Weight loss is greater with consumption of large morning meals and fat-free mass is preserved with large evening meals in women on a controlled weight reduction regimen.

Keim NL. Van Loan MD. Horn WF. Barbieri TF. Mayclin PL.

U.S. Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Presidio of San
Francisco, CA 94129, USA.

Journal of Nutrition. 127(1):75-82, 1997 Jan.

Abstract
The purpose of this study was to determine whether meal ingestion pattern [large morning meals (AM) vs. large evening meals (PM)] affects changes in body weight, body composition or energy utilization during weight loss. Ten women completed a metabolic ward study of 3-wk weight stabilization followed by 12 wk of weight loss with a moderately energy restricted diet [mean energy intake +/- SD = 107 +/- 6 kJ/(kg.d)] and regular exercise. The weight loss phase was divided into two 6-wk periods. During period 1, 70% of daily energy intake was taken as two meals in the AM (n = 4) or in the PM (n = 6). Subjects crossed over to the alternate meal time in period 2. Both weight loss and fat-free mass loss were greater with the AM than the PM meal pattern: 3.90 +/- 0.19 vs. 3.27 +/- 0.26 kg/6 wk, P < 0.05, and 1.28 +/- 0.14 vs. 0.25 +/- 0.16 kg/6 wk, P < 0.001, respectively. Change in fat mass and loss of body energy were affected by order of meal pattern ingestion. The PM pattern resulted in greater loss of fat mass in period 1 (P < 0.01) but not in period 2. Likewise, resting mid-afternoon fat oxidation rate was higher with the PM pattern in period 1 (P < 0.05) but not in period 2, corresponding with the fat mass changes.To conclude, ingestion of larger AM meals resulted in slightly greater weight loss, but ingestion of larger PM meals resulted in better maintenance of fat-free mass. Thus, incorporation of larger PM meals in a weight loss regimen may be important in minimizing the loss of fat-free mass.

Sugar, alternative sweeteners and meal frequency in relation to caries prevention: new perspectives

Kandelman D.

Department of Oral Health, Faculty of Dental Medicine, University of Montreal, Quebec, Canada.

British Journal of Nutrition. 77 Suppl 1:S121-8, 1997 Apr.

Abstract
In the last 20 years, mainly due to optimum fluoride exposure, and practice of good oral hygiene procedures, an important reduction in caries has been observed, despite the fact that sugar consumption was maintained and/or was increasing during the same lapse of time. A sugar-caries relationship cannot be established in most of the industrialized countries and the dietary factor is not as preponderant in the caries process as it used to be two decades ago. The factors which seem to contribute the most significantly to the cariogenicity of the diet are the frequency of carbohydrate ingestion and eating patterns. The relative cariogenicity of food is not correlated with the amount of carbohydrate it contains. Even if sucrose remains the most important sugar consumed in sweets, beverages and confectionery products, all fermentable-carbohydrate foods can be involved in the caries process. The use of chewing gum and other xylitol-containing products have resulted in defined reduction in caries and represent interesting alternatives for high-caries-risk populations. Caries risk and oral health assessments as well as the evaluation of oral hygiene procedures and fluoride exposure should become essential tools in dietary counselling. People who receive optimum fluoride exposure and follow regular oral hygiene measures can safely use dietary carbohydrates, preferably during meals and two to three times daily in snacks or drinks.

Food habits, triceps skinfold thickness and body mass in adolescents. [German]

Bruppacher R. Ritzel G.

Sozial- und Praventivmedizin. 20(5):222-3, 1975 Sep-Oct.

Abstract
Frequency of regular meals, milk and fat consumption were found negatively correlated with triceps skinfold and body mass index in a representative sample of eight grade Basle School Children confirming an interaction of eating habits and anthropometric measurements.

Meal pattern, food choice, nutrient intake and lifestyle factors in The Goteborg Adolescence Study.

Sjoberg A. Hallberg L. Hoglund D. Hulthen L.

Department of Clinical Nutrition, Sahlgrenska Academy at Goteborg University, Box 459, SE 405 30 Goteborg, Sweden. agneta.sjoberg@nutrition.gu.se

European Journal of Clinical Nutrition. 57(12):1569-78, 2003 Dec.

