-297
    • Jackson S.
    • Leahy F.
    • Jebb S.
    • Prentice A.
    • Coward W.
    • Bluck L.
    Frequent feeding delays the gastric emptying of a subsequent meal.
    Appetite. 2007; 48: 199-205
    • Allirot X.
    • Saulais L.
    • Seyssel K.
    • et al.
    An isocaloric increase of eating episodes in the morning contributes to decrease energy intake at lunch in lean men.
    Physiol Behav. 2013; (169-178): 110-111
    • Pérez-Escamilla R.
    • Obbagy J.
    • Altman J.
    • et al.
    Dietary energy density and body weight in adults and children: A systematic review.
    J Acad Nutr Diet. 2012; 112: 671-684
    • Rolls B.
    • Morris E.
    • Roe L.
    Portion size of food affects energy intake in normal-weight and overweight men and women.
    Am J Clin Nutr. 2002; 76: 1207-1213
    • Morgan L.
    • Aspostolakou F.
    • Wright J.
    • Gama R.
    Diurnal variations in peripheral insulin resistance and plasma non-esterified fatty acid concentrations: A possible link?.
    Ann Clin Biochem. 1999; 36: 447-450
    • Bingham S.
    • Gill C.
    • Welch A.
    • et al.
    Comparison of dietary assessment methods in nutritional epidemiology: Weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records.
    Br J Nutr. 1994; 72: 619-643
    • Mattson M.
    The need for controlled studies of the effects of meal frequency on health.
    Lancet. 2005; 365: 1978-1980
  2. Rhodes DG, Clemens JC, Goldman JD, LaComb RP, Moshfegh AJ. 2012. 2009-2010 What We Eat In America, NHANES Tables 1-36. Worldwide Web Site: Food Surveys Research Group. http://www.ars.usda.gov/Services/docs.htm?docid=18349. Accessed December 9, 2014.

Biography

G. S. Aljuraiban is a research associates, Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.

Biography

Q. Chan is a research associates, Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.

Biography

L. M. Oude Griep is a research associates, Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.

Biography

I. J. Brown is a research associates, Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.

Biography

P. Elliott is a professor, Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.

Biography

G. S. Frost is a professor, The Nutrition and Dietetic Research Group, Imperial College London, UK.

Biography

M. L. Daviglus is an adjunct professor, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.

Biography

J. Stamler is professor emeritus, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.

Biography

L. Van Horn is a professor, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
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