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Skipping Meals, Fasting and Eating Meals Too Closely Together May Be Linked to Increased Mortality Risk

Overview: A new study links daily eating to mortality risk. Those over the age of 40 who eat one meal a day have a higher mortality risk. Those who skip breakfast have an increased risk of death from cardiovascular disease, and those who eat less than 4.5 hours apart have an increased risk of death.

Source: Elsevier

Eating just one meal a day is associated with an increased risk of death in American adults ages 40 and older, according to a new study in the Journal of the Academy of Nutrition and Dietetics.

Skipping breakfast is associated with a higher risk of death from cardiovascular disease and skipping lunch or dinner with all-cause mortality.

Even among individuals who eat three meals daily, eating two contiguous meals less than or equal to 4.5 hours apart is associated with a higher risk of all-cause death.

“At a time when intermittent fasting is widely touted as a solution for weight loss, metabolic health and disease prevention, our study is important for the vast majority of US adults who eat fewer than three meals per day. Our research found that individuals who eat only one meal a day are more likely to die than those who eat more daily meals.

Among them, participants who skip breakfast are more likely to develop fatal cardiovascular disease, while those who skip lunch or dinner increase their risk of death from all causes,” said lead author Yangbo Sun, MBBS, Ph.D. , Department of Preventive Medicine , University of Tennessee Health Sciences Center, Memphis TN, USA “Based on these findings, we recommend eating a minimum of two to three meals throughout the day.”

The researchers analyzed data from a cohort of more than 24,000 U.S. adults ages 40 and older who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2014. An ongoing, nationally representative health survey of the noninstitutionalized U.S. population, NHANES collects a broad range of health-related data every two years to assess diet, nutritional status, general health, disease history, and health behaviors.

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The mortality status and cause of the 4,175 deaths identified among this group were determined using the NHANES Public-use Linked Mortality File. The researchers observed a number of commonalities among participants who ate less than three meals a day (about 40% of respondents): they are more likely to be younger, male, non-Hispanic, black, have less education and lower household income, smoke, drink more alcohol, be food insecure and eat less nutritious food, more snacks and less energy intake in general.

Dr. Bao explained that skipping meals usually means taking in a larger amount of energy all at once, which can exacerbate the regulation of glucose metabolism and lead to subsequent metabolic deterioration. The image is in the public domain

“Our results are significant even after adjusting for dietary and lifestyle factors (smoking, alcohol consumption, physical activity levels, energy intake and diet quality) and food insecurity,” said senior researcher Wei Bao, MD, Ph.D., senior investigator on the study. . Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA. He noted: “Our findings are based on observations from public data and do not imply causation. Nevertheless, what we observed makes metabolic sense.

Dr. Bao explained that skipping meals usually means taking in a larger amount of energy all at once, which can exacerbate the regulation of glucose metabolism and lead to subsequent metabolic deterioration. This may also explain the association between a shorter meal interval and mortality, as a shorter time between meals would result in a greater energy load in the given period.

Dr. Bao noted, “Our study provides much-needed evidence on the association between eating behavior and mortality in the context of meal timing and the duration of the daily prandial period.”

Meal frequency, skipping, and intervals were not addressed in the Dietary Guidelines for Americans 2020-2025 because the Dietary Guidelines Advisory Committee “was unable to find sufficient evidence to summarize the evidence between eating frequency and health.”

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Previous nutritional studies and dietary guidelines for Americans have focused primarily on dietary components and food combinations.

About this diet research news

Author: Press Office
Source: Elsevier
Contact: Press Office – Elsevier
Image: The image is in the public domain

Original research: Open access.
Skipping meals and shorter meal intervals are associated with an increased risk of all-cause mortality and cardiovascular disease in US adultsby Yangbo Sun et al. Journal of the Academy of Nutrition and Dietetics


Abstract

Skipping meals and shorter meal intervals are associated with an increased risk of all-cause mortality and cardiovascular disease in US adults

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Background

Previous nutritional studies and current dietary guidelines have mainly focused on dietary intake and dietary patterns. Little is known about the relationship between eating behaviors such as meal frequency, skipping and intervals, and mortality.

Objective

The aim was to examine the associations of meal frequency, skipping, and intervals with all-cause and cardiovascular disease (CVD) mortality.

Design

This was a prospective study.

Participants/environment

A total of 24,011 adults (≥ 40 years old) who participated in the 1999-2014 National Health and Nutrition Examination Survey were included in this study. Eating behavior was assessed using 24-hour recall. Death and underlying causes of death were determined by reference to death certificates through December 31, 2015.

Main outcome measures

The outcomes were all-cause mortality and CVD.

Statistical analyzes performed

Multivariable Cox proportional risk models were used to estimate adjusted hazard ratios (HRs) of all-cause and CVD mortality.

Results

During the follow-up period of 185,398 person-years, there were 4,175 deaths, including 878 cardiovascular deaths. Most participants ate three meals a day. Compared to participants who ate three meals per day, the multivariable adjusted HRs for participants who ate one meal per day were 1.30 (95% CI 1.03 to 1.64) for all-cause mortality, and 1.83 ( 95% CI 1.26 to 2.65) for cardiovascular disease mortality. Participants who skipped breakfast had multivariable adjusted HRs of 1.40 (95% CI 1.09 to 1.78) for cardiovascular disease mortality compared to those who did not. The multivariable adjusted HRs for all-cause mortality were 1.12 (95% CI 1.01 to 1.24) for skipping lunch and 1.16 (95% CI 1.02 to 1.32) for skipping dinner compared to those who didn’t. Among participants who ate three meals per day, the multivariable adjusted HR for participants with a mean interval of ≤4.5 hours in two contiguous meals was 1.17 (95% CI 1.04 to 1.32) for mortality regardless of cause, compared to those with a meal interval of 4.6 to 5.5 hours.

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Conclusions

In this large, prospective study of US adults age 40 or older, eating one meal a day was associated with an increased risk of all-cause mortality and cardiovascular disease. Skipping breakfast was associated with an increased risk of cardiovascular disease mortality, while skipping lunch or dinner was associated with an increased risk of all-cause mortality. Among participants with three meals per day, a meal interval of ≤4.5 hours in two contiguous meals was associated with higher all-cause mortality.

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