Abstract
OBJECTIVE: To relate meal pattern of Swedish adolescents to food choice, nutrient intake and other lifestyle factors. DESIGN: Cross-sectional study including diet history and interview about smoking, ethnicity, social factors and retrospectively collected data of menarche and growth. SETTING: School setting, Goteborg, Sweden. SUBJECTS: A total of 611 boys and 634 girls in grade 9 (15-16 y). RESULTS: The majority of the students, 65% of the boys and 52% of the girls, consumed three main meals daily. The in-between meals, however, contributed the major part of the energy intake. The energy intake was 12.9+/-3.5 MJ (mean+/-s.d.) for boys and 9.0+/-2.5 MJ for girls. Irregular breakfast eating, 12% of the boys and 24% of the girls, was related to negative lifestyle factors where smoking was the strongest, odds ratio 3.8 (95% CI: 2.6-5.4) and to irregular intake of lunch and dinner. These boys and girls had a food choice including a higher percentage of energy from snack food (26% vs 20% and 19% in boys and girls respectively, all P<0.001), mostly consumed between the main meals. These groups had significantly lower intakes of micronutrients, but higher intakes of sucrose and alcohol compared to the groups with regular breakfast intake. Girls omitting breakfasts and lunches (8%) also had a less healthy food choice and the poorest nutrient intake. These girls had matured earlier, with menarche age of 12.2+/-1.1 y vs 12.9+/-1.0 y (P<0.001) in girls with regular main meal intake. CONCLUSIONS: Meal pattern with omission of breakfast or breakfast and lunch was related to a clustering of less healthy lifestyle factors and food choice leading to a poorer nutrient intake. SPONSORSHIP: The Swedish Medical Research Council (project B94-19X-04721-19A), the Swedish Mill Industry and the Wilhelm and Martina Lundgren Foundation.

Greater appetite control associated with an increased frequency of eating in lean males.

Speechly DP. Buffenstein R.

Department of Physiology, University of the Witwatersrand Medical School,Johannesburg, South Africa.

Appetite. 33(3):285-97, 1999 Dec.

Abstract
Eight healthy males of age 22.9+/-4.2 years (mean+/-SD) and body weight 73.26+/-11.50 kg, with BMI of 23.11+/-2.84 kg/m(2)underwent two different eating meal frequency patterns on 2 separate days. On both days they were fed approximately 33.3% of their average daily energy requirements as a breakfast pre-load meal: served either as a single meal (SINGLE) or divided into five equal portions (served hourly) (MULTI). Five and a half hours after the initial meal, an ad libitum meal was served. Venous blood was tested to determine plasma glucose and serum insulin concentrations every hour until the ad libitum lunch, and at 15-, 45- and 75-min after lunch. Visual analogue scales (VAS) were completed every hour until the ad libitum lunch, and at 15-, 45- and 75-min after lunch as a measure to determine hunger, appetite and satiety indices. Although both groups were fed isocaloric and identical macronutrient "breakfast pre-loads" (3450+/-466 kJ), the SINGLE group consumed 26.6% more (p<0.02) energy in the ad libitum lunch (5111+/-1502 kJ vs. 3752+/-893 kJ) than the MULTI group did. The pre-load feeding pattern had no effect on blood glucose responses throughout the trial. Following the larger SINGLE pre-load, serum insulin concentration rose to a higher (p<0.01) level compared to the first of the MULTI pre-load meals (123.04+/-61.51 microIU/ml vs. 37. 30+/-26.65 microIU/ml SINGLE vs. MULTI, respectively). Serum insulin rose to a higher (p<0.01) level following the fifth and final of the MULTI pre-load meals compared to the serum insulin levels in the SINGLE group at the same time into the trial (74. 21+/-51.64 microIU/ml vs. 24.98+/-13.46 microIU/ml MULTI vs. SINGLE, respectively). Despite consuming more energy in the ad libitum lunch, the SINGLE group showed no difference in serum insulin concentration following the ad libitum lunch compared to the insulin response of the MULTI group. These data suggest that when the nutrient load was spread into equal amounts and consumed evenly through the day in lean healthy males, there was an enhanced control of appetite. This greater control of satiety when consuming smaller multiple meals may possibly be linked to an attenuation in insulin response although clearly both other physical (gastric stretch) and physiological (release of gastric hormones) factors may also be affected by the periodicity of eating. Copyright 1999 Academic Press.

Independent effects of palatability and within-meal pauses on intake and appetite ratings in human volunteers.

Yeomans MR. Gray RW. Mitchell CJ. True S.

Laboratory of Experimental Psychology, University of Sussex, Brighton BN1 9QG, U.K.

Appetite. 29(1):61-76, 1997 Aug.

Abstract
The effects of the introduction of timed pauses within meals and palatability on food intake and changes in rated appetite during a meal were assessed in three experiments in which volunteers ate a lunch of pasta with a tomato sauce. Eating was monitored using a disguised electronic balance attached to a micro-computer, which also allowed the introduction of timed pauses within meals. In the first experiment, 16 subjects were tested with both a bland and palatable food (with 0.27% oregano), with eating uninterrupted or with pauses after every 50 g consumed during which appetite ratings were completed. Both the addition of oregano and the introduction of regular within-meal pauses enhanced overall intake. Rated hunger increased in the early stages of eating the palatable food in the interrupted condition, and then declined, whereas hunger declined throughout with the bland food. Similarly, the linear function relating intake to time in the uninterrupted condition was greater with the palatable food. In the second experiment, nine subjects ate the palatable food with no pauses within meals, with 30-second pauses with appetite ratings or with 30-second pauses in a non-appetite task. Intake was greater in both pause conditions than when eating was uninterrupted. In Experiment 3, the effect of pause duration was investigated in a further 16 subjects, with either no pause or a pause of 5, 30 or 60 seconds. Subjects ate more in all pause conditions than with no pauses, while ratings of hunger and fullness suggested that subjects were less satisfied at the end of the meal with longer pauses. These data confirm previous work which suggests that palatability exerts its effect by stimulating appetite and eating rate, but also suggest that the introduction of pauses within meals enhances intake as well, contradicting the idea that pausing within meals should reduce intake by allowing more time for post-ingestive satiety to develop.

Impact of binge eating on metabolic and leptin dynamics in normal young women.

Taylor AE. Hubbard J. Anderson EJ.

Reproductive Endocrine Unit and National Center for Infertility Research, Massachusetts General Hospital, Boston 02114, USA. aetaylor@partners.org

Journal of Clinical Endocrinology & Metabolism. 84(2):428-34, 1999 Feb.

Abstract
Well defined eating disorders such as anorexia nervosa and bulimia are associated with significant known health risks. Although binge eating behavior is increased in unsuccessfully dieting obese women, other health implications of this common eating pattern are unknown. We hypothesized that ingestion of an entire day's calories at one time in the evening, a common eating practice among Americans, would lead to disruptions in glucose, insulin, and leptin metabolism and in menstrual cyclicity, even in healthy young women. Seven lean women without a history of eating disorders were studied on two occasions separated by one or two menstrual cycles. During one admission, they ate three regular meals plus a snack on each of 3 days. On the other admission, they ate the same number of calories, macronutrient matched to the normal diet, in a single evening meal. Glucose, insulin, and leptin were measured frequently for 12-14 h beginning at 0800 h on the third day of each diet, and an insulin tolerance test was performed while the subjects were fasting on the fourth day. Daily blood samples were obtained until ovulation was documented to assess any impact on menstrual function. Ingestion of an entire day's calories at dinner resulted in a significant increase in fasting glucose levels and a dramatic increase in insulin responses to the evening meal. The diurnal pattern of leptin secretion was altered, such that the gradual rise in leptin from 0800 h observed during the normal diet was abolished, and leptin did not begin to rise during the binge diet until at least 2 h after the evening meal. No changes were demonstrated in insulin sensitivity, follicular growth, or ovulation between the two diets. We conclude that 1) ingestion of a large number of calories at one time (binge eating) impacts metabolic parameters even when total calories and macronutrients are appropriate for weight; 2) the timing of energy intake is an independent determinant of the diurnal rhythm of leptin secretion, indicating a relatively acute affect of energy balance on leptin dynamics; 3) the mechanism of exaggerated insulin secretion after a binge meal remains to be determined, but may be related to the altered diurnal pattern of leptin secretion; and 4) as most binge eating episodes in the population are associated with the ingestion of excess calories, it is hypothesized that binge eating behavior is associated with even greater metabolic dysfunction than that described herein.