Meal frequency closely linked to BMI, study finds

20 Jul 2017 --- Eating only one or two meals a day and making breakfast the largest meal of the day are two examples of significant factors associated with a decrease in body mass index (BMI), according to a study by researchers from Loma Linda University School of Public Health (LLUSPH) and the Czech Republic.

Researchers used information from more than 50,000 participants in the Adventist Health Study-2 (AHS-2) to discover four factors associated with a decrease in BMI: eating only one or two meals per day; maintaining an overnight fast of up to 18 hours; eating breakfast instead of skipping it; and making breakfast or lunch the largest meal of the day. Making breakfast the largest meal was found to lead to a more significant decrease in BMI than did lunch.

Conversely, the two factors that were found to be associated with higher BMI were eating more than three meals a day – snacks were counted as extra meals – and making dinner the largest meal of the day.

When it comes to practically managing weight, Hana Kahleova, MD, Ph.D, recommends eating breakfast and lunch, skipping dinner, avoiding snacks, making breakfast the largest meal of the day and fasting overnight for up to 18 hours. A postdoctoral research fellow at LLUSPH when the study was conducted, Kahleova is now director of clinical research for the Physicians Committee for Responsible Medicine in Washington, DC, and is currently on sabbatical from the Institute for Clinical and Experimental Medicine in Prague, Czech Republic, as a postdoctoral research fellow and diabetes consultant physician.

The findings support an old nutritional saying, according to Kahleova: “Eat breakfast like a king, lunch like a prince and dinner like a pauper.”

The study, called “Meal frequency and timing are associated with Body Mass Index in the Adventist Health Study-2,” was co-written by Gary Fraser, Ph.D, a professor at LLU Schools of Medicine and Public Health and director of AHS-2.

Fraser says that even without considering meal pattern, there was, on average, an increase in weight gain year on year until participants reached the age of 60. After age 60, most participants experienced weight loss each year.

“Before the age of 60, those eating calories earlier in the day had less weight gain,” Fraser explains, adding that after age 60, the same behavior tended to produce a larger rate of weight loss than average. “Over decades, the total effect would be very important.”

The team used a technique called linear regression analysis and adjusted their findings to exclude demographic and lifestyle factors that might skew the results.

The study will appear in the September edition of the Journal of Nutrition. The full text – which was supported by grants from the National Cancer Institute, the World Cancer Research Fund, and the Ministry of Health of the Czech Republic – is available online